Work

Determinants of measles second-dose vaccine coverage in the Gambia – a secondary analysis of 2019 demographic and health survey data

Year: 2025

Type: article

Abstract: BACKGROUND: Measles remains a leading cause of vaccine-preventable mortality in Africa, despite the availability of safe and effective vaccines. The World Health Organization recommends ≥95 % coverage with two doses of a measles-containing vaccine (MCV) to achieve elimination. In The Gambia, coverage with the second dose of measles containing vaccine (MCV2) remains below this target. Understanding the factors associated with sub-optimal MCV2 coverage in The Gambia is crucial for developing strategies to improve vaccine coverage. METHODS: We conducted a secondary analysis of data from the 2019 Gambia Demographic and Health Survey to identify determinants of MCV2 vaccination among children aged 18-35 months (n = 1010). Multivariable logistic regression was used to assess associations between MCV2 vaccination status and child-, caregiver-, and household-level factors and interactions between these factors. RESULTS: MCV2 coverage was 67.7 %. In multivariable analysis, completion of the recommended infant vaccine schedule in the first year of life was strongly associated with MCV2 uptake (adjusted odds ratio [aOR]: 7.75; 95 % CI: 3.98-15.12). Female children in urban areas had half the odds of vaccination compared to male children (aOR: 0.49; 95 % CI 0.31-0.78); while no significant difference was observed in rural areas (aOR: 0.92; 95 % CI; 0.60-1.39). Sex also modified the association between age and vaccination status. Among children aged 18-23 months, females had lower odds of vaccination compared to similarly aged males (aOR: 0.41; 95 % CI: 0.23-0.76) but the difference was not significant among children aged 24-35 months (aOR: 0.73; 95 % CI: 0.46-1.16). CONCLUSION: MCV2 coverage in The Gambia remains below the elimination threshold. Interventions should focus on strengthening early-life immunization, addressing gender and urban-rural disparities, and encouraging timely vaccination before 2 years of age. These findings highlight the need for context-specific strategies to close immunization gaps in The Gambia and similar settings.

Source: Vaccine

DOI: 10.1016/j.vaccine.2025.127789

Authors: Andrew Ayi-Ashong Bruce, Katherine Gallagher

Institutions: London School of Hygiene & Tropical Medicine, MRC Unit the Gambia, Kumasi Centre for Collaborative Research in Tropical Medicine

Language: English

Topic: Vaccine Coverage and Hesitancy

Subfield: Health

Field: Social Sciences

Domain: Social Sciences

SDGs: Good health and well-being, Gender equality, Reduced inequalities

Open Access status: hybrid

Estimated APC paid: $3,620