{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T22:09:05Z","timestamp":1784758145128,"version":"3.55.0"},"reference-count":28,"publisher":"Public Library of Science (PLoS)","issue":"12","license":[{"start":{"date-parts":[[2025,12,30]],"date-time":"2025-12-30T00:00:00Z","timestamp":1767052800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosglobalpublichealth.org"],"crossmark-restriction":false},"short-container-title":["PLOS Glob Public Health"],"abstract":"<jats:p>\n                    Measles &amp; Rubella (MR) zero-dose children (unvaccinated for measles\u2013rubella) cluster in underserved communities can sustain measles transmission. We estimated MR zero-dose prevalence after Zambia\u2019s 2024 MR Supplementary Immunisation Activity (SIA) and identified associated risk factors and barriers. A coverage survey (two-stage stratified cluster design) across all 10 provinces, was conducted from 27\n                    <jats:sup>th<\/jats:sup>\n                    December 2024\u201316\n                    <jats:sup>th<\/jats:sup>\n                    January 2025, involved interviewing caregivers of children aged 9\u201359 months; vaccination status was verified by card (11.7%) or recall (88.3%). Data were analysed using survey-weighted methods and logistic regression, adjusting for stratification, clustering, and sampling weights. Among 8,634 children, MR zero-dose prevalence was 11.97% (95% CI: 11.03\u201312.91), highest in Central (19.15%) and Western (17.71%), lowest in Copperbelt (6.69%). Urban residence reduced odds by 24% vs. rural (aOR 0.76, 95% CI: 0.63\u20130.92). Risks rose with age (&gt;36 months: aOR 1.60, 95% CI: 1.27\u20132.00), maternal absence (aOR 1.74, 95% CI: 1.33\u20132.27), or death (aOR 2.40, 95% CI: 1.23\u20134.68). Most zero-dose children (88.75%) lacked other vaccines, indicating systemic gaps. Key barriers included unawareness (42.58%) and travel time (&gt;2 hours: aOR 3.20, 95% CI: 1.43\u20137.16). Nearly one in eight Zambian children remained MR zero-dose post-2024 SIA, concentrated in rural, high-prevalence areas, older children, and motherless households. Priorities include health worker-led awareness campaigns, mobile services to cut travel time, and integrated SIA-Routine Immunisation (RI) strategies (microplanning, tracing, catch-up) to address systemic gaps, supporting global measles elimination under Immunisation Agenda 2030.\n                  <\/jats:p>","DOI":"10.1371\/journal.pgph.0005265","type":"journal-article","created":{"date-parts":[[2025,12,30]],"date-time":"2025-12-30T19:00:48Z","timestamp":1767121248000},"page":"e0005265","update-policy":"https:\/\/doi.org\/10.1371\/journal.pgph.corrections_policy","source":"Crossref","is-referenced-by-count":1,"title":["Profiling zero-dose measles-rubella children in Zambia: Insights from the 2024 post-campaign coverage survey"],"prefix":"10.1371","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3414-3523","authenticated-orcid":true,"given":"Moses","family":"Mwale","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guissimon","family":"Phiri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francis Dien","family":"Mwansa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5381-3820","authenticated-orcid":true,"given":"Peter J.","family":"Chipimo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Penelope","family":"Masumbu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kennedy","family":"Matanda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-1027-645X","authenticated-orcid":true,"given":"Princess","family":"Kayeye","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5099-3392","authenticated-orcid":true,"given":"Kelvin","family":"Mwangilwa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7922-1222","authenticated-orcid":true,"given":"Chola","family":"Nakazwe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harriet","family":"Namukoko","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon","family":"Mutembo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Freddie","family":"Masaninga","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacob","family":"Sakala","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter Clement","family":"Lugala","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2025,12,30]]},"reference":[{"issue":"2","key":"pgph.0005265.ref001","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1016\/j.vaccine.2017.07.066","article-title":"Measles vaccines: WHO position paper, April 2017 - 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