Changes in childhood vaccination coverage and sociodemographic determinants across Nigerian states, 2018-2024.

Authors

Ryoko Sato, Olufunmilayo Bello, Olorunfemi A Ogundele

Published in

Vaccine. Volume 96. Pages 129317. Nov 07, 2026. Epub Nov 07, 2026.

Abstract

Nigeria accounts for a substantial share of the world's zero-dose children and exhibits marked subnational disparities in childhood vaccination coverage. Although national estimates indicate modest gains in full vaccination, less is known about how vaccination outcomes and their determinants have changed across states over time, particularly following the COVID-19 pandemic. This study examines factors associated with changes in full vaccination coverage and zero-dose prevalence across Nigerian states between 2018 and 2024.
We conducted a repeated cross-sectional, state-level ecological analysis using data from the Nigeria Demographic and Health Surveys conducted in 2018 and 2024. Outcomes were full vaccination coverage and zero-dose prevalence among children aged 12-23 months. State-level sociodemographic, governance, and health system indicators were drawn from survey, administrative, and budget data. Ordinary least squares regression models assessed cross-sectional associations and relationships between changes in vaccination outcomes and explanatory variables over time.
Mean full vaccination coverage increased from 33.0% in 2018 to 40.8% in 2024, while zero-dose prevalence rose from 14.1% to 24.2%. Geographic disparities persisted, with states experiencing high zero-dose prevalence in 2024 often showing the largest increases since 2018. Maternal education was consistently associated with higher full vaccination coverage and lower zero-dose prevalence. In 2024, higher state health budgets, greater trust in local government, and COVID-19-related service disruptions were associated with higher full vaccination coverage.
Despite modest national gains, zero-dose prevalence increased and disparities widened. Institutional factors appear increasingly important, underscoring the need for targeted, state-specific strategies to reach zero-dose children.

PMID:
42998535
Bibliographic data and abstract were imported from PubMed on 08 Nov 2026.

Read full publication at:
Please sign in to see all details.

Stats

1-terrible, 9-excellent. How would you rate this publication? Sign in in to submit your rating.

Post a comment

You need to be signed in to post comments. You can sign in here.

Comments

There are no comments yet.