Investigating Factors Associated with Vaccine Hesitancy in Makkah, KSA

"To better address vaccine hesitancy within a specific country or a population, we must first understand the extent of the problem and where it came from..."

In the Kingdom of Saudi Arabia (KSA), public support for immunisation programmes is generally high. However, some researchers are concerned that the benefits of vaccines are often not fully known or appreciated. When public discussion on vaccine safety, quality, or efficacy occurs, misinformation can creep into the debate through the internet and other media sources, significantly weakening immunisation programmes. This study reflects on the factors associated with vaccine hesitancy in KSA through an investigation of parents' knowledge, attitudes, and beliefs.

A cross-sectional study was carried out in 7 primary schools in Makkah city, KSA. Data were collected in 2017 through a computer-based survey administered to 100 parents with children aged between 2 months and 17 years of age.

Many parents (with a total of 292 children) agreed on the importance of vaccinations as a tool to protect their children's health and to prevent the spread of disease in the community. Most parents (68.7%, P < 0.05) reported that their child had received all recommended vaccines. However, approximately one-third (31.3%, P < 0.05) indicated their hesitation in having their child vaccinated. The lack of vaccines in primary care centres, fear of adverse events following vaccination (AEFIs), and vaccine safety were the reasons most frequently mentioned by these vaccine-hesitant parents. In addition, some parents believed vaccines had become a business and that profits were more important than their children's safety. Other parents complained about the increasingly "crowded" vaccination schedules. (In the discussion section of the paper, the researchers correct misconceptions such as that the simultaneous administration of multiple vaccines overwhelms or weakens the immune system.)

Approximately 60% of parents (P < 0.05) reported not having enough information about potential AEFIs. The parents said they did not receive any brochures, educational community sessions, or even simple instructions in the clinics to educate and teach them about potential side effects associated with vaccination.

To address such lapses and to increase vaccine acceptance in KSA, the researchers say, "most effective interventions use multi-component strategies. Additionally, most were tailored to specific populations and concerns. This is important...[for] understanding the drivers of vaccines hesitancy. We must use this knowledge to support interventions to deliver optimum performances in increasing immunisation rates."

They conclude the paper with a list of possible strategies: engagement of religious or other influential leaders to promote community vaccination strategies; social mobilisation; mass media; communications training for healthcare professionals; non-financial incentives; sanctions for non-vaccination; reminder and follow-up; efforts to improve convenience and access to vaccination; and campaigns to increase vaccination knowledge and awareness.