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.