Determinants of Hesitancy to Childhood Immunizations in a Peri -Urban Settlement; A Case Study of Nansana Municipality, Uganda

Abstract

Vaccine hesitancy to immunization against the childhood vaccine-preventable diseases is increasingly becoming a concern worldwide, which negatively impacts the parents’ willingness to vaccinate their children. The objective of this study was to establish the current prevalence of vaccine hesitancy and the factors that determine parent’s hesitancy to childhood immunizations in Nansana Municipality, Wakiso District, Uganda. This was a cross-sectional mixed methods study, utilizing both qualitative and quantitative approaches. Evaluation of the determinants of vaccine hesitancy was carried out on 344 parents of children under 24 months, using simple random sampling on pre-tested structured questionnaires. Data was analyzed using SPSS 20.0 software. Additionally, 2 focus group discussions with parents were also conducted. Vaccine hesitancy was found to be 27.6%. Education level (AOR=4.9, 95% CI, 2.6 -29.5, p=0.01), belief in vaccine effectiveness (AOR= 0.47, 95% CI, 0.17 – 0.97, p=0.01), health workers attitude (AOR=0.22, 95% CI, 0.06 - 0.86, p=0.03), timing of immunization service clinic (AOR = 3.4, 95% CI, 1.8 – 6.4, p=0.01) and adequate information provision (AOR = 0.64, 95% CI, 0.16 – 0.99, p=0.04), were the factors that were independently determining vaccine hesitancy. The vaccine hesitancy prevalence rate is comparatively similar to previous urban area studies. Despite parents overwhelmingly believing in vaccines protecting their children from vaccine-preventable disease, these same parents, express concerns regarding timing of the clinic and the side effects of vaccines. There is a need to improve on communication and information flow to address the many vaccine safety concerns, such as side effects.