Exploring young fathers’ roles and decision-making regarding childhood vaccination in Tajikistan: A focus group study

Father involvement is an important factor in childhood vaccination. Despite Tajikistan's significant efforts to improve vaccination coverage, vaccine hesitancy persists, with parents exhibiting signs of mistrust towards vaccinations due to misinformation. This study aims to examine how fathers describe their role in their child's vaccination plans and to explore their beliefs and attitudes regarding childhood vaccinations through thematic analysis of data from seven focus groups. Focus group discussions aimed to understand influences on immunization and potential communication channels, messages, and behavior change goals for future campaigns. Our analysis categorized fathers based on their attitudes towards vaccines (supportive or hesitant) and on their level of engagement in vaccine decisions (active or passive). Fathers in the focus groups reported seeing themselves as protectors, particularly given their cultural role as primary decision-makers for their children's health. Our findings indicate that, although many fathers are supportive of childhood vaccines, vaccine hesitancy due to misinformation remains a concern. Current gender norms, as well as employment logistics, also pose barriers for fathers to become more involved in their children's vaccination process. Fathers expressed a desire for more opportunities to learn about health issues in their communities. These insights offer opportunities for public health campaigns to educate and engage fathers as partners in advocating for childhood vaccinations. Future interventions should focus on promoting father involvement, both in terms of attitude and agency, while remaining sensitive to cultural gender norms. • Fathers' attitudes toward vaccinations affect their children's vaccination status. • Vaccine hesitancy remains a concern among fathers in Tajikistan. • Barriers hinder fathers' involvement in their children's vaccination process. • Interventions promoting father involvement and education are needed in Tajikistan.