Abstract
BackgroundVaccine hesitancy is one of the contributors to low vaccination coverage in both developed and developing countries. Sudan is one of the countries that suffers from low measles vaccine coverage and from measles outbreaks. In order to facilitate the future development of interventions, this study aimed at exploring the opinions of Expanded Program on Immunization officers at ministries of health, WHO, UNICEF and vaccine care providers at Khartoum-based primary healthcare centers.MethodsQualitative data were collected using semi-structured interviews during the period January-March 2018. Data (i.e. quotes) were matched to the categories and the sub-categories of a framework that was developed by the WHO-SAGE Working Group called ''Determinants of Vaccine Hesitancy Matrix''.FindingsThe interviews were conducted with 14 participants. The majority of participants confirmed the existence of measles vaccine hesitancy in Khartoum state. They further identified various determinants that were grouped into three domains including contextual, groups and vaccination influences. The main contextual determinant as reported is the presence of people who can be qualified as "anti-vaccination". They mostly belong to particular religious and ethnic groups. Parents' beliefs about prevention and treatment from measles are the main determinants of the group influences. Attitude of the vaccine providers, measles vaccine schedule and its mode of delivery were the main vaccine related determinants.ConclusionMeasles vaccine hesitancy in Sudan appears complex and highly specific to local circumstances. To better understand the magnitude and the context-specific causes of measles vaccine hesitancy and to develop adapted strategies to address them, there is clearly a further need to investigate measles vaccine hesitancy among parents.
Highlights
Vaccination is recognized as one of the most cost-effective public health measures [1].It is estimated that a 60% reduction in measles mortality occurred worldwide since 1999, measles still remains a leading cause of vaccine- preventable death in children aged less than 5 years in sub- Saharan Africa. [2]Over the past twenty years, concerns have been raised regarding the spurious link between the measles, mumps, rubella (MMR) vaccines and development of autism and autism spectrum disorders (ASD) [3]
Complacency exists where perceived risks of vaccine-preventable diseases are low; convenience relates to access issues such as the physical availability, ability to understand, and vaccine confidence is defined as the level of trust in a vaccine or provider.[6]
For a further understanding of measles vaccine hesitancy in Sudan, this study aims to explore the opinions of Expanded Program on Immunization (EPI) officers/experts and front-line vaccine providers who are based in Khartoum state
Summary
Over the past twenty years, concerns have been raised regarding the spurious link between the measles, mumps, rubella (MMR) vaccines and development of autism and autism spectrum disorders (ASD) [3] Such concerns contributed to a decrease in vaccine uptake and an increase in the number of cases of many vaccine preventable diseases over the past several years in Europe and the USA [4,5,6]. Complacency exists where perceived risks of vaccine-preventable diseases are low; convenience relates to access issues such as the physical availability, ability to understand (language and health literacy), and vaccine confidence is defined as the level of trust in a vaccine or provider.[6]. For a further understanding of measles vaccine hesitancy in Sudan, this study aimed at exploring the opinions of Expanded Program on Immunization officers at ministries of health, WHO, UNICEF and vaccine care providers at Khartoum-based primary healthcare centers
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