Abstract
BACKGROUND: Immunization is among the most impactful, effective, and cost-effective public health interventions for preventing deaths and illnesses associated with several childhood infectious diseases worldwide. Given the protective effect of immunization and the observed low immunization coverage in Nigeria, it is essential to evaluate immunization coverage and identify factors influencing its uptake in this region. This study examined the determinants of childhood immunization in Gboko, Benue State, Nigeria. METHODS: This community-based cross-sectional survey was conducted in Gboko between June and August 2024 among 446 mothers and caregivers of children aged 12-23 months. Participants were recruited using a multistage sampling technique, and data were collected through an interviewer-administered questionnaire. The data were analysed using descriptive and inferential statistics (binary and multivariate logistic regression) via SPSS version 25. RESULTS: Of the children surveyed, 68.4% were fully immunized, 19.7% partially immunized, and 11.9% unimmunized for age. Uptake rates for all five antigens assessed were higher than national averages but lower than those found in similar sub-national studies. A significant drop-off in vaccine uptake was observed between the initial and later doses. Key determinants of immunization completion included caregiver wealth status, availability of vaccines, and informal payment requirements at health facilities. CONCLUSION: Although immunization uptake in Gboko LGA was relatively high, full coverage remains below the WHO-recommended targets. Major barriers, such as vaccine stockouts, informal charges, and caregiver misconceptions, continue to hinder completion. Strengthening vaccine supply systems, enforcing free immunization policies, and addressing socio-cultural and economic barriers are essential for improving immunization equity and coverage.