Vaccine hesitancy among legal guardians of children with chronic neurological disorders: a cross-sectional study in Saudi Arabia

Vaccine hesitancy poses a significant public health challenge, particularly among vulnerable populations such as children with chronic neurological disorders (NDDs). Despite the proven efficacy of vaccines, limited data exist on parental attitudes toward immunization in this high-risk group in Saudi Arabia. This study aims to assess the prevalence of vaccine hesitancy and its associated factors among legal guardians of children with NDDs in Riyadh, Saudi Arabia. A cross-sectional study was conducted from October 2021 to September 2022 at Sultan Bin Abdulaziz Humanitarian City (SBAHC), Riyadh, Saudi Arabia. A total of 401 legal guardians of children aged 2–18 years with NDDs completed a validated Arabic version of the Parent Attitudes about Childhood Vaccines (PACV) questionnaire. Statistical analyses included Chi-square tests and multivariate logistic regression to identify predictors of vaccine hesitancy. The level of vaccine hesitancy among respondents was 10.2%. Vaccine hesitancy was higher statistically among caregivers of male children (p = 0.031), young mothers (p = 0.016), educated mothers (p = 0.017), less educated fathers (p = 0.046), and low-income families (p = 0.014). Analysis showed that older maternal age (AOR = 0.446, p = 0.028), higher paternal education (AOR = 0.408, p = 0.023), and greater household income (AOR = 0.412, p = 0.035) as protective factors for hesitancy, while younger educated mothers increased the likelihood of greater hesitancy (AOR = 3.400, p = 0.001). Vaccine hesitancy among caregivers of children with NDDs in Saudi Arabia appears to be comparable to rates reported in prior regional studies. The association between higher maternal education and increased hesitancy warrants further investigation. These findings support the need for nuanced educational and communication strategies to improve vaccine acceptance among caregivers of neurologically vulnerable children.