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Influence of Yellow Fever Awareness on Vaccination Uptake among Residents of High-Risk Communities in Nigeria

Abstract

Yellow fever remains an important public health concern in Nigeria, particularly in communities where ecological and social conditions may support transmission of the disease. Yellow fever is a vaccine-preventable viral disease transmitted primarily through the bites of infected mosquitoes, and outbreaks can result in severe illness and death. Vaccination is one of the most effective measures for preventing yellow fever and reducing the risk of outbreaks. Yellow fever awareness provides individuals with information about the disease, its mode of transmission, symptoms, risk factors, prevention, availability of vaccines, vaccination benefits, and the importance of completing recommended vaccination. Vaccination uptake refers to the receipt of the recommended yellow fever vaccine among eligible individuals. In Nigeria, inadequate awareness, misconceptions about vaccination, fear of adverse effects, limited knowledge of yellow fever transmission, concerns about vaccine safety, and inadequate access to vaccination services may contribute to low vaccination uptake in some high-risk communities. Improving yellow fever awareness may increase knowledge, perceived risk, confidence in vaccination, and willingness to utilize available vaccination services. Against this background, this study investigates the influence of yellow fever awareness on vaccination uptake among residents of high-risk communities in Nigeria. The study is anchored on the Health Belief Model, Theory of Planned Behavior, and Knowledge-Attitude-Practice framework. The Health Belief Model explains preventive health behaviour through perceived susceptibility, perceived severity, perceived benefits, perceived barriers, and cues to action, providing a basis for understanding residents' decisions to receive yellow fever vaccination. The Theory of Planned Behavior explains how attitudes, subjective norms, and perceived behavioural control influence intentions and subsequent vaccination behaviour. The Knowledge-Attitude-Practice framework provides a basis for examining how increased awareness and favourable attitudes toward vaccination may influence vaccination uptake. Collectively, these theoretical perspectives provide a suitable framework for explaining how yellow fever awareness may influence vaccination uptake among residents of high-risk communities in Nigeria. The study will adopt a quantitative cross-sectional research design. Primary data will be collected from adult residents of selected high-risk communities in Nigeria using a structured interviewer-administered questionnaire. A multistage sampling technique will be employed to select states, local government areas, high-risk communities, households, and eligible participants. Yellow fever awareness will be assessed using participants' knowledge of yellow fever transmission, symptoms, risk factors, complications, prevention, vaccine availability, vaccine benefits, and recommended vaccination practices. Vaccination uptake will be assessed based on participants' reported receipt of the yellow fever vaccine, vaccination status, and, where feasible and ethically appropriate, verification using vaccination cards, immunization records, or relevant health records. Descriptive statistics will be used to summarize participants' sociodemographic characteristics, levels of yellow fever awareness, and vaccination uptake. Inferential statistical techniques, including chi-square tests, correlation analysis, and multiple logistic regression analysis, will be used to determine the influence of yellow fever awareness on vaccination uptake. Appropriate diagnostic tests will also be conducted to assess the reliability of the research instrument, model assumptions, goodness of fit, and robustness of the findings. The study is expected to find that higher levels of yellow fever awareness have a significant positive influence on vaccination uptake among residents of high-risk communities in Nigeria. Residents with greater awareness are expected to demonstrate better knowledge of yellow fever transmission and prevention, greater perceived susceptibility to infection, increased confidence in the benefits of vaccination, and higher utilization of available vaccination services. Improved awareness may also reduce misconceptions and fears concerning yellow fever vaccination and encourage residents to seek vaccination when services are available. However, awareness alone may not guarantee vaccination uptake because residents may continue to experience barriers such as distance to vaccination centres, vaccine availability, financial and transportation difficulties, concerns about vaccine safety, misinformation, and inadequate access to reliable health information. Consequently, yellow fever awareness programmes should be supported by accessible vaccination services, reliable vaccine supply, effective community mobilization, and appropriate public health communication. The study is expected to contribute to the literature on vaccine-preventable diseases, immunization, health education, infectious disease prevention, community health, and public health in Nigeria by providing empirical evidence on the influence of yellow fever awareness on vaccination uptake among residents of high-risk communities. The findings will provide useful information to the Federal Ministry of Health and Social Welfare, Nigeria Centre for Disease Control and Prevention (NCDC), National Primary Health Care Development Agency (NPHCDA), National Emergency Management Agency, state ministries of health, local government health authorities, primary healthcare facilities, community health workers, immunization programmes, development partners, and policymakers regarding strategies for improving yellow fever prevention and vaccination coverage. The study will also provide evidence-based recommendations for strengthening community-based yellow fever education, improving risk communication, addressing vaccine misinformation, expanding access to vaccination services, strengthening routine and outbreak-response immunization activities, and promoting timely yellow fever vaccination among residents of high-risk communities across Nigeria.

Keywords: Yellow fever awareness, vaccination uptake, yellow fever vaccination, high-risk communities, vaccine-preventable diseases, immunization, health education, infectious disease prevention, vaccine awareness, community health, public health, Nigeria.