Assessment of Factors Affecting Vaccine Hesitancy in Isoka District, Muchinga Province, Zambia

Background: Vaccine hesitancy poses a serious threat to public health efforts globally, including in Zambia. Despite national immunization programs, Isoka District in Muchinga Province has experienced low vaccination rates. This study aimed to assess the factors contributing to vaccine hesitancy in the district, including individual beliefs, social influences, and health system limitations. Methods: A mixed-methods cross-sectional study was conducted among 163 community members from Kawenga and Chuwi communities, and a focus group discussion was held with healthcare workers at Kasoka Urban Clinic. Quantitative data were collected using structured questionnaires and analyzed with SPSS version 24. Qualitative data were thematically analyzed to extract health system and socio-cultural insights. Results: Findings showed that 60% of participants were concerned about vaccine safety, 50% did not believe vaccines prevent disease, and 70% believed social media spreads misinformation. Myths such as vaccines causing infertility (60%) and being part of a Western control plot (40%) were prevalent. Qualitative findings revealed issues with vaccine accessibility, inadequate communication, and mistrust in the healthcare system. Correlation analyses highlighted strong associations between trust in healthcare information and vaccine concerns (r = 0.795, p < 0.01). Conclusion: Vaccine hesitancy in Isoka District is driven by misinformation, cultural beliefs, and systemic challenges. Public health interventions should prioritize community engagement, culturally sensitive education, and trust-building measures within the healthcare system to increase vaccine uptake. Key words: Vaccine hesitancy, Isoka district, Zambia