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Examining enablers of vaccine hesitancy toward routine childhood and adolescent vaccination in Malawi

Examining enablers of vaccine hesitancy toward routine childhood and adolescent vaccination in Malawi
Examining enablers of vaccine hesitancy toward routine childhood and adolescent vaccination in Malawi

BACKGROUND: The contribution of vaccination to global public health and community wellbeing has been described as one of the greatest success stories of modern medicine. However, 13.5 million children still miss at least one of their routine vaccinations, and this contributes to about 1.5 million deaths from vaccine-preventable diseases. One of the contributing factors has been associated with vaccine hesitancy. Vaccine hesitancy is the delay or refusal of vaccines despite their availability. The study explored factors from multiple perspectives that influence hesitancy among caregivers of children and adolescent girls eligible for childhood routine immunisation and the Human Papillomavirus vaccine in Malawi.

METHODS: The methodology used was qualitative such as key informant interviews and focus-group discussion. Information was obtained from caregivers, community and religious leaders, leaders of civil society groups, teachers in schools where Human Papillomavirus vaccine were piloted, healthcare workers, national and district-level officials of the expanded program on immunisation. There were 25 key informant interviews and two focus-group discussions, with 13 participants. The study was conducted between April to May 2020. The Interviews and discussions were audio-recorded, transcribed, and analysed using a thematic content approach.

RESULTS: Most vaccine-hesitancy drivers for routine immunisation were also relevant for the HPV vaccine. The drivers included inadequate awareness of the vaccination schedule, rumours and conspiracy theories exacerbated by religious beliefs, low literacy levels of caregivers, distance and transport to the vaccination clinic, gender role and a disconnect between community healthcare workers and community leaders.

CONCLUSIONS: The study demonstrated that a network of factors determines vaccine hesitancy for childhood Routine Immunisation and Human Papillomavirus, and some of them are interrelated with one another. This has implications both for current levels of vaccine acceptance and the introduction of any new vaccine, such as those against Malaria, HIV/AIDS, HPV or COVID-19 (coronavirus disease 2019). Therefore, strategies developed to address vaccine hesitancy must be multi-component and wide-ranging.

Adolescent, COVID-19, Child, Female, Humans, Malawi, Papillomaviridae, Papillomavirus Vaccines, Vaccination, Vaccination Hesitancy
2397-0642
Adeyanju, Gbadebo Collins
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Betsch, Cornelia
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Adamu, Abdu A
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Gumbi, Khadijah Sanusi
372735fb-fd0c-4a94-b1ae-5d7898df5959
Head, Michael G
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Aplogan, Aristide
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Tall, Haoua
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Essoh, Tene-Alima
cdf7f152-5ce3-49d6-b8dc-94e4f9b7e8d6
Adeyanju, Gbadebo Collins
8c1f3e0f-2f2b-4410-8db1-210787105a4c
Betsch, Cornelia
e955a611-df7a-45a0-b189-0557566fd224
Adamu, Abdu A
69f6cbdb-97b1-4357-afa1-cab2e29ee8d5
Gumbi, Khadijah Sanusi
372735fb-fd0c-4a94-b1ae-5d7898df5959
Head, Michael G
67ce0afc-2fc3-47f4-acf2-8794d27ce69c
Aplogan, Aristide
3a30902e-7399-4ddc-9bd7-ed0a63309177
Tall, Haoua
39fb806f-d8cb-4a76-aebb-3ca34822cde0
Essoh, Tene-Alima
cdf7f152-5ce3-49d6-b8dc-94e4f9b7e8d6

Adeyanju, Gbadebo Collins, Betsch, Cornelia, Adamu, Abdu A, Gumbi, Khadijah Sanusi, Head, Michael G, Aplogan, Aristide, Tall, Haoua and Essoh, Tene-Alima (2022) Examining enablers of vaccine hesitancy toward routine childhood and adolescent vaccination in Malawi. Global health research and policy, 7 (1), [28]. (doi:10.1186/s41256-022-00261-3).

Record type: Article

Abstract

BACKGROUND: The contribution of vaccination to global public health and community wellbeing has been described as one of the greatest success stories of modern medicine. However, 13.5 million children still miss at least one of their routine vaccinations, and this contributes to about 1.5 million deaths from vaccine-preventable diseases. One of the contributing factors has been associated with vaccine hesitancy. Vaccine hesitancy is the delay or refusal of vaccines despite their availability. The study explored factors from multiple perspectives that influence hesitancy among caregivers of children and adolescent girls eligible for childhood routine immunisation and the Human Papillomavirus vaccine in Malawi.

METHODS: The methodology used was qualitative such as key informant interviews and focus-group discussion. Information was obtained from caregivers, community and religious leaders, leaders of civil society groups, teachers in schools where Human Papillomavirus vaccine were piloted, healthcare workers, national and district-level officials of the expanded program on immunisation. There were 25 key informant interviews and two focus-group discussions, with 13 participants. The study was conducted between April to May 2020. The Interviews and discussions were audio-recorded, transcribed, and analysed using a thematic content approach.

RESULTS: Most vaccine-hesitancy drivers for routine immunisation were also relevant for the HPV vaccine. The drivers included inadequate awareness of the vaccination schedule, rumours and conspiracy theories exacerbated by religious beliefs, low literacy levels of caregivers, distance and transport to the vaccination clinic, gender role and a disconnect between community healthcare workers and community leaders.

CONCLUSIONS: The study demonstrated that a network of factors determines vaccine hesitancy for childhood Routine Immunisation and Human Papillomavirus, and some of them are interrelated with one another. This has implications both for current levels of vaccine acceptance and the introduction of any new vaccine, such as those against Malaria, HIV/AIDS, HPV or COVID-19 (coronavirus disease 2019). Therefore, strategies developed to address vaccine hesitancy must be multi-component and wide-ranging.

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s41256-022-00261-3 - Version of Record
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Accepted/In Press date: 6 August 2022
Published date: 18 August 2022
Additional Information: © 2022. The Author(s).
Keywords: Adolescent, COVID-19, Child, Female, Humans, Malawi, Papillomaviridae, Papillomavirus Vaccines, Vaccination, Vaccination Hesitancy

Identifiers

Local EPrints ID: 470001
URI: http://eprints.soton.ac.uk/id/eprint/470001
ISSN: 2397-0642
PURE UUID: 9c21cd26-0721-4fd3-a798-1bf002fba3e1
ORCID for Michael G Head: ORCID iD orcid.org/0000-0003-1189-0531

Catalogue record

Date deposited: 29 Sep 2022 17:02
Last modified: 30 Sep 2022 01:46

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Contributors

Author: Gbadebo Collins Adeyanju
Author: Cornelia Betsch
Author: Abdu A Adamu
Author: Khadijah Sanusi Gumbi
Author: Michael G Head ORCID iD
Author: Aristide Aplogan
Author: Haoua Tall
Author: Tene-Alima Essoh

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