A comparison of local determinants of vaccine hesitancy in Botswana and the Dominican Republic, two middle-income countries
Methods: We conducted focus groups with 33 providers and 22 caregivers in Gaborone, Botswana and 37 providers and 59 caregivers in the DR. Focus groups were conducted in the participants’ native language, digitally recorded and transcribed. Transcripts were translated into English, coded in qualitative data analysis software (NVivo 10), and analyzed for common themes.
Results: Botswana’s vaccination rates are >99.5% (based on DTP3). Respondents reported high vaccine acceptance due to societal norms, trust in the healthcare system and knowledge about vaccines. In the DR, vaccination rates are 85% (based on DTP3). Respondents reported knowledge about vaccines and VPD was the major promoter of vaccine acceptance. Participants did not express the same level of trust in the government and healthcare system as was expressed in Botswana, and did not view vaccination as a societal norm. In both countries, the majority of vaccine communication is from healthcare workers and, for providers, is from medical literature. Negative information from popular media is regarded with skepticism.
Conclusion: Knowledge of vaccines and VPD were key promoters of vaccine acceptance in both Botswana and the DR. Participants from Botswana were also significantly influenced by societal norms and a high level of trust in the healthcare system and government, which may affect vaccination rates. In settings such as the DR, where societal norms and trust of the healthcare system are not primary drivers of vaccine acceptance, public health efforts should consider local promoters of vaccine acceptance.
M. Murphy, None
M. Callender, None
I. Japa, None
B. Nfila, None
C. Moser, None
P. Offit, None
N. Monyatsi, None
K. Feemster, None