# Uptake of malaria vaccine (RTS,S/AS01) among children aged 6–24 months: A cross-sectional survey conducted in the Western region of Cameroon, 1 year following the vaccine introduction

## TL;DR

A study in Cameroon found low uptake of a malaria vaccine in children, with parental perceptions significantly affecting vaccination rates.

## Contribution

The study evaluates vaccine coverage and the influence of parental perceptions in two Cameroonian health districts.

## Key findings

- Vaccination coverage for the first dose was 31.2%, with completion rates declining for subsequent doses.
- Parental perception was strongly associated with vaccination uptake and timeliness.
- Coverage indicators were below expected levels to significantly impact malaria reduction.

## Abstract

Malaria vaccination using RTS,S/AS01 was introduced as part of Cameroon’s EPI to prevent malaria morbidity and mortality among children aged 6–24 months. This study aims to assess the coverage, completeness, and timeliness of this vaccine and to explore parental perceptions of children’s access to vaccination. This was a community-based, descriptive cross-sectional study targeting children aged 6–24 months and caregivers, selected by stratified random cluster sampling in Foumbot and Foumban health districts. Data were collected from caregivers by trained and supervised enumerators using a pretested questionnaire administered face-to-face. Malaria vaccine coverage, completeness, and timeliness were estimated with 95% confidence intervals. The contribution of caregivers’ perception on the first dose malaria vaccination status was explored by estimating crude odds ratio (cOR) and adjusted odds ratio (aOR) estimated from mixed-effects logistic regression. Of the 55 targeted and reached clusters, 399 children were included in this study. Vaccination coverage of first, second, and third doses of the malaria vaccine was 31.20% (95%CI 30.38 - 32.02), 22.61% (95%CI 21.85 - 23.37), and 17.70% (95%CI 16.88 - 18.52), respectively. Among the children who received the first dose, 56.49% (95%CI 44.61 - 68.37) completed the 3-dose schedule. The timeliness of the three administered doses was between 50–57%. In multivariate analysis, parental perception remained significantly associated with dose 1 malaria administration (aOR 15.54 (95%CI 12.63 - 19.10) p < 0.001), dose 1 timeliness (aOR 2.36 (95%CI 1.52 - 3.65) p < 0.001) and dose 2 completeness (aOR 9.81 (95%CI 7.78 - 12.36) p < 0.001). More than a year after the malaria vaccine introduction in the health districts of Foumbot and Foumban, the performance indicators for this vaccination are below expectations for the vaccine to have a significant impact on reducing malaria morbidity in children. Communicating to positively influence caregivers’ perceptions of malaria vaccination is expected to contribute to improving the situation.