Socio-economic and demographic determinants of full immunization among children of 12–23 months in Afghanistan

Immunization is one of the most cost-effective interventions to reduce vaccine-preventable diseases morbidity and mortality. Vaccination coverage is very low in Afghanistan; National Risk and Vulnerability Assessment (NRVA) Survey 2008 estimated the coverage of fully immunized children to be 37%. The current study was designed to examine the factors influencing full immunization among children aged 12-23 months. Demographic and vaccination data of 2,561 children of 12-23 months was extracted from the Afghanistan Health Survey (AHS) 2012. The data was analyzed by logistic regression to estimate adjusted odds ratios (AOR) and 95% confidence intervals (CI). The study found that 38.8% of the children were fully immunized. The coverage for specific vaccines was 80.9% for BCG, 72.0% for OPV3, 64.8% for measles, and 50.1% for Penta3. Urban residence (AOR = 0.60, 95% CI 0.40-0.90 relative to rural), children of poorer families (AOR = 1.36, 95% CI 1.10-1.67 relative to poorest), some education (AOR = 1.59, 95% CI 1.20-2.11 relative to no education) and antenatal care (AOR = 1.70, 95% CI 1.44-2.01 relative to not received) were found to be significant predicators of full immunization. This study indicated that the full-immunization rate in Afghanistan was quite low compared to the national target of 90% coverage. Therefore, strategies taking into account the identified factors seem to be vital to improve vaccination coverage.