Factors Contributing to Pneumococcal Vaccination Hesitancy among Caregivers of Children with Sickle Cell Anaemia in a Resource-limited Setting: Implications for Vaccine Coverage

Abstract

Background: Children with sickle cell anaemia (SCA) are at increased risk of invasive pneumococcal disease, making pneumococcal vaccination an important preventive measure. However, vaccine hesitancy may reduce uptake, particularly in resource-limited settings where access to vaccines and reliable information may be constrained. Aim: This study examined factors contributing to pneumococcal vaccination hesitancy among caregivers of children with SCA and their implications for vaccine coverage. Study Design: The work was a hospital-based cross-sectional study conducted among caregivers of children with SCA. Place and Duration of Study: The study was conducted at the sickle cell clinic of the Yobe State Specialist Hospital, Potiskum, from April to June 2026. Methodology: Data were collected using a structured, interviewer-administered questionnaire addressing sociodemographic characteristics, vaccination status, and reported reasons for hesitancy. Descriptive statistics were used to summarise the reported barriers. Results: Of the 126 participating caregivers, 108 (85.7%) vaccinated their children, while 18 (14.3%) did not or were unsure of their vaccination status. The most frequently reported reasons for hesitancy were fear of side effects and vaccine unavailability (27.8% each), followed by lack of trust (16.7%), lack of awareness (11.1%), and high cost (11.1%).  The majority (83.3%) of the hesitant caregivers indicated that encouragement from healthcare workers would motivate them to vaccinate their children. Conclusion: Pneumococcal vaccine hesitancy is influenced by both caregiver-related concerns and health-system barriers. Strengthening vaccine counselling services, addressing safety concerns, and ensuring that vaccines are available, affordable, and accessible may enhance pneumococcal conjugate vaccine (PCV) uptake among children with SCA.