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Highlights • Understanding vaccine non-receipt is crucial in areas where vaccination uptake is low. • Source and type of vaccine messaging are associated with vaccine non-receipt. • Previous experiences with health facilities also predict vaccine non-receipt. Abstract Introduction Rates of full childhood immunization in Ethiopia are well below the WHO global goal of 90% coverage by 2020. This study explores associations between sociodemographic characteristics and healthcare services utilization with experiences of not receiving a vaccine in Ethiopia. Methods This analysis uses data from Ethiopia's 2012 Expanded Program on Immunization Coverage Survey. The relationships between explanatory variables, including sociodemographic and healthcare utilization factors, and various reasons a child was not vaccinated were assessed with Rao-Scott chi-square tests. Multivariable logistic regression analyses examined significant predictors of these experiences. Results The sample includes the caregivers of 2,722 children. Experiences of not receiving a vaccine were characterized overall and by type of experience: whether a caregiver ever refused vaccination for their child (2.9%), ever decided to not take their child to a health center for vaccination (3.6%), and ever went to a health facility for vaccination but child was not vaccinated (12.0%). Region of residence, possession of a vaccination card, and the setting of the child's last routine vaccination were predictors of not receiving a vaccine. Caregivers reported negative perceptions of vaccines were among their reasons for refusing a vaccine or declining to take their child to a health facility for vaccination. Conclusion Prior experiences with health facilities, such as where a child received their last routine vaccine, play a key role in future vaccination. Vaccine receipt at an outreach event is associated with not bringing a child to a health facility for vaccination, which may indicate an unwillingness to visit or difficulty accessing health centers. Further, negative perceptions of vaccines may result in vaccine refusal or delay. Findings of this study provide public health officials with a better understanding of factors related to vaccination experiences and can inform development of interventions that will improve childhood vaccination rates in Ethiopia. [ABSTRACT FROM AUTHOR]

Background: We characterize the risk factors for delayed polio dose 1, diphtheria-tetanus-pertussis (DTP) dose 1, pentavalent dose 1, and measles dose 1 in Ethiopian infants. We also examine the interaction between institutional delivery and demographic factors on the birth doses of the BCG and polio vaccines to better understand factors influencing vaccination. Methods: Using the 2011 Ethiopia Demographic and Health Survey, we calculated the distribution of the study population across different demographic and vaccination characteristics. We computed acceleration factors using a multivariable accelerated failure time model with a Weibull distribution to account for left and right censoring. For the birth doses, we further specified an interaction term between institutional delivery and every other a priori specified independent variable to test whether institutional delivery modifies sociodemographic disparities in vaccination timeliness. Results: Low wealth status, home delivery, and ethnicity are risk factors for delayed vaccination of polio 1, DPT 1, pentavalent 1, and measles 1. Religion is a risk factor for measles 1 vaccination delay and rural residence are risk factors for delayed DPT1 and polio 1 doses. For birth doses of polio and BCG, institutional delivery attenuated many sociodemographic disparities in vaccination delay, except for urbanicity, which showed rural dwellers with more delay than urban dwellers with an institutional vs home birth. Conclusions: Less delayed vaccination among children with institutional deliveries highlights the importance of perinatal care and the potential for promoting healthy behaviors to parents. Persistent disparities between urban and rural residents, even among those with institutional births, can be targeted for future interventions. Timely vaccination is key to prevention of unnecessary childhood mortality. [ABSTRACT FROM AUTHOR]