DETERMINANTS OF SECOND-DOSE MEASLES IMMUNIZATION ACCEPTANCE AMONG TODDLERS: A SYSTEMATIC LITERATURE REVIEW
DOI:
https://doi.org/10.36720/nhjk.v15i1.883Keywords:
Keywords: determinant, immunization, measles, second doseAbstract
Background: Measles is a contagious disease with high morbidity and mortality rates. Globally, measles immunization coverage has reached 81% for the first dose and 71% for the second dose. In Southeast Asia, the coverage is 91% for the first dose and 85% for the second dose; however, these figures remain below the measles elimination target. Purpose: identify the factors influencing second-dose measles immunization coverage. Methods: The method used is a Systematic Literature Review with keywords formulated based on the PICO framework: Population: “children,” Exposure: “second-dose measles vaccine,” and Outcome: “associated factors,” “predictors,” or “determinants.” From a total of 1,159 articles identified, ten studies met the inclusion criteria and were analyzed further. Results: The results show that second-dose measles immunization coverage is influenced by several factors, including maternal age, education level, knowledge, utilization of maternal health services, and accessibility to healthcare facilities. Maternal health service utilization, such as antenatal care visits, delivery at health facilities, and postnatal checkups, significantly increases the likelihood of children receiving the second dose. Conversely, barriers such as long distances, limited transportation, and long waiting times remain major challenges. Conclusion: Therefore, strengthening education, integrating maternal health services with immunization programs, and expanding access in remote areas are essential to improving measles immunization coverage. These efforts provide an important foundation for formulating more effective policies to support both global and national measles elimination strategies.
Downloads
References
Adugna, B., Tola, A., Fite, M. B., & Motuma, A. (2024). Determinants of second-dose measles vaccination dropout in Ethiopia: A community-based matched case-control study. Heliyon, 10(9), e30764. https://doi.org/10.1016/J.HELIYON.2024.E30764
Alemu, T. G., Tamir, T. T., Workneh, B. S., Mekonen, E. G., Ali, M. S., Zegeye, A. F., Wassie, M., Kassie, A. T., Tekeba, B., & Gonete, A. T. (2024). Coverage and determinants of second-dose measles vaccination among under-five children in East Africa countries: a systematic review and meta-analysis. Frontiers in Public Health, 12, 1359572. https://doi.org/10.3389/FPUBH.2024.1359572
Bello, I. M., Akpan, G. U., Teshager, H. F., Jepkorir, L. E., & Girma, M. B. (2024). Factors influencing recurrent measles outbreak in Ethiopia among under-five children: a systematic review. PAMJ-OH. 2024; 15:7, 15(7). https://doi.org/10.11604/PAMJ-OH.2024.15.7.43800
Chilot, D., Belay, D. G., Shitu, K., Gela, Y. Y., Getnet, M., Mulat, B., Muluneh, A. G., Merid, M. W., Bitew, D. A., & Alem, A. Z. (2022). Measles second dose vaccine utilization and associated factors among children aged 24–35 months in Sub-Saharan Africa, a multi-level analysis from recent DHS surveys. BMC Public Health, 22(1), 1–12. https://doi.org/10.1186/S12889-022-14478-X/TABLES/5
Demewoz, A., Wubie, M., Mengie, M. G., Kassegn, E. M., Jara, D., Aschale, A., & Endalew, B. (2023). Second Dose Measles Vaccination Utilization and Associated Factors in Jabitehnan District, Northwest Ethiopia. Dose-Response, 21(1), 15593258231164042. https://doi.org/10.1177/15593258231164042
Do, L. A. H., & Mulholland, K. (2025). Measles 2025. New England Journal of Medicine. https://doi.org/10.1056/NEJMRA2504516
Goshu Muluneh, A., Woldemariam Merid, M., Tigabu, B., Getie Ferede, M., Molla Kassa, G., & Animut, Y. (2022). Less than one-fifth of Ethiopian children were vaccinated for measles second dose; evidence from the Ethiopian mini demographic and health survey 2019. Vaccine: X, 12. https://doi.org/10.1016/j.jvacx.2022.100217
Hermawan, A., Irawan, I. R., Widiyanti, M., Rosnani, R., & Arifin, H. (2025). Association of socio-demographic factors with measles vaccination coverage among Indonesian children aged 12-23 months: a nationwide study. The Turkish Journal of Pediatrics, 67(3), 304–316. https://doi.org/10.24953/TURKJPEDIATR.2025.5886
Ibrahim, H. A., Wariyo, A., Asefa, E. M., Cheru, A., Abebe Lonsako, A., & Dirirsa, G. (2024). Measles second dose vaccine uptake and associated factors among under-five children in Jigjiga City, Somali Region, Eastern Ethiopia: a community-based cross-sectional study. Frontiers in Public Health, 12, 1395802. https://doi.org/10.3389/FPUBH.2024.1395802/BIBTEX
Kantner, A. C., van Wees, S. H., Olsson, E. M. G., & Ziaei, S. (2021). Factors associated with measles vaccination status in children under the age of three years in a post-soviet context: a cross-sectional study using the DHS VII in Armenia. BMC Public Health, 21(1), 1–10. https://doi.org/10.1186/S12889-021-10583-5/TABLES/2
Kanyiru, R. W., Kikuvi, G., . J., & Jomo, D. M. (2019). Factors Associated with Uptake of Measles Rubella Vaccine Among Children Age 9-18 Months in Eastleigh North Ward Nairobi County. International Journal of Scientific and Research Publications (IJSRP), 9(5), p8905. https://doi.org/10.29322/ijsrp.9.05.2019.p8905
Kemenkes RI. (2024). Profil Kesehatan Indonesia .
Levesque, J. F., Harris, M. F., & Russell, G. (2013). Patient-centred access to health care: conceptualising access at the interface of health systems and populations. International Journal for Equity in Health, 12(1). https://doi.org/10.1186/1475-9276-12-18
Mamuti, S., Tabu, C., Marete, I., Opili, D., Jalang’o, R., & Abade, A. (2022). Measles containing vaccine coverage and factors associated with its uptake among children aged 24–59 months in Cherangany Sub County, Trans Nzoia County, Kenya. PLoS ONE, 17(2), e0263780. https://doi.org/10.1371/JOURNAL.PONE.0263780
Maulida, R., Rahmartani, L. D., Hairani, L. K., & Wahyono, T. Y. M. (2019). Coverage and Determinants of Second-Dose Measles Vaccination Among Under-Five Children in Aceh Jaya District, Aceh Province, Indonesia. Jurnal Epidemiologi Kesehatan Indonesia, 2(1). https://doi.org/10.7454/epidkes.v2i1.3049
Naim, H. Y. (2015). Measles virus. Human Vaccines & Immunotherapeutics, 11(1), 21–26. https://doi.org/10.4161/HV.34298
Olufadewa, I., Bamidele, D., Olufadewa, T., Adesina, M., & Oladele, R. (2024). Combating recurrent measles outbreaks in Nigeria: Short-term and long-term strategies. Journal of Medicine, Surgery, and Public Health, 3, 100123. https://doi.org/10.1016/J.GLMEDI.2024.100123
Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., Shamseer, L., Tetzlaff, J. M., Akl, E. A., Brennan, S. E., Chou, R., Glanville, J., Grimshaw, J. M., Hróbjartsson, A., Lalu, M. M., Li, T., Loder, E. W., Mayo-Wilson, E., McDonald, S., … Moher, D. (2021). The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ, 372. https://doi.org/10.1136/BMJ.N71
Patel, M. K., Dumolard, L., Nedelec, Y., Sodha, S. V., Steulet, C., Gacic-Dobo, M., Kretsinger, K., McFarland, J., Rota, P. A., & Goodson, J. L. (2019). Progress Toward Regional Measles Elimination - Worldwide, 2000-2018. MMWR. Morbidity and Mortality Weekly Report, 68(48), 1105–1111. https://doi.org/10.15585/MMWR.MM6848A1
Sugishita, Y., Kurita, J., Akagi, T., Sugawara, T., & Ohkusa, Y. (2019). Determinants of Vaccination Coverage for the Second Dose of Measles-Rubella Vaccine in Tokyo, Japan. The Tohoku Journal of Experimental Medicine, 249(4), 265–273. https://doi.org/10.1620/TJEM.249.265
Tadesse, A. W., Sahlu, D., & Benayew, M. (2022). Second-dose measles vaccination and associated factors among under-five children in urban areas of North Shoa Zone, Central Ethiopia, 2022. Frontiers in Public Health, 10, 1029740. https://doi.org/10.3389/FPUBH.2022.1029740/FULL
Taffie, W., Temesgen, H., Ashebir, W., & Mekonen, H. (2024). Measles second dose vaccine uptake and its associated factors among children aged 24–35 months in Northwest Ethiopia, 2022. Scientific Reports, 14(1), 1–10. https://doi.org/10.1038/S41598-024-61048-9;SUBJMETA=250,631,692,699,700;KWRD=DISEASES,HEALTH+CARE,IMMUNOLOGY
WHO. (2023). Measles - Indonesia.
World Health Organization. (2019). Measles vaccines: WHO position paper, April 2017 – Recommendations. Vaccine, 37(2), 219–222. https://doi.org/10.1016/j.vaccine.2017.07.066
Yitbarek, K., Mahimbo, A., Tekle Bobo, F., Woldie, M., Sheel, M., Frawley, J., Hayen, A., & Glob Health, B. (2025). Impact of measles vaccination strategies on vaccination rates in low-income and middle-income countries: a systematic review and meta-analysis. BMJ Global Health, 10(2), e016647. https://doi.org/10.1136/BMJGH-2024-016647
Zahidi, K., Obtel, M., Naji, S., Zahidi, K., Obtel, M., & Naji, S. (2024). Healthcare Accessibility: Metrics, Assessment, Policies, and Barriers. Economics of Healthcare, Studies and Cases [Working Title]. https://doi.org/10.5772/INTECHOPEN.1006821
Zenbaba, D., Sahiledengle, B., Debela, M. B., Tufa, T., Teferu, Z., Lette, A., Gezahegn, H., Solomon, D., & Tekalegn, Y. (2021). Determinants of Incomplete Vaccination Among Children Aged 12 to 23 Months in Gindhir District, Southeastern Ethiopia: Unmatched Case-Control Study. Risk Management and Healthcare Policy, 14, 1669–1679. https://doi.org/10.2147/RMHP.S295806
Downloads
Published
How to Cite
Issue
Section
Citation Check
License
Copyright (c) 2026 Nurse and Health: Jurnal Keperawatan
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Authors who publish with Nurse and Health: Jurnal Keperawatan agree to the following terms:
- Authors retain copyright licensed under a Creative Commons Attribution-NonCommercial 4.0 (CC BY-NC 4.0), which allows others to remix, tweak, and build upon the authors' work non-commercially, and although the others' new works must also acknowledge the authors and be non-commercial, they don't have to license their derivative works on the same terms.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access). Authors can archive pre-print and post-print or publisher's version/PDF.
