Assessing risk perceptions that contribute to tetanus toxoid maternal vaccine hesitancy in Kilifi County, Kenya

Vaccination is one of the most effective public health interventions today. However, there is a growing number of people who perceive vaccines as unsafe and unnecessary. Waning vaccine confidence threatens global immunization programmes, contributing to decreased immunization rates and outbreaks of vaccine-preventable diseases. We used a mixed-method approach surveying men and women of reproductive age and Focus Group Discussions with expectant mothers to understand maternal vaccine hesitancy within a rural setting of Kilifi County, Kenya. Of the 104 people surveyed, 70% of the participants were aware of the vaccine that expectant women receive and 26% stating that they know people in their community who have refused or were hesitant to take maternal vaccination. Reasons given for refusals include religion and rumors that have spread in the community that the tetanus toxoid vaccine was a family planning method. Stockout of the vaccine was identified as one of the healthcare factors affecting vaccine uptake. The majority of the respondents (84%) reported that they mainly trust a healthcare worker for vaccination information. Approximately 53% and 23% reported that they strongly agree or agreed, respectively, that vaccines for expectant women should be made compulsory. The availability of safe and effective maternal vaccines will only be beneficial if mothers choose to use them. Dissemination of accurate information and continuous engagement with the community members can build trust and confidence in vaccines.