Caregivers’ Willingness to Vaccinate Their Children against Childhood Diseases and Human Papillomavirus: A Cross-Sectional Study on Vaccine Hesitancy in Malawi

Background: Vaccines are among the most effective and cost-efficient public health interventions for promoting child health. However, uptake is considerably affected by vaccine hesitancy. An example is Malawi, with a decline in second vaccine doses and the highest cervical cancer incidence and morta...

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Autores principales:	Gbadebo Collins Adeyanju, Philipp Sprengholz, Cornelia Betsch, Tene-Alima Essoh
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	immunization vaccine hesitancy vaccine demand vaccination Malawi drivers Medicine R
Acceso en línea:	https://doaj.org/article/4eebd620e793422bbe5bf18cccc32c0a
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spelling	oai:doaj.org-article:4eebd620e793422bbe5bf18cccc32c0a2021-11-25T19:10:18ZCaregivers’ Willingness to Vaccinate Their Children against Childhood Diseases and Human Papillomavirus: A Cross-Sectional Study on Vaccine Hesitancy in Malawi10.3390/vaccines91112312076-393Xhttps://doaj.org/article/4eebd620e793422bbe5bf18cccc32c0a2021-10-01T00:00:00Zhttps://www.mdpi.com/2076-393X/9/11/1231https://doaj.org/toc/2076-393XBackground: Vaccines are among the most effective and cost-efficient public health interventions for promoting child health. However, uptake is considerably affected by vaccine hesitancy. An example is Malawi, with a decline in second vaccine doses and the highest cervical cancer incidence and mortality rate in Sub-Saharan Africa. Understanding vaccine hesitancy is especially important when new vaccines are introduced. This study explores factors contributing to vaccine hesitancy for routine childhood immunization and the human papillomavirus vaccine in Malawi. Methods: The study used a cross-sectional survey design targeting caregivers of children under five years old and adolescent girls. The sample population was derived using three inclusion criteria: one district with low vaccine uptake (Dowa), one district with high vaccine uptake (Salima), and one district where human papillomavirus vaccine was piloted earlier (Zomba). A convenience sample of one primary and one secondary health facility was selected within each district, and participants were systematically included (<i>n</i> = 600). The measures were based on 5C scale for measuring vaccine hesitancy. Multiple regression analyses were performed to explore vaccination intention predictors. Results: Confidence in vaccine safety was the strongest predictor of routine childhood immunization, followed by constraints due to everyday stress. Caregivers had lower confidence in vaccine safety and efficacy when they believed rumors and misinformation and were unemployed. Confidence was higher for those who had more trust in healthcare workers. Age, gender, religion, education, employment, belief in rumors, and trust in healthcare workers were considered predictors of vaccination intention. A husband’s positive attitude (approval) increased childhood vaccination intention. For human papillomavirus, vaccination intentions were higher for those with lower education, more trust in healthcare workers, lower complacency, and a lower tendency toward calculating the benefits and risks of vaccination. Knowledge of human papillomavirus did not increase vaccination intention, but the need to attain a husband’s approval did. Being a young adult and unemployed increased belief in rumors, while trust in healthcare workers reduced the belief. Conclusions: This study provides good insights into the drivers of vaccine hesitancy across different contexts in Malawi. However, further studies are necessary to understand low risk perception among elderly people and the declining trend in second vaccine doses.Gbadebo Collins AdeyanjuPhilipp SprengholzCornelia BetschTene-Alima EssohMDPI AGarticleimmunizationvaccine hesitancyvaccine demandvaccinationMalawidriversMedicineRENVaccines, Vol 9, Iss 1231, p 1231 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	immunization vaccine hesitancy vaccine demand vaccination Malawi drivers Medicine R
spellingShingle	immunization vaccine hesitancy vaccine demand vaccination Malawi drivers Medicine R Gbadebo Collins Adeyanju Philipp Sprengholz Cornelia Betsch Tene-Alima Essoh Caregivers’ Willingness to Vaccinate Their Children against Childhood Diseases and Human Papillomavirus: A Cross-Sectional Study on Vaccine Hesitancy in Malawi
description	Background: Vaccines are among the most effective and cost-efficient public health interventions for promoting child health. However, uptake is considerably affected by vaccine hesitancy. An example is Malawi, with a decline in second vaccine doses and the highest cervical cancer incidence and mortality rate in Sub-Saharan Africa. Understanding vaccine hesitancy is especially important when new vaccines are introduced. This study explores factors contributing to vaccine hesitancy for routine childhood immunization and the human papillomavirus vaccine in Malawi. Methods: The study used a cross-sectional survey design targeting caregivers of children under five years old and adolescent girls. The sample population was derived using three inclusion criteria: one district with low vaccine uptake (Dowa), one district with high vaccine uptake (Salima), and one district where human papillomavirus vaccine was piloted earlier (Zomba). A convenience sample of one primary and one secondary health facility was selected within each district, and participants were systematically included (<i>n</i> = 600). The measures were based on 5C scale for measuring vaccine hesitancy. Multiple regression analyses were performed to explore vaccination intention predictors. Results: Confidence in vaccine safety was the strongest predictor of routine childhood immunization, followed by constraints due to everyday stress. Caregivers had lower confidence in vaccine safety and efficacy when they believed rumors and misinformation and were unemployed. Confidence was higher for those who had more trust in healthcare workers. Age, gender, religion, education, employment, belief in rumors, and trust in healthcare workers were considered predictors of vaccination intention. A husband’s positive attitude (approval) increased childhood vaccination intention. For human papillomavirus, vaccination intentions were higher for those with lower education, more trust in healthcare workers, lower complacency, and a lower tendency toward calculating the benefits and risks of vaccination. Knowledge of human papillomavirus did not increase vaccination intention, but the need to attain a husband’s approval did. Being a young adult and unemployed increased belief in rumors, while trust in healthcare workers reduced the belief. Conclusions: This study provides good insights into the drivers of vaccine hesitancy across different contexts in Malawi. However, further studies are necessary to understand low risk perception among elderly people and the declining trend in second vaccine doses.
format	article
author	Gbadebo Collins Adeyanju Philipp Sprengholz Cornelia Betsch Tene-Alima Essoh
author_facet	Gbadebo Collins Adeyanju Philipp Sprengholz Cornelia Betsch Tene-Alima Essoh
author_sort	Gbadebo Collins Adeyanju
title	Caregivers’ Willingness to Vaccinate Their Children against Childhood Diseases and Human Papillomavirus: A Cross-Sectional Study on Vaccine Hesitancy in Malawi
title_short	Caregivers’ Willingness to Vaccinate Their Children against Childhood Diseases and Human Papillomavirus: A Cross-Sectional Study on Vaccine Hesitancy in Malawi
title_full	Caregivers’ Willingness to Vaccinate Their Children against Childhood Diseases and Human Papillomavirus: A Cross-Sectional Study on Vaccine Hesitancy in Malawi
title_fullStr	Caregivers’ Willingness to Vaccinate Their Children against Childhood Diseases and Human Papillomavirus: A Cross-Sectional Study on Vaccine Hesitancy in Malawi
title_full_unstemmed	Caregivers’ Willingness to Vaccinate Their Children against Childhood Diseases and Human Papillomavirus: A Cross-Sectional Study on Vaccine Hesitancy in Malawi
title_sort	caregivers’ willingness to vaccinate their children against childhood diseases and human papillomavirus: a cross-sectional study on vaccine hesitancy in malawi
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/4eebd620e793422bbe5bf18cccc32c0a
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Caregivers’ Willingness to Vaccinate Their Children against Childhood Diseases and Human Papillomavirus: A Cross-Sectional Study on Vaccine Hesitancy in Malawi

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