Measles vaccine hesitancy among caregivers of children aged 12–35 months in the Biyem-Assi Health District, Yaoundé, Cameroon: a cross-sectional study

Abstract Despite the fact that vaccination remains one of the most effective strategies to reduce the burden of measles disease, the access of children to measles vaccination is compromised by caregivers’ hesitancy to vaccinate their children. The aim of this study was to map the distribution and reasons for caregivers' hesitancy to vaccinate their children against measles in the Biyem-Assi health district of the central region of Cameroon. This community-based descriptive cross-sectional study targeted caregivers of children aged 12 to 35 months in the Biyem-Assi health district, selected by stratified cluster random sampling. Data were collected from March to April 2024 via pretested paper-based questionnaires administered face-to-face to caregivers in households. The vaccine hesitancy rate and distribution were estimated on the basis of the WHO definition. Analysis was performed via Microsoft Excel 2021 and IBM SPSS Statistics 23.0. A total of 1229 caregivers were reached, and 1135 (92.34%) consented to participate. Among them, 251 (22.1% CI95%:[19.5–24.2]) caregivers were identified as vaccine hesitant, 123 (10.8% CI95%:[9.0–12.6]) refused vaccination, and the average vaccination delay rate was 21.2% CI95%:[19.7–24.5], (20.5% CI95%:[17.2–23.6]) for MCV1 and (3.6% CI95%:[1.4–6.1]) for MCV2. The three main reasons for hesitancy reported by caregivers included fear of side effects [67 (53.2%)], concerns about efficacy [65 (51.6%)] and lack of information [65 (51.6%)]. The study also revealed that 56.2% of vaccine hesitant individuals were exposed to rumors against vaccination. Vaccine hesitancy remains high in Biyem-Assi, with 1 in 5 caregivers delaying measles vaccinations for their children and 1 in 10 refusing the vaccine. Establishing communication strategies could further reduce vaccine hesitancy.