INTRODUCTION: Measles remains a major public health challenge despite the availability of safe and effective vaccines. Completion of the second dose of the measles-containing vaccine (MCV2) is essential for achieving herd immunity and preventing outbreaks. This study determined the prevalence of MCV2 uptake and factors associated with its completion among children aged 18–59 months attending healthcare facilities in Rusizi District, Rwanda.
METHODS: A facility-based cross-sectional study was conducted between March and April 2025 among 287 caregivers selected using multistage and systematic random sampling. Data were collected through interviewer-administered questionnaires and vaccination card reviews. Descriptive statistics, chi-square tests, and multivariable logistic regression were performed using SPSS version 27. Adjusted odds ratios (AORs) with 95% confidence intervals (CIs) were used to identify factors associated with MCV2 uptake at p<0.05.
RESULTS: MCV2 uptake was 74.9% (215/287), below the WHO target of 95% required for herd immunity. Higher household income was associated with increased vaccine uptake (201,000–300,000 RWF: AOR=2.49, 95% CI: 1.05–5.88; >301,000 RWF: AOR=3.36, 95% CI: 1.37–8.22). High caregiver knowledge also increased the likelihood of MCV2 completion (AOR=2.11, 95% CI: 1.01–4.42). Conversely, living more than 10 km from a health facility, waiting over two hours for services, and inconsistent vaccine availability significantly reduced vaccine uptake.
CONCLUSION: MCV2 uptake in Rusizi District remains below the level required for herd immunity. Strengthening outreach services, improving vaccine availability, reducing waiting times, and enhancing caregiver education are essential to increase MCV2 completion and reduce the risk of measles outbreaks.
