Parental vaccine hesitancy in Brazil: results from a household survey

Vaccine-hesitant parents delay or refuse their children's immunization and constitute a significant public health concern. Our study aims to measure parental vaccination hesitancy and its associated factors in parents residing in Campo Grande, Mato Grosso do Sul State, Brazil. From September 2022 to October 2023, a cross-sectional study aligned to a household survey was carried out to measure vaccination coverage in Campo Grande. The two-stage cluster sampling proposed by the World Health Organization to estimate vaccination coverage was adopted in this study. All residing parents of children aged under 12 years were included. Data were collected by face-to-face interviews using the SAGE Working Group questionnaire to assess parental vaccine hesitancy. We classified the reasons for hesitancy under the 3C conceptual model of vaccine hesitancy determinants. Descriptive statistics characterized the study population and a univariate and multivariate logistic regression assessed the association between hesitancy and other study variables. This study included 158 parents, 39.2% of whom hesitated to get their children immunized. COVID-19 vaccines produced the greatest hesitancy (77.4%). Participants mentioned lack of confidence as the most common motive for their hesitancy (85.5%). Hesitant parents resided in bigger households (aOR = 1.31; 95%CI: 1.02; 1.72), believed there were reasons for not immunizing children (aOR = 4.02; 95%CI: 1.41; 12.77), and hesitated to get their own vaccines (aOR = 3.74; 95%CI: 1.80; 8.16). Results suggest an association of parental hesitancy with socioeconomical and behavioral factors.