Special vaccine uptake among children with sickle cell disease: coverage, determinants and barriers in a tertiary hospital in Benin City, Nigeria

Abstract Background Children with sickle cell disease (SCD) are highly susceptible to severe infections due to functional asplenia. Special vaccines such as pneumococcal, Haemophilus influenzae type b (Hib), meningococcal, influenza and hepatitis B vaccines are recommended to reduce infection- related morbidity and mortality. However, uptake in low-resource settings remains suboptimal. Objective To assess caregivers’ knowledge, attitude and practices regarding special vaccination of children with SCD and determine factors associated with vaccination status. Methods A hospital-based cross-sectional study was conducted among 130 caregivers of children with SCD attending the University of Benin Teaching Hospital, Benin City. Data were collected using a structured questionnaire assessing socio-demographic characteristics, knowledge, attitude, vaccination history (vaccination cards reviewed) and barriers to uptake. Knowledge and attitude were graded using predefined scoring systems. Data were analysed using descriptive statistics, chi-square test for bivariate associations, and binary logistic regression to identify independent predictors of vaccination status. Statistical significance was set at p < 0.05. Results Although 60.8% of caregivers knew that children with SCD are prone to serious infections, only 16.2% demonstrated good knowledge. Regarding vaccination practices, only 40.0% of children had received PCV, 31.5% meningococcal vaccine, and 13.8% Hib vaccine. Nearly half (49.2%) of the children were completely unvaccinated with any special vaccine, and only 3.1% were fully vaccinated. Most (78.5%) caregivers reported that a health worker had recommended special vaccines, and 86.9% expressed willingness to vaccinate if vaccines were free. Financial constraints (65.6%) emerged as the leading barrier to uptake. In bivariate analysis, caregivers’ knowledge ( p < 0.001), attitude ( p = 0.024), and family monthly income ( p = 0.018) were significantly associated with vaccination status. On multivariate logistic regression, caregivers’ knowledge remained the only independently significant predictor of vaccination status. Compared with caregivers with good knowledge, those with poor knowledge had significantly lower odds of vaccinating their children (aOR = 0.111, 95% CI: 0.019–0.632; p = 0.013). Conclusion Despite generally positive attitudes, poor knowledge and financial barriers contribute to low uptake of special vaccines among children with SCD. Subsidization and targeted caregiver education are recommended.