Timeliness of the second dose of measles-containing vaccine uptake and its determinants among children aged 24-36 months in Gondar City, Northwest Ethiopia, 2023: Community-based cross-sectional study design.

Background: Measles remains a global public health concern, despite the availability of effective vaccines. Recent outbreaks highlight the need for strong vaccination programs. Since launching both doses, Ethiopia has been working with global health organizations to increase vaccination coverage. However, focusing solely on coverage overlooks the importance of timely vaccination. In Ethiopia, despite occasional increases in coverage, measles outbreaks persist due to insufficient attention to timeliness. This study aims to assess the timeliness and its determinants of second-dose measles-containing vaccine uptake in Gondar City to inform efforts to strengthen immunization programs and prevent measles infections. Methods: A community-based cross-sectional study was conducted among 618 children aged 24-36 months. Participants were selected using a two-stage systematic random sampling method from April 25 to May 25. Structured questionnaires were administered through interviews, and data were collected using the Kobo toolbox and then analyzed using Stata version 17. A binary logistic regression model was utilized to determine factors associated with the outcome, with significance declared at a p-value <0.05. Adjusted odds ratios with 95 % confidence intervals were used to assess the direction and strength of associations. Results: Among the total of 618 children, 523 (84.63 %) (95 % CI: 81.77 %-87.48 %) were vaccinated for MCV2 timely (in the national recommended age). Paternal college and above in their education (AOR: 5.84, 95 % CI: 1.55-8.18), four or more ANC follow-ups (AOR: 5.84, 95 % CI: 1.55-8.18), at least two doses of vitamin An uptake (AOR: 6.39, 95 % CI: 2.92-12.59), mothers having high awareness (AOR: 2.04, 95 % CI: 1.05-3.99), and mothers having positive perception (AOR: 4.81, 95 % CI: 2.13-10.86) to measles vaccination were significant determinants for timely uptake of the second dose measles-containing vaccine. Conclusion and recommendations: The timely uptake of the second dose of the measles vaccine in the study area was suboptimal, and efforts should be continued to eradicate measles infection. Paternal educational status, ANC follow-ups, repeated vitamin An uptake, maternal awareness, and perception of measles vaccination were statistically significant determinants for the timely uptake of a second dose of measles-containing vaccine. Strengthening maternal and child health services, increasing awareness, and changing mothers' perceptions about measles vaccination may increase the timely uptake of MCV2 among children receiving a second MCV dose.