Routine childhood immunization in Sub-Saharan Africa: addressing parental vaccine hesitancy

Area of Science:

• Global Health
• Pediatrics
• Public Health Policy

Background:

• Parental vaccine hesitancy (VH) poses a significant challenge to achieving high childhood immunization rates globally.
• Understanding the specific determinants of VH in diverse populations is essential for developing effective public health strategies.

Purpose of the Study:

• To identify the key factors contributing to parental VH towards routine childhood immunizations.
• To analyze the mediating role of VH in the relationship between maternal characteristics and vaccination uptake in Sub-Saharan Africa.

Main Methods:

• A cross-sectional study involving 5032 parents of children aged 19 months to 6 years in 12 Sub-Saharan African countries.
• Data collected via anonymous online surveys and face-to-face interviews using the Parent Attitude about Childhood Vaccine Scale.
• Multivariate regression and mediating analyses were employed to identify determinants and mediation effects.

Main Results:

• 21.2% of parents exhibited hesitancy towards routine childhood immunizations.
• Factors increasing VH included urban residency, non-first-born children, and chronically ill children.
• Higher maternal education, antenatal care (ANC) visits, and facility-based delivery were associated with decreased VH.
• VH mediated the effects of ANC and maternal age on vaccination uptake, reducing uptake likelihood.

Conclusions:

• Targeted, context-specific interventions are necessary to address parental VH.
• Improving access to ANC and facility-based delivery may help reduce VH and increase vaccine acceptance.
• Strategies should consider socio-demographic and child-specific factors influencing parental decisions on vaccination.