Prevalence and Determinants of Polio Vaccine Hesitancy Among Parents in Lahore

Abstract

Background: Polio eradication in Pakistan remains threatened by persistent vaccine hesitancy despite repeated immunization campaigns and service availability. Parental mistrust, misinformation, and sociocultural concerns continue to undermine uptake, particularly in high-risk populations. Objective: To determine the prevalence of polio vaccine hesitancy among parents attending a tertiary pediatric hospital in Lahore and to identify factors independently associated with hesitancy. Methods: A cross-sectional observational study was conducted at Children’s Hospital Lahore among 257 parents or primary caregivers of children aged five years or younger. Data were collected using a structured interviewer-administered questionnaire assessing demographic characteristics, knowledge of polio, trust in vaccine safety, exposure to misinformation, and attitudinal barriers. Descriptive statistics, chi-square testing, and multivariable logistic regression were used for analysis. Results: Polio vaccine hesitancy was observed in 71 of 257 participants, yielding a prevalence of 27.6%. Hesitancy was significantly associated with lower education, lower household income, lack of trust in vaccine safety, belief in infertility-related myths, religious concerns, and exposure to vaccine-related misinformation on social media. In multivariable analysis, lack of trust in vaccine safety remained the strongest predictor of hesitancy (adjusted OR 5.72; 95% CI 2.76-11.87), followed by infertility myth belief (adjusted OR 4.38; 95% CI 2.01-9.53) and social media misinformation exposure (adjusted OR 3.16; 95% CI 1.68-5.93). Conclusion: Polio vaccine hesitancy among parents in Lahore is substantial and is driven primarily by mistrust and misinformation. Targeted communication, myth-correction strategies, and trust-building interventions are needed to strengthen vaccine acceptance.