Factors Influencing the Acceptance of Immunization Among Mothers Who Attend Federal Medical Centre Umuahia, Abia State
DOI:
https://doi.org/10.67224/ioasdjmps.2026.v03i03.002Keywords:
Immunization acceptance, vaccine uptake, mothers, childhood vaccination, maternal education, immunization coverage, Federal Medical Centre Umuahia, NigeriaAbstract
Immunization is one of the most effective and cost-efficient public health interventions for preventing childhood morbidity and mortality caused by vaccine-preventable diseases. Despite the availability of routine immunization services in Nigeria, incomplete immunization remains a challenge due to various socioeconomic, cultural, and health system-related factors. This study assessed the factors influencing the acceptance and uptake of immunization among mothers attending the Maternal and Child Health Unit of the Federal Medical Centre (FMC), Umuahia, Abia State, Nigeria. A hospital-based cross-sectional study was conducted among 380 mothers of children aged 0–5 years attending FMC Umuahia. Data were collected using a structured interviewer-administered questionnaire that assessed socio-demographic characteristics, knowledge of immunization, immunization practices, and factors influencing vaccine uptake. Data were analyzed using the Statistical Package for Social Sciences (SPSS) version 20. Descriptive statistics were presented as frequencies and percentages, while Chi-square and logistic regression analyses were used to determine factors associated with complete immunization uptake at a significance level of p < 0.05. The majority of mothers (59.7%) were below 30 years of age, 96.8% were married, and 37.9% had primary education or less. Most respondents demonstrated good knowledge of immunization, with 91.8% knowing that immunization should commence within the first week of life. 60.5% of children had completed their immunization schedule. The major reason for accepting immunization was disease prevention (86.8%), while the leading causes of missed immunization doses were vaccine unavailability (31.9%) and transportation difficulties (18.8%). Factors hindering immunization uptake included non-availability of vaccines (39.0%), ignorance (20.0%), religious influences (8.2%), and cultural beliefs (5.8%). Maternal educational level was significantly associated with complete immunization uptake (χ² = 8.132, p = 0.017). Mothers with secondary education (AOR = 2.81, 95% CI: 1.31–6.01, p = 0.008) and tertiary education (AOR = 2.78, 95% CI: 1.25–6.17, p = 0.012) were significantly more likely to complete their children's immunization schedules compared to those with primary education or less. Acceptance and uptake of immunization among mothers attending FMC Umuahia were generally high and strongly influenced by maternal education, vaccine availability, accessibility of healthcare services, and knowledge of immunization benefits. Strengthening health education programs, ensuring uninterrupted vaccine supply, improving transportation access, and addressing sociocultural misconceptions are essential strategies for improving immunization coverage and achieving optimal child health outcomes.
References
• Abel, N., Wondewosen, K., Sahilu, A., & Ada, K. (2023). Factors associated with incomplete childhood immunization in Arbegona district, southern Ethiopia: A case-control study. BMC Public Health, 16(1), 27. https://doi.org/10.1186/s12889-016-2700-z
• Anand, S., & Bärnighausen, T. (2022). Health workers and vaccination coverage in developing countries: An econometric analysis. Lancet, 369(9567), 1277–1285. https://doi.org/10.1016/S0140-6736(07)60686-4
• Awodele, O., Oreagba, I. A., Akinyede, A., Awodele, D. F., & Dolapo, D. C. (2021). The knowledge and attitude towards childhood immunization among mothers attending antenatal clinic in Lagos University Teaching Hospital, Nigeria. Tanzania Journal of Health Research, 12(3), 1-8. https://doi.org/10.4314/thrb.v12i3.12380
• Babalola, S. (2022). Determinants of the uptake of the full dose of diphtheria-pertussis-tetanus vaccines (DPT3) in Northern Nigeria: A multilevel analysis. Maternal and Child Health Journal, 13(4), 550-558. https://doi.org/10.1007/s10995-008-0393-x
• Bonu, S., Rani, M., & Baker, T. D. (2022). The impact of the national polio immunization campaign on levels and equity in immunization coverage: Evidence from rural North India. Social Science & Medicine, 57(10), 1807–1819. https://doi.org/10.1016/S0277-9536(03)00067-X
• Brugha, R., Starling, M., & Walt, G. (2021). GAVI, the first steps: Lessons for the Global Fund. Lancet, 359(9304), 435–438. https://doi.org/10.1016/S0140-6736(02)07595-7
• Centre for Global Development. (2023). Making markets for vaccines: From ideas to actions. Centre for Global Development.Challenges in global immunization and the global immunization vision and strategy 2021-2023. (n.d.).
• Federal Ministry of Health (FMOH). (2022). National immunization policy and standard practices. Abuja: Federal Ministry of Health.
• Federal Ministry of Health (FMOH). (2021). Immunization report. Retrieved June 12, 2022, from http://www.fmo.gov.ng
• Fatunde, O. J., & Familusi, J. B. (2001). Post-neonatal tetanus in Nigeria: A need for booster doses of tetanus toxoid. Nigerian Journal of Paediatrics, 28(1), 35–38.
• Guttman, A., Manuel, D., Dick, P. T., To, T., Lam, K., & Stukel, T. A. (2022). Volume matters: Physician practice characteristics and immunization coverage among young children insured through a universal health plan. Pediatrics, 117(2), 595–602. https://doi.org/10.1542/peds.2021-2451
• Haynes, K., & Stone, C. (2004). Predictors of incomplete immunization in Victorian children. Australian and New Zealand Journal of Public Health, 28(1), 72–79. https://doi.org/10.1111/j.1467-842X.2004.tb00638.x
• Hu, Y., Li, Q., Chen, E., Chen, Y., & Qi, X. (2021). Determinants of childhood immunization uptake among socio-economically disadvantaged migrants in East China. International Journal of Environmental Research and Public Health, 10(7), 2845–2856. https://doi.org/10.3390/ijerph10072845
• Impicciatore, P., Bosetti, C., Schiavio, S., Pandolfini, C., & Bonati, M. (2021). Mothers as active partners in the prevention of childhood diseases: Maternal factors related to immunization status of preschool children in Italy. Preventive Medicine, 31(1), 49–55. https://doi.org/10.1006/pmed.2023.0682
• Jamil, K., Bhuiya, A., Streatfield, K., & Chakrabarty, N. (2023). The immunization Program in Bangladesh: Impressive gains in coverage, but gaps remain. Health Policy and Planning, 14(1), 49–58. https://doi.org/10.1093/heapol/14.1.49
• Matsumura, T., Nakayama, T., Okamoto, H. O., & Ito, H. (2023). Measles vaccine coverage and factors related to uncompleted vaccination among 18-month-old and 36-month-old children in Kyoto, Japan. BMC Public Health, 5(1), 59. https://doi.org/10.1186/1471-2458-5-59
• Mayinbe, J. C., Braa, J., & Bjunne, G. (2023). Assessing immunization data quality from routine reports in Mozambique. BMC Public Health, 5(1), 108. https://doi.org/10.1186/1471-2458-5-108
• Naeem, M., Khan, M. Z., Adil, M., Abbas, S. H., Khan, M. U., Khan, A., & Naz, S. M. (2022). Inequity in childhood immunization between urban and rural areas of Peshawar. Journal of Ayub Medical College, 23(3), 134–137. https://doi.org/10.1186/s12887-017-0935-5
• National Population Commission. (2021). National immunization coverage survey. Abuja.
• Odunsaya, O. O., Alufohai, J. E., Meurice, F. P., & Ahonkhai, V. I. (2023). Determinants of vaccination coverage in rural Nigeria. BMC Public Health, 8(1), 381. https://doi.org/10.1186/1471-2458-8-381
• Ophori, E. A., Tula, M. Y., Azih, A. V., Okojie, R., & Ikpo, P. E. (2022). Current trends of immunization in Nigeria: Prospect and challenges. Tropical Medicine and Health, 42(2), 67–75. https://doi.org/10.1186/s41182-017-0065-6
• Paulussen, G. W., Hocksstra, F., Lanting, C. I., Buijs, G. B., & Hirasing, R. A. (2021). Determinants of Dutch parents' decision to vaccinate their child. Vaccine, 24(1), 644–651. https://doi.org/10.1016/j.vaccine.2021.08.049
• Plotkin, S. A., Orenstein, W. A., & Offit, P. A. (Eds.). (2023). Vaccines (5th ed.). Saunders.
• Samad, L., Tate, A. R., Dezateux, C., Peckham, C., Butler, N., & Bedford, H. (2021). Differences in risk factors for partial and no immunization in the first year of life: Prospective cohort study. BMJ, 332(7553), 1312–1314. https://doi.org/10.1136/bmj.38824.671410.7C
• Sadoh, A. E., & Eregie, C. O. (2022). Timeliness and completion rate of immunization among Nigerian children attending a clinic-based immunization service. Journal of Health, Population and Nutrition, 27(3), 391–395. https://doi.org/10.3329/jhpn.v27i3.3383
• Stefan, R. (2023). Edward Jenner and the history of smallpox and vaccination. Proceedings of the Baylor University Medical Center, 18(1), 21–25. https://doi.org/10.1080/08998280.2021.11928068
• Taffa, N., Chepngeno, G., & Amuyunzu-Nyamong, S. (2023). Child mortality and health care utilization in slums of Nairobi, Kenya. Journal of Tropical Pediatrics, 51(5), 279–284. https://doi.org/10.1093/tropej/fmi026
• The National Institute of Allergy and Infectious Diseases. (2012). Overview of the Immune System. U.S. Department of Health & Human Services.
• UNICEF. (2022). The progress of nations. United Nations Children’s Fund.
• UNICEF. (2022). Immunization campaign seeks to prevent resurgence of polio in the Philippines. https://www.unicef.org/infobycountry/philippines_28751.html
• World Health Organization (WHO). (2021). Immunization safety surveillance: Guidelines for managers of immunization programs on reporting and investigating adverse events following immunization. WHO.
• World Health Organization (WHO). (2023). Immunization, vaccines, and biologicals. http://www.who.int/immunization/en/
• Yousif, M. A., Albarraq, A. A., Abdallah, M. A. A., & Elbur, A. I. (2021). Parents' knowledge and attitudes on childhood immunization, Taif, Saudi Arabia. Vaccine, 5(3), 215. https://doi.org/10.3389/fped.2021.687492
• Ophori, E. A., Tula, M. Y., Azih, A. V., Okojie, R., & Ikpo, P. E. (2014). Current trends of immunization in Nigeria: prospect and challenges. Tropical medicine and health, 42(2), 67–75. https://doi.org/10.2149/tmh.2013-13
• Iba, B., Zar, V. D., & Oteng, J. (2025). Determinants of uptake of childhood immunization in Gboko, Benue State, Nigeria. BMC public health, 25(1), 3940. https://doi.org/10.1186/s12889-025-25355-8
• Alabadi, M., & Aldawood, Z. (2020). Parents' Knowledge, Attitude and Perceptions on Childhood Vaccination in Saudi Arabia: A Systematic Literature Review. Vaccines, 8(4), 750. https://doi.org/10.3390/vaccines8040750
• Hu, Y., Li, Q., Chen, E., Chen, Y., & Qi, X. (2013). Determinants of Childhood Immunization Uptake among Socio-Economically Disadvantaged Migrants in East China. International Journal of Environmental Research and Public Health, 10(7), 2845-2856. https://doi.org/10.3390/ijerph10072845
• Rodrigues, F., Ziade, N., Jatuworapruk, K., Caballero-Uribe, C. V., Khursheed, T., & Gupta, L. (2023). The Impact of Social Media on Vaccination: A Narrative Review. Journal of Korean medical science, 38(40), e326. https://doi.org/10.3346/jkms.2023.38.e326
• Salmon, D. A., Smith, P. J., Pan, W. K., Navar, A. M., Omer, S. B., & Halsey, N. A. (2009). Disparities in preschool immunization coverage associated with maternal age. Human vaccines, 5(8), 557–561. https://doi.org/10.4161/hv.5.8.9009.
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Copyright (c) 2026 Nneka Juliet Nnamdi, Chinyere Evangeline Achukwu, Ngozi Priscilla Eze-Onuegbu, Chidinma Grace Eluwa, Emmanuel Ifeanyi Obeagu (Author)
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