Document Type : original article
Authors
1
Social determinants of health (SDH) research center, Kashan University of Medical Sciences, Kashan, I.R. Iran.
2
Department of Public Health, School of Public Health, Kashan University of Medical Sciences, Kashan, I.R. Iran
3
Department of Public Health, School of Public Health, Kashan University of Medical Sciences, Kashan, I.R. Iran 39996636
10.22038/jpp.2026.95418.5648
Abstract
Background: Immunization programs are critical interventions for controlling infectious diseases, significantly reducing childhood mortality. However, parental refusal of childhood vaccination is increasing, potentially leading to the resurgence of debilitating and fatal childhood diseases. This study explores the reasons behind such decisions among families in Kashan, Iran.
Methods: This qualitative study utilized semi-structured interviews to collect data. Participants were parents who refused vaccination for their children. Interviews were transcribed and analyzed concurrently with data collection using thematic analysis. Data saturation determined the sample size.
Results: From eight interviews, 200 codes (merging similar codes) were extracted, forming 19 themes related to refusal reasons. These were categorized into immediate causes (vaccine hesitancy), intermediary causes (misinformation, belief in natural immunity, perceived low risk of infection, belief in safer alternatives, conspiracy theories, distrust in services, personal and others’ experiences, influence of propaganda and rumors, modeling others’ behavior, personality traits, and immunization costs), and underlying causes (popularity of traditional medicine, anti-vaccine movement, COVID-19 outbreak, organizational issues, individual choice, perceived non-urgency of immunization services, and the expansion of virtual spaces).
Conclusion: This study highlights the importance of understanding the multifaceted and complex factors contributing to vaccine refusal. It suggests that multifaceted, evidence-based interventions can enhance vaccine acceptance and improve public health.
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