Vaccination Status and Its Association with Complications among the Patients Admitted with Measles in the Dedicated Measles Hospitals, Dhaka, Bangladesh

Bangladesh is facing a major resurgence of measles, with more than 60,000 suspected cases and over 600 deaths reported between March and May 2026. Despite the growing outbreak, hospital-based evidence in Bangladesh remains limited regarding measles vaccination status and its association with clinical complications. To address this critical gap, our study aimed to assess the vaccination status and its relationship with the development of clinical complications. A total of 260 children admitted to the measles ward were enrolled in this cross-sectional study. They were aged 2-72 months, had clinically confirmed measles, and were admitted to four dedicated measles treatment hospitals in Dhaka, Bangladesh, between 15 and 25 April 2026. Data on vaccination status, sociodemographic characteristics, feeding practices, Nutritional status, clinical symptoms, and complications were collected through caregiver interviews and hospital records. Adjusted odds ratios (AOR) with a corresponding 95% confidence interval (CI), and a p-value of <0.05 were considered statistically significant. Among enrolled children, 74.6% were unvaccinated, 18.8% were partially vaccinated, and only 6.5% were fully vaccinated. In the multivariable model, age below 9 months (aOR 0.077, 95% CI 0.025-0.236,p<0.001) was independently associated with lower odds of vaccination, while household income at or above the median (aOR 3.480, 95% CI 1.493-8.110,p=0.004) was associated with higher odds. Complications developed in 31.1% of cases, with respiratory involvement being most common. Absence of exclusive breastfeeding (aOR 2.336, 95% CI 1.027-5.313,p=0.043) and presenting with exactly three symptoms at admission (aOR 3.106, 95% CI 1.274-7.572,p=0.013) were independently associated with complications. Unvaccinated individuals exhibited markedly elevated odds of complications compared to those who were vaccinated (aOR 5.729,95% CI: 2.363-13.889, p<0.001). The overwhelming burden of measles in unvaccinated children, shaped by socioeconomic disadvantage and suboptimal feeding practices, underscores the urgent need to restore immunization coverage and strengthen equitable health services in Bangladesh.