TITLE:
Factors Associated with Refusal of Vaccination among Children Aged 12 to 23 Months in the City of Kisangani, Democratic Republic of the Congo
AUTHORS:
Antoine Ependja Towaka, Raphael Iseayembele Bosalo, Placide Bakalunga Assani, Baombolia Lokangu Zenon, Kalongo Bokuwakuwa Georges, John Panda Lukongo Kitronza, Joris Losimba Likwela
KEYWORDS:
Vaccine Hesitancy, Vaccine Refusal, Immunization, Kisangani, Republic Democratic of the Congo
JOURNAL NAME:
Journal of Biosciences and Medicines,
Vol.13 No.11,
November
10,
2025
ABSTRACT: Introduction: Health systems are facing an alarming increase in cases of hesitation, delay and even refusal of vaccination, despite the availability of quality vaccination services. This study aims to identify the factors associated with vaccination refusal among children aged 12 to 23 months in Kisangani. Materials and methods: A cross-sectional analytical study was conducted in 2022 in five health zones in the city of Kisangani. A total of 336 children aged 12 to 23 months and their mothers selected using three-stage cluster sampling. Analyses were performed on STATA 13 using stepwise logistic regression with a threshold of 0.10. Results: The prevalence of vaccination refusal was 37.5%. Factors independently associated with refusal included the belief that vaccinating boys is more important than girls (adjusted OR 5.1, 95% CI 1.6 - 15), long waiting times (AOR 3.5, 95% CI 1.7 - 6.9), the mother’s lifestyle (AOR 3.1, 95% CI 1.6 - 6.3), existence of a controversial vaccine in the community (AOR 3.0, 95% CI 1.7 - 5.1), lack of trust in vaccine manufacturers (AOR 1.8, 95% CI 1.1 - 3.4), preference for vaccination method, adverse events following immunisation (AOR 2.0, 95% CI 1.1 - 3.6), poor reception by healthcare professionals (AOR 1.9, 95% CI 1.1 - 3.4), and introduction of a new vaccine (AOR 1.8, 95% CI 1.1 - 3.2). Conclusion: Targeted interventions addressing these factors are needed to improve adherence to childhood vaccination schedules and reduce preventable morbidity in Kisangani. Communication strategies for social and behavioural change, tailored to mothers and addressing identified barriers, could enhance vaccine uptake.