Coverage and determinants of COVID-19 vaccination among 36 555 Nigerian women of childbearing age: a mixed-effects analysis of nationally representative data
Abstract Introduction Even though COVID-19 has spread globally, with millions of deaths, vaccination remains low in resource-constrained settings. Uptake of COVID-19 vaccine has remained suboptimal despite its potential for protection against the disease. The objective of this study was to assess the factors associated with higher COVID-19 vaccination uptake among Nigerian women of reproductive age. Methods A sample of 36 555 women aged 15–49 years was extracted from the 2024 Nigeria Demographic and Health Survey data. The outcome variable was COVID-19 vaccination. Percentage and χ2 tests were used in univariate and bivariate analyses. In addition, self-reported COVID-19 vaccination uptake was examined using multilevel ordinal logistic regression analysis. Results Approximately 73.9% of Nigerian women received no dose of COVID-19 vaccination. Those who received one dose were 13.4%, two doses were 10.5% and >2 doses were 2.1%, respectively. The full model (model V) was selected based on model fitness selection criteria. Older women, educated, Muslims, those covered by health insurance, formerly married, employed, exposed to media, from higher household wealth, have community-level willingness for COVID-19 vaccine uptake, native of the community and living in North East/North Central/South East/South South/South West had higher odds of being in a higher COVID-19 vaccination category when compared with women aged 15–19 years, with no formal education, Christians, uninsured, single, unemployed, not exposed to media, from poorest household, no community-level willingness for COVID-19 uptake, not a native of the community and from North West, respectively. On the other hand, women having a household size >6 were less likely to be in a higher COVID-19 vaccination category when compared with those having a household size of 1–2 members. Conclusions COVID-19 vaccination was approximately one-quarter. This finding is grossly suboptimal for herd immunity. Demographic, socioeconomic and environmental factors were associated with higher COVID-19 vaccination uptake among Nigerian women of reproductive age.