Abstract

WILLINGNESS TO ACCEPT MALARIA VACCINE AMONG CAREGIVERS OF UNDER-5 CHILDREN: A CROSS-SECTIONAL STUDY AT PCMH AND CONNAUGHT HOSPITAL, FREETOWN

Alimamy Kamara, Dr. Brian Thompson*

Abstract

Background: Sierra Leone has one of the highest malaria burdens in the world and children under 5 years of age are the most vulnerable. The malaria vaccine RTS,S/AS01 is a promising vaccine, but its use is still very low (around 50% of eligible children nationally). Knowledge of the willingness of caregivers and related factors is crucial for enhancing vaccine uptake. Objective: To evaluate the uptake of malaria vaccination among caregivers of under fives children attending two major government hospitals in Freetown and to determine factors influencing uptake of malaria vaccine. Method: A cross sectional study was carried out from January to July 2025 at Princess Christian Maternity Hospital (PCMH) and Connaught Hospital. The immunization registers were used to select 201 caregiver-child records through systematic random sampling. Structured questionnaires were employed to gather data on the socio-demographic characteristics, awareness, trust, and perceived effectiveness. Chi-square tests and logistic regression (SPSS v25) were used to identify predictors of vaccine acceptance. Results: Vaccine uptake was only 21.9% (44/201). The most common primary barriers were concerns about side effects (58.0%) and lack of awareness (29.3%). Significant predictors of acceptance were: awareness (χ²=17.82, p

Keywords: Malaria vaccine; vaccine acceptance; caregivers; under-five children; Sierra Leone.