Assessment of the Timely Administration of Birth Dose Vaccines in Northern Nigeria and Associated Factors

BACKGROUND: Lack of a timely receipt of vaccines can cause uncertain immune response and under-vaccination. Hence, timely vaccination is crucial to ensure an infant’s early protection. OBJECTIVES: To identify the age of presentation for the birth dose vaccines, vaccine antigens received and factors associated with vaccination presentation by day one in Northern Nigeria. METHOD: A descriptive cross-sectional study involving 1 952 mother-infant pairs enrolled from 5 different states in Northern Nigeria. Data was collected using a questionnaire including the socio-demographic, antenatal care (ANC), delivery details, birth dates, vaccination presentation and birth vaccine antigens received. Data analysis was done with the SPSS-21 software. FINDINGS: The median age of the infants at presentation for birth vaccines was six (interquartile range 2–16) days. A total of 413 (21.2%) infants were brought by the day of birth (day 0) or the next day (Day one), while one-fifth (20.6%) presented after Day 28. The most frequently received antigen was the Bacille-Calmette-Guerin by 1 781 infants (91.2%), oral polio vaccine 1 703 (87.2%), and hepatitis B vaccine birth dose the lowest at 75.1% (1 565). The commonest reasons for delayed presentations were an ill baby (24.7%) and an ill mother (21.9%). Factors associated with presentation within Day one post-birth were hospital delivery (OR–1.67, 95% CI; 1.28–2.19), firstborn (OR–1.40; 95%CI; 1.02–1.93), Christianity (OR–2.14 95% CI; 1.63–2.81), and mother with tertiary education (OR–1.62, 95% CI; 1.05–2.48). CONCLUSION: Timely administration of the birth dose vaccines is low in Northern Nigeria. Furthermore, some babies do not get the required vaccines despite presenting for vaccination due to stockout. Strategies for early neonatal vaccination such as vaccination in hospital suites post-delivery and utilizing relatives/fathers to take the baby for vaccination when a mother is indisposed are imperative.