Vaccine hesitancy among mothers of under-five children in Coastal South India: a facility-based cross-sectional study

Prevalence and predictors of vaccine hesitancy among mothers of under-five children: A hospital-based cross-sectional study

BACKGROUND

The World Health Organization (WHO) states that vaccine hesitancy is one of the top 10 threats to global public health. Evidence shows that vaccine hesitancy studies in India are limited and targeted toward individual vaccines. The study aimed to fill this gap by exploring the relationship between demographics and SAGE factors toward vaccine hesitancy.

MATERIALS AND METHODS

A hospital-based, cross-sectional, analytical study was conducted in a non-governmental organization (NGO) hospital with 330 beds, located in Bathalapalli, Andhra Pradesh, India. Mothers of under-five children who attended outpatient departments of pediatrics or obstetrics and gynecology were included. A total of 574 mothers were enrolled and vaccine hesitancy was determined by reviewing the mother-child protection card for the presence of delay or refusal of the recommended vaccine. A face-to-face interview was conducted to obtain demographics and WHO-SAGE variables from the participants. Binary logistic regression analysis was performed to associate independent variables (demographics and SAGE variables) with the dependent variable (vaccine hesitancy).

RESULTS

Out of 574 respondents, 161 mother's children were noted as vaccine-hesitant (refusal = 7; delay = 154); and the prevalence of vaccine hesitancy was 28.05%. The delay was observed in all recommended vaccines, but the refusal or reluctance was seen in only four vaccines (hepatitis B birth dose = 1; IPV 1 and 2 = 2; Measles 1 and 2 = 3; and Rota 1, 2, and 3 = 1). The respondents' demographics like no or lower parent education (OR = 3.17; 95%CI = 1.50-6.72) and fewer antenatal visits (OR = 2.30; 95%CI = 1.45-3.36) showed higher odds, whereas the upper socioeconomic status showed lower odds (OR = 0.09; 95%CI = 0.02-0.36) toward vaccine hesitancy. The WHO-SAGE dimensions like awareness (OR = 0.14; 95%CI = 0.03-0.53), poor access (OR = 7.76; 95%CI = 3.65-16.51), and low acceptability of the individual (OR = 07.15; 95%CI = 1.87-27.29), community (OR = 6.21; 95%CI = 1.58-24.33) were significantly associated with vaccine hesitancy.

CONCLUSION

The study concludes that the prevalence of vaccine hesitancy was high. Vaccine safety and children's health are primary concerns for parents' refusal/reluctance. To achieve 100% immunization coverage, policymakers need to reduce vaccine hesitancy by developing strategies based on demographic and WHO-SAGE working group predictors.

Vaccine hesitancy among mothers of under-five children in Coastal South India: a facility-based cross-sectional study

Background: Vaccine hesitancy (VH) has been identified by the World Health Organization as one among the top ten threats to global public health. There is limited literature regarding VH from developing countries like India. Methods: In this facility based cross-sectional study, 172 mothers of under-five children were assessed regarding VH using the parental attitude towards childhood vaccination questionnaire (PACV). Results: The prevalence of VH was 3.4% (n=6). Only 7.6% (n=13) of the study participants had ever refused vaccination for their child and the most common reason cited for their refusal was that they thought it was not safe (n=6). Government health facilities was the place of routine immunization for 60.5% (n=104) participants. Health care providers (n =79, 46%) were the major source of information regarding vaccines. Conclusions: Our study highlights the presence of very low prevalence of VH in Mangalore compared to similar studies from India and other parts of the world. The limited number of participants had refused vaccination due to concerns related to vaccine safety.