Towards a further understanding of measles vaccine hesitancy in Khartoum state, Sudan: A qualitative study

Abstract

Background Vaccine hesitancy is one of the contributors to low vaccination coverage in both developed and developing countries. Sudan is one of the countries that suffers from low measles vaccine coverage and from measles outbreaks. For a further understanding of measles vaccine hesitancy in Sudan, this study aimed at exploring the opinions of Expanded Program on Immunization officers at ministries of health, WHO, UNICEF and vaccine care providers at Khartoum-based primary healthcare centers. Methods Qualitative data were collected using semi-structured interviews during the period January-March 2018. The topic list for the interviews was developed and analyzed using the framework ''Determinants of Vaccine Hesitancy Matrix'' that developed by the WHO-SAGE Working Group. Findings The interviews were conducted with 14 participants. The majority of participants confirmed the existence of measles vaccine hesitancy in Khartoum state. They further identified various determinants that grouped into three domains including contextual, groups and vaccination influences. The main contextual determinant as reported is the presence of "anti-vaccination"; who mostly belong to some religious and ethnic groups. Parents' beliefs about prevention and treatment from measles are the main determinants of the group influences. Attitude of the vaccine providers, measles vaccine schedule and its mode of delivery were the main vaccine related determinants. Conclusion Measles vaccine hesitancy in Sudan appears complex and highly specific to local circumstances. To better understand the magnitude and the context-specific causes of measles vaccine hesitancy and to develop adapted strategies to address them, there is a need to investigate measles vaccine hesitancy among parents.