Vaccine Refusal Research Articles

Qualitative Insights into Vaccine Uptake of Nursing Staff in Long-Term Care Facilities in Finland.

Vaccine hesitancy and refusal have undermined COVID-19 vaccination efforts of nursing staff. This study aimed to identify behavioral factors associated with COVID-19 vaccine uptake among unvaccinated nursing staff in long-term care facilities (LTCF) in Finland. Methodology: The study was based on the Theoretical Domains Framework. Data were collected through qualitative in-depth interviews among nursing staff and managers of LTCFs. The analysis was based on thematic analysis. We identified seven behavioral domains, with several themes, that reduced the staff's intention to get vaccinated: knowledge (information overload, inability to identify trustworthy information sources, lack of vaccine-specific and understandable scientific information), beliefs about consequences (incorrect perceptions about the vaccine effectiveness, and lack of trust in the safety of the vaccine), social influences (influence of family and friends), reinforcement (limited abilities of the management to encourage vaccination), beliefs about capabilities (pregnancy or desire to get pregnant), psychological factors (coping with changing opinion), and emotions (confusion, suspicion, disappointment, and fatigue). We also identified three behavioral domains that encouraged vaccine uptake: social influences (trust in health authorities), environmental context and resources (vaccination logistics), and work and professional role (professional pride). The study findings can help authorities to develop tailored vaccine promotion strategies for healthcare workers in LTCFs.

Childhood vaccine hesitancy in two regions with different socioeconomic backgrounds in Turkey.

This study investigated childhood vaccine hesitancy in two regions with different socioeconomic backgrounds in Kayseri, Turkey. The study population consisted of all people over 18 years of age admitted to two family health centers (No 65 and 103) in a city center for any reason. Participants living in the high socioeconomic status (SES) region had a significantly lower mean rating on the CVHQ (Childhood Vaccine Hesitancy Questionnaire - see below) than those living in the low SES region. Vaccine hesitancy is the main reason for vaccine refusal. Therefore, authorities should provide adequate and accurate information about the significance of vaccines to raise public awareness.

Vaccine hesitancy, parental concerns, and COVID-19 in a digital leisure context: Implications for out-of-school time

Due to the increasing prevalence of parental vaccine hesitancy or refusal, it is important to understand parental motives for vaccine hesitancy. This study examines social media conversations and commentaries regarding concerns about parenting, vaccine hesitancy, and the COVID-19 pandemic within an in-person leisure and recreation context: out-of-school time (OST) programs. A generative, probabilistic Bayesian machine learning model was used to analyze 31,925 tweets and group them into seven categories: Government, Feelings, School, Public Health, Christmas, Risk and Safety, and Families. As a result, recommendations for research and practice are discussed in connection to both OST programs and digital leisure, including a diverse range of vaccine hesitancy motivations related to children and parents, communication management strategies for OST professionals, and the impact of the politization of leisure in a digital leisure context.

Spillover of Vaccine Hesitancy into Adult COVID-19 and Influenza: The Role of Race, Religion, and Political Affiliation in the United States.

Due to its potential to lead to vaccine delays and refusals, vaccine hesitancy has attracted increased attention throughout the COVID-19 pandemic. It is crucial to investigate whether demographic patterns differ between adult general vaccine hesitancy and COVID-19 and flu vaccine non-receipt. A cross-sectional survey was conducted online in August 2022. In response to questions about vaccine hesitancy, participants indicated whether they would receive the vaccine given various safety and efficacy profiles. Through logistic regression models, we examined variations between general vaccine hesitancy and COVID-19 non-vaccination. Among the 700 participants, 49% of the respondents were classified as having general vaccine hesitancy, 17% had not received the COVID-19 vaccine, and 36% had not had flu vaccinations. In the multivariable analysis, general vaccine hesitancy and the non-receipt of COVID-19 vaccines were significantly higher in Non-Hispanic Black participants, those with no religious affiliation, and Republicans and Independents. Patterns of vaccine hesitancy and the non-receipt of the COVID-19 vaccination did not vary, indicating a substantial overlap and potential spillover in vaccine hesitancy over the course of the pandemic. Because changing people's opinions regarding vaccinations is generally a challenge, different interventions specific to demographic subgroups may be necessary.

Stuck: How Vaccine Rumors Start—and Why They Won’t Go Away

Stuck: How Vaccine Rumors Start—and Why They Won’t Go Away

Association between COVID-19 and Seasonal Influenza Vaccines to Vaccine Hesitancy, Intolerance of Uncertainty and Mental Health.

Vaccine hesitancy is a universal problem that is becoming more prevalent, ranging from partial acceptance to the complete refusal of various vaccines. The current study seeks to assess the relationship between vaccine hesitancy, intolerance of uncertainty, and mental health factors and those who were vaccinated against COVID-19 and seasonal influenza in comparison to those who did not vaccinate against both or decided to be vaccinated with only one of these vaccines. Employing a cross-sectional design, 1068 Israeli participants were recruited via social media (mainly Facebook) and Whatsapp and completed questionnaires assessing vaccine hesitancy, intolerance of uncertainty, and mental health factors. Our results revealed that previous history of neither COVID-19 nor seasonal influenza vaccination was associated with increased vaccine hesitancy. In addition, individuals who received either one vaccine or both claimed elevated levels of intolerance of uncertainty and reported elevated levels of mental health symptoms. Therefore, an association between vaccine hesitancy and intolerance of uncertainty and mental health symptoms is demonstrated. Future campaigns against vaccine hesitancy may focus on the intolerance of uncertainty in vaccine-hesitant individuals.

COVID-19 vaccine refusal associated with health literacy: findings from a population-based survey in Korea

Background:Poor health literacy is associated with lower utilization of preventable services. However, the relationship between health literacy and COVID-19 vaccine hesitancy remains controvertible.Methods:This study used data from 229,242 individuals who completed the Community Health Survey in Korea from August 16 to October 31 in 2021. To operationalize COVID-19 vaccine hesitancy, we measured vaccine refusal, which is defined as not having been vaccinated and not intending to get vaccinated against COVID-19. Health literacy is operationalized in two dimensions; the ability to understand spoken directions from health professionals and the ability to understand written information regarding health. Covariates include sex, age, educational level, marital status, employment status, basic living security pension status, and subjective health status. Two multivariable logistic regression models were run to determine factors associated with COVID-19 vaccine refusal. Model 1 included sociodemographic characteristics and subjective health status. Model 2 added two health literacy variables. Odds ratio (OR) and 95% confidence intervals (CI) were calculated.Results:Only 3.9% of the Korean adult population were estimated to refuse COVID-19 vaccine. The most commonly cited reasons for COVID-19 vaccine refusal were concerns about vaccine adverse events (47.6%), followed by the assessment of one’s own health status (29.5%). Individuals who found spoken directions very difficult to understand were more likely to refuse COVID-19 vaccine than those who found spoken directions very easy (OR = 1.55, 95% CI: 1.28–1.87, p < 0.001). People who did not pay attention to written information were more likely to refuse COVID-19 vaccine than those who reported it to be very easy to understand (OR = 1.28, 95% CI: 1.13–1.45, p < 0.001). People in all other categories of the literacy spectrum for either spoken or written information did not have an increased risk of COVID-19 vaccine refusal.Conclusion:Health literacy was significantly associated with COVID-19 vaccine refusal. Health literacy programs could be beneficial to reduce vaccine refusal, particularly for the people who find spoken directions from health professionals very difficult to understand and those who do not pay attention to written information.

Local infectious disease experience influences vaccine refusal rates: a natural experiment.

Vaccination has been critical to the decline in infectious disease prevalence in recent centuries. Nonetheless, vaccine refusal has increased in recent years, with complacency associated with reductions in disease prevalence highlighted as an important contributor. We exploit a natural experiment in Glasgow at the beginning of the twentieth century to investigate whether prior local experience of an infectious disease matters for vaccination decisions. Our study is based on smallpox surveillance data and administrative records of parental refusal to vaccinate their infants. We analyse variation between administrative units of Glasgow in cases and deaths from smallpox during two epidemics over the period 1900-1904, and vaccine refusal following its legalization in Scotland in 1907 after a long period of compulsory vaccination. We find that lower local disease incidence and mortality during the epidemics were associated with higher rates of subsequent vaccine refusal. This finding indicates that complacency influenced vaccination decisions in periods of higher infectious disease risk, responding to local prior experience of the relevant disease, and has not emerged solely in the context of the generally low levels of infectious disease risk of recent decades. These results suggest that vaccine delivery strategies may benefit from information on local variation in incidence.

COVID‑19 vaccine hesitancy among pregnant women and their reported reasons for vaccine refusal - A prospective study in Tehran, Iran.

Evaluation of covid‑19 vaccine hesitancy among pregnant women and their reported reasons for vaccine refusal. This prospective study was performed in Arash women's Hospital, Tehran, Iran, between December 1, 2021 and January 1, 2022. All pregnant women who were attended to prenatal care unit were considered eligible for inclusion. A validated questionnaire was used for data gathering. Written informed consent was obtained from all participants. Finally, 477 pregnant women were recruited and were divided into two groups according the status of vaccine acceptance (237 accepted and 240 women refused vaccination). The mean age of accepted participants was higher (31.65±5.69 vs 30.39±5.5; P=0.01). There was a significant statistical difference between the groups regarding education level. Access to internet and social media were also significantly different between the two groups (94.8% in accepted vs 86.6% in refused group; P=0.002). There was more rate of severe COVID-19 infection in friends or relatives of accepted group (50% vs 38%). we did not find any statistically significant differences in obstetric characteristics and the rate of obstetric complications between the two groups. The most common reasons reported by participants for vaccine refusal, was fear of vaccination side effects on the fetus (86.5%), and the less common reported reasons were husband's disagreement (9.7%), use of traditional medicine (5.6%), religious beliefs (3.7%), and information obtained from social media (2.8%). After advices from medical staff, most of these mothers (86.5%) still refused vaccination. Based on the results of the present study,rate of COVID-19 vaccine hesitancy was about 50% and its most common reported reason was fear of probable side effects of vaccine on the fetus.

Correlation between Knowledge and Hesitancy towards COVID-19 Vaccine in Pregnant Women in The Working Area of Ranomeeto Health Centre

Background: Acceptance or refusal of vaccinations can be influenced by hesitancy about the COVID-19 vaccine. Hesitancy is determined by knowledge, attitudes, practices, and public concerns about the safety, efficacy, risks, and benefits associated with the COVID-19 vaccination program. Purpose: To determine the association between knowledge and hesitancy about the COVID-19 vaccine in pregnant women in the Ranomeeto Health Center Working Area. Methods: This is an analytic observational study with a cross-sectional approach. This study was conducted at the Ranomeeto Health Center, Konawe Selatan District. The number of samples is 77 people, collected by purposive sampling technique. Knowledge was measured using a knowledge questionnaire about the covid-19 vaccine. Hesitation was measured using a questionnaire about the COVID-19 vaccine. Data were collected and analyzed using the Chi-Square statistical test with a significance value of p&lt;0.05. Results: The results showed that most pregnant women had good knowledge about the COVID-19 vaccine (42.9%) and had no hecitation about the COVID-19 vaccine (61.0%). Statistical tests obtained a significant p-value between knowledge and hesitancy about the COVID-19 vaccine (p=0.010). Conclusion: There is a significant correlation between knowledge and hesitancy about the COVID-19 vaccine in pregnant women in the Working Area of the Ranomeeto Health Center. Keywords: covid-19 vaccine; hesitancy; knowledge; pregnant women

Is Covid Vaccine Hesitancy Unfounded? A Local Comparative Study on Short-Term Side Effects of Different Covid Vaccinations

Introduction: Side Effects of Covid Vaccinations have been responsible for Vaccine hesitancy (VH), which is defined as the delay in acceptance or refusal of vaccines despite availability of vaccine services.&#x0D; Aims &amp; Objectives: To evaluate and compare the severity of common short term side effects of different types and dosages of vaccines in different age groups at a local setting and whether Covid vaccine hesitancy is unfounded.&#x0D; Place and duration of study: The present study was conducted at Specialist Clinic Haroon Chowk Rawalpindi &amp; Doctors Clinic Karachi, Pakistan between August and September 2021&#x0D; Material &amp; Methods: This cross-sectional survey-based study was conducted based on a structured close ended questionnaire designed using google forms after the immense literature search on the research question and provided to individuals aged 18 years and above who had either completed or partially completed their vaccination dosage at any center. SPSS version 24 (IBM, Armonk, New York, USA) was used for data analysis, P-value&lt;0.05 was taken as significant.&#x0D; Results: The survey was conducted on a total of 248 patients Out of 248, 150 (60.48%) were male &amp; 98 (39.52%) were females. Majority 153(61.69%) were of age group 19-30 years, whereas 95 (38.31%) were aged between 31-40 years. 17 participants reported that they were allergic, 7 patients had asthma, 8 respondents mentioned that they were diabetic and hypertensive, the remaining participants did not report any comorbidities at all. Regarding vaccination status, 243 (97.98%) respondents confirmed that they completed the two-dose vaccination process. Short term adverse events were noted, including fever, severe swelling, myalgia, a change in taste, a headache, hypersensitivity, and medication-related symptoms.&#x0D; Conclusion: Compared to COVID-19 vaccines created using inactivated virus, those based on messenger RNA were found to be significantly safer for patients. Widely ranging short term mild and manageable adverse effects were recorded. Covid vaccine hesitancy appears to be unfounded.

Understanding the Impact of General Vaccine Attitudes on the Intent for Early COVID-19 Vaccination.

Despite relatively high rates of population spread, morbidity and mortality, the adoption of COVID-19 vaccines among the eligible populations was relatively slow. Some of the reasons for vaccination hesitancy and refusals have been attributed to unique aspects of this pandemic, including attitudes toward COVID-19 vaccines. However, little attention has been paid to the role of underlying vaccine beliefs in the likelihood of early vaccine adoption for COVID-19. This study provides a more comprehensive assessment of factors influencing willingness to get an early vaccination, and the relative contribution of general vaccine attitudes, compared to demographics, perceived threat and institutional trust. Monthly national surveys were conducted between June and November 2020 using a national consumer panel of U.S. adults (n = 6185). By late November, only 24% of respondents said they were very likely to get a Food and Drug Administration (FDA)-approved COVID-19 vaccine as soon as it became available. While COVID-19 risk perceptions, confidence and trust in key institutions and information sources, and some demographic variables, were predictive of early vaccination intent, general beliefs regarding vaccines played a significant role, even compared to demographics, perceived risk and institutional trust. This lesson from the COVID-19 experience could help inform public health communications in future epidemics.

Racial Health Disparities and Black Heterogeneity in COVID-19: A Case Study of Miami Gardens.

The COVID-19 pandemic is a critical public health concern that has disproportionately affected the Black community in the United States. The purpose of this study was to examine the risk and protective factors faced by residents in the City of Miami Gardens during the COVID-19 pandemic, with emphases placed on racial health disparities and Black heterogeneity. Using convenience and snowball sampling, quantitative and qualitative data for this study were collected via an anonymous online questionnaire using QuestionPro. Survey links were distributed by e-mail invitations with assistance from city officials to the residents of this predominantly Black city in Florida (n = 83). Descriptive statistics and relevant qualitative responses are presented. Furthermore, a machine learning (ML) approach was used to select the most critical variables that characterized the two racial groups (Black versus non-Black participants) based on four ML feature selectors. Study findings offered important and interesting insights. Specifically, despite the greater prevalence of adopting measures to protect themselves and others from COVID-19, Black participants were more susceptible to activities that increased their COVID-19 risk levels. In addition, their rate of infection, particularly among the Afro-Caribbean ethnic group, was reported to be higher, indicating the need to further investigate the underlying conditions and root causes (including vaccine hesitancy and refusal) that contribute to their greater health disparities.

Knowledge of the Malaysian National Immunisation Programme and its associated factors among parents in Dungun, Terengganu: A cross-sectional study.

The number of unvaccinated children and the rate of vaccination refusal among parents have recently increased despite the robust vaccination programme in Malaysia. The purpose of this study was to determine the level of knowledge of the Malaysian National Immunisation Programme among Malaysian parents as well as the variables that contribute to poor knowledge. Methods: This study used systematic random sampling to recruit 375 parents from seven health clinics in the Dungun District of Malaysia. The participants were asked to complete a selfadministered validated questionnaire that included sociodemographic and knowledge questions. A multiple logistic regression analysis was applied to determine the associated factors of poor knowledge of immunisation. P-values of <0.05 were considered statistically significant. A total of 189 (50.4%) respondents had poor knowledge of immunisation. The multiple logistic regression analyses revealed that a low educational level (adjusted odds ratio (OR): 1.92; 95% CI 1.25-2.95) was associated with poor knowledge while the age-group of 30-40 years old (adjusted OR: 0.56; 95% CI 0.34-0.93) was protected against it as compared to the age-group of <30 years old. The prevalence of poor knowledge of immunisation among parents in Dungun, Terengganu, is relatively high. The focus of health promotion and education must be switched to increasing immunisation knowledge among the public, particularly among high-risk groups.

Addressing the social inequities of vaccination: an imperative to close the gap

Addressing the social inequities of vaccination: an imperative to close the gap

Not Getting Vaccinated? It Is a Matter of Problem-Solving Abilities and Socio-Cognitive Polarization.

The anti-COVID-19 vaccination campaign in the United States provided a significant contribution to the control of the virus spread. Despite the recommendations by public health institutions, vaccine skepticism and hesitancy contributed to low vaccine uptake, thus possibly disrupting the management of preventable diseases associated with the COVID-19 infection. The process that led individuals to accept COVID-19 vaccines required the ability to gather, synthesize, and weigh-up information within a novel, dynamically changing, complex, and ambiguous context. To deal with such complexity, we hypothesized that both the ability of reflection and flexible adaptation played a fundamental role. Based on previous research on cognitive predictors of vaccine refusal, we decided to investigate the combined role of two constructs, namely, problem-solving skills and socio-cognitive polarization (SCP), on vaccine acceptance and uptake. Two-hundred-seventy-seven US participants completed an online survey aimed to measure problem-solving ability, through a rebus puzzles task, and SCP, through a composite measure of absolutist thinking, political conservatism, and xenophobia. Mediation analyses indicated that SCP mediated the association between problem-solving ability and vaccine acceptance, so lower problem-solving abilities associated with higher polarization predicted vaccine rejection. Thus, our findings suggested that low problem-solving skills may represent a risk factor for COVID-19 vaccine refusal, with cognitive and social rigidity playing a crucial role in undermining the anti-COVID-19 vaccine uptake.

The refusal of COVID-19 vaccination and its associated factors: a systematic review

Background: To date, more than 10% of the global population is unvaccinated against the coronavirus disease 2019 (COVID-19), and the reasons why this population is not vaccinated are not well identified. Objectives: We investigated the prevalence of COVID-19 vaccine refusal and to assess the factors associated with COVID-19 vaccine refusal. Methods: A meta-analysis was conducted during August to November 2022 (PROSPERO: CRD42022384562). We searched articles investigating the refusal of COVID-19 vaccination and its potential associated factors in PubMed, Scopus, and the Web of Sciences. The quality of the articles was assessed using the Newcastle–Ottawa scale, and the data were collected using a pilot form. The cumulative prevalence of the refusal to vaccinate against COVID-19 was identified using a single-arm meta-analysis. The factors associated with COVID-19 vaccine refusals were determined using the Mantel-Haenszel method. Results: A total of 24 articles were included in the analysis. Our findings showed that the global prevalence of COVID-19 vaccine refusal was 12%, and the highest prevalence was in the general population, and the lowest prevalence was in the healthcare worker subgroup. Furthermore, individuals with a high socioeconomic status, history of previous vaccination, and medical background had a lower rate of COVID-19 vaccination refusal. Subsequently, the following factors were associated with an increased risk of COVID-19 vaccine refusal: being female, educational attainment lower than an undergraduate degree, and living in a rural area. Conclusion: Our study identified the prevalence of and factors associated with COVID-19 vaccine refusal. This study may serve as an initial reference to achieve global coverage of COVID-19 vaccination by influencing the population of COVID-19 vaccine refusal.

A Scoping Review on COVID-19 Vaccine Hesitancy among the Lesbian, Gay, Bisexual, Transgender, Queer, Intersex and Asexual (LGBTQIA+) Community and Factors Fostering Its Refusal.

The ramifications of the existing crisis caused by the coronavirus pandemic are sensed in all walks of life. Among the various efforts made to curb the spread of this novel infection, the development of COVID-19 vaccines had a profound role in flattening the pandemic curve. Even though the rapid vaccine drive received a highly welcoming response among people, the reluctance and ignorance of a part of the population towards available safe vaccines stand as impediments to achieving the desired outcome. The LGBTQIA+ (Lesbian, Gay, Bisexual, Transgender, Queer, Intersex and Asexual) communities are the least studied groups in this regard. The purpose of this study is to extensively review and report on COVID-19 vaccine uptake and refusal among the LGBTQIA+ population and enumerate the factors contributing to vaccine hesitancy. The study extends further to outline a conceptual framework for interventions to enhance COVID-19 vaccine acceptance among the LGBTQIA+ population. We performed a systematic search using key terms on Google Scholar and PubMed. The obtained results were filtered using the eligibility criteria framed for this study. The initial search provided an extensive result of 4510 articles which were later screened at various levels to arrive at the final inclusive collection of manuscripts adding to 17. The studies were analyzed by the authors individually, and the data were categorized using variables. The results are interpreted using charts and graphs. The whole manuscript has been structured in accordance with the PRISMA extension for scoping reviews. The comprehensive search yielded 17 eligible articles for this review. Most of the studies were conducted in the United States (n = 17), and predominantly cross-sectional studies have been conducted. The major comparative factor was the HIV status of the LGBTQIA+ population. HIV-affected patients were more willing to take up COVID-19 vaccination. However, social stigma, discrimination, lack of access and non-prioritization in vaccine drives were found to be the major factors contributing to vaccine hesitancy among this population. The invention of the COVID-19 vaccination revolutionized the healthcare systems burdened with COVID-19. Although this is a breakthrough scientific contribution, many factors are associated with the rate of vaccine acceptance, especially among sexual and gender minorities. The reviewed studies have revealed numerous factors that influence vaccine uptake and refusal with the commonest being concerns on discrimination, social stigma, inequitable access to healthcare, vaccine safety, efficacy, potency, side effects and lack of trust in medical workers. These impediments in vaccine coverage should be meticulously addressed to ensure optimum LGBTQIA+ physical and mental health as well as for providing non-discriminative, equitable and quality healthcare service regardless of the gender or sexual orientation of individuals.

Organizational actions to tackle distrust: Building Trust Italy.

According to the italian Code of Medical Deontology, mutual trust and mutual respect for values and rights are the care relationship foundation. To establish reciprocal trust and respect, the communication between care providers and patients must be skilled and appropriate, and the time devoted to communication must be considered time of care. But in Italy, in the last decades costs containment policy in the organizations of the National Health Service critically shortened the time available for care. Today, doctors and other healthcare professionals literally do not have the time to establish appropriate care relationships, and this causes a widespread and increasing distrust of patients and their families in the care system. During Covid-19 pandemic also vaccine hesitancy, defined by experts as a delay in acceptance or refusal of vaccination despite availability of vaccination services, was mainly due to a lack of confidence in care system and in scientific research. Slow Medicine ETS, an italian proactive movement of healthcare professional and citizen, following the example of the initiative “Building Trust” recently activated by the ABIM Foundation in the USA, launched a national initiative aimed to promote and plan concrete actions to restore and consolidate people’s trust in health professionals and organizations, in researchers, in scientific and rational approach to knowledge and in its use for the improvement of health and quality of life. Slow Medicine ETS, still successfully leading and supporting the “Choosing Wisely Italy” project, will be engaged in assembling the national network of the new project “Building Trust Italy”.

REASONS OF REFUSING POLIO VACCINATION AMONG PARENTS OF UNDER-5 YEARS CHILDREN IN DISTRICT MULTAN, PAKISTAN

Background and Objective: Polio is still endemic in Pakistan and Afghanistan. In Pakistan, transmission of polio virus is high due to poor political environment and internal security threats especially in war against terrorism in Swat and FATA. Meanwhile, some groups tried to create misconception about polio vaccine. The objective of the study was to describe the reasons underpinning the refusals to polio vaccine in District Multan.&#x0D; Methods:- This descriptive, cross sectional study was conducted in a District Multan. A closed ended pre- tested questionnaire in Urdu language was used to collect data from 34 parents of under five year children, who refused polio vaccaniation during polio compaign.&#x0D; Results:- Out of 34 polio vaccine refusal parents, 15 did not respond or either locked the doors as researcher tried to interview them. About 29% refusing parents mentioned religious reasons, about 42% have apprehensions on polio vaccine contents. One third reported that it was a western world conspricy against mullims. 45% states that government vaccine supply is of poor quality, as the main factor for refusal.&#x0D; Conclusion: Majority of refusing parents were uncomfortable in responding to the survey or either they were never counseled for Polio and now they are habitual refusals or may be perception about polio vaccine is negative. In District Multan, religious reasons and misconception that vaccine causes sterility in male children were main reasons of polio vaccine refusal. Efforts will be required in changing the perception of parents.