Changes and determinants of pneumococcal vaccine uptake in Ethiopia

Abstract Background: Pneumococcal pneumonia is one of the most common causes of severe pneumonia and pneumonia-related mortality globally. It is one of the top five causes of mortality and mortality in children under five in Ethiopia. Vaccinating children reduced the disease burden of pneumonia and death-related pneumococcal infection for both child and adult populations. Pneumococcal Pneumonia is one of the vaccine-preventable diseases. Objective: To assess how pneumococcal vaccine uptake changes over time and to identify factors associated with uptake of the pneumococcal vaccine. Data: This study was conducted based on secondary data obtained from the Ethiopian Demographic and Health Surveys (EDHS) conducted in 2016 and 2019, two nationally representative surveys. A total of 1929 and 1008 children of aged 12–23 months were included res from the 2016 and 2019 Demographic and Health Surveys respectively. Method: The Percentage change in pneumococcal vaccine (PCV) coverage was used to quantify the degree of change over time. To identify the significant factors associated with the uptake of PCV vaccines, a multilevel ordinal logistic regression model was used. All statistical tests were run with a significance threshold of 5%. Result: The percentage of children aged 12-23 months who received complete doses of PCV vaccination increased from 49.1% in 2016 to 59.8% in 2019 with a significant 21.8% increase [95% CI: 9.8-35.2]. Children in rural areas are 69% less likely to receive more doses of PCV vaccinations than those who live in urban areas (AOR=0.307, 95% CI: 0.127 - 0.742). Second-or higher-order births are associated with higher uptake of doses of PCV vaccinations (AOR=2.519, 95% CI: 1.143-5.548]). Compared to children born at home, children born in health facilities were 2.35 times more likely to receive greater doses of the PCV vaccination (AOR=2.350, 95% CI: 1.132-4.882). Children born from the women who received more ANC visits were significantly more likely to receive complete PCV coverage. Conclusion: We observed a significant increase in the uptake of PCV vaccines across the two survey years even though Ethiopia is still far away from achieving national immunization goals. Our results also show that place of residence, birth order, place of delivery, ANC visits, and region were significantly associated with pneumococcal vaccine uptake.