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Published on: December 1, 2017
A qualitative assessment of influenza vaccine uptake among children in Kenya
Nzisa Liku1, Caroline Mburu2, Kathryn E Lafond3
1Influenza Program, U.S. Centers for Disease Control and Prevention, Nairobi, Kenya.
Insights
Influenza vaccination acceptance in Kenya was high among caregivers, despite some hesitancy due to misconceptions and convenience factors. Effective communication strategies can increase vaccine uptake for children.
Area of Science:
- Public Health
- Vaccinology
- Infectious Diseases
Background:
- Influenza is a major cause of acute respiratory infections in children under 5.
- Kenya's Expanded Programme on Immunization (KEPI) does not currently include the influenza vaccine.
- Children under 5 are at higher risk for severe influenza disease.
Purpose of the Study:
- To assess factors influencing influenza vaccine acceptance and hesitancy among caregivers in Kenya.
- To inform the potential roll-out of a national influenza vaccination program.
- To understand community and healthcare worker perspectives on influenza vaccination.
Main Methods:
- Semi-structured questionnaires were used for data collection.
- Eight focus group discussions and twelve key informant interviews were conducted.
- Thematic analysis employed the World Health Organization's "3 Cs" model of vaccine hesitancy.
Main Results:
- Influenza vaccine was generally well-received, but concerns about confidence, complacency, and convenience were noted.
- Misconceptions about the vaccine's introduction and disease severity fueled hesitancy.
- The COVID-19 pandemic and concerns about the number of recommended vaccines impacted uptake.
Conclusions:
- Caregiver vaccination of children indicates that hesitancy can coexist with acceptance.
- Targeted communication strategies can address misconceptions and boost vaccine confidence.
- Efforts to increase confidence and reduce misconceptions are crucial for improving influenza vaccine uptake.
Background:
Influenza is a significant contributor to acute respiratory infections (ARI), and children < 5 years are at increased risk of severe influenza disease. In Kenya the influenza vaccine is not included in the Kenya Expanded Programme on Immunization (KEPI). To inform roll-out of a national influenza vaccination program, we implemented an influenza vaccine demonstration project in Nakuru and Mombasa counties in Kenya from 2019 to 2021 and set out to establish factors driving influenza vaccine acceptance and hesitancy among caregivers of children aged 6-23 months.
Methods:
Using semi-structured questionnaires, we conducted eight focus group discussions among community members and twelve key informant interviews among healthcare workers to elicit both lay and expert opinions. Thematic analysis of the interviews was conducted using the World Health Organization's "3 Cs" model of vaccine hesitancy to determine reasons for acceptance or hesitancy of the influenza vaccine.
Results:
The influenza vaccine was well received among community members and healthcare workers though concerns were raised. Vaccine hesitancy was fuelled by misconceptions about reasons for introducing the vaccine (confidence), perceptions that influenza was not a serious disease (complacency) and administrative fees required at some facilities (convenience). Despite the use of various advocacy, communication and social mobilisation strategies targeted at educating the community on the influenza disease and importance of vaccination, there remained a perception of inadequate reach of the sensitization among some community members. Contextual factors such as the COVID-19 pandemic affected uptake, and parents expressed concern over the growing number of vaccines recommended for children.
Conclusion:
Despite lingering concerns, caregivers had their children vaccinated indicating that vaccine hesitancy exists, even among those who accepted the vaccine for their children. Efforts targeted at increasing confidence in and reducing misconceptions towards vaccines through effective communication strategies, are likely to lead to increased vaccine uptake.
