Caregivers’ Experiences of Childhood Immunization Barriers and Community Perceptions in Damaturu, Yobe State, Nigeria: A Qualitative Study

Abstract

Background: Childhood immunisation remains essential for preventing vaccine-preventable diseases, yet household, sociocultural and health-service factors may hinder uptake. Understanding community experiences and perceptions is important for developing contextually appropriate interventions. Aim: To explore caregivers’ and community stakeholders’ perceptions and experiences of childhood immunisation, including barriers, vaccine concerns, household decision-making and community communication in Damaturu, Yobe State, Nigeria. Methods: This qualitative component of a concurrent mixed-methods study purposively recruited 19 participants, comprising 14 caregivers, three community leaders and two healthcare workers. Data were collected through two focus group discussions with caregivers, three community-leader in-depth interviews, two healthcare-worker key informant interviews and two follow-up in-depth interviews with caregivers who had participated in the discussions. Interviews and discussions were conducted in Hausa or English, audio-recorded with consent and analysed thematically using Braun and Clarke’s six-phase approach. Results: Four interconnected themes emerged. Perceived benefits and confidence reflected participants’ belief that immunisation protects children and promotes health. Community acceptance and sociocultural influences showed increasing acceptance and supportive religious messages alongside persistent cultural concerns. Vaccine concerns and household decision-making encompassed fear of side effects, rumours and misconceptions, and the influence of fathers or husbands on vaccination decisions. Communication and community mobilisation emphasised the trusted roles of healthcare workers and community leaders in providing information, reassurance and encouragement. Conclusion: Positive attitudes towards immunisation coexisted with vaccine concerns and household and sociocultural barriers. Contextually appropriate communication, household involvement, trusted community leadership and responsive immunisation services may help address these challenges.