Barriers to vaccine acceptance and immunization coverage in Kazakhstan: a mixed-methods study using the COM-B framework

BackgroundVaccine hesitancy remains a significant public health challenge, affecting immunization coverage and increasing the risk of vaccine-preventable diseases. Understanding the factors influencing vaccine acceptance is crucial for developing targeted interventions. This study examines immunizat...

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Main Authors: Lena Kassabekova, Manar Smagul, Gaukhar Nukenova, Aigul Satayeva, Bibigul Aubakirova, Gulnur Zhakhina, Aizhan Yesmagambetova
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-06-01
Series:Frontiers in Public Health
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Online Access:https://www.frontiersin.org/articles/10.3389/fpubh.2025.1600363/full
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author Lena Kassabekova
Manar Smagul
Gaukhar Nukenova
Aigul Satayeva
Bibigul Aubakirova
Gulnur Zhakhina
Aizhan Yesmagambetova
author_facet Lena Kassabekova
Manar Smagul
Gaukhar Nukenova
Aigul Satayeva
Bibigul Aubakirova
Gulnur Zhakhina
Aizhan Yesmagambetova
author_sort Lena Kassabekova
collection DOAJ
description BackgroundVaccine hesitancy remains a significant public health challenge, affecting immunization coverage and increasing the risk of vaccine-preventable diseases. Understanding the factors influencing vaccine acceptance is crucial for developing targeted interventions. This study examines immunization coverage, vaccine hesitancy, and barriers to vaccine uptake in Kazakhstan, focusing on routine childhood immunization, COVID-19 vaccination, and HPV vaccination.MethodsA mixed-methods approach was used, combining quantitative immunization coverage data with qualitative insights from focus group discussions (FGDs). Immunization trends were presented using national data from 2020 to 2022. The study included FGDs with healthcare workers, unvaccinated older adults, mothers/caregivers of unvaccinated young children and of adolescent girls, focusing on COVID-19, routine immunization, and HPV vaccination. Thematic analysis was used for defining main themes in discussions.ResultsAlthough routine immunization coverage improved in 2022 compared to 2020, general vaccine refusals increased by 2.62 times. The primary reasons for vaccine refusal included personal beliefs (68%), concerns about vaccine safety (54%), and distrust in healthcare institutions (39%). COVID-19 vaccine hesitancy was particularly high among older adult individuals, influenced by skepticism regarding vaccine safety, multiple vaccine options, and conspiracy theories. Healthcare professionals exhibited mixed confidence in COVID-19 vaccines expressing concerns about long-term safety. HPV vaccination hesitancy was linked to limited awareness and misconceptions about cervical cancer.ConclusionDespite improvements in immunization coverage, vaccine hesitancy remains a critical barrier in Kazakhstan. Addressing misinformation, enhancing healthcare communication, and implementing targeted educational campaigns are essential for improving vaccine acceptance and public trust in immunization programs.
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spelling doaj-art-24ff19b753914328adba40f2b677ef052025-08-20T03:31:21ZengFrontiers Media S.A.Frontiers in Public Health2296-25652025-06-011310.3389/fpubh.2025.16003631600363Barriers to vaccine acceptance and immunization coverage in Kazakhstan: a mixed-methods study using the COM-B frameworkLena Kassabekova0Manar Smagul1Gaukhar Nukenova2Aigul Satayeva3Bibigul Aubakirova4Gulnur Zhakhina5Aizhan Yesmagambetova6Scientific and Practical Center for Sanitary and Epidemiological Expertise, Astana, KazakhstanNational Center for Public Health, Astana, KazakhstanNational Center for Public Health, Astana, KazakhstanScientific and Practical Center for Sanitary and Epidemiological Expertise, Astana, KazakhstanNational Center for Public Health, Astana, KazakhstanNazarbayev University School of Medicine, Astana, KazakhstanNational Center for Public Health, Astana, KazakhstanBackgroundVaccine hesitancy remains a significant public health challenge, affecting immunization coverage and increasing the risk of vaccine-preventable diseases. Understanding the factors influencing vaccine acceptance is crucial for developing targeted interventions. This study examines immunization coverage, vaccine hesitancy, and barriers to vaccine uptake in Kazakhstan, focusing on routine childhood immunization, COVID-19 vaccination, and HPV vaccination.MethodsA mixed-methods approach was used, combining quantitative immunization coverage data with qualitative insights from focus group discussions (FGDs). Immunization trends were presented using national data from 2020 to 2022. The study included FGDs with healthcare workers, unvaccinated older adults, mothers/caregivers of unvaccinated young children and of adolescent girls, focusing on COVID-19, routine immunization, and HPV vaccination. Thematic analysis was used for defining main themes in discussions.ResultsAlthough routine immunization coverage improved in 2022 compared to 2020, general vaccine refusals increased by 2.62 times. The primary reasons for vaccine refusal included personal beliefs (68%), concerns about vaccine safety (54%), and distrust in healthcare institutions (39%). COVID-19 vaccine hesitancy was particularly high among older adult individuals, influenced by skepticism regarding vaccine safety, multiple vaccine options, and conspiracy theories. Healthcare professionals exhibited mixed confidence in COVID-19 vaccines expressing concerns about long-term safety. HPV vaccination hesitancy was linked to limited awareness and misconceptions about cervical cancer.ConclusionDespite improvements in immunization coverage, vaccine hesitancy remains a critical barrier in Kazakhstan. Addressing misinformation, enhancing healthcare communication, and implementing targeted educational campaigns are essential for improving vaccine acceptance and public trust in immunization programs.https://www.frontiersin.org/articles/10.3389/fpubh.2025.1600363/fullvaccine hesitancyimmunization coveragepublic healthvaccine acceptanceCOM-B framework
spellingShingle Lena Kassabekova
Manar Smagul
Gaukhar Nukenova
Aigul Satayeva
Bibigul Aubakirova
Gulnur Zhakhina
Aizhan Yesmagambetova
Barriers to vaccine acceptance and immunization coverage in Kazakhstan: a mixed-methods study using the COM-B framework
Frontiers in Public Health
vaccine hesitancy
immunization coverage
public health
vaccine acceptance
COM-B framework
title Barriers to vaccine acceptance and immunization coverage in Kazakhstan: a mixed-methods study using the COM-B framework
title_full Barriers to vaccine acceptance and immunization coverage in Kazakhstan: a mixed-methods study using the COM-B framework
title_fullStr Barriers to vaccine acceptance and immunization coverage in Kazakhstan: a mixed-methods study using the COM-B framework
title_full_unstemmed Barriers to vaccine acceptance and immunization coverage in Kazakhstan: a mixed-methods study using the COM-B framework
title_short Barriers to vaccine acceptance and immunization coverage in Kazakhstan: a mixed-methods study using the COM-B framework
title_sort barriers to vaccine acceptance and immunization coverage in kazakhstan a mixed methods study using the com b framework
topic vaccine hesitancy
immunization coverage
public health
vaccine acceptance
COM-B framework
url https://www.frontiersin.org/articles/10.3389/fpubh.2025.1600363/full
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