{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T02:49:14Z","timestamp":1781664554222,"version":"3.54.5"},"reference-count":46,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2025,3,10]],"date-time":"2025-03-10T00:00:00Z","timestamp":1741564800000},"content-version":"unspecified","delay-in-days":9,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"United States International University - Africa","award":["Not applicable"],"award-info":[{"award-number":["Not applicable"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["bmjph"],"accepted":{"date-parts":[[2025,2,10]]},"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>Vaccine hesitancy among mothers in low-income communities in Kenya presents a serious obstacle to achieving successful childhood immunisation. The aim of this study was to explore the determinants of vaccine hesitancy among mothers from low-income rural communities, risk perceptions associated with vaccines and how these factors influence decision-making regarding their children\u2019s immunisation.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>A qualitative descriptive study was conducted in three counties in Kenya (Murang\u2019a, Kiambu and Machakos) using in-depth interviews and focus group discussions with mothers of children under 5 years. Participants were purposively sampled from low-income rural communities and were mothers attending postnatal clinics at various health facilities. Thematic analysis was used to identify key themes and subthemes, coding of transcripts, identification of patterns and organisation of themes into categories.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Several critical factors that contribute to vaccine hesitancy among mothers regarding their children\u2019s immunisation were identified through thematic analysis. Safety concerns emerged as a primary issue, with mothers expressing fears of adverse reactions such as fever, pain, swelling or other unexpected complications. Misinformation significantly influenced perceptions, including beliefs that vaccines might cause infertility or long-term health problems. Distrust in the health system further exacerbated hesitancy, with mothers questioning the quality, administration and motives of vaccinators. Limited vaccine knowledge also played a role, which led to misconceptions about the severity and risks of vaccine-preventable diseases. Moreover, sociocultural and religious beliefs influenced decision-making, with some mothers viewing vaccines as unsafe or ineffective, driven by cultural norms, reliance on traditional remedies or religious objections.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>This study provides valuable insights into the complexities of vaccine hesitancy among mothers in low-income communities in Kenya. Furthermore, the results emphasise the complex nature of hesitancy, driven by an interplay of safety concerns, misinformation, distrust, limited knowledge, and sociocultural and religious influences. Addressing these determinants requires interventions that would prioritise clear and accurate communication about vaccine safety, engagement with community and religious leaders, and strengthening trust in healthcare providers and systems. Additionally, enhancing vaccine knowledge through targeted health education programmes would be crucial for empowering mothers to make informed decisions about their children\u2019s health.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjph-2024-001601","type":"journal-article","created":{"date-parts":[[2025,3,13]],"date-time":"2025-03-13T08:06:02Z","timestamp":1741853162000},"page":"e001601","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":10,"title":["Role of risk perceptions and vaccine hesitancy on decision-making among low-income mothers in Kenya: a qualitative study"],"prefix":"10.1136","volume":"3","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9880-6819","authenticated-orcid":false,"given":"Stephen Gichuhi","family":"Kimotho","sequence":"first","affiliation":[{"name":"Communication, United States International University, Nairobi, Kenya, Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2025,3,13]]},"reference":[{"key":"2025101800251048000_3.1.e001601.1","doi-asserted-by":"crossref","unstructured":"Al-Worafi YM . Vaccination in Developing Countries: Pediatrics. Handbook of Medical and Health SciencesinDeveloping Countries: Education, Practice and Research. Springer, 2023:1\u201321.","DOI":"10.1007\/978-3-030-74786-2_270-1"},{"key":"2025101800251048000_3.1.e001601.2","first-page":"83","article-title":"Advancing Immunization in Africa: Overcoming Challenges to Achieve the 2030 Global Immunization Targets","volume":"15","author":"Okesanya","year":"2024","journal-title":"Adolesc Health Med Ther"},{"key":"2025101800251048000_3.1.e001601.3","doi-asserted-by":"crossref","first-page":"1270","DOI":"10.15585\/mmwr.mm6545a5","article-title":"Global Routine Vaccination Coverage, 2015","volume":"65","author":"Casey","year":"2016","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"2025101800251048000_3.1.e001601.4","doi-asserted-by":"crossref","DOI":"10.1186\/s12889-020-09965-y","article-title":"Complete basic childhood vaccination and associated factors among children aged 12-23\u2009months in East Africa: a multilevel analysis of recent demographic and health surveys","volume":"20","author":"Tesema","year":"2020","journal-title":"BMC Public Health"},{"key":"2025101800251048000_3.1.e001601.5","doi-asserted-by":"crossref","DOI":"10.1186\/s12889-020-08940-x","article-title":"Full vaccination coverage among children aged 12-23\u2009months in Ethiopia: a systematic review and meta-analysis","volume":"20","author":"Ketema","year":"2020","journal-title":"BMC Public Health"},{"key":"2025101800251048000_3.1.e001601.6","doi-asserted-by":"crossref","DOI":"10.1186\/s12889-023-16508-8","article-title":"Contextual factors influencing incomplete immunization and investigation of its geospatial heterogeneity in Pakistan: a cross-sectional study based on PDHS (2017-18)","volume":"23","author":"Kamal","year":"2023","journal-title":"BMC Public Health"},{"key":"2025101800251048000_3.1.e001601.7","doi-asserted-by":"crossref","first-page":"22","DOI":"10.53819\/81018102t6047","article-title":"Immunization Coverage among Children Aged Between 12-23 Months in West Pokot County, Kenya","volume":"5","author":"Kirongo","year":"2022","journal-title":"JMNPH"},{"key":"2025101800251048000_3.1.e001601.8","doi-asserted-by":"crossref","first-page":"1252","DOI":"10.15585\/mmwr.mm6645a3","article-title":"Global Routine Vaccination Coverage, 2016","volume":"66","author":"Feldstein","year":"2017","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"2025101800251048000_3.1.e001601.9","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1007\/s40272-020-00385-4","article-title":"Vaccine Hesitancy: A Growing Concern","volume":"22","author":"Kennedy","year":"2020","journal-title":"Paediatr Drugs"},{"key":"2025101800251048000_3.1.e001601.10","doi-asserted-by":"crossref","unstructured":"Otenyo EE . Policy Images in Africa. Routledge Handbook of Public Policy in Africa. Routledge, 2021:95\u2013106.","DOI":"10.4324\/9781003143840-10"},{"key":"2025101800251048000_3.1.e001601.11","doi-asserted-by":"crossref","DOI":"10.3390\/vaccines10101595","article-title":"Vaccine Hesitancy: Contemporary Issues and Historical Background","volume":"10","author":"Nuwarda","year":"2022","journal-title":"Vaccines (Basel)"},{"key":"2025101800251048000_3.1.e001601.12","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pgph.0002986","article-title":"A qualitative inquiry on drivers of COVID-19 vaccine hesitancy among adults in Kenya","volume":"4","author":"Orangi","year":"2024","journal-title":"PLOS Glob Public Health"},{"key":"2025101800251048000_3.1.e001601.13","doi-asserted-by":"crossref","DOI":"10.1186\/s12879-021-06271-9","article-title":"Inequities in childhood immunisation coverage associated with socioeconomic, geographic, maternal, child, and place of birth characteristics in Kenya","volume":"21","author":"Allan","year":"2021","journal-title":"BMC Infect Dis"},{"key":"2025101800251048000_3.1.e001601.14","doi-asserted-by":"crossref","DOI":"10.1186\/s12889-020-09486-8","article-title":"Spatial access inequities and childhood immunisation uptake in Kenya","volume":"20","author":"Joseph","year":"2020","journal-title":"BMC Public Health"},{"key":"2025101800251048000_3.1.e001601.15","doi-asserted-by":"crossref","DOI":"10.1186\/s12889-023-15855-w","article-title":"Exploring the factors contributing to low vaccination uptake for nationally recommended routine childhood and adolescent vaccines in Kenya","volume":"23","author":"Essoh","year":"2023","journal-title":"BMC Public Health"},{"key":"2025101800251048000_3.1.e001601.16","doi-asserted-by":"publisher","DOI":"10.1080\/14760584.2018.1541406"},{"key":"2025101800251048000_3.1.e001601.17","doi-asserted-by":"crossref","DOI":"10.4081\/jphr.2019.1436","article-title":"Vaccine hesitancy: An overview on parents\u2019 opinions about vaccination and possible reasons of vaccine refusal","volume":"8","author":"Facciol\u00e0","year":"2019","journal-title":"J Public Health Res"},{"key":"2025101800251048000_3.1.e001601.18","unstructured":"Hoffmann M , Baggio M , Krawczyk M . Vaccination demand and acceptance. 2023."},{"key":"2025101800251048000_3.1.e001601.19","doi-asserted-by":"crossref","DOI":"10.1016\/j.ijnsa.2022.100062","article-title":"Decision making in vaccine hesitant parents and pregnant women - An integrative review","volume":"4","author":"Smith","year":"2022","journal-title":"Int J Nurs Stud Adv"},{"key":"2025101800251048000_3.1.e001601.20","article-title":"Vaccine hesitancy: clarifying a theoretical framework for an ambiguous notion","volume":"7","author":"Peretti-Watel","year":"2015","journal-title":"PLoS Curr"},{"key":"2025101800251048000_3.1.e001601.21","doi-asserted-by":"crossref","DOI":"10.1016\/j.pmedr.2023.102341","article-title":"Vaccine decision making among people who inject drugs: Improving on the WHO\u2019s 3C model of vaccine hesitancy","volume":"35","author":"Hardin","year":"2023","journal-title":"Prev Med Rep"},{"key":"2025101800251048000_3.1.e001601.22","unstructured":"Sommariva S . Promoting HPV Vaccination with Vaccine-Hesitant Parents Using Social Media: A Formative Research Mixed-Method Study. University of South Florida, 2021."},{"key":"2025101800251048000_3.1.e001601.23","unstructured":"Second round of polio immunisation campaign underway in 13 counties, to prevent childhood disease. 2021."},{"key":"2025101800251048000_3.1.e001601.24","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1016\/j.srhc.2017.08.005","article-title":"Parents\u2019 involvement in the human papillomavirus vaccination decision for their sons","volume":"14","author":"Perez","year":"2017","journal-title":"Sexual & Reproductive Healthcare"},{"key":"2025101800251048000_3.1.e001601.25","unstructured":"Johnson RB , Christensen LB . Educational Research: Quantitative, Qualitative, and Mixed Approaches. Sage publications, 2024."},{"key":"2025101800251048000_3.1.e001601.26","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1177\/160940690900800301","article-title":"A Qualitative Framework for Collecting and Analyzing Data in Focus Group Research","volume":"8","author":"Onwuegbuzie","year":"2009","journal-title":"Int J Qual Methods"},{"key":"2025101800251048000_3.1.e001601.27","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1177\/160940690900800301","article-title":"Toward more rigor in focus group research: A new framework for collecting and analyzing focus group data","volume":"8","author":"Onwuegbuzie","year":"2009","journal-title":"International Journal of Qualitative Methods: ARCHIVE"},{"key":"2025101800251048000_3.1.e001601.28","doi-asserted-by":"crossref","unstructured":"Fusch P , Ness L . n.d. Are We There Yet? Data Saturation in Qualitative Research. TQR. doi:10.46743\/2160-3715\/2015.2281","DOI":"10.46743\/2160-3715\/2015.2281"},{"key":"2025101800251048000_3.1.e001601.29","unstructured":"Cresswell J . Qualitative inquiry & research design: choosing among five approaches. 2013."},{"key":"2025101800251048000_3.1.e001601.30","unstructured":"Lincoln YS , Guba EG . Establishing trustworthiness. In: Naturalistic Inquiry. SAGE, 1985: 289\u2013331."},{"key":"2025101800251048000_3.1.e001601.31","doi-asserted-by":"crossref","first-page":"415","DOI":"10.4135\/9781544364902.n22","volume-title":"The Handbook of Social Work Research Method","volume":"2010","author":"Miles","year":"2010"},{"key":"2025101800251048000_3.1.e001601.32","doi-asserted-by":"crossref","unstructured":"Lim WM . What Is Qualitative Research? An Overview and Guidelines. Australasian Marketing Journal 2024.:14413582241264619. doi:10.1177\/14413582241264619","DOI":"10.1177\/14413582241264619"},{"key":"2025101800251048000_3.1.e001601.33","unstructured":"Miles MB , Huberman AM , Saldana J . Qualitative Data Analysis: A Methods. Sourcebook: SAGE Publications, 2013."},{"key":"2025101800251048000_3.1.e001601.34","doi-asserted-by":"crossref","first-page":"1609406917733847","DOI":"10.1177\/1609406917733847","article-title":"Thematic analysis: Striving to meet the trustworthiness criteria","volume":"16","author":"Nowell","year":"2017","journal-title":"Int J Qual Methods"},{"key":"2025101800251048000_3.1.e001601.35","doi-asserted-by":"crossref","first-page":"2150","DOI":"10.1016\/j.vaccine.2014.01.081","article-title":"Understanding vaccine hesitancy around vaccines and vaccination from a global perspective: A systematic review of published literature, 2007\u20132012","volume":"32","author":"Larson","year":"2014","journal-title":"Vaccine (Auckl)"},{"key":"2025101800251048000_3.1.e001601.36","doi-asserted-by":"publisher","DOI":"10.1093\/jpepsy\/jsp108"},{"key":"2025101800251048000_3.1.e001601.37","doi-asserted-by":"crossref","first-page":"1807","DOI":"10.4161\/hv.28779","article-title":"Effect of the decision-making process in the family on HPV vaccination rates among adolescents 9\u201317 years of age","volume":"10","author":"Berenson","year":"2014","journal-title":"Human Vaccines & Immunotherapeutics"},{"key":"2025101800251048000_3.1.e001601.38","doi-asserted-by":"publisher","DOI":"10.4161\/hv.24657"},{"key":"2025101800251048000_3.1.e001601.39","first-page":"100349","article-title":"\u201cWhat is the problem with vaccines?\u201d A typology of religious vaccine skepticism","volume":"14","author":"Trangerud","year":"2023","journal-title":"Vaccine: X"},{"key":"2025101800251048000_3.1.e001601.40","doi-asserted-by":"publisher","DOI":"10.1016\/j.pcl.2022.11.012"},{"key":"2025101800251048000_3.1.e001601.41","doi-asserted-by":"crossref","DOI":"10.1177\/25151355211047514","article-title":"Vaccine hesitancy in Africa: causes and strategies to the rescue","volume":"9","author":"Aborode","year":"2021","journal-title":"Ther Adv Vaccines Immunother"},{"key":"2025101800251048000_3.1.e001601.42","doi-asserted-by":"crossref","DOI":"10.1186\/s41256-022-00255-1","article-title":"COVID-19 vaccine hesitancy in Africa: a scoping review","volume":"7","author":"Ackah","year":"2022","journal-title":"Glob Health Res Policy"},{"key":"2025101800251048000_3.1.e001601.43","doi-asserted-by":"crossref","DOI":"10.1186\/s12879-021-06398-9","article-title":"Vaccine preferences driving vaccine-decision making of different target groups: a systematic review of choice-based experiments","volume":"21","author":"Diks","year":"2021","journal-title":"BMC Infect Dis"},{"key":"2025101800251048000_3.1.e001601.44","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1186\/s12913-016-1867-7","article-title":"Exploring pathways for building trust in vaccination and strengthening health system resilience","volume":"16","author":"Ozawa","year":"2016","journal-title":"BMC Health Serv Res"},{"key":"2025101800251048000_3.1.e001601.45","first-page":"36","article-title":"Social and Emotional Determinants of COVID-19 Vaccination Attitudes among the Elderly at Health Center Manatuto, Timor-Leste","volume":"4","author":"Chorry Santana","year":"2024","journal-title":"Ascarya j of islam sci cult and soc stud"},{"key":"2025101800251048000_3.1.e001601.46","unstructured":"Desai S , Kiersten J . Women\u2019s decision making and child health: familal and social hierachies. 2005."}],"container-title":["BMJ Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjph-2024-001601","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,18]],"date-time":"2025-10-18T07:25:28Z","timestamp":1760772328000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjpublichealth.bmj.com\/lookup\/doi\/10.1136\/bmjph-2024-001601"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3]]},"references-count":46,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,3,13]]},"published-print":{"date-parts":[[2025,3]]}},"alternative-id":["10.1136\/bmjph-2024-001601"],"URL":"https:\/\/doi.org\/10.1136\/bmjph-2024-001601","relation":{},"ISSN":["2753-4294"],"issn-type":[{"value":"2753-4294","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3]]}}}