Knowledge, attitudes and modelling of refusal to vaccinate children by users of the Expanded Programme on Immunisation in Côte d'Ivoire during COVID-19.

Abstract

The COVID-19 pandemic has profoundly affected perceptions of childhood vaccination in Côte d'Ivoire, leading to disruptions in the Expanded Programme on Immunisation (EPI). This study aims to identify the factors associated with vaccine refusal during this period. This study is based on a descriptive and analytical survey conducted among 422 users of the Expanded Programme on Immunisation between 26 April and 14 May 2021 at the National Institute of Public Health. The target population consisted of parents of children aged 0 to 11 months who had been attending the center for at least six months. Data were collected using a questionnaire on sociodemographic characteristics, attitudes and perceptions towards COVID-19 and vaccination. A descriptive analysis, supplemented by logistic regression, was carried out to identify levels of knowledge and attitudes and to model the factors associated with refusal of vaccination. The results reveal that 46.68% of parents were reluctant to vaccinate their children. Geographical variations were observed: general fear of vaccination was predominant in Abobo, Yopougon and Port-Bouët, while fear of substitution by the COVID-19 vaccine was more pronounced in Cocody and Treichville. Six factors were identified as predictors of refusal, including fear of side effects (ORa = 3.63) and fear of receiving a COVID-19 vaccine (ORa = 6.57). These results highlight the need to strengthen communication to restore confidence in vaccination