Determinants of Children Vaccine Hesitancy among the Parents of Newly Merged Districts of Khyber Pakhtunkhwa

Vaccine hesitancy for children immunization vaccine programs in parents is one of key topics in public health in the Global South including most of Pakistan. However, in the erstwhile Federally Administered Areas (FATA) which are now merged in Khyber Pakhtunkhwa, known as Newly Merged Districts (NMDs), there is a dearth of such research. This study aimed to fill this void. Through two-staged sampling, 384 participants were selected and administered with WHO SAGE Vaccine Hesitancy Scale along with open-ended question for quantum and determinants of vaccine hesitancy. The study found that more than one third of the parents (35.41%) are severely hesitant regarding their children routine immunization while more than half (55.72) are moderately resistant which is alarming. Major factors affecting vaccine hesitancy are negative perceptions about vaccination (22.14%), religious conspiracies (14.06%), lack of information about vaccination (11.72%), fears of adverse effects (11.7%), Western funding for vaccination (6.25%) demand of other life necessities from the Government (7.81%) and few others. Interestingly, Odd Ratios (OR) values revealed that sever hesitancy is more prevalent in those who has both formal education and religious education (OR=19.4, p>.001) than only formally educated or religiously educated parents, this point need further investigation. Similarly, parents who has availed Seht Sahulat Card, sever hesitancy (OR=1.5, p>.001) in them was less than those who didn’t avail it (OR=1.3, p>.001). Results also showed that moderate hesitancy is more prevalent in high-income parents than middle- and lower-income parents. Expanded Program of Immunization – EPI was operational in NMDs (former FATA), but it got momentum recently, still there is alarming vaccine hesitancy in these areas. This call for a comprehensive and all-stakeholders inclusive strategy to eradicate this vaccine hesitancy in these vulnerable tribal areas of Pakistan.