Articlebronze2012

Social and cultural determinants of oral cholera vaccine uptake in Zanzibar

Christian Schaetti · Said Mohammed Ali · Raymond C. W. Hutubessy · Ahmed Khatib · Claire‐Lise Chaignat · Mitchell G. Weiss

17 citations0/0 files storedHuman Vaccines & Immunotherapeutics

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Vaccine Coverage and Hesitancy Risk Perception and Management Vibrio bacteria research studies

Abstract

Effectiveness of mass cholera vaccination campaigns requires not only technical and financial capacity but also consideration of social and cultural factors affecting vaccine acceptance. This study examined the influence of local community views of cholera on oral cholera vaccine (OCV) uptake in a mass vaccination campaign in 2009 in peri-urban and rural areas of Zanzibar. It used data from interviews conducted before the campaign and followed previous research assessing determinants of anticipated OCV acceptance. OCV uptake was lower than the reported anticipated acceptance. Less than half of the 356 adult respondents (49.7%) drank the required two doses of OCV. Variables referring to socio-cultural features of diarrheal illness that respondents identified with a cholera case vignette explained uptake better than analysis only of socio-demographic characteristics. Somatic features of illness not specific for cholera were negative determinants. Recognition of unconsciousness as a serious sign of dehydration and concern that cholera outbreaks would overwhelm the local healthcare system in the rural area were positive determinants of acceptance. Female gender, rural residence and older age were also positive determinants of OCV uptake. For further vaccine action with OCVs, cholera as a cause of severe dehydration should be distinguished from other causes of diarrhea. Planning should acknowledge rural concern about the relationship of limited capacity of the healthcare system to cope with cholera outbreaks and the priority of a cholera vaccine. Findings recommend particular efforts to increase cholera immunization coverage among young adults, in peri-urban areas and for men.

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References

1997Explanatory Model Interview Catalogue (EMIC): Framework for Comparative Study of Illness 2001Cultural epidemiology: An introduction and overview 2011Factors Affecting Intention to Receive and Self-Reported Receipt of 2009 Pandemic (H1N1) Vaccine in Hong Kong: A Longitudinal Study 2004Policymakers’ views regarding the introduction of new-generation vaccines against typhoid fever, shigellosis and cholera in Asia 2003Coverage and costs of mass immunization of an oral cholera vaccine in Vietnam.2003Introduction of a HIV vaccine in developing countries: social and cultural dimensions 2004Assessment of relevant cultural considerations is essential for the success of a vaccine.2009Do People Who Intend to Get a Flu Shot Actually Get One?

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