International Journal of Advanced Biological and Biomedical Research

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Determinants and Interventions for Vaccine Hesitancy in Rural Communities: A Global Narrative Review of Socio-Cultural, Institutional, and Infrastructural Barriers

Document Type : Review Article

Authors

Micheal Abimbola Oladosu 1
Moses Adondua Abah 2
Shola David Omoseeye 3
Zakka Musa 4
Patra Chisom Ezeamii 5
Patrick Chimuanya Etus 6
Joseph Oteng 7
Oluwadamilola Zainab Yakub 8
Emmanuel Obia Ginika 9
Olaide Ayokunmi Oladosu 10

1 Department of Biochemistry, Faculty of Basic Medical Sciences, University of Lagos, Idi-Araba, Nigeria

2 Department of Biochemistry, Faculty of Biosciences, Federal University Wukari, Taraba State, Nigeria

3 Department of Anatomy, Faculty of Basic Medical Sciences, College of Medicine Ekiti State University, Ado Ekiti, Nigeria

4 Department of Community Medicine, Federal University of Health Sciences, Azare, Bauchi State, Nigeria

5 Department of Biostatistics, Epidemiology and Environmental Health Sciences, Jiann-Ping Hsu College of Public Health, Georgia Southern University, USA

6 Department of Microbiology, Faculty of Science, Imo State University, Imo State, Nigeria

7 Department of Public Health, Faculty of Epidemiology, University of Port Harcourt, Port Harcourt, River State Nigeria

8 Department: Medical Laboratory Science, Faculty of Basic Medical Sciences, College of Health Sciences, Ladoke Akintola University of Technology, Ogbomosho, Nigeria

9 Department of Pharmacy, Faculty of Pharmacy, Madonna University, Okada, Edo State, Nigeria

10 Department of Computer Science, Faculty of Science and Technology, Babcock University, Ilisan-Remo Ogun State, Nigeria

https://doi.org/10.48309/ijabbr.2026.2065686.1634
Abstract
The objective of this study is to synthesize global evidence on vaccine hesitancy determinants in rural communities and evaluate intervention strategies for improving immunization coverage in underserved populations. A comprehensive narrative review was conducted across PubMed, Scopus, and Google Scholar databases from January 2005 to December 2024. Search terms included "vaccine hesitancy," "rural immunization," "healthcare access," and related terms. Two independent reviewers screened 1,247 articles using predefined inclusion criteria. Studies focusing on rural or underserved communities, socio-political determinants of vaccine hesitancy, and intervention strategies were included. Thematic analysis was conducted using established vaccine hesitancy frameworks, with quality assessment performed using appropriate tools for different study designs. Rural vaccine coverage consistently lags behind urban areas globally, with disparities ranging from 18 to 25 percentage points. Five primary determinants emerged: psychological barriers (fear of adverse effects in 45% of hesitant individuals), religious and cultural beliefs (particularly influential in 23% of rural communities studied), institutional mistrust (affecting 35% of minority populations), socio-economic constraints (transport costs averaging $15-50 per vaccination visit), and misinformation exposure (reaching 67% of rural populations through social media). Evidence-based interventions showed varying effectiveness: community engagement programs (65% improvement in uptake), mobile vaccination services (40% coverage increase), and culturally tailored education (30% hesitancy reduction). Vaccine hesitancy in rural communities requires multi-level, culturally sensitive interventions addressing structural, informational, and trust-related barriers. Successful strategies integrate community leadership, improved access, transparent communication, and sustainable healthcare system reforms. Future research should prioritize randomized controlled trials of integrated intervention models and develop context-specific frameworks for diverse rural populations.

Graphical Abstract

Determinants and Interventions for Vaccine Hesitancy in Rural Communities: A Global Narrative Review of Socio-Cultural, Institutional, and Infrastructural Barriers

Keywords

Vaccine Hesitancy
Rural Health
Immunization Coverage
Health Equity
Community Engagement
Public Trust
Intervention Strategies

Subjects

OPEN ACCESS

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International Journal of Advanced Biological and Biomedical Research
Volume 14, Issue 2
March and April 2026
Pages 171-190

  • Receive Date 13 July 2025
  • Revise Date 07 August 2025
  • Accept Date 21 October 2025

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