Assessment of Childhood Vaccine Immunization Coverage, Card Retention, and Compliance in Bayelsa State post-Gavi support: A Household Survey of Children Aged 0-59 Months

Background: Immunization is a vital public health intervention for preventing childhood diseases and reducing mortality rates. Despite global efforts, Nigeria, particularly Bayelsa State, continues to experience suboptimal immunization coverage, often exacerbated by logistical challenges, caregiver misconceptions, and cultural beliefs. The GAVI Alliance has aimed to enhance vaccine availability and community engagement in immunization programs, yet the impact on local coverage and card retention remains under-researched. Objective: This study aimed to assess the current immunization coverage, card retention, and barriers to vaccination among children aged 0-59 months in Bayelsa State, following GAVI support. Methods: A descriptive cross-sectional survey was conducted, utilizing a multistage sampling approach to collect data from 420 caregivers of eligible children through structured interviews and immunization card verification. Data were analysed using descriptive and inferential statistics, including Chi-square tests and logistic regression. Results: The findings revealed an overall immunization coverage of 95.5%, a significant increase from the baseline of 61.12%. BCG and OPV vaccines demonstrated high coverage rates (93.6% and 94.3%, respectively), while the measles and yellow fever vaccines showed lower coverage (56.0% and 54.5%). Notably, caregiver concerns about vaccine safety and potential side effects were prevalent, influencing non-compliance, with 34.6% citing forgetfulness as a reason for missed vaccinations. Moreover, educational level and distance to health facilities were significant factors affecting immunization card retention and compliance. Conclusion: The study underscores the positive impact of GAVI-supported initiatives on immunization coverage in Bayelsa State. However, persistent gaps in specific vaccine uptake and caregiver perceptions necessitate targeted educational interventions and improved access to healthcare services to sustain high immunization rates and protect children from vaccine-preventable diseases.