Dengue vaccine acceptability in Peru: A mixed-methods study in two dengue-endemic Peruvian cities

Area of Science:

• Public Health
• Vaccinology
• Infectious Diseases

Background:

• Dengue fever is a significant public health issue in Peru, with frequent outbreaks in Piura and Iquitos.
• Limited dengue control options necessitate exploring new strategies like vaccination.
• Community perceptions and barriers to dengue vaccine uptake are not well understood.

Purpose of the Study:

• To assess community perceptions and acceptability of a hypothetical dengue vaccine in Peru.
• To identify factors influencing vaccine hesitancy towards a dengue vaccine.
• To inform the development of effective dengue vaccination strategies.

Main Methods:

• A mixed-methods study combining focus group discussions (n=147) and a quantitative survey (n=883) in Piura and Iquitos.
• The 5C's Framework of Vaccine Hesitancy guided the exploration of acceptability and concerns.
• Vaccine acceptability was measured using a theory-driven, multi-item outcome, and multivariable logistic regression analyzed factors associated with uncertainty.

Main Results:

• 81.9% of participants were classified as "acceptors" of a future dengue vaccine, while 14.5% were "unsure" and 3.6% were "refusers".
• Qualitative data highlighted the need for clear information on vaccine efficacy, eligibility, and side effects from trusted health professionals.
• Vaccine uncertainty was linked to negative views on COVID-19 vaccination, higher education, reduced confidence in vaccine development, lower trust in benefits, and less willingness to pay.

Conclusions:

• While dengue vaccine acceptance is high, uncertainty stems from confidence, convenience, and communication issues.
• Mistrust in vaccines, potentially exacerbated by COVID-19 vaccine experiences, can hinder dengue vaccine acceptance.
• Tailored communication, community engagement with trusted leaders, and accessible delivery are crucial for successful dengue vaccination campaigns.