Abstract

Background
Vaccine hesitancy encompasses varying degrees of uncertainty over the use of certain vaccines or uptake of vaccinations. Understanding the hesitant individuals and their unique concerns is the first step in overcoming this complex public health problem. This thesis’s primary goals were to measure the prevalence of vaccine hesitancy among UK parents and guardians and determine predictors of this target population's intention to follow official vaccination recommendations to inform effective methods to promote vaccination in the country.

Methods
Between November and December 2021, 818 UK parents and guardians of pre-schoolers aged 0–6 were surveyed online. Vaccine hesitancy prevalence was estimated using the Parent Attitudes about Childhood Vaccines (PACV) questionnaire. The cross-sectional survey, which was influenced by the Protection Motivation Theory (PMT), also examined threat and coping appraisal indicators regarding vaccine-preventable diseases (VPDs), vaccine-related sociocultural behaviours and norms, past experiences with VPDs and vaccinations, and data sources in the COVID-19 vaccine context. The factors influencing the desire of parents and guardians to embrace childhood vaccinations were examined, and cognitive variables were established. Using multivariable logistic regression, correlations between sociodemographic characteristics and vaccine hesitancy were examined.

Results
Vaccine hesitancy prevalence of 41.7% on the PACV 100-point scale was found among participants of this study. Significant disparities in the level of parental vaccine hesitancy were attributed to factors including marital status, age, ethnicity, and political and social ideologies. Those who identified as White Other were the most vaccine hesitant when compared to other ethnic groups. It was discovered that all of the key elements of the PMT characterising people's threat and coping appraisal were strongly predictive of vaccination intention. However, compared to other constructs, disease severity, response efficacy, and self-efficacy were more significantly predictive. Additionally, by triggering various threat and coping appraisal mechanisms, social attitudes, behaviours, norms, knowledge of an individual who has had a history of vaccine side effects and seeking vaccine data from public health organisations all implicitly indicated parents' intention to embrace childhood vaccinations.

Conclusions
The thesis underlines the value of the PACV scale as a tool for screening vaccine hesitant parents. The findings also point to significant vaccine hesitancy determinants including attitudes toward prevention and the communication and media environment. Future public health initiatives should emphasise herd immunity’s role and the high efficacy of vaccines in lowering disease transmission at all levels of contracting VPDs. Providers of healthcare might play a significant role in boosting public confidence in scientific and epidemiological findings. Older migrants (age 45+), who have worse self-reported health and wellbeing status and less accessibility to healthcare, should be the target of health intervention strategies.