Assessment of the associated factors of measles immunization dropout: A community-based study in a high-dropping region

Measles is a viral disease that can be prevented through vaccination and is a leading cause of childhood mortality. Immunizing children against measles is a highly effective and cost-efficient public health intervention. However, there are still gaps in vaccination coverage; some children do not receive complete immunization. We aimed to describe caregivers' factors and identify determinants of vaccine dropout. We used community-based participatory research and in-depth interviews. The study included 430 caregivers of infants aged between 12 and 36 months. Most infants came from low-income families, had only one sibling, and lived more than 1 km from the vaccination centers. The study found that lack of support from family (Adj. PR=4.23; 2.82 – 6.33; p<0.001) and social support (Adj. PR=2.43; 1.33 – 4.45; p= 0.04) was the main reason for vaccine dropout, followed by the distance from the vaccination centers (Adj. PR= 1.47; 1.07 – 2.00; p= 0.02), and low socioeconomic status (Adj. PR= 1.40; 1.05 – 1.88; p= 0.02). In conclusion, the absence of support from family, and local leaders, and the distance of households from measles vaccination providers were the determinants of the measles vaccine dropout rate. To address these issues, the study recommends that healthcare workers engage local leaders in collaborative efforts to deliver integrated health education in the local dialect. This will help to ensure that all children receive the full course of immunization against measles, and reduce the risk of childhood mortality.