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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| Format: | Article |
| Language: | English |
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MDPI AG
2021-10-01
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| Series: | Vaccines |
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| Online Access: | https://www.mdpi.com/2076-393X/9/11/1231 |
| _version_ | 1797508295455408128 |
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| 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 |
| collection | DOAJ |
| 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. |
| first_indexed | 2024-03-10T05:00:05Z |
| format | Article |
| id | doaj.art-4eebd620e793422bbe5bf18cccc32c0a |
| institution | Directory Open Access Journal |
| issn | 2076-393X |
| language | English |
| last_indexed | 2024-03-10T05:00:05Z |
| publishDate | 2021-10-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Vaccines |
| spelling | doaj.art-4eebd620e793422bbe5bf18cccc32c0a2023-11-23T01:51:22ZengMDPI AGVaccines2076-393X2021-10-01911123110.3390/vaccines9111231Caregivers’ Willingness to Vaccinate Their Children against Childhood Diseases and Human Papillomavirus: A Cross-Sectional Study on Vaccine Hesitancy in MalawiGbadebo Collins Adeyanju0Philipp Sprengholz1Cornelia Betsch2Tene-Alima Essoh3Psychology and Infectious Disease Lab (PIDI), Media and Communication Science, University of Erfurt, Nordhäuser Straße 63, 99089 Erfurt, GermanyPsychology and Infectious Disease Lab (PIDI), Media and Communication Science, University of Erfurt, Nordhäuser Straße 63, 99089 Erfurt, GermanyPsychology and Infectious Disease Lab (PIDI), Media and Communication Science, University of Erfurt, Nordhäuser Straße 63, 99089 Erfurt, GermanyAgence de Médecine Préventive, Regional Directorate for Africa, Abidjan 08 BP 660, Côte d’IvoireBackground: 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.https://www.mdpi.com/2076-393X/9/11/1231immunizationvaccine hesitancyvaccine demandvaccinationMalawidrivers |
| spellingShingle | 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 Vaccines immunization vaccine hesitancy vaccine demand vaccination Malawi drivers |
| title | 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_short | 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 |
| topic | immunization vaccine hesitancy vaccine demand vaccination Malawi drivers |
| url | https://www.mdpi.com/2076-393X/9/11/1231 |
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