Prevalence and factors associated with vaccine hesitancy among caregivers of children under five years in Pece-Laroo Division, Gulu City, Uganda

Abstract

Background: Vaccine hesitancy is a growing concern worldwide, particularly among caregivers of vulnerable populations such as children. We determined the prevalence and factors associated with vaccine hesitancy among caregivers of children under five years in northern Uganda. Methods: A cross-sectional analytical study was conducted in the Pece-Laroo Division, utilizing a multistage sampling technique to select caregivers of children under 5 years who provided written informed consent. Vaccine hesitancy and its underlying reasons were assessed using a two-part approach: a screening question followed by open-ended probing. A pre-tested structured questionnaire was administered to collect data, which was then analyzed using Stata version 18. A P < 0.05 was considered statistically significant. Results: Overall, 393 of the expected 427 participants were enrolled (response rate: 92.0%). In total, 40% (n = 157) of the participants were hesitant. The main reasons for hesitancy were lack of information (41.4%, n = 65), fear of side effects (14%, n = 22), and cultural beliefs (17.3%, n = 28). Multivariate analysis revealed that caregivers with two children under 5 years were more likely to be hesitant compared to those with one child (aOR = 1.96, 95% CI 1.16–3.30, p = 0.011). Additionally, caregivers with a monthly income of 100,000–500,000 UGX were less likely to be hesitant compared to those earning less than 100,000 UGX [< $27 USD] (aOR = 0.53, 95% CI 0.32–0.88, p = 0.014). Conclusion: Vaccine hesitancy remains high among caregivers in Northern Uganda, with 2 in 5 of participants expressing hesitancy. To reduce hesitancy and improve timely vaccination, immunization programs should prioritize young mothers with multiple young children through digital-first outreach.