Factors associated with Missed Opportunities for Vaccination among children in the first year of life at a tertiary health facility in Lagos

  • OA Kehinde Author
  • YA Kuyinu
  • OO Odusanya
Keywords: Children, Health Facility, Immunization, Lagos, Missed Opportunities, Vaccination


Background: Low vaccination rates in children remain a major problem in resource-poor areas of the world. Missed opportunities for vaccination may be one of the important contributors to the menace.

Objectives: To determine the prevalence of missed opportunities for vaccination and identify factors associated with this among Nigerian children in the first year of life.

Methods: The study was a descriptive, cross-sectional study of children who were recruited consecutively and data were obtained using a questionnaire.

Results: Two hundred and fifty-six children were recruited. The prevalence of missed opportunities for vaccination was 11.3%. Gender (p = 0.04) and parental socioeconomic status (p = 0.008) were significantly associated with missed opportunities for vaccination. Non- availability of required vaccines and reluctance to open a multi-dose vial of vaccine caused MOV in 55.5% and 51.8% of children respectively. The evaluation of vaccination status among subjects who were not fully vaccinated by health workers was low at 18.3%.

Conclusion: The rate of missed opportunities for vaccination was low. Educating caregivers and encouraging health workers to evaluate the vaccination status of children at every contact with a health facility may reduce the prevalence of missed opportunities for vaccination.


Centre for Global Development. Making Markets for vaccines: from ideas to actions. Washington DC: Centre for Global Development; 2005.

World Health Organization. Immunization surveillance, assessment and monitoring. http://www.who.int/immunization_monitoring/diseases/en/

WHO/UNICEF. Global immunization vision and strategy, 2006-2015. Geneva, Switzerland and New York. 2005.

Hutchins SS, Jansen HA, Robertson SE, Evans P, Kim-Farley RJ. Studies of missed opportunities for immunization in developing and industrialized countries. Bull World Health Org 1993; 71: 549-550.

Malual AC, Jowi Y, Irimu G, Admani B. Missed opportunities for immunization among children attending a Paediatric Outpatient Clinic at Juba Teaching Hospital. South Sudan Med J 2018; 11: 36-39.

Watson MA, Feldman KW, Sugar NF, Sommer CJ, Thomas ER, Lin T. Inadequate history as a barrier to immunization. Arch Pediatr Adolesc Med 1996; 150:135–139.

Fu LY, Zook K, Gingold J, Gillespie CW, Briccetti C, Cora-Bramble D, et al. Frequent vaccination missed opportunities at primary care encounters contribute to under immunization. The J of Pediatr 2015; 166: 412-417.

Abdulraheem IS, Onajole AT, Jimoh AAG, Oladipo AR. Reasons for incomplete vaccination and factors for missed opportunities among rural Nigerian children. J Public Health Epidemiol2011; 3: 194-203.

Aderibigbe SA, Alatishe-Muhammad BW, Ameen HA, Bolarinwa OA, Salaudeen AG, Uthman MM, et al. Determinants of Missed Opportunities for Immunization among Under-five children in Ilorin Metropolis. Trop J Health Sci 2017; 24: 18-23.

Anah MU, Etuk IS, Udo JJ. Opportunistic immunization with in-patient programme: eliminating a missed opportunity in Calabar, Nigeria. Ann Afr Med 2006; 5: 188-191.

Ubajaka FC, Ukegbu AU, Okafor NJ, Ejiofor O. The prevalence of missed opportunities for immunization among children utilizing immunization services in Nnamdi Azikiwe University Teaching Hospital, Nnewi. J Biol Agric Health 2012; 6:112-119.

Jani JV, De Schacht C, Jani IV, Bjune G. Risk factors for incomplete vaccination and missed opportunity for immunization in rural Mozambique. BMC Public Health 2008; 8: 161.

Gentile A, Bakir J, Firpo V, Caruso M, Lución MF, Abate HJ, et al. Delayed vaccine schedule and missed opportunities for vaccination in children up to 24 months. A multicentre study. Archivos Argentinos de Pediatria 2011; 109: 219-225.

Deivanayagam N, Nedunchelian K, Mala N, Ashok TP, Rathnam SR, Ahmed SS. Missed opportunities for immunization in children under 2 year attending an urban teaching hospital. Indian Pediatr 1995; 32: 51-57.

Pourhoseingholi MA, Vahedi M, Rahimzadeh M. Sample size calculation in medical studies. Gastroenterol Hepatol 2013; 6: 14-17.

Oyedeji GA. Socioeconomic and cultural background of hospitalized children in Ilesa. Niger J Paediatr 1985; 12: 111-117.

Jacob N, Coetzee D. Missed opportunities for immunisation in health facilities in Cape Town, South Africa. South Afr Med J 2015; 105: 917-921.

Restrepo-Méndez MC, Barros AJ, Wong KL, Johnson HI, Pariyo G, Wehrmeister FC, et al. Missed opportunities in full immunization coverage: findings from low-and lower-middle-income countries. Global Health Action 2016; 9: 30963.

Ilah BG, Sakajiki AM, Musa A, Edem B, Adelakun MB, Adenji AO, et al. Immunisation status of children 12-59 months attending a specialist hospital, Gusau, Nigeria. Ann Trop Med Public Health 2015; 8: 23-27.

Ndwandwe D, Uthman OA, Adamu AA, Sambala EZ, Wiyeh AB, Olukade T, et al. Decomposing the gap in missed opportunities for vaccination between poor and non-poor in sub-Saharan Africa: a multi-country analysis. Hum Vaccine Immunother 2018; 14: 2358–2364. doi:10.1080/21645515.2018.1467685.

World Health Organization. Immunization surveillance, assessment and monitoring. Vaccine-preventable diseases. 2012. http://www.who.int/immunization_monitoring/diseases/en/. Accessed 2 July 2019.

World Health Organization. Missed Opportunities for Vaccination (MOV) Strategy 2017. Available from: http://www.who.int/immunization/programmes_systems/policies_strategies/MOV/en/. Accessed 2 July 2019.

Verma SK, Mourya HK, Yadav A, Mourya S, Dabi DR. Assessment of missed opportunities of immunization in children visiting a health facility. Int J Contemp Pediatr 2017; 4: 1748-1753.

Olorunsaiye CZ, Langhamer MS, Wallace AS, Watkins ML. Missed opportunities and barriers for vaccination: a descriptive analysis of private and public health facilities in four African countries. Pan Afr Med J 2017; 27(Suppl 3): 6. doi:10.11604/pamj.supp.2017.27.3.12083.

Odusanya OO, Alufohai EF, Meurice FP, Ahonkhai VI. Determinants of vaccination coverage in rural Nigeria. BMC Public Health 2008; 8: 381. doi:10.1186/1471-2458-8-381.

Original Research

Most read articles by the same author(s)