Prevalence of second-dose measles vaccination utilization and associated factors among MCV1-vaccinated children aged 15–36 months in Tocha Woreda, Dawuro Zone, Southwest Ethiopia, 2025

Background Measles is a highly contagious viral disease and a leading cause of morbidity and mortality among children worldwide. Evidence regarding the utilization of the second dose of the measles-containing vaccine (MCV2) and its associated factors in Southwest Ethiopia remains limited. This study examined MCV2 utilization rates and the factors associated with its uptake in Tocha Woreda, Dawuro Zone. Methods A community-based cross-sectional study was conducted among 585 children aged 15–36 months who had received the first dose of the measles-containing vaccine (MCV1). Participants were selected using a multi-stage systematic sampling method. Data were collected through in-person interviews with mothers or caregivers, using a structured questionnaire administered via the Kobo Collect mobile application. Data were analyzed using Statistical Package for the Social Sciences (SPSS) version 27.0. Descriptive statistics summarized participant characteristics. Bi-variable logistic regression identified candidate variables ( p < 0.25) for inclusion in a multivariable logistic regression model to identify independent predictors of MCV2 utilization. Statistical significance was defined as a p -value of <0.05. Multicollinearity was assessed using variance inflation factors, and model fit was evaluated using the Hosmer–Lemeshow goodness-of-fit test. Results Among the 585 children included (response rate: 94.4%), 67.2% (95% CI: 63–71%) received the second dose of measles vaccine. Urban residence [adjusted odds ratio (AOR) = 3.43; 95% confidence interval (CI): 1.74–6.44], maternal or caregiver education at the college level or higher (AOR = 12.76; 95% CI: 4.39–20.64), participation in conferences for pregnant women (AOR = 2.25; 95% CI: 1.11–4.56), shorter vaccination waiting times (≤15 min: AOR = 4.28; 95% CI: 1.83–10.01; 15–30 min: AOR = 3.33; 95% CI: 1.35–8.16), and favorable caregiver attitudes (AOR = 6.05; 95% CI: 2.96–12.35) were significantly associated with MCV2 utilization. Conclusion MCV2 utilization in Tocha Woreda remains below the World Health Organization (WHO) target for measles elimination. Improving maternal education, strengthening conferences for pregnant women, reducing waiting times at vaccination sites, and enhancing caregiver attitudes are essential to increasing MCV2 coverage.