Determinants of Zero-Dose Vaccination Status Among Children Aged 12–23 Months in Abuja, Nigeria: A Cross-Sectional Survey

Abstract

Background: Zero-dose vaccination is defined as the status of a child aged 12–23 months who has not received even the first dose of the pentavalent vaccine, which protects against diphtheria, tetanus, pertussis, hepatitis B, and Haemophilus influenzae Type b. Addressing zero-dose vaccination is vital for public health security. Completely unvaccinated children are at highest risk for contracting and transmitting vaccine-preventable diseases, which can lead to outbreaks even in partially immunized communities.

Objective: To explore the prevalence and determinants of zero-dose vaccination among children aged 12–23 months in Abuja.
Methods: A descriptive, cross-sectional study was conducted among 350 caregivers using multistage sampling. Data were collected through interviewer-administered questionnaires adapted from WHO tools. Logistic regression was used to determine predictors of zero-dose vaccination status.
Results: The prevalence of zero-dose vaccination among children aged 12–23 months in Abuja was 11.1%. The key determinants included maternal education, antenatal care attendance, delivery location, and possession of an immunization card. Multivariate analysis revealed that children of mothers with no formal education (aOR = 3.8, 95% CI: 1.5–9.6) and those born at home (aOR = 4.2, 95% CI: 1.6–11.0) were significantly more likely to be zero-dose vaccinated.
Maternal tetanus toxoid (TT) vaccination emerged as the strongest independent predictor. Children of mothers without TT were nearly 600 times more likely to be zero-dose vaccinated (p < 0.001).

Conclusion: Promoting maternal education and institutional deliveries are critical to addressing zero-dose immunization in urban Nigerian settings.