Factors contributing to incomplete vaccination among children aged 12 to 59 months in Mbale city, Eastern Uganda: a caregivers and health workers' perspective.

BACKGROUND

Vaccination is one of the most effective public health interventions, substantially reducing morbidity, disability, and mortality among children under five years of age from vaccine-preventable diseases. Despite global progress, vaccination coverage remains suboptimal, with the highest burden of incomplete vaccination reported in sub-Saharan Africa. In 2020, an estimated 14 million infants worldwide did not receive the first dose of diphtheria pertussis tetanus (DPT1) vaccine. Children with zero dose vaccination and those who do not receive all types and doses of vaccines remain highly vulnerable to vaccine-preventable diseases, contributing to outbreaks, morbidity, disability, and mortality. This study explored caregivers' and health workers' perspectives on factors contributing to incomplete vaccination among children aged 12-59 months in Mbale City, Eastern Uganda.

MATERIALS AND

METHODS

A descriptive qualitative study was conducted in Namatala (Industrial Division) and Nakaloke (Northern Division), Mbale City, Eastern Uganda. Ethical approval was obtained from the Busitema University Research and Ethics Committee. Participants were selected using purposive sampling. Data were collected from 18 caregivers and 30 health care workers and analyzed thematically using Colaizzi's seven-step approach.

RESULTS

Six major themes emerged: misconceptions about vaccination; perceived susceptibility to and severity of incomplete vaccination; perceived benefits of vaccination; perceived barriers to vaccination; information gaps; and strategies for ending incomplete vaccination. Misconceptions included myths surrounding vaccination, perceived vaccine-related morbidity, and mortality. Limited understanding and misbeliefs regarding the benefits of vaccination were common. Information gaps were driven by misinformation from social media, delayed, unclear, or inadequate communication, and general ignorance. Identified barriers included fear of side effects, transportation challenges, and negative health worker attitudes, lack of partner support, peer influence, multiple injections, child illness, and caregivers' busy schedules. Proposed solutions included training village health teams (VHTs), continuing medical education (CMEs) for health workers, intensified community sensitization, male partner involvement, and improved accessibility to vaccination services.

CONCLUSION

Factors contributing to incomplete vaccination are multifaceted, involving individual, community, and health system related challenges. Strengthening collaboration between health teams and religious and cultural leaders, alongside targeted interventions such as mobile vaccination clinics to address access barriers, is essential to improving vaccination completion rates in this setting.