Vaccine hesitancy toward childhood vaccination in the Madinah Region, Saudi Arabia: A cross-sectional study

Objectives: Vaccine hesitancy poses a significant threat to public health and childhood immunization programs globally. Despite high vaccination coverage in Saudi Arabia, limited data exist on parental attitudes toward childhood vaccines in the Madinah region. The objective of the study is to assess the prevalence and determinants of parental vaccine hesitancy toward childhood vaccination in the Madinah region, Saudi Arabia. Methods: A cross-sectional survey was conducted between December 2024 and March 2025 among the parents recruited from five selected healthcare facilities in the Madinah region, with supplementary online participation. Parents of children aged 1–10 years were recruited using convenience sampling. Results: Of 322 participating parents, 89 (27.6%, 95% confidence interval [CI]: 23.0–32.7%) were classified as vaccine hesitant. The mean PACV score was 38.4 ± 18.2. In multivariate analysis, factors independently associated with vaccine hesitancy included lower parental education (adjusted odds ratio [aOR]: 2.87, 95% CI: 1.52–5.41, p = 0.001), unemployment (aOR: 2.14, 95% CI: 1.18–3.89, p = 0.012), exposure to anti-vaccine information on social media (aOR: 3.76, 95% CI: 2.08–6.79, p < 0.001), and having ≥4 children (aOR: 1.98, 95% CI: 1.05–3.73, p = 0.034). Parents with previous experience of vaccine adverse events were also more likely to be hesitant (aOR: 2.52, 95% CI: 1.31–4.85, p = 0.006). Conclusion: More than one-quarter of parents in Madinah demonstrate vaccine hesitancy, with social media exposure and lower education being key modifiable risk factors. Targeted educational interventions and social media monitoring strategies are needed to address parental concerns and maintain high vaccination coverage.