Parental Attitudes and Hesitancy About COVID-19 vs. Routine Childhood Vaccinations: A National Survey

Objectives: To quantify parental acceptance of the COVID-19 vaccine and assess the vaccine hesitancy (VH) for COVID-19 vs. childhood vaccines.Methods: Eight vaccine hesitancy scale (VHS) items, adopted from WHO's Strategic Advisory Group of Immunization (SAGE), were used to assess VH for COVID-19 vaccine vs. routine childhood vaccines. We distributed the online survey to parents with the commence of the national childhood COVID-19 vaccination program in Saudi Arabia.Results: Among 3,167 parents, 47.6% are decided to vaccinate their children against COVID-19. The most common reasons for refusal were inadequate safety information (69%) and worry about side effects (60.6%). Parents have a significantly greater positive attitudes toward children's routine vaccines vs. the COVID-19 vaccine, with higher mean VHS (±SD) = 2.98 ± 0.58 vs. 2.63 ± 0.73, respectively (p-value < 0.001). Parents agreed more that routine childhood vaccines are more essential and effective as compared to the COVID-19 vaccine (Cohen's D: 0.946, and 0.826, consecutively; T-test p-value < 0.00). There is more parental anxiety about serious side effects of the COVID-19 vaccine vs. routine childhood vaccines (Cohen's D = 0.706, p-value < 0.001). Parents who relied on the Ministry of Health information were more predicted (OR = 1.28, p-value = 0.035) to intend to vaccinate as opposed to those who used the WHO website (OR = 0.47, −53%, p-value < 0.001). In a multivariate logistic regression analysis, the factors associated with intention to vaccinate children were parents who received COVID-19 vaccine, older parents, having children aged 12–18, and parents with lower education levels.Conclusions: Significant proportion of parents are hesitant about the COVID-19 vaccine because they are less confident in its effectiveness, safety, and whether it is essential for their children. Relying on the national official healthcare authority's website for the source of information was associated with increased acceptance of childhood COVID-19 vaccination. As parental intention to vaccinate children against COVID-19 is suboptimal, healthcare authorities could boost vaccine uptake by campaigns targeting hesitant parents.

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Parent Attitudes about Childhood Vaccines: Point Prevalence Survey of Vaccine Hesitancy in an Irish Population

Pharmacy ◽

10.3390/pharmacy9040188 ◽

2021 ◽

Vol 9 (4) ◽

pp. 188

Author(s):

Sarah Marshall ◽

Anne C. Moore ◽

Laura J. Sahm ◽

Aoife Fleming

Keyword(s):

Parental Attitudes ◽

Family Doctor ◽

Vaccine Safety ◽

Vaccine Uptake ◽

Vaccine Hesitancy ◽

Future Research ◽

Parent Attitudes ◽

Prevalence Survey ◽

Convenience Sample ◽

Childhood Vaccines

Understanding parental attitudes to their children’s vaccination is critical to developing and implementing interventions that address parents’ hesitancy and improve vaccine uptake. The Parent Attitudes about Childhood Vaccines (PACV) survey is a validated tool for identifying vaccine hesitancy in parents. We evaluated the rate of vaccine hesitancy and areas of concern regarding childhood vaccinations using an adapted version of the PACV survey, in a convenience sample of parents attending a STEM (Science, Technology, Engineering and Mathematics) outreach event in Ireland, in 2018. A score ≥ 50 identified vaccine hesitant parents. Of 105 parents who completed the survey, the prevalence of vaccine hesitancy was 6.7%, (7/105). Parents had concerns around vaccine side effects (36.2%, n = 38), vaccine safety (20%, n = 21) and the number of vaccines administered (13.3%, n = 14). Parents trusted the vaccine information they received (85.6%, n = 90) and 81.9% (n = 86) believed that the vaccine schedule was good for their child. The findings indicate the presence of vaccine hesitancy in parents in Ireland regarding paediatric vaccines with further research necessary to address parents’ vaccine concerns. Future research should explore further, by qualitative methods, parents’ vaccine concerns. There is also potential to identify vaccine hesitant parents with the PACV survey as a surveillance method in healthcare settings; for example, in community pharmacies, family doctor clinics and out-patient clinics.

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A systematic review of parental vaccine hesitancy and refusal in childhood vaccination

10.21203/rs.2.14640/v1 ◽

2019 ◽

Author(s):

Amalie Dyda ◽

Catherine King ◽

Aditi Dey ◽

Julie Leask ◽

Adam Dunn

Keyword(s):

Study Design ◽

Quantitative Methods ◽

Parental Attitudes ◽

Vaccine Uptake ◽

Childhood Vaccination ◽

Vaccine Hesitancy ◽

Attitudes And Beliefs ◽

Cross Sectional ◽

Survey Instruments ◽

Childhood Vaccines

Abstract Background Acceptance of vaccines is an important predictor of vaccine uptake. This has public health implications as those who are not vaccinated are at a higher risk of infection from vaccine preventable diseases. We aimed to systematically review studies of parental attitudes and beliefs in childhood vaccination, with a focus on the methods used to measure hesitancy and refusal.Methods We identified and reviewed primary research studies using quantitative methods and investigating vaccine attitudes and beliefs published between January 2012 and May 2018. Studies were included if they involved a quantitative survey of the attitudes and beliefs of parents about vaccinations recommended for children. We undertook a narrative synthesis of the results with a focus on evaluating variation in the use of behavioural theories, validated survey instruments, and localisation and adaptation of questions to suit local context.Results A total of 116 studies met the inclusion criteria; 99 used a cross sectional study design, 5 used a case control study design, 4 used a pre-post study design and 8 used mixed methods study designs. Sample sizes of included studies ranged from 49 to 12,259. Thirty-six countries were represented in the included studies. The most commonly used tool was the Parent Attitudes about Childhood Vaccines (PACV) Survey. Questions eliciting vaccination attitudes and beliefs varied widely.Conclusions There was heterogeneity in the types of measures used in studies investigating attitudes and beliefs about vaccination in parents. Broader and more consistent use of validated survey instruments for measuring parental attitudes and beliefs about childhood vaccination would help to better understand localised differences in the reasons for vaccine hesitancy and refusal.

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SARS-CoV-2: Vaccine Hesitancy among Underrepresented Racial and Ethnic Groups with HIV in Miami, Florida

Open Forum Infectious Diseases ◽

10.1093/ofid/ofab154 ◽

2021 ◽

Author(s):

Deborah L Jones ◽

Ana S Salazar ◽

Violeta J Rodriguez ◽

Raymond R Balise ◽

Claudia Uribe Starita ◽

...

Keyword(s):

Race And Ethnicity ◽

Cross Sectional Study ◽

Vaccine Uptake ◽

Vaccine Hesitancy ◽

Baseline Survey ◽

Advisory Group ◽

Medical Mistrust ◽

Cross Sectional ◽

Exact Test ◽

Novel Coronavirus

Abstract Background SARS-CoV-2 and HIV disproportionally affect underrepresented ethnoracial groups in the US. Medical mistrust and vaccine hesitancy will likely impact acceptability of SARS-CoV-2 vaccines. This study examined SARS-CoV-2 vaccine hesitancy among underrepresented ethnoracial groups with HIV and identified factors that may reduce vaccine uptake. Methods We conducted a cross-sectional study of adults ≥18 years with HIV residing in Miami, FL. Participants were invited to participate in the ACTION (A Comprehensive Translational Initiative on Novel Coronavirus) cohort study. A baseline survey was administered from April-August 2020 and followed by a COVID-19 vaccine hesitancy survey from August-November 2020. The COVID-19 vaccine hesitancy survey was adapted from the Strategic Advisory Group Experts survey. Comparisons by race and ethnicity were performed using the Freedman-Haltmann extension of Fisher’s exact test Results A total of 94 participants were enrolled, mean age 54.4 years, 52% female, 60% Black non-Latinx, and 40% non-Black Latinx. Black non-Latinx participants were less likely to agree that vaccinations are important for health when compared to non-Black Latinx (67.8% vs 92.1%, p=0.009), less likely to agree that vaccines are effective in preventing disease (67.8% vs 84.2%, p=0.029), less likely to believe that vaccine information is reliable and trustworthy (35.7% vs 71.1%, p=0.002), and less likely to believe vaccines were unnecessary because COVID-19 would disappear soon (11% vs 21%, p=0.049). Conclusion Medical mistrust, vaccine hesitancy and negative sentiments about SARS-CoV-2 vaccines are prevalent among underrepresented ethnoracial groups with HIV, particularly Black non-Latinx. Targeted strategies to increase vaccine uptake in this population are warranted.

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1172. SARS-CoV-2 Vaccine Hesitancy in Caregivers of Hospitalized Children

Open Forum Infectious Diseases ◽

10.1093/ofid/ofab466.1365 ◽

2021 ◽

Vol 8 (Supplement_1) ◽

pp. S677-S677

Author(s):

Marisa Orbea ◽

Rachel Cunningham ◽

C Mary Healy ◽

Julie A Boom ◽

Claire Bocchini

Keyword(s):

Vaccine Uptake ◽

Vaccine Hesitancy ◽

Hospitalized Children ◽

Parent Attitudes ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Vaccine Acceptance ◽

And Behaviors ◽

Childhood Vaccines ◽

To Receive

Abstract Background SARS-CoV-2 vaccine hesitancy (VH) is hindering nationwide vaccination efforts; little is known about caregiver SARS-CoV-2 vaccine acceptance for children. We aimed to identify associations with SARS-CoV-2 VH in caregivers of hospitalized children. Methods We conducted a prospective cross-sectional survey in English and Spanish of caregiver COVID-19 knowledge, attitudes, behaviors, and associated VH among hospitalized children 6 months - 18 years at a large pediatric medical institution. Parents were approached daily, averaging 4-5 days/week, from 12/8/2020--4/5/2021. VH was assessed using the Parent Attitudes about Childhood Vaccines (PACV) survey; PACV score ≥50 denoted VH. Descriptive statistics and multivariable logistic regression were used. Responses were categorized. Results 295/307 (96%) of approached caregivers enrolled; 79% were ≥ 30 years, 68% were married/ living with a partner, and 57% had at least some college. 36% identified as white, 19% Black, and 46% Hispanic/ Latino. 53% of caregiver children had public insurance. 91% of caregivers self-reported their children were up to date with routine vaccines. 17% of caregivers were vaccine-hesitant overall. 50% of caregivers were willing to receive COVID-19 vaccine themselves. Figure 1 shows intention to vaccinate their child by PACV score. 65% knew someone who was hospitalized for COVID-19. 67% were scared of their child getting COVID-19. However, 49% were scared of their child getting the vaccine, 28% did not want to vaccinate their child and 27% were neutral in the intention to vaccinate their child. Caregivers who did not intend to vaccinate their child were more likely to be Black (27% vs. 16%, p=0.04) and less likely to be Hispanic/ Latino (33% vs. 49%, p=0.02). Table 1 shows attitudes, beliefs, and behaviors surrounding the COVID-19 pandemic and vaccine in caregivers who did or did not intend to vaccinate their child. Figure 1 COVID-19 vaccine uptake by PACV score Table 1 Caregiver attitudes, beliefs, and behaviors surrounding the COVID-19 pandemic and the COVID-19 vaccine Conclusion The majority of caregivers believe that SARS-CoV-2 vaccine will help control the pandemic, but less than half plan to vaccinate their children. A quarter of caregivers expressed uncertainty regarding the vaccine and therefore may be amenable to education and discussion. COVID-19 VH is different from VH towards routine vaccinations. More research is needed to address COVID-19 specific VH. Disclosures C. Mary Healy, MD, Dexcom (Shareholder)Intuitive (Shareholder)Quidel Corporation (Shareholder)Up to Date (Other Financial or Material Support, Honorarium)Vapotherm (Shareholder)

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COVID-19 Vaccine Perceptions and Differences by Sex, Age, and Education in 1,367 Community Adults in Ontario

Frontiers in Public Health ◽

10.3389/fpubh.2021.719665 ◽

2021 ◽

Vol 9 ◽

Author(s):

Sabrina K. Syan ◽

Mahmood R. Gohari ◽

Emily E. Levitt ◽

Kyla Belisario ◽

Jessica Gillard ◽

...

Keyword(s):

Side Effects ◽

Vaccine Safety ◽

Bachelor's Degree ◽

Vaccine Uptake ◽

Vaccine Hesitancy ◽

Online Assessment ◽

Cross Sectional ◽

Global Pandemic ◽

To Receive

Background: COVID-19 is a global pandemic and vaccination efforts may be impeded by vaccine hesitancy. The present study examined willingness to receive a COVID-19 vaccine, the associated reasons for willingness/unwillingness, and vaccine safety perceptions in a cross-sectional assessment of community adults in Ontario.Methods: One thousand three hundred sixty seven individuals (60.6% female, mean age = 37.5%) participated in this study between January 15, 2021 and February 15, 2021. Perceptions of vaccine safety and reasons for willingness/unwillingness to receive the COVID-19 vaccine were investigated using an online assessment. Perceptions were investigated in general and by age, sex and education using analysis of variance.Results: Overall, 82.8% of the sample reported they were willing to receive a COVID-19 vaccine and 17.2% reported they were unwilling. The three most common reasons for unwillingness were long-term side effects (65.5%), immediate side effects (60.5%), and lack of trust in the vaccine (55.2%). Vaccine willingness significantly differed by sex and education level, with female participants and those with less than a bachelor's degree being more likely to report unwillingness. Perception of COVID-19 vaccine safety was significantly lower (−10.3%) than vaccines in general and differed by age, sex and education, with females, older adults, and individuals with less than a bachelor's degree reporting lower perceived COVID-19 vaccine safety.Conclusion: In this sample of community adults, the COVID-19 vaccine hesitancy rate was less than one in five individuals, but with higher rates in population subgroups. Targeting public health messaging to females and individuals with less than bachelor's degree, and addressing concerns about long-term and immediate side effects may increase vaccine uptake.

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Parent attitudes about childhood vaccines: a vaccine hesitancy point prevalence study.

10.1101/2021.07.26.21261018 ◽

2021 ◽

Author(s):

Sarah Marshall ◽

Anne C Moore ◽

Laura J Sahm ◽

Aoife Fleming

Keyword(s):

Side Effects ◽

Vaccine Safety ◽

Vaccination Schedule ◽

Survey Study ◽

Vaccine Hesitancy ◽

Parent Attitudes ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Number Of Children ◽

Childhood Vaccines

Abstract Objectives The aim of this study was to measure the prevalence of vaccine hesitancy using Parent Attitudes about Childhood Vaccines (PACV) survey regarding paediatric vaccines for their children, in a population of parents attending a STEM (Science, Technology, Engineering and Mathematics) outreach event in Cork, Ireland. Study design Cross-sectional survey study. Methods This study was conducted in November 2018 at the Community Festival of Science STEM event. Eligible attendees were invited to read the participant information leaflet, provide written informed consent, and complete the validated Parent Attitudes about Childhood Vaccines (PACV) survey. Each of the 15 PACV survey items was scored. A score ≥50 identified vaccine hesitant parents. Results A total of 105 parents participated in the study. A small number of participants (6.7%, n = 7) were identified as vaccine hesitant. There were no statistically significant differences between the vaccine hesitant and non-hesitant groups based on age, education, or number of children. Parents had concerns around vaccine side effects (36.2%, n=38) and vaccine safety (20%, n=21). Parents trusted the information they received on vaccines (85.6%, n=90) and 81.9% (n=86) believed that the vaccine schedule was good for their child. Conclusions The findings of this research indicate the presence of vaccine hesitancy in parents in Ireland regarding paediatric vaccines. Parents had concerns regarding vaccine side effects and the number of vaccines on the paediatric immunisation schedule. Further research is necessary to understand how these issues may contribute to vaccine hesitancy, and to develop evidence-based interventions to build on parents existing trust in the vaccination schedule.

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SARS-CoV-2 Vaccine Acceptability in Patients on Hemodialysis: A Nationwide Survey

Journal of the American Society of Nephrology ◽

10.1681/asn.2021010104 ◽

2021 ◽

pp. ASN.2021010104

Author(s):

Pablo Garcia ◽

Maria E. Montez-Rath ◽

Heather Moore ◽

Johnie Flotte ◽

Chris Fults ◽

...

Keyword(s):

United States ◽

Native American ◽

Side Effects ◽

The United States ◽

Vaccine Uptake ◽

Vaccine Hesitancy ◽

Vaccine Acceptability ◽

Increased Risk ◽

Hispanic White ◽

White Patients

BackgroundPatients on dialysis are at increased risk for COVID-19–related complications. However, a substantial fraction of patients on dialysis belong to groups more likely to be hesitant about vaccination.MethodsWith the goal of identifying strategies to increase COVID-19 vaccine uptake among patients on hemodialysis, we conducted a nationwide vaccine acceptability survey, partnering with a dialysis network to distribute an anonymized English and Spanish language online survey in 150 randomly selected facilities in the United States. We used logistic regression to evaluate characteristics of vaccine-hesitant persons.ResultsA total of 1515 (14% of eligible) patients responded; 20% of all responders, 29% of patients aged 18–44 years, and 29% of Black responders reported being hesitant to seek the COVID-19 vaccine, even if the vaccine was considered safe for the general population. Odds of vaccine hesitancy were higher among patients aged 18–44 years versus those 45–64 years (odds ratio [OR], 1.5; 95% confidence interval [95% CI], 1.0 to 2.3), Black patients versus non-Hispanic White patients (OR, 1.9; 95% CI, 1.3 to 2.7), Native Americans or Pacific Islanders versus non-Hispanic White patients (OR, 2.0; 95% CI, 1.1 to 3.7), and women versus men (OR, 1.6; 95% CI, 1.2 to 2.0). About half (53%) of patients who were vaccine hesitant expressed concerns about side effects. Responders’ main information sources about COVID-19 vaccines were television news and dialysis staff (68% and 38%, respectively).ConclusionsA substantial proportion of patients receiving in-center hemodialysis in the United States are hesitant about seeking COVID-19 vaccination. Facilitating uptake requires outreach to younger patients, women, and Black, Native American, or Pacific Islander patients, and addressing concerns about side effects.

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Caregivers’ Willingness to Vaccinate Their Children against Childhood Diseases and Human Papillomavirus: A Cross-Sectional Study on Vaccine Hesitancy in Malawi

Vaccines ◽

10.3390/vaccines9111231 ◽

2021 ◽

Vol 9 (11) ◽

pp. 1231

Author(s):

Gbadebo Collins Adeyanju ◽

Philipp Sprengholz ◽

Cornelia Betsch ◽

Tene-Alima Essoh

Keyword(s):

Human Papillomavirus ◽

Healthcare Workers ◽

Vaccine Safety ◽

Vaccine Uptake ◽

Vaccine Hesitancy ◽

Human Papillomavirus Vaccine ◽

Childhood Immunization ◽

Cross Sectional ◽

Routine Childhood ◽

Papillomavirus Vaccine

Background: Vaccines are among the most effective and cost-efficient public health interventions for promoting child health. However, uptake is considerably affected by vaccine hesitancy. An example is Malawi, with a decline in second vaccine doses and the highest cervical cancer incidence and mortality rate in Sub-Saharan Africa. Understanding vaccine hesitancy is especially important when new vaccines are introduced. This study explores factors contributing to vaccine hesitancy for routine childhood immunization and the human papillomavirus vaccine in Malawi. Methods: The study used a cross-sectional survey design targeting caregivers of children under five years old and adolescent girls. The sample population was derived using three inclusion criteria: one district with low vaccine uptake (Dowa), one district with high vaccine uptake (Salima), and one district where human papillomavirus vaccine was piloted earlier (Zomba). A convenience sample of one primary and one secondary health facility was selected within each district, and participants were systematically included (n = 600). The measures were based on 5C scale for measuring vaccine hesitancy. Multiple regression analyses were performed to explore vaccination intention predictors. Results: Confidence in vaccine safety was the strongest predictor of routine childhood immunization, followed by constraints due to everyday stress. Caregivers had lower confidence in vaccine safety and efficacy when they believed rumors and misinformation and were unemployed. Confidence was higher for those who had more trust in healthcare workers. Age, gender, religion, education, employment, belief in rumors, and trust in healthcare workers were considered predictors of vaccination intention. A husband’s positive attitude (approval) increased childhood vaccination intention. For human papillomavirus, vaccination intentions were higher for those with lower education, more trust in healthcare workers, lower complacency, and a lower tendency toward calculating the benefits and risks of vaccination. Knowledge of human papillomavirus did not increase vaccination intention, but the need to attain a husband’s approval did. Being a young adult and unemployed increased belief in rumors, while trust in healthcare workers reduced the belief. Conclusions: This study provides good insights into the drivers of vaccine hesitancy across different contexts in Malawi. However, further studies are necessary to understand low risk perception among elderly people and the declining trend in second vaccine doses.

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Indecisión a las vacunas: una revisión sistemática para abordar el fenómeno en Latinoamérica

SANUS ◽

10.36789/sanus.vi1.182 ◽

2021 ◽

Vol 6 ◽

pp. e182

Author(s):

Bruno Michel Bernal Vaquera ◽

Alejandro Morales Jinez ◽

Norma Elvira Moreno P´erez

Keyword(s):

Parental Attitudes ◽

Vaccine Hesitancy ◽

Redes Sociales ◽

Revisión Sistemática ◽

Childhood Vaccines ◽

America Latina

Introducción: En los últimos años se han desarrollado movimientos de personas, generalmente padres, que rechazan o están indecisas en cuanto al uso de las vacunas por la falta de conciencia de riesgos y la gravedad de las enfermedades prevenibles por vacunación, así como, por la difusión en las redes sociales de noticias falsas sobre la inocuidad y la eficacia de las vacunas. Investigaciones en países de Europa y América del Norte han descrito un término para estudiar este fenómeno el cual es Indecisión a las Vacunas, estas investigaciones son escasas en Latinoamérica. Objetivo: identificar instrumentos potencialmente válidos y confiables que puedan ser adaptados y modificados tanto al idioma español como al contexto de América Latina relacionados a la indecisión a las vacunas entre padres. Metodología: Se realizó una búsqueda en tres bases de datos PubMed, EBSCOhost y Biblioteca Virtual en Salud; con los términos descriptores de ciencias de la salud: “vaccine hesitancy”, “parents” y “vaccine refutation”. Resultados: Los resultados arrojaron 394 artículos de los cuales 19 fueron elegidos para el análisis. Los principales instrumentos identificados para medir la indecisión a las vacunas fueron los cuestionarios “Parental Attitudes About Childhood Vaccines” y “Vaccine Hesitancy Scale”. Conclusiones: El cuestionario “Parental Attitudes About Childhood Vaccines” es el instrumento más usado y validado en diferentes idiomas para medir la indecisión a las vacunas.

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Caregivers’ Willingness to Vaccinate Their Children Against Childhood Diseases and Human Papillomavirus: a Cross-sectional Study on Vaccine Hesitancy in Malawi

10.21203/rs.3.rs-618575/v1 ◽

2021 ◽

Author(s):

Gbadebo Collins Adeyanju ◽

Philipp Sprengholz ◽

Cornelia Betsch ◽

Tene-Alima Essoh

Keyword(s):

Human Papillomavirus ◽

Healthcare Workers ◽

Vaccine Safety ◽

Vaccine Uptake ◽

Vaccine Hesitancy ◽

Human Papillomavirus Vaccine ◽

Childhood Immunization ◽

Cross Sectional ◽

Routine Childhood ◽

Papillomavirus Vaccine

Abstract Background: Vaccines are among the most effective and cost-efficient public health interventions for promoting child health. However, uptake is considerably affected by vaccine hesitancy. Malawi has experienced a decline in second vaccine doses and has the highest cervical cancer incidence and mortality rate in Sub-Saharan Africa. Understanding vaccine hesitancy is especially important when new vaccines are introduced. This study explores factors contributing to vaccine hesitancy for routine childhood immunization and the human papillomavirus vaccine in Malawi. Methods: The study used a cross-sectional survey design to target caregivers of children under five years of age and adolescent girls. The sample population was derived using three inclusion criteria: one district with low vaccine uptake (Dowa), one district with high vaccine uptake (Salima), and one district where human papillomavirus vaccine was piloted earlier (Zomba). A convenience sample of one primary and one secondary health facility was selected within each district, and participants were systematically included (N = 600). Multiple regression analyses were performed to explore vaccination intention predictors.Results: Confidence in vaccine safety was the strongest predictor of routine childhood immunization, followed by constraints due to everyday stress. The participants had lower confidence in vaccine safety and efficacy when they believed rumors and misinformation and were unemployed. Confidence was higher for those who had more trust in healthcare workers. Age, gender, religion, education, employment, belief in rumors, and trust in healthcare workers were considered predictors of vaccination intention. A husband’s positive attitude (approval) increased childhood vaccination intention. For human papillomavirus, vaccination intentions were higher for those with lower education, more trust in healthcare workers, lower complacency, and a lower tendency toward calculating the benefits and costs of vaccination. Knowledge of human papillomavirus did not increase vaccination intention, but a husband’s approval did. Being a younger adult and being unemployed increased belief in rumors, while trust in healthcare workers reduced it. Conclusions: This study provides insights into the drivers of vaccine hesitancy across different contexts in Malawi. However, further studies are necessary to understand low risk perception among elderly people and the declining trend in second vaccine doses.

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