# Routine immunization status of nomadic children aged five years and below in Volta Region, Ghana in the post-COVID-19 pandemic era: a cross-sectional study

## TL;DR

This study examines the immunization status of nomadic children in Ghana after the COVID-19 pandemic and finds moderate coverage influenced by factors like age and caregiver behavior.

## Contribution

The study provides new insights into post-pandemic immunization trends among nomadic children in Ghana and identifies specific factors influencing full immunization.

## Key findings

- 51% of children aged five years and below were fully immunized.
- Children aged 24–35 and 36–59 months had significantly higher odds of full immunization.
- Long waiting times at vaccination centers reduced the likelihood of full immunization.

## Abstract

Despite the benefits of routine childhood immunization, coverage has remained low in parts of Ghana, particularly among nomadic children. Moreover, the COVID-19 pandemic exacerbated the uptake of routine immunization and other health services. We, therefore, assessed the routine immunization status of nomadic children aged five years and below during the post-COVID-19 pandemic era in two districts of the Volta Region.

Between July and October 2022, we conducted a community-based analytical cross-sectional study among 157 nomadic children aged five years and below to asses post-COVID-19 pandemic immunization status. Data were collected through interviews of caregivers using a structured questionnaire and analyzed with Stata Version 17. Descriptive statistics were used to summarize the data. A multivariate logistic regression model was used to determine factors associated with full immunization status at p < 0.05 and 95% confidence interval.

Of the 157 children involved in the study, males comprised the dominant group, accounting for 52.2% (82/157). The overall complete immunization for age was 51%, with 73.6% full immunization observed among those aged 12–59 months. The odds of full immunization were higher among children aged 24–35 months [aOR = 15.50, 95%CI: (2.03-118.39)] and those aged 36–59 months [aOR = 14.18, 95% CI: (3.17, 63.46)], children of caregivers with a history of postnatal care (PNC) visits [aOR = 4.16, 95% CI: (1.29–13.40)], caregivers being convenient with the immunization schedule [aOR = 4.50, 95% CI: (1.16–17.42)] and those encouraged by community leaders [aOR = 95%CI: (1.06–13.70)]. Caregivers reporting long waiting times at vaccination centres had lower odds [aOR = 0.19, 95% CI: (0.04–0.84)] of full immunization.

The full immunization status of nomadic children under five years in the study area was moderate and was associated with the child’s age, PNC visits, community leader encouragement, the convenience of immunization schedules, and waiting times. We recommend that the District Health directorates employ targeted and multifaceted strategies to address the suboptimal immunization uptake observed among this vulnerable group.

The online version contains supplementary material available at 10.1186/s12889-025-23290-2.