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Article . 2026
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Transactions of the Royal Society of Tropical Medicine and Hygiene
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Article . 2026
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When coverage is high: rethinking the role of caregiver perceptions in childhood vaccination uptake in Uganda

Authors: Annika K Gunderson; Taeim Kwon; Yohhan Kumarasinghe; Yuanyuan Yan; Joyce Choe; Qikai Jiang; Emmanuel Baguma; +7 Authors

When coverage is high: rethinking the role of caregiver perceptions in childhood vaccination uptake in Uganda

Abstract

Abstract Background Beliefs of a child’s primary caregiver are known to influence immunization uptake. As coverage increases, the characteristics of households with undervaccinated children may be shifting. Methods We conducted a cross-sectional survey of households with a child 12–23 months of age. Vaccine status was verified by inspection of immunization cards or caregiver report. Composite scores captured caregiver beliefs and experiences with vaccination. Associations between these measures and vaccination status were evaluated using weighted logistic regression. Results Caregivers of 1689 children were surveyed. The odds of full vaccination were not associated with composite beliefs (adjusted odds ratio [aOR] 1.04 [95% confidence interval {CI} 0.95 to 1.14]) or experiences scores (aOR 1.04 [95% CI 0.96 to 1.13]). Specific beliefs that vaccines prevent severe disease (aOR 2.68 [95% CI 1.64 to 4.37]) and protect the community (aOR 1.67 [95% CI 1.10 to 2.53]) were positively associated, whereas beliefs that children receive too many vaccines (aOR 0.60 [95% CI 0.44 to 0.83]) were negatively associated with full vaccination. Positive experiences, including knowing someone affected by a vaccine-preventable disease (aOR 2.10 [95% CI 1.47 to 3.00]) were also linked to full vaccination. Conclusions Although composite scores were not associated with immunization status, individual beliefs and experiences may still factor into caregiver decisions to vaccinate their children.

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
0
Average
Average
Average
hybrid