Community adherence to the second dose of measle and rubella: a cross-sectional survey in a rural health district of Cameroon

BackgroundMeasles remains a significant public health challenge in sub-Saharan Africa, including Cameroon, where vaccination coverage falls below the WHO target of 95%. The second dose of the measles-rubella vaccine (MCV2) is critical for strengthening immunity, yet adherence remains low in rural areas. This study aimed to assess MCV2 coverage and identify factors influencing vaccination uptake in the Ngog-Mapubi Health District of Cameroon. MethodsA community-based cross-sectional survey was conducted in March 2024, involving 140 parents or guardians of children aged 15-23 months. Data were collected using a pretested questionnaire, covering sociodemographic characteristics, vaccination status, and barriers to uptake. Logistic regression was employed to identify determinants of MCV2 vaccination. Data were analyzed using R statistics version 4.4.2. A p-value 11 0.05 was considered statistically significant. ResultsThe study revealed an MCV2 vaccination coverage of 46.4% (95% CI: 38.0-55.0). Among unvaccinated children, 85.3% (95% CI: 75.3-92.4) of caregivers expressed willingness to vaccinate, indicating high acceptance but persistent barriers. Distance to health facilities (43%), lack of information about vaccine availability (37%), and missed opportunities during health visits (25%) were the most cited obstacles. Awareness of MCV2 was high (89%), but knowledge gaps persisted, with 61% of respondents demonstrating poor understanding of vaccination schedules. Multivariate analysis identified the absence of advanced vaccination strategies (e.g., outreach programs) as the strongest predictor of non-vaccination (aOR = 7.15; 95% CI: 3.19-17.2; p < 0.001). Sociodemographic factors like single/widowed marital status (cOR = 3.15; p = 0.025) and student occupation (cOR = 10.0; p = 0.048) were also associated with lower uptake at univariate analysis. Geographic disparities were notable, with coverage below 10% in three health areas (Makak, Mbebe-kikot, Ntouleng). Healthcare workers were the primary information source (93.6%). ConclusionDespite the high MCV2 acceptance rate, low MCV2 coverage in this rural district underscores the need for improved access through advanced vaccination strategies and targeted community education. Addressing structural and informational barriers is essential to achieving equitable immunization coverage.