Abstract

Vaccine uptake is one of the indicators that has been used to guide immunization programs. This study aimed to evaluate whether measles vaccine uptake is predicted by measles vaccine hesitancy. A community-based cross-sectional study was conducted in urban districts in Khartoum state in February 2019. Measles vaccine uptake among children was measured as either fully vaccinated or partially/not vaccinated. The Parent Attitudes about Childhood Vaccines (PACV) scale was used to measure measles vaccine hesitancy. Multivariate logistic regression was run to identify the predictors of measles vaccination uptake, controlling for sociodemographic variables, and the adjusted odds ratios (aORs) with 95% CI were calculated. The receiver operator characteristic (ROC) curve was created, and the area under the curve (AUC) for the PACV was computed. Data were collected from 495 participants. We found that measles vaccine hesitancy (PACV scores) predicts the uptake of measles vaccine after controlling for other potential social confounders, such as the mother’s age and the number of children (aOR 1.055; 95% CI 1.028–1.028). Additionally, the ROC for the PACV yielded an area under the curve (AUC 0.686 (95% CI 0.620–0.751; p < 0.001)). Our findings show that measles vaccine hesitancy in Sudan directly influences the uptake of the measles vaccine. Addressing the determinants of vaccine hesitancy through communication strategies will improve vaccine uptake.

Highlights

  • Measles vaccination prevented about 23 million deaths worldwide between 2000 and2018

  • The mean age of the mothers who participated in the study was 31.14 (SD = 5.73)

  • We found that measles vaccine hesitancy (PACV scores) predicted the uptake of measles vaccine (b = 0.053; Waldχ2 = 16.812; p-value < 0.00; adjusted odds ratios (aORs) = 1.054 (95% C.I, 1.028–1.081))

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Summary

Introduction

73% decline in measles-related deaths during the same period [1]. Health Organization (WHO) reported a 300% increase in measles cases worldwide in the first quarter of 2019 compared to the same period in 2018 [2,3]. It has been reported that measles cases increased by 246% in the African region in 2018 compared to 2016. In countries with refugee camps and internally displaced people, measles ranks among the top causes of child deaths, with case–fatality ratios between 20% and 30% [4]. Sudan has witnessed measles outbreaks in different parts of the country in the past couple of years, with an increase of 649% in the number of confirmed cases (4978 in 2018) compared to 2017 [3]

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