Determinants of vaccine hesitancy among caregivers of children in rural South India: a comprehensive cross-sectional framework analysis

Maddineni Sowmya; G. M. Pranam; Usha Hirevenkanagoudar; Sanjeev Chetty

doi:10.18203/2349-3291.ijcp20263307

Authors

Maddineni Sowmya Department of Paediatrics, Navodaya Medical College, Hospital and Research Centre, Raichur, Karnataka, India
G. M. Pranam Department of Paediatrics, Navodaya Medical College, Hospital and Research Centre, Raichur, Karnataka, India
Usha Hirevenkanagoudar Department of Paediatrics, Navodaya Medical College, Hospital and Research Centre, Raichur, Karnataka, India
Sanjeev Chetty Department of Paediatrics, Navodaya Medical College, Hospital and Research Centre, Raichur, Karnataka, India

DOI:

https://doi.org/10.18203/2349-3291.ijcp20263307

Keywords:

Vaccine hesitancy, Anganwadi, Children

Abstract

Background: Vaccine hesitancy-the delay in acceptance or refusal of immunization despite availability-poses an important challenge to immunization programmes. This study investigated the behavioral pattern and determinants of vaccine hesitancy among caregivers of children in rural South India using the WHO-SAGE Vaccine Hesitancy framework.

Methods: A descriptive cross-sectional questionnaire-based survey was conducted among 360 caregivers registered in Anganwadi demographic records in Zaheerabad, Raichur, over a three-month period from June 2025 to August 2025. The structured questionnaire assessed caregiver characteristics, childhood vaccination profiles and behavioral variables mapped to SAGE domains. Pearson's chi-square test was used for categorical associations.

Results: Safety concerns were the most frequently reported reason for hesitancy (30.0%, n=108), followed by lack of awareness (25.0%, n=90). Hesitancy was concentrated in HPV (n=121), COVID-19 (n=112) and PCV (n=98), while routine EPI vaccines accounted for 29 responses. Significant associations were observed for primary hesitancy reason (χ²=132.381, p<0.001), vaccine type (χ²=33.785, p<0.001) and SAGE domain (χ²=55.445, p<0.001).

Conclusions: Vaccine hesitancy in this setting was predominantly product-specific and associated with safety concerns, awareness gaps and confidence-related factors. Communication-focused, context-specific interventions may help improve vaccine confidence and acceptance.

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