Conference Abstract | Volume 8, Abstract NACNDC/19JASH00007 (Oral) | Published: 17 Nov 2025
Pauline Achom1,&, Sharon Namasambi1, Nasif Matovu1, Vianney Kigongo1, Brian Boneventure Kawere2, Daniel Kiiza2, Duncan Matovu2, Deogratious Migadde3, Yasiini Nuwamanya1, Benon Kwesiga1, Richard Migisha1, Daniel Kadobera4, Alex Riolexus Ario1
1Uganda Public Health Fellowship Program, Uganda National Institute of Public Health, Kampala, Uganda, 2Infectious Disease Institute, Makerere University, 3Ministry of Health, Kampala Uganda, 4Division of Global Health Protection, US Centers for Disease Control and Prevention, Kampala, Uganda
&Corresponding author: Pauline Achom, Uganda Public Health Fellowship Program Email: achompauline@uniph.go.ug
Received: 18 Aug 2025, Accepted: 20 Oct 2025, Published: 17 Nov 2025
Domain: Immunisation
Keywords: Zero-dose, DPT1, Immunization, Uganda
CDC Disclaimer: The findings and conclusions in this report are those of the author(s) and do not necessarily represent the official position of the Centres for Disease Control and Prevention.
©Pauline Achom et al. Journal of Interventional Epidemiology and Public Health (ISSN: 2664-2824). This is an Open Access article distributed under the terms of the Creative Commons Attribution International 4.0 License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Cite this article: Pauline Achom et al. Prevalence and factors associated with zero-dose status of DPT1 vaccine among children aged 12-23 months in Uganda, 2024. Journal of Interventional Epidemiology and Public Health. 2025;8(ConfProc6):00007. https://doi.org/10.37432/JIEPH-CONFPRO6-00007
GAVI defines zero-dose children as those who have not received Diphtheria-Pertussis-Tetanus1 (DPT1), which represents a gap in immunisation programs and a marker of inequity in access to essential health services. In Uganda, while DPT1 coverage exceeds 90%, there are regional variations due to health system factors leaving pockets of unvaccinated children and pausing an increased risk of outbreaks. We determined the prevalence and factors associated with zero-dose status among children aged 12–23 months in Uganda.
We conducted a cross-sectional household survey in all 15 regions of Uganda. We sampled 2,254 children aged 12–23 months using multi-stage cluster sampling. Data were collected through caregiver interviews using a standard questionnaire and review of vaccination cards. Weighted prevalence estimates were calculated. Multivariable logistic regression was applied to assess factors associated with zero-dose status among the children.
The overall prevalence of zero-dose status was 9.1%. The highest zero-dose prevalence was observed in South Central (17%) and Bunyoro (17%) while the lowest was in Acholi (3.9%) and Kigezi (2%). The factors significantly associated with zero-dose status included absence of information on the next appointment (aOR=18, p<0.001), lack of trust in vaccines (aOR=7.1, p=0.013), having above secondary education (aOR=6.6, p=0.012) and unfavorable family norms (aOR=3.5, p<0.001).
Despite overall high national coverage, nearly 1 in 10 Ugandan children aged 12–23 months remain unvaccinated with DPT1, with substantial regional disparities. Zero-dose status is driven by a combination of caregiver characteristics, social norms, and systemic barriers. We recommend strengthening community engagement by leveraging VHTs and local leaders to create awareness and reminders on next appointments through media platforms. Promoting use of immunization champions to build care-giver trust in vaccines and celebrating positive societal practices on immunization to achieve equitable coverage.
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