Determinants of Age-appropriate vaccination among infants at a tertiary hospital in Lagos, Nigeria
DOI:
https://doi.org/10.30442/Abstract
Background: Timely vaccination is crucial for protecting infants from vaccine-preventable diseases, yet delays in receiving age-appropriate vaccines persist in many low- and middle-income countries, including Nigeria. Understanding determinants of age-appropriate vaccination is essential for improving immunization coverage. This study assessed the determinants of age-appropriate vaccination among infants at a tertiary facility in Lagos, Nigeria.
Methods: A descriptive, facility-based cross-sectional study was conducted from March to August 2016 at the Newborn and General Outpatient Clinics of Lagos State University Teaching Hospital, Ikeja. Caregivers of the infants aged 0–12 months were recruited through convenience sampling. Data on infant and caregiver characteristics, vaccination history, and health facility access were collected using structured questionnaires. Age-appropriate vaccination was defined as receipt of all vaccines recommended for the infant’s age. Data were analyzed using IBM SPSS Statistics v26.
Results: Of 256 infants enrolled, 78.9% received age-appropriate vaccinations. Term birth (AOR 2.33; 95% CI 1.10–4.95), caregiver’s marital status (married vs single/separated: AOR 7.74; 95% CI 1.71–34.98), and upper-class socioeconomic status (AOR 2.11; 95% CI 1.02–4.33) were independently associated with timely vaccination. Residence in a Local Council Development Area (LCDA) with a health facility showed increased odds but was not statistically significant (AOR 3.28; 95% CI 0.94–11.50).
Conclusion: Age-appropriate vaccination was suboptimal. Caregiver’s marital status, term birth and higher socioeconomic status were key determinants of age-appropriate vaccination, underscoring the need for targeted interventions to address social vulnerability and support preterm infants to improve timely vaccination coverage.
References
1. WHO. 2020. Immunization Agenda 2030: A Global Strategy to Leave No One Behind. Available at https://cdn.who.int/media/docs/default-source/immunization/strategy/ia2030/ia2030-draft-4-wha_b8850379-1fce-4847-bfd1-5d2c9d9e32f8.pdf?sfvrsn=5389656e_69&download=true
2. Nguyen PT, Nakamura R, Shimadzu H, Abubakar AK, Le PM, Nguyen HV. et al. Progress and inequality in child immunization in 38 African countries, 2000-2030: A spatio-temporal Bayesian analysis at national and sub-national levels. PLoS Med 2025; 22(7):e1004664. doi: 10.1371/journal.pmed.1004664.
3. Balogun FM, Bamgboye EA, Orimadegun AE. Trends of infant vaccination timeliness and completion in selected urban slum communities in Ibadan, Southwestern Nigeria: A four-year review. PLoS ONE 2023;18(5): e0285805. https://doi.org/10.1371/journal.pone.0285805
4. Rauniyar SK, Iwaki Y, Yoneoka D, Hashizume M, Nomura S. Age-appropriate vaccination coverage and its determinants in children aged 12-36 months in Nepal: a national and subnational assessment. BMC Public Health 2021; 21(1):2063. doi: 10.1186/s12889-021-11841-2.
5. Prakash R, Kumar P, Dehury B, Thacker D, Shoemaker E, Manjappa RB. et al. Preventing vaccine drop-outs: Geographic and system-level barriers to full immunization coverage among children in Uttar Pradesh, India. Vaccine X 2025; 23:100613. doi: 10.1016/j.jvacx.2025.100613.
6. National Primary Health Care Development Agency (NPHCDA). 2021. Nigeria Routine Immunisation Strategic Plan.
7. Ogunniyi TJ. Revealing the challenges and efforts of routine immunization coverage in Nigeria. Health Sci Rep 2024;7(8):e70000. doi: 10.1002/hsr2.70000.
8. Adedokun ST, Uthman OA, Adekanmbi VT. Wiysonge CS. Incomplete childhood immunization in Nigeria: a multilevel analysis of individual and contextual factors. BMC Public Health 2017;17: 236 https://doi.org/10.1186/s12889-017-4137-7
9. Olaniyan A, Isiguzo C, Agbomeji S, Akinlade-Omeni O, Ifie B, Hawk M. Barriers, facilitators, and recommendations for childhood immunisation in Nigeria: perspectives from caregivers, community leaders, and healthcare workers. Pan Afr Med J 2022; 43:97. doi: 10.11604/pamj.2022.43.97.35797.
10. Sadeck LSD, Kfouri RA. An update on vaccination in preterm infants. Jornal de Pediatria 2023; 99 (suppli 1): S81-S86, https://doi.org/10.1016/j.jped.2022.12.004.
11. Fortmann MI, Dirks J, Goedicke-Fritz S, Liese J, Zemlin M, Morbach H. et al. Immunization of preterm infants: current evidence and future strategies to individualized approaches. Semin Immunopathol 2022; 44: 767–784. https://doi.org/10.1007/s00281-022-00957-1
12. Kehinde OA, Kuyinu YA, Odusanya OO. Factors associated with Missed Opportunities for Vaccination among children in the first year of life at a tertiary health facility in Lagos. Annals of Health Research 2020; 6 (3): 287-297. https://doi.org/10.30442/ahr.0603-05-91
13. Oyedeji GA. Socioeconomic and cultural background of hospitalized children in Ilesa. Niger J Paediatr 1985; 12: 111-117. doi: 10.12691/ajphr-3-4-1
14. Wariri O, Okomo U, Kwarshak YK, Utazi CE, Murray K, Grundy C. et al. Timeliness of routine childhood vaccination in 103 low-and middle-income countries, 1978-2021: A scoping review to map measurement and methodological gaps. PLOS Glob Public Health 2022; 2(7):e0000325. doi: 10.1371/journal.pgph.0000325.
15. Kolawole OT, Akinyemi A, Solanke BL. Household Vulnerability and Childhood Immunization Status in Nigeria. Sage Open 2023; 13(3). https://doi.org/10.1177/21582440231179943.
16. Kuroda H, Goto A, Kawakami, C. Yamamoto K, Ito S, Japan Environment and Children’s Study (JECS). Association between a single mother family and childhood undervaccination, and mediating effect of household income: a nationwide, prospective birth cohort from the Japan Environment and Children’s Study (JECS). BMC Public Health 2022; 22: 117 https://doi.org/10.1186/s12889-022-12511-7
17. Mohammed Y, Reynolds HW, Waziri H, Attahiru A, Olowo-okere A, Kamateeka M. et al. Exploring the landscape of routine immunization in Nigeria: A scoping review of barriers and facilitators, Vaccine: X 2024; 20. https://doi.org/10.1016/j.jvacx.2024.100563
18. Ali HA, Hartner AM, Echeverria-Londono, S, Roth J, Li X, Abbas K. et al. Vaccine equity in low and middle income countries: a systematic review and meta-analysis. Int J Equity Health 2022;21:82. https://doi.org/10.1186/s12939-022-01678-5
19. Freeman RE, Leary CS, Graham JM, Albers AN, Wehner BK, Daley MF. et al. Geographic proximity to immunization providers and vaccine series completion among children ages 0-24 months. Vaccine 2023;41(17):2773-2780. doi: 10.1016/j.vaccine.2023.03.025.
20. Joseph NK, Macharia PM, Ouma PO, Mumo J, Jalang'o R, Wagacha PW. et al. Spatial access inequities and childhood immunisation uptake in Kenya. BMC Public Health 2020; 20,1407. https://doi.org/10.1186/s12889-020-09486-8
21. Salako J, Bakare D, Uchendu OC, Bakare AA, Graham H, Falade AG. Factors associated with immunization status among children aged 12-59 months in Lagelu local government area, Ibadan: a cross-sectional study. Pan Afr Med J. 2024; 47:35. doi: 10.11604/pamj.2024.47.35.37013.
22. Ekholuenetale M, Ochagu VA, Ilesanmi OS, Badejo O, Arora A. Childhood Vaccinations and Associated Factors in 35 Sub-Saharan African Countries: Secondary Analysis of Demographic and Health Surveys Data from 358 949 Under-5 Children. Glob Pediatr Health 2024;11:2333794X241310487. doi: 10.1177/2333794X241310487.
Downloads
Published
Issue
Section
License
Copyright (c) 2026 Annals of Health Research (The Journal of the Medical and Dental Consultants Association of Nigeria, OOUTH, Sagamu, Nigeria)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
The articles and other materials published in the Annals of Health Research are protected by the Nigerian Copyright laws. The journal owns the copyright over every article, scientific and intellectual materials published in it. However, the journal grants all authors, users and researchers access to the materials published in the journal with the permission to copy, use and distribute the materials contained therein only for academic, scientific and non-commercial purposes.
