Abstract

Introduction The most common indirect impact of the Coronavirus Disease 2019 (COVID-19) pandemic has been the interruption of routine immunisation services, resulting in a significant decline in childhood immunisation rates, particularly during the early stages of the pandemic. This study aimed to explore the socio-demographic characteristics associated with continued routine immunisation in Rwanda.

Methods A cross-sectional survey was conducted between January 3rd to March 31st, 2022 amongst mothers from five districts in Rwanda. Multinomial logistic regression was used to determine associations between demographic characteristics and the willingness to vaccinate children, considering the impact of the COVID-19 pandemic on vaccination attitudes.

Results Among the 2,045 mothers surveyed, 92.2% and 91.6% admitted that their religion and culture support immunisation respectively. Marital status, educational status, and average monthly income were significantly associated with culture and tradition. Out of the 2,045 mothers, 77.3% and 58.7% were concerned about the serious adverse effects of vaccines and COVID-19 vaccines, while 8.1% were concerned with the safety of COVID-19 vaccines. With the exception of age, marital status, and the number of children in the immunisation age bracket, there was a significant association between the perceived risks of vaccination and all other socio-demographic characteristics.

Conclusion Global routine immunisation was disrupted throughout the duration of the COVID-19 pandemic. However, Rwanda’s initial preparedness to combat infectious diseases such as Ebola minimized the influence of COVID-19 on routine immunisation in the country. This study suggests an association between routine immunisation and factors such as culture, financial constraints, vaccine misinformation, concern about adverse effects of vaccines, and apprehensions over the safety of COVID-19 vaccines.

Competing Interest Statement

The authors have declared no competing interest.

Funding Statement

This study was funded by the Government of Rwanda and the German Government through Germany Academic Exchange Service

Author Declarations

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

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The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

Institutional Review Board (IRB) of the University of Rwanda, College of Medicine and Health Science (No. 402/CMHS IRB/2020)

I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.

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I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).

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AbbreviationsMean95%C.I95%Confidence IntervalAEsAdverse effectsaORAdjusted Odds RatioBCGBacille Calmette-GuérinCOVID-19Coronavirus Disease 2019DTP33rd dose Diphtheria Tetanus Toxoid and PertussisMCV11st dose of Measles Containing VaccineOPV33rd dose of Oral Poliovirus VaccineOROdds RatioRIRoutine ImmunisationVHVaccine hesitancyχ2Pearson Chi square.