Title : Spatial and demographic analysis of life-course vaccination coverage in selected regions of Ethiopia: Evidence from a household digital head count
Abstract:
Background: Equitable access to vaccination across all stages of life is a key goal of the Immunization Agenda 2030. Ethiopia has made progress in routine immunization, but disparities persist, especially in underserved, pastoralist, and conflict-affected regions. This study aimed to explore disparities and barriers to life course vaccination in four regions of Ethiopia.
Description: A cross-sectional study was conducted between March to July,2025 with multi-stage cluster sampling methods in 57 selected woredas from Afar, Amhara, Oromia, and Tigray regions. Trained health workers administered digital questionnaires with GPS facilities to caregivers, then vaccines were administered to eligible groups. The study enumerated 1.2 million households, covering 5.3 million individuals, including children under five, adolescent girls (9–14 years), pregnant women, and individuals aged 12 years and above. Descriptive and geospatial analyses were made to present vaccination coverage, disparities, and barriers.
Lessons Learnt: The findings revealed that among children aged 12 – 59 months 9.1% were zero-dose and 11.2% under immunized. The prevalence of measles-containing vaccine (MCV1) was 88.3%. 79.6% of the pregnant women identified were vaccinated for tetanus-diphtheria (Td) vaccine. Among adolescents’ girls aged 9 – 14 years, 75.3% were vaccinated for HPV. Furthermore, out of people aged 12 and above, almost half or 53.8% were vaccinated for COVID-19. We observed significant regional disparities, i.e., Afar had the highest zero-dose prevalence (24%) while Amhara and Tigray had less than 10%.
Conclusions: Despite gains in routine immunization, inequities remain, disproportionately impacting remote and marginalized groups. Integrating geospatial microplanning, mobile outreach, and culturally tailored demand strategies is vital to close equity gaps and achieve IA2030 goals.
