title: An assessment of the reasons for oral poliovirus vaccine refusals in northern Nigeria.
abstract: BACKGROUND
  Accumulation of susceptible children whose caregivers refuse to accept oral poliovirus vaccine (OPV) contributes to the spread of poliovirus in Nigeria.
  
  
  METHODS
  During and immediately following the OPV campaign in October 2012, polio eradication partners conducted a study among households in which the vaccine was refused, using semistructured questionnaires. The selected study districts had a history of persistent OPV refusals in previous campaigns.
  
  
  RESULTS
  Polio risk perception was low among study participants. The majority (59%) of participants believed that vaccination was either not necessary or would not be helpful, and 30% thought it might be harmful. Religious beliefs were an important driver in the way people understood disease. Fifty-two percent of 48 respondents reported that illnesses were due to God's will and/or destiny and that only God could protect them against illnesses. Only a minority (14%) of respondents indicated that polio was a significant problem in their community.
  
  
  CONCLUSIONS
  Caregivers refuse OPV largely because of poor polio risk perception and religious beliefs. Communication strategies should, therefore, aim to increase awareness of polio as a real health threat and educate communities about the safety of the vaccine. In addition, polio eradication partners should collaborate with other agencies and ministries to improve total primary healthcare packages to address identified unmet health and social needs.
authors.affiliation: African Field Epidemiology Network, Kampala, Uganda.
authors.forename: Charles A
authors.initials: CA
authors.lastname: Michael
authors.affiliation: Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Ikechukwu U
authors.initials: IU
authors.lastname: Ogbuanu
authors.affiliation: Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Aaron D
authors.initials: AD
authors.lastname: Storms
authors.affiliation: African Field Epidemiology Network, Kampala, Uganda.
authors.forename: Chima J
authors.initials: CJ
authors.lastname: Ohuabunwo
authors.affiliation: Nigeria Country Office, United Nations Children's Fund, Abuja.
authors.forename: Melissa
authors.initials: M
authors.lastname: Corkum
authors.affiliation: Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Samra
authors.initials: S
authors.lastname: Ashenafi
authors.affiliation: Nigeria Country Office, United Nations Children's Fund, Abuja.
authors.forename: Panchanan
authors.initials: P
authors.lastname: Achari
authors.affiliation: African Field Epidemiology Network, Kampala, Uganda.
authors.forename: Oladayo
authors.initials: O
authors.lastname: Biya
authors.affiliation: African Field Epidemiology Network, Kampala, Uganda.
authors.forename: Patrick
authors.initials: P
authors.lastname: Nguku
authors.affiliation: Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Frank
authors.initials: F
authors.lastname: Mahoney
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D005191:Family Characteristics; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009549:Nigeria; D010342:Patient Acceptance of Health Care / Q000523:psychology* / Q000706:statistics & numerical data; D011055:Poliovirus Vaccine, Oral / Q000008:administration & dosage*; D011795:Surveys and Questionnaires; D016312:Treatment Refusal / Q000523:psychology* / Q000706:statistics & numerical data; D055815:Young Adult
chemical_list: D011055:Poliovirus Vaccine, Oral
keywords: OPV; assessment; noncompliance; oral polio vaccine; refusals