Determinants of vaccine hesitancy among parents: a cross-sectional survey-based study

Abstract

Background: Vaccine hesitancy is among the top 10 global health threats. In Saudi Arabia, despite good vaccination coverage (e.g., 96% for measles-mumps-rubella), parental confidence is low. This study assessed the frequency of vaccine hesitancy among parents in Taif City, Saudi Arabia, and its associated demographic and health-related characteristics, including domain-specific attitudes (behavior, attitude, safety, and efficacy). Methods: Parents of children aged 2 months-7 years completed an online Arabic questionnaire collecting sociodemographic data, vaccination history, and the parent attitudes on childhood vaccines (PACV) measure. The scale ranged from 0 to 100, with a score of 50 or higher suggesting indecision. Associations were analyzed by the chi-square or Fisher’s exact test, the Mann-Whitney U test, or the Kruskal-Wallis H test. Results: The prevalence of hesitating was 19.8% (87/440). The mean PACV score was 34.1±19.4. The highest score was in the attitude category (4.99±3.9), followed by safety and efficacy (4.12±2.5) and behavior (1.03±1.4). Strong predictors were divorced or widowed status (50.0% versus 17.2%; p<0.001), younger age (75.0%; p=0.017), incomplete immunization (38.5% versus 14.2%; p<0.001), and previous refusal (62.3% versus 14.0%; p<0.001). Conclusions: Hesitancy towards vaccination was observed among ~20% of the parents in Taif. Their attitudes and concerns regarding safety and efficacy were of great significance. General hesitancy is low, but specific communication strategies, systematic screening with the PACV measure, and interventions for first-time parents and single mothers are recommended.