Abstract
BackgroundVaccine hesitancy has been recognized as an important barrier to timely vaccinations around the world, including in sub-Saharan Africa. In Tanzania, 1 in 4 children is not fully vaccinated. The objective of this mixed methods study was to describe and contextualize parental concerns towards vaccines in Tanzania.MethodsBetween 2016 and 2017, we conducted a cross-sectional survey (n = 134) and four focus group discussions (FGDs, n = 38) with mothers of children under 2 years of age residing in Mtwara region in Southern Tanzania. The survey and FGDs assessed vaccination knowledge and concerns and barriers to timely vaccinations. Vaccination information was obtained from government-issued vaccination cards.ResultsIn the cross-sectional survey, 72% of mothers reported missed or delayed receipt of vaccines for their child. Although vaccine coverage was high, timeliness of vaccinations was lower and varied by vaccine. Rural mothers reported more vaccine-related concerns compared to urban mothers; literacy and access to information were identified as key drivers of the difference. Mothers participating in FGDs indicated high perceived risk of vaccine-preventable illnesses, but expressed concerns related to poor geographic accessibility, unreliability of services, and missed opportunities for vaccinations resulting from provider efforts to minimize vaccine wastage.ConclusionsFindings from our cross-sectional survey indicate the presence of vaccination delays and maternal concerns related to childhood vaccines in Tanzania. In FGDs, mothers raised issues related to convenience more often than issues related to vaccine confidence or complacency. Further research is necessary to understand how these issues may contribute to the emergence and persistence of vaccine hesitancy and to identify effective mitigation strategies.
Highlights
Vaccine hesitancy has been recognized as an important barrier to timely vaccinations around the world, including in sub-Saharan Africa
Several drivers of vaccine hesitancy have been identified in the literature, including factors related to parental confidence in vaccines, complacency towards vaccines and vaccination programs, and the convenience of accessing vaccines [13]
The Tanzania Ministry of Health, Community Development, Gender, Elderly and Children and the national Immunization and Vaccine Development (IVD) program oversee the provision of routine childhood vaccinations in Mtwara Region
Summary
Vaccine hesitancy has been recognized as an important barrier to timely vaccinations around the world, including in sub-Saharan Africa. Recurring vaccine-preventable outbreaks in various regions of SSA and persistent vaccine-related concerns among parents have raised worries that gains made by immunization programs in the coverage of childhood vaccines may be reversed [3,4,5,6,7]. In light of these concerns, there is a growing emphasis on identifying and mitigating vaccine hesitancy - the decision of parents to decline or delay vaccinations for their children [8, 9].
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