Sebastian Taylor|M. Mahmud Khan|Ado Muhammad|Okey Akpala|Marit van Strien|Chris Morry|Warren Feek|Ellyn Ogden
Understanding vaccine hesitancy in polio eradication in northern Nigeria
Royal College of Paediatrics and Child Health|University of South Carolina|National Primary Health Care Development Agency|Federal Government of Nigeria|National Primary Health Care Development Agency|Federal Government of Nigeria
vaccine hesitancy constitutes major threat global polio eradication initiative gpei expansion routine immunisation understanding hesitancy leading cases refusal vital success gpei reemergence circulating wild poliovirus northern nigeria mid2016 24 months poliofree gives urgency equally important protect sustain global gains available routine immunisation time rising scepticism potential rejection specific vaccines immunisation generally study based purposive sampling survey 1653 households high lowperforming rural semiurban urban areas three highrisk states northern nigeria 201314 sokoto kano bauchi survey sought understand factors household community level associated propensity refuse polio vaccine wealth female education knowledge vaccines associated lower propensity refuse oral polio vaccine opv among rural households higher risk refusal among wealthier literate urban household rendered findings ambiguous ethnic religious identity appear associated risk opv refusal risk vaccine refusal highly clustered among households within small subgroup sampled settlements contrary expectations households settlements reported higher levels expectation government service provider time lesser confidence efficacy relations government results suggest strategies address micropolitical dimension vaccination expanding communitylevel engagement strengthening role local government public health enhancing public participation women effective reducing noncompliance important set strategies complementary conventional didacticeducational approaches working religious traditional influencers