Vaccination coverage and timeliness among children in Ethiopia

Vaccinations are crucial for preventing and controlling infectious diseases. However, in Ethiopia, a significant proportion of children remain unimmunised. This study aimed to describe vaccination coverage among children in a field site in Ethiopia, and the proportion of children who were vaccinated on time according to the National Vaccination Schedule. We analysed data from a longitudinal study of 7417 children conducted in Ethiopia, which includes a health and demographic surveillance system (HDSS) with house-to-house surveillance visits every 3 months. The study population was children born between 2018 and 2021 enrolled in the HDSS. Vaccination data were collected through standardised questionnaires, which abstracted information from vaccination cards and reports from caregivers. We used two analytical approaches to calculate the vaccination coverage of the full package of recommended vaccines, the coverage of each specific recommended vaccine and timeliness of vaccine administration. Using a longitudinal approach, 26% (2018) to 31% (2021) of children were fully vaccinated. Using a cross-sectional survey approach, 32% (2018) to 42% (2021) were fully vaccinated. Similarly, coverage of specific vaccines is lower in the longitudinal approach compared with cross-sectional surveys. Using the longitudinal and cross-sectional strategies, 76% and 67% of children, respectively, who received the measles vaccine before 12 months of age were vaccinated within 4 weeks of becoming eligible. Additionally, about 40% of children received the third doses of oral poliovirus, pentavalent and pneumococcal vaccines, as well as the second dose of rotavirus vaccine, within 4 weeks of eligibility. In this study, vaccination coverage in the study area was low, with fewer than half of infants receiving their vaccinations within 4 weeks of the recommended administration time. Estimates of vaccination coverage with longitudinal data compared with cross-sectional data provide a more accurate assessment of vaccine coverage and timeliness and support more precise monitoring of immunisation efforts.