Factors associated with full vaccination and zero vaccine dose in children aged 12-59 months in 6 health districts of Cameroon.

Background: Routine immunisation coverage in Cameroon is still below the target of the national Expanded Programme on Immunisation (EPI), with only 42% of children fully immunised according to Demographic and Health Survey (DHS) report in 2018. The objective of this study was to evaluate factors associated with full immunisation and zero-dose in Cameroonian children.

Methods: A two-stage cross-sectional cluster survey was conducted in Yaoundé in November 2021, targeting children aged 12-59 months. The clusters were chosen with probability proportionate to population size (PPS), and households selected by restricted sampling technique. Data were collected from the vaccination card of the child or from parents' recall, if the card was not available, using electronic forms with tablets. Using R (version 4.1.0.), the proportion of fully immunised children was calculated. The household wealth index was described using principal component analysis, and factors associated with full immunisation assessed with multiple logistics regression. The threshold of statistical significance was set at 5%.

Findings: A total, 273 children aged 12-59 months enrolled; 37% of participants were fully immunised, and 16% had never received any vaccine. Mother's level of education: Primary (OR = 3.59, p = 0.0200), high school (OR = 3.68, p = 0.0400*), and higher education (OR = 8.25, p = 0.0018), and sharing household with biological father (OR = 2.11, p = 0.0305) were significantly associated with full vaccination. Living in a richer (3-5 wealth quintiles) household (OR = 0.25, p = 0.0053); mother's education: Primary (OR = 0.07, p = 0.0271) and Higher education (OR = 0.10, p = 0.0419), living with the mother (OR = 0.05, p =  < 0.0001) and living with the father (OR = 0.22, p = 0.0253) had significant negative association with zero-dose in children.

Conclusion: The proportion of fully vaccinated children in Yaounde is lower than the national average. Children from poor homes and those borne by uneducated mother have higher odds of not being vaccinated. Immunisation programmes in Yaounde need to be stepped up to improve coverage. Equally, there is a need to reconsider how the poor can the better reached with immunisation services.