Determinants of measles-rubella vaccine second dose uptake among 24 to 35 month-old children in Wajir Town, Kenya

Background: Two vaccine doses can prevent measles and rubella (MR2); achieving ≥95% coverage is crucial for effective population immunity. Low MR2 uptake is linked to increased measles outbreaks. With only 57.1% MR2 uptake, Kenya reported 1,775 measles cases in 2021. This study evaluates MR2 uptake and its determinants among 24-35-month-old children in Wajir town. Methods: A cross-sectional design was employed using cluster sampling in Wajir town, Wajir East sub-county, in December 2023. Parents of 399 children aged 24-35 months were interviewed using a pretested and predesigned questionnaire. Data was analyzed in SPSS V27. Socio-demographic characteristics were summarized in proportions. COR, aOR, and 95% Confidence Intervals measured association and significance. The analysis was two-tailed with a significance level set at p<0.05. Results: The study included 399 children with a median age of 25 months (interquartile range 24-29). MR2 uptake was 49.6%. Statistically significant predictors of MR2 uptake were parents' or guardians' occupation (aOR 2.85, 95% CI=1.18, 6.87, p=0.020), knowledge of the number of measles vaccines (aOR 16.05, 95% CI=4.16, 62.87, p<0.001), and the child’s gender (aOR 3.9, 95% CI=1.81, 7.86, p<0.001). Inadequate awareness about MR2 was the primary reason for not vaccinating children. Conclusions: MR2 uptake was low compared to the WHO-recommended target of ≥95%. The parents’ occupation, knowledge of the vaccine schedule, and the child’s gender determined MR2 uptake. The Wajir County Department of Health should carry out targeted knowledge-creation for parents/guardians and gender-aligned advocacy to improve MR2 uptake.