Exploring drivers of childhood vaccine hesitancy among caregivers in Brazil and South Africa: A qualitative study

This article examines the global issue of vaccine hesitancy in Brazil and South Africa, two economically unequal BRICS nations. Despite their established immunization programs, both countries are grappling with coverage decreases, leading to outbreaks. The role of vaccine hesitancy in this scenario is significant. This qualitative study aims to understand childhood vaccine hesitancy in these contexts, highlighting social and behavioral drivers. In-depth interviews were conducted in Sao Luis (Brazil), Florianopolis (Brazil), and Cape Town (South Africa), involving 42 caregivers from diverse socioeconomic backgrounds, race/color, and gender, with children up to 6 years old. Thematic analysis method was used to analyze the empirical data. The drivers of vaccine hesitancy have been arranged across three domains: 'practical issues', prevalent among lower-income non-white families; 'social processes', as informed decisions reflecting neoliberal parenting values, found among higher-income white families; and, in the 'thinking and feeling about vaccines' domain, common fears of side effects and vaccines components are presented. These findings underscore the necessity of tailored health policies, taking into account the influence of historical, cultural, and social contexts. The study also highlights the crucial role of qualitative research in comprehending the intricate interplay of social and behavioral factors in health decision-making.