Social and Economic Factors Associated With Vaccine Hesitancy Among Parents of Infants in Nairobi County

Abstract

Background Vaccine hesitancy (VH) is a spectrum ranging from total acceptance to absolute refusal of vaccines and includes deferring the decision to vaccinate, agreeing to vaccinate but staying doubtful about the safety or effectiveness of the vaccines, being receptive to some vaccines and not others and total refusal to vaccinate. Vaccine hesitancy is indeed a great public health issue as it has been shown to result in higher odds of untimely vaccination and could also or subsequently increase the risk of VPD outbreaks and epidemics in populations where the vaccine uptake is lower than what is required to warrant herd immunity. An evidence-based understanding of the prevalence of vaccine hesitancy in Kenya as well as the demographic, economic and sociocultural drivers of the same may allow health practitioners and policymakers to design more effective programmatic interventions around childhood immunizations by using a wider approach that incorporates the scope of vaccine hesitancy and possible drivers of the same. Objectives This study sought to investigate the social and economic factors that influence the decision to take up vaccination of infants among residents of Eastleigh North and Eastleigh South Wards in Kamukunji, Nairobi County. It also sought to investigate the prevalence of Vaccine hesitancy in this study population. Methodology A cross-sectional study design was employed. Through a questionaire, data was collected from 423 randomly selected households on the parents’ decision to vaccinate their child(ren). Logistic regression analysis was conducted to test the relationship between the participants’ economic and sociocultural factors and vaccine hesitancy. Results Vaccine hesitancy was found to be present in slightly more than half of the study population (51%, n=219). Monthly income category and tribe were associated with the odds of 15 Vaccine Hesitancy (VH). Compared to households with an income slightly above minimum wage (Ksh 10,000-20,000) those with household income below minimum age (Kshs 5,000-10,000) had twice the odds of VH (OR=2.07, 95% CI [1.0835,3.9730]) while those with higher household income i.e Kshs 30,000-50,000 had 68% less odds of VH (OR=0.32, 95%CI [0.1359,0.7373]), controlling for the effect of tribe. Compared to the Somali tribe, the tribes Kamba (p=0.011) and Luo (p=0.028) were found to be significant predictors of the odds of VH at a 5% significance level, controlling for the parents’ or care-givers’ monthly income category. Conclusion Vaccine hesitancy could be plaguing the efforts by the government and other players to increase the uptake of childhood vaccination and decrease VPDs in Nairobi, Kenya. The greatest contributor of VH in this study population was lack of trust in the safety and effectiveness of the vaccines. There was a statistically significant association between household income and belonging to the Kamba or Luo tribes and VH, controlling for the effects of each other. Recommendations Health workers should conduct health education meetings with parents and care-givers attending the maternal and child health clinics focusing on the safety and efficacy of childhood vaccinations. The government and partners should prioritize on government facilities when it comes to ensuring that childhood vaccines are fully stocked. Employers should be encouraged to follow the guidelines set by the government on minimum wages as this might reduce hesitancy to childhood vaccination among parents of low socioeconomic status. Additionally, researchers should conduct In-depth qualitative studies focusing on the Luo and Kamba communities in order to unfold any 16 unique behavioral, social or cultural patterns they could have that could explain the association with vaccine hesitancy.