Determinants of Measles Vaccine Hesitancy among Sudanese Parents in Khartoum State, Sudan: A Cross-Sectional Study

Abstract

Determinants of vaccine hesitancy are not yet well understood. This study aims to assess measles vaccine hesitancy and characterize its determinants among Sudanese parents in Omdurman in Khartoum State. A community-based cross-sectional quantitative study was conducted in Khartoum State in February 2019. The Parent Attitudes about Childhood Vaccination (PACV) was used to measure measles vaccine hesitancy. Questions about the sociodemographic characteristics of the family, the perception of the parents about the measles vaccine, and the parental exposure to information were asked. Proportions of vaccine hesitancy and coefficients of linear regression were computed. Five hundred parents were recruited for the study. We found that a significant proportion of participants (about 1 in 5 parents) had hesitations regarding the measles vaccine. Significant predictors of measles vaccine hesitancy were parental exposure to anti-vaccination information or materials (β = −0.478, p-value < 0.001), the parents’ perception of the effectiveness of measles vaccines (β = 0.093, p-value = 0.020), the age of the mother (β = 0.112, p-value = 0.017), the birth rank of the child (β = −0.116, p-value = 0.015), and the total number of the children in the family (β = 0.098, p-value = 0.013). Vaccination access issues were the common justification for parental vaccination hesitancy. Our findings indicate that investment in vaccine communication as well as addressing access issues might be an effective intervention for improving measles vaccine acceptance and, ultimately, measles vaccine coverage.

Vaccine Hesitancy among Parents and Its Association with the Uptake of Measles Vaccine in Urban Settings in Khartoum State, Sudan

“…Given the complexity of the relationship between supply-side and demand-side factors and measles vaccine hesitancy as suggested by previous studies in Sudan [29,43], different approaches should be adopted to address vaccine hesitancy to increase the uptake of measles vaccine in Sudan. For the demand side, previous findings in Sudan have shown that parental exposure to anti-vaccine information is predicting measles vaccine hesitancy among them [43]. We suggest that communication strategies be theory and evidence based to address the behavioral determinants of vaccine hesitancy, such as knowledge of, beliefs about, and attitude toward measles and measles vaccine.…”

“…The reasons behind the low uptake of the measles vaccine are not fully understood. Data from Sudan suggest the existence of measles vaccine hesitancy in Sudan, with several social and behavioral drivers behind this hesitancy [26,29,43]. In this study, we aimed to evaluate whether measles vaccine uptake is predicted by measles vaccine hesitancy.…”

Perceived Vaccine Availability and the Uptake of Measles Vaccine in Sudan: The Mediating Role of Vaccination Hesitancy

“…This study is part of a large research project about measles vaccine hesitancy in Sudan [ 21 , 22 ]. The sample size was calculated for the whole research using a power analysis for the association between measles vaccine hesitancy and the measles vaccination status (outcome), which showed that at least 386 participants were needed to yield an 80% power to detect an odds ratio of 1.7 at alpha level (5%).…”

“…The national measles vaccination coverage is the lowest among all child vaccinations (i.e., for the first and the second dose of measles-containing vaccine, 88% and 72%, respectively) and is lower than the required level of 95% coverage for measles elimination [ 20 ]. Previous studies in Sudan showed the existence of measles vaccine hesitancy is attributed to different drivers including vaccination access-related issues, such as the parental perception that measles vaccination services are unavailable and inaccessible [ 7 , 21 ]. Additionally, a study found that the uptake of the measles vaccine among children is predicted by their parental hesitancy toward the measles vaccine [ 22 ].…”

Perceived Vaccine Access Issues and the Uptake of Measles Vaccine in Sudan: The Mediating Role of Vaccination Hesitancy

“…The national measles vaccination coverage is the lowest among all child vaccinations (i.e., the first and the second dose of measles-containing vaccine, 88%, and 72%, respectively). [20] Previous studies in Sudan showed the existence of measles vaccine hesitancy is attributed to different drivers including vaccination access-related issues such as the parental perception that measles vaccination services are unavailable and inaccessible [7,21]. Additionally, a study found that the uptake of the measles vaccine among children is predicted by their parental hesitancy toward the measles vaccine [22].…”