Using the Social-Ecological Model to Assess Vaccine Hesitancy and Refusal in a Highly Religious Lower-Middle-Income...

Area of Science:

• Public Health
• Sociology
• Health Communication

Background:

• Vaccine hesitancy and refusal pose significant challenges to public health initiatives.
• The Social-Ecological Model (SEM) provides a framework for understanding complex health behaviors.

Purpose of the Study:

• To investigate factors associated with vaccine hesitancy and refusal in Indonesia.
• To apply the Social-Ecological Model to analyze these factors.

Main Methods:

• An online survey collected data on demographics, religiosity, family dynamics, and perceptions of public health efforts.
• Data were analyzed to identify associations with vaccine hesitancy and refusal rates.

Main Results:

• Income, sex, and perceived privacy threats were linked to vaccine hesitancy.
• Beliefs about religious groups' vaccination experiences and perceived religious power influenced hesitancy and refusal.
• Structural barriers like transportation and distance were strongly associated with vaccine hesitancy and refusal.
• Religious leaders significantly impacted vaccination decisions, and vaccine refusers were more likely to share unverified information.

Conclusions:

• Cultural and structural factors significantly influence vaccine hesitancy and refusal in Indonesia.
• The SEM is a valuable framework for developing targeted, multi-level interventions.
• Collaboration among stakeholders is essential for improving community health outcomes through vaccination programs.