Predictors of incomplete childhood vaccination in four West African countries: a population based cross-sectional study

Children with incomplete vaccination are at higher risk of contracting Vaccine-Preventable Diseases and can contribute to the spread of outbreaks. This study assessed the prevalence and predictors of incomplete vaccination among children aged 12-23 months in four West African countries. Using data from the latest DHS of these countries and a weighted sample of 11,333 children, multivariable logistic regression analysis was performed, with a p-value of < 0.05 considered statistically significant. The pooled prevalence of incomplete vaccination was 67%. The odds of incomplete vaccination were lower among children whose mothers attended antenatal clinics (AOR 0.46; 95% CI: 0.39-0.54), were educated (AOR 0.54; 95% CI: 0.47-0.63), and were employed (AOR 0.88; 95% CI: 0.79-0.99). Facility delivery (AOR 0.85; 95% CI: 0.74-0.97), higher household wealth (AOR 0.85; 95% CI: 0.73-0.98), and older maternal age (AOR 0.69; 95% CI: 0.56-0.86) were all associated with reduced odds of incomplete vaccination. In conclusion, the study reveals a high prevalence of incomplete vaccination emphasizing the need for targeted interventions to address identified barriers and improve coverage. We recommend implementing programmes and policies to address country-specific and regional level predictors of incomplete vaccination.