Prevalence and Determinants of Vaccine Hesitancy Among Caregivers of Children Aged 0-59 Months in Urban Settings of Buea, Cameroon

Abstract

Background: Vaccine hesitancy, defined as reluctance or refusal to vaccinate despite vaccine availability, represents one of the ten leading threats to global public health. In Cameroon, vaccine hesitancy has reached concerning levels, with previous studies documenting an 84.6% vaccine hesitancy rate for COVID-19 vaccines among adults and only 31.21% expressing willingness to accept vaccination. Understanding the determinants of vaccine hesitancy among caregivers of young children is crucial for developing targeted interventions. Methodology: This community-based cross-sectional analytical study was conducted in urban settings of Buea, Cameroon. A multistage sampling technique was employed to recruit 438 caregivers of children aged 0–59 months. Data were collected using a structured, interviewer-administered questionnaire incorporating a modified version of the WHO SAGE Vaccine Hesitancy Scale. Bivariate and multivariate logistic regression analyses were performed to identify significant determinants of vaccine hesitancy. Results: The prevalence of vaccine hesitancy was 11.0% among caregivers. Significant determinants included gender (females less likely to exhibit hesitancy: AOR = 0.245, 95% CI: 0.075–0.805), income (higher income associated with lower hesitancy: AOR = 0.211, 95% CI: 0.056–0.799), caregiver status (shared caregiving associated with higher hesitancy: AOR = 4.931, 95% CI: 1.596–15.230), family influence (no family influence increased hesitancy: AOR = 2.801, 95% CI: 1.120–7.006), and cultural beliefs (AOR = 5.748, 95% CI: 2.446–13.508). Behavioral factors strongly associated with hesitancy included missed health appointments (AOR = 33.519, 95% CI: 9.053–124.103), delayed vaccination schedules (AOR = 17.431, 95% CI: 4.171–72.845), and cultural practices (AOR = 21.971, 95% CI: 7.305–66.077). Conclusion: The study identified multiple determinants of vaccine hesitancy operating at individual, social, and cultural levels. The findings underscore the need for culturally appropriate interventions that address deeply rooted factors influencing vaccination decisions among caregivers in Cameroon.