Pneumococcal vaccine awareness, acceptance, and hesitancy among caregivers of children with sickle cell anaemia attending a tertiary hospital in north-eastern Nigeria

Abstract

Background: Children with sickle cell anaemia (SCA) are at increased risk of invasive pneumococcal disease (IPD) due to functional asplenia and impaired immunity. Although the pneumococcal vaccine (PCV) effectively prevents IPD, caregivers' awareness, acceptance, and hesitancy strongly influence vaccine uptake.

Methods: We conducted a cross-sectional study among caregivers of children with SCA who attended the Yobe State Specialist Hospital in Potiskum from April to June 2026. We collected data using interviewer-administered questionnaires and analysed them using descriptive and inferential statistics. We assessed associations between categorical variables using Chi-square and Fisher's exact tests, with significance set at p < 0.05.

Results: Of the 126 caregivers who participated in the study, 88.9% had heard of PCV, with healthcare workers as the primary source of information (82.5%). Furthermore, 72.2% correctly identified the disease prevented by PCV, and 73.0% knew it is recommended for children with SCA; 85.7% of children had received the vaccine, with 76.2% completion of the recommended doses. Vaccine acceptance was largely driven by protection from severe illness (58.3%) and healthcare provider recommendations (25.0%). Conversely, fear of side effects (27.8%) and vaccine unavailability (27.8%) were the main reasons for hesitancy. Information source was significantly associated with vaccine uptake (χ² = 49.723, p < 0.001).

Conclusion: Caregivers showed high PCV awareness and acceptance, with healthcare providers as the primary information source. Addressing vaccine safety concerns, improving availability, and strengthening caregiver education may further reduce hesitancy and improve uptake among children with SCA.