Vaccine hesitancy among mothers of under‑five children: A community based cross‑sectional study in migrant settlements of Ahmedabad

Abstract

Background: Vaccine hesitancy remains a major barrier to achieving optimal childhood immunization coverage, particularly among underserved communities. This study assessed the prevalence of vaccine hesitancy and its predictors among mothers of under-five children residing in migrant settlements of Ahmedabad, Gujarat.

Material and methods: A community-based cross-sectional study was conducted from April 2025 to March 2026 among 361 mothers of under-five children in nine migrant settlements under Jodhpur Urban Primary Health Centre (UPHC), Ahmedabad. Participants were selected using probability proportional to size (PPS) allocation and snowball sampling. Data were collected through face-to-face interviews using the WHO–SAGE Vaccine Hesitancy Questionnaire and verification of immunization cards. Multivariable logistic regression was performed to identify independent predictors of vaccine hesitancy.

Results: The prevalence of vaccine hesitancy was found to be 38.2%. The highest vaccine-specific hesitancy was observed for Pentavalent vaccines (19.6%) followed by Hepatitis B birth dose (17.7%). Fear of side effects (34.9%) and child illness at the time of vaccination (25.3%) were the most common reasons for hesitancy. Significant predictors of vaccine hesitancy were found to be low socioeconomic status (AOR=4.102, p<0.001), maternal education ≤ primary level (AOR=2.511, p=0.001), migrant status (AOR=2.215, p=0.003), paternal education ≤ primary level (AOR=2.140, p=0.005), distance >10 km from a health facility (AOR=1.614, p=0.045), and nuclear family structure (AOR=1.543, p=0.049).

Conclusion: More than one-third of mothers exhibited vaccine hesitancy. Injectable vaccines were found to carry higher hesitancy among mothers of under 5 children. Socioeconomic disadvantage, low parental education, migration, poor accessibility to health facilities, and family structure significantly influenced hesitancy.