Understanding Caregiver Readiness and Awareness of Malaria Vaccination for Children under-Five in a High-Burden Region

Abstract

Background: The malaria vaccine has proven effective in preventing malaria alongside other preventive methods. This study aimed to assess caregiver knowledge, willingness, and barriers to malaria vaccination in a tertiary healthcare facility in southeast Nigeria. It also explored factors influencing willingness to vaccinate. Methods: A cross-sectional descriptive study was conducted at the Institute of Child Health (ICH), UNTH, with 350 caregivers of children under five from a period of March to May 2025. Interviewer-administered questionnaires, developed by researchers and validated against WHO studies on the malaria vaccine, were used to collect data. Participants were selected through simple random sampling. Analysis was done using SPSS v26, with Chi-square tests and a significance level of p<0.05. Results: The study involved 350 caregivers (mean age 35 ± 9 years); most were female (94.6%), urban residents (61.7%), and Igbo (95.7%). Awareness of malaria was high (97.4%), and 71.4% had heard of the malaria vaccine. However, only 44% knew about the RTS,S vaccine, and 60.3% were aware of the recommended age of administration. About 82.9% correctly identified the vaccine as preventive, and 61.5% had good overall understanding. While only 27.1% were willing to enroll their child in a vaccine study, 96% were willing to receive the malaria vaccine, with 82.3% willing to vaccinate their child and 84.3% encouraging others. Key barriers included cultural beliefs, misinformation, and cost. No significant associations were found between knowledge or willingness and sociodemographic factors (p>0.05), as a satisfactory number seemed to be accommodating of the vaccine. Conclusion: Despite strong willingness to vaccinate, knowledge gaps and sociocultural challenges persist among caregivers. For the malaria vaccine rollout in Nigeria to succeed, efforts must focus on improving public education, building trust in health systems, and addressing financial and informational obstacles. These findings are crucial for health policymakers, educators, and program developers focused on malaria eradication through immunization.