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Immunization has saved millions of lives globally from vaccine-preventable diseases. Childhood immunization is an effective public health strategy for decreasing morbidity and mortality among children in developing countries. Tanzania has one of the highest rates of coverage of routine child immunization among sub-Saharan African countries. However, obstacles to universal immunization still exist, particularly in rural areas of the country. Assessing routine immunization coverage is essential to inform vaccine policies and program implementation. This study aimed to assess routine immunization status and factors associated with its coverage among children aged 12-23 months. We conducted a cross-sectional, quantitative household survey in 31 regions with caretakers of children in Tanzania, where a total of 4,560 households were visited. Nationally, 85.5% of children aged 12-23 months had completed the full recommended course of vaccines. Overall, 14.5% of children aged 12-23 months did not complete routine immunization schedules in 2019. We found that factors associated with immunization coverage included having one to six family members, higher household wealth, the family's head engaging in subsistence farming, caretakers' age, children's age, educational level, children with clinic cards, and children receiving the diphtheria, pertussis, tetanus-3 vaccine. The country is about to reach the vaccination coverage target set by the WHO and the United Nations Children Fund. Improving existing vaccination coverage and optimizing the use of recommended interventions are required. We strongly advise using the periodic micro-planning tool and satellite image technology, particularly in areas where immunization coverage is less than 80%.

Although studies on COVID-19 vaccine hesitancy are being undertaken widely worldwide, there is limited evidence in Tanzania. This study aims to assess the sociodemographic factors associated with COVID-19 vaccine hesitancy and the reasons given by unvaccinated study participants. We conducted a mixed-method cross-sectional study with two components-health facilities and communities-between March and September 2022. A structured questionnaire and in-depth interviews were used to collect quantitative and qualitative data, respectively. A total of 1,508 individuals agreed to participate in the survey and explained why they had not vaccinated against COVID-19. Of these participants, 62% indicated they would accept the vaccine, whereas 38% expressed skepticism. In a multivariate regression analysis, adult study participants 40 years and older were significantly more likely to report not intending to be vaccinated (adjusted odds ratio [AOR], 1.28; 95% CI, 1.01-1.61; P = 0.04) than youth and middle-aged study participants between 18 and 40 years. Furthermore, female study participants had a greater likelihood of not intending to be vaccinated (AOR, 1.51; 95% CI, 1.19-1.90; P = 0.001) than male study participants. The study identified fear of safety and short-term side effects, and lack of trust of the COVID-19 vaccine; belief in spiritual or religious views; and belief in local remedies and other precautions or preventive measures as the major contributors to COVID-19 vaccine hesitancy in Tanzania. Further empirical studies are needed to confirm these findings and to understand more fully the reasons for vaccine hesitancy in different demographic groups.