Determinants of routine immunizations dropout among children less than five years of age in Ethiopia: A further multilevel analysis from mini 2019 EDHS

Abstract Background Globally, immunization prevents an estimated 2–3 million deaths from illnesses that can be prevented by vaccination. The burden of Pentavalent and Measles immunizations dropout was not investigated sufficiently. Therefore, this analysis is meant to determine the coverage, burden, and predictors of Pentavalent and Measles immunizations in Ethiopia. Materials and methods this study is a further analysis of Mini EDHS 2019 which was conducted with a nationally representative sample. In this study immunization data was collected from a total sample of 3208 and 2004 (34.8%) children who received pentavalent 1 were considered for this study. Univariate, Bi variate and multilevel mixed effect analysis was done using STATA version 17 Software. The mixed-effect model with the lowest AIC and BIC (information criteria) was chosen and a factor was designated as a significant predictor of immunization dropout if its p-value was less than 0.05 at 95% CI. The best-fitting model among the fitted models was ultimately chosen using the Akaike and Bayesian Information Criteria (AIC and BIC). Result The mean age of the head of the house hold is 37.6. Majority (68.9%) of the residents were from rural area. of the total population 64.9% have no formal education. The immunization coverage of Ethiopian children is 72.85% and 60.68% for Pentavalent 1 and Measles (fully vaccinated) respectively. From Children who started pentavalent 1 vaccination, 26.7% and 39.3% of the children dropped from taking Pentavalent 3 and measles vaccination respectively. Factors such as household wealth indexes, marital status being married, being in an age group of above 6 months, and living in Addis Ababa reduced the likelihood of pentavalent 3 vaccine dropout and living in Afar compared to Tigray. expose a child to drop from Pentavalent 1. Religion, family size, and living in the Afar region increased the likelihood of measles dropouts compared to their counterparts whereas, children aged above one year was prevented from dropping from measles dropout compared to those aged nine months to one year. Conclusions Immunization coverage among Ethiopian children was low and the dropout from pentavalent 1 and measles vaccination is high compared the national and international targets to improve immunization coverage and reduce dropout. So different cost-effective interventions like Education provision for community, decision-making facilitation, behavioral change support, multi-system participation were requited to increase vaccination coverage and reduce the vaccine dropout among children in Ethiopia.