Childhood vaccination coverage and determinants in Jordan: a population-based study

Globally, concerns about vaccine efficacy, safety, and long-term health impacts continue to increase among parents, resulting in a decline in the percentage of children receiving full vaccination. Within Jordan, several parental-related factors have previously been implicated in vaccine uptake. The current study aimed to investigate whether vaccination rates are changing in Jordan and to explore further the factors that influence parental vaccine decisions. The current study analyzed data from the survey responses of mothers of 1,426 mother-child pairs (ages 12–23 months) sampled in the Jordan Population and Family Health Survey (JPFHS) between January and June 2023. The associations between sociodemographic and socioeconomic factors (including age, education, and employment), healthcare access, and childhood vaccination outcomes were explored. Healthcare access was measured through self-report of distance to a healthcare facility, while healthcare utilization was measured through the number of antenatal care visits. Whether the child’s mother had health insurance coverage was also included in the analysis model. Key confounding variables were included in the adjusted logistic regression model. The outcome variable was full vaccination coverage (defined in the national immunization schedule of Jordan). Among the participants, 79% (n = 1,132) reported full vaccination coverage. 57% of mothers had a secondary or higher education, and this group was more likely to report full vaccination, higher education (AOR: 3.86, 95% CI: 1.14–13.05) and secondary education (AOR: 3.11, CI: 1.07–9.08). Most participants live in urban areas, with mothers living in rural areas less likely to report full child vaccination (AOR: 0.50, CI: 0.29–0.85). The results of the current study demonstrate that the percentage of children who received all basic vaccinations between 2023 and 2024 has declined since 2017–2018 in Jordan. Furthermore, maternal education is a key driving force behind achieving full vaccine uptake. Living in a rural area appears to reduce the likelihood of a child receiving full vaccination, while distance to a healthcare facility does not. These results require further investigation to inform the development of interventions aimed at slowing declining vaccine rates.