Factors Associated with Vaccine Refusal (Polio and Routine Immunization) in High-Risk Areas of Pakistan: A Matched Case-Control Study
Background: Pakistan has subpar childhood immunization rates and immunization activities have faced several challenges over the past years. We evaluated the social-behavioral and cultural barriers and risk factors for refusal of polio, Routine Immunization (RI), or both in high-risk areas of poliovi...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-05-01
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| Series: | Vaccines |
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| Online Access: | https://www.mdpi.com/2076-393X/11/5/947 |
| _version_ | 1797598135660314624 |
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| author | Sajid Bashir Soofi Khadija Vadsaria Sara Mannan Muhammad Atif Habib Farhana Tabassum Imtiaz Hussain Sajid Muhammad Khalid Feroz Imran Ahmed Muhammad Islam Zulfiqar A. Bhutta |
| author_facet | Sajid Bashir Soofi Khadija Vadsaria Sara Mannan Muhammad Atif Habib Farhana Tabassum Imtiaz Hussain Sajid Muhammad Khalid Feroz Imran Ahmed Muhammad Islam Zulfiqar A. Bhutta |
| author_sort | Sajid Bashir Soofi |
| collection | DOAJ |
| description | Background: Pakistan has subpar childhood immunization rates and immunization activities have faced several challenges over the past years. We evaluated the social-behavioral and cultural barriers and risk factors for refusal of polio, Routine Immunization (RI), or both in high-risk areas of poliovirus circulation. Methods: A matched case-control study was conducted from April to July 2017 in eight super high-risk Union Councils of five towns in Karachi, Pakistan. A total of 3 groups, each with 250 cases, including refusals for the Oral Polio Vaccine (OPV) in campaigns (national immunization days and supplementary immunization activities), RI, and both, were matched with 500 controls and identified using surveillance records. Sociodemographic characteristics, household information, and immunization history were assessed. Study outcomes included social-behavioral and cultural barriers and reasons for vaccine refusal. Data were analyzed in STATA using conditional logistic regression. Results: RI refusal was associated with illiteracy and fear of the vaccine’s adverse effects, while OPV refusals were linked to the mother’s decision authority and the assumption that the OPV caused infertility. Conversely, higher socioeconomic status (SES) and knowledge of and willingness to vaccinate with Inactivated Polio Vaccine (IPV) were inversely associated with RI; and lower SES, walking to the vaccination point, knowledge of IPV, and an understanding of contracting polio were inversely associated with OPV refusals, with the latter two also inversely associated with complete vaccine refusal. Conclusion: Education, knowledge and understanding of vaccines, and socioeconomic determinants influenced OPV and RI refusals among children. Effective interventions are needed to address knowledge gaps and misconceptions among parents. |
| first_indexed | 2024-03-11T03:15:04Z |
| format | Article |
| id | doaj.art-0a87632f0f014f7a906378e8bc3cb00f |
| institution | Directory Open Access Journal |
| issn | 2076-393X |
| language | English |
| last_indexed | 2024-03-11T03:15:04Z |
| publishDate | 2023-05-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Vaccines |
| spelling | doaj.art-0a87632f0f014f7a906378e8bc3cb00f2023-11-18T03:36:09ZengMDPI AGVaccines2076-393X2023-05-0111594710.3390/vaccines11050947Factors Associated with Vaccine Refusal (Polio and Routine Immunization) in High-Risk Areas of Pakistan: A Matched Case-Control StudySajid Bashir Soofi0Khadija Vadsaria1Sara Mannan2Muhammad Atif Habib3Farhana Tabassum4Imtiaz Hussain5Sajid Muhammad6Khalid Feroz7Imran Ahmed8Muhammad Islam9Zulfiqar A. Bhutta10Centre of Excellence in Women and Child Health, Aga Khan University, Karachi 74800, PakistanCentre of Excellence in Women and Child Health, Aga Khan University, Karachi 74800, PakistanCentre of Excellence in Women and Child Health, Aga Khan University, Karachi 74800, PakistanCentre of Excellence in Women and Child Health, Aga Khan University, Karachi 74800, PakistanInstitute for Global Health and Development, Aga Khan University, Karachi 74800, PakistanCentre of Excellence in Women and Child Health, Aga Khan University, Karachi 74800, PakistanCentre of Excellence in Women and Child Health, Aga Khan University, Karachi 74800, PakistanCentre of Excellence in Women and Child Health, Aga Khan University, Karachi 74800, PakistanCentre of Excellence in Women and Child Health, Aga Khan University, Karachi 74800, PakistanCentre for Global Child Health, The Hospital for Sick Children, 686 Bay Street, Toronto, ON M5G 0A4, CanadaCentre of Excellence in Women and Child Health, Aga Khan University, Karachi 74800, PakistanBackground: Pakistan has subpar childhood immunization rates and immunization activities have faced several challenges over the past years. We evaluated the social-behavioral and cultural barriers and risk factors for refusal of polio, Routine Immunization (RI), or both in high-risk areas of poliovirus circulation. Methods: A matched case-control study was conducted from April to July 2017 in eight super high-risk Union Councils of five towns in Karachi, Pakistan. A total of 3 groups, each with 250 cases, including refusals for the Oral Polio Vaccine (OPV) in campaigns (national immunization days and supplementary immunization activities), RI, and both, were matched with 500 controls and identified using surveillance records. Sociodemographic characteristics, household information, and immunization history were assessed. Study outcomes included social-behavioral and cultural barriers and reasons for vaccine refusal. Data were analyzed in STATA using conditional logistic regression. Results: RI refusal was associated with illiteracy and fear of the vaccine’s adverse effects, while OPV refusals were linked to the mother’s decision authority and the assumption that the OPV caused infertility. Conversely, higher socioeconomic status (SES) and knowledge of and willingness to vaccinate with Inactivated Polio Vaccine (IPV) were inversely associated with RI; and lower SES, walking to the vaccination point, knowledge of IPV, and an understanding of contracting polio were inversely associated with OPV refusals, with the latter two also inversely associated with complete vaccine refusal. Conclusion: Education, knowledge and understanding of vaccines, and socioeconomic determinants influenced OPV and RI refusals among children. Effective interventions are needed to address knowledge gaps and misconceptions among parents.https://www.mdpi.com/2076-393X/11/5/947polioroutine vaccinationrefusalhigh-risk areasPakistan |
| spellingShingle | Sajid Bashir Soofi Khadija Vadsaria Sara Mannan Muhammad Atif Habib Farhana Tabassum Imtiaz Hussain Sajid Muhammad Khalid Feroz Imran Ahmed Muhammad Islam Zulfiqar A. Bhutta Factors Associated with Vaccine Refusal (Polio and Routine Immunization) in High-Risk Areas of Pakistan: A Matched Case-Control Study Vaccines polio routine vaccination refusal high-risk areas Pakistan |
| title | Factors Associated with Vaccine Refusal (Polio and Routine Immunization) in High-Risk Areas of Pakistan: A Matched Case-Control Study |
| title_full | Factors Associated with Vaccine Refusal (Polio and Routine Immunization) in High-Risk Areas of Pakistan: A Matched Case-Control Study |
| title_fullStr | Factors Associated with Vaccine Refusal (Polio and Routine Immunization) in High-Risk Areas of Pakistan: A Matched Case-Control Study |
| title_full_unstemmed | Factors Associated with Vaccine Refusal (Polio and Routine Immunization) in High-Risk Areas of Pakistan: A Matched Case-Control Study |
| title_short | Factors Associated with Vaccine Refusal (Polio and Routine Immunization) in High-Risk Areas of Pakistan: A Matched Case-Control Study |
| title_sort | factors associated with vaccine refusal polio and routine immunization in high risk areas of pakistan a matched case control study |
| topic | polio routine vaccination refusal high-risk areas Pakistan |
| url | https://www.mdpi.com/2076-393X/11/5/947 |
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