# Behavioral and social drivers of rotavirus vaccine uptake in a rural ethnic minority population in Vietnam: A cross-sectional study

## TL;DR

This study explores why rotavirus vaccination rates are low in rural ethnic minority communities in Vietnam, finding that low knowledge, geographic barriers, and the need for better communication are key factors.

## Contribution

The study applies the WHO's Behavioral and Social Drivers framework to identify specific factors influencing rotavirus vaccine uptake in a rural ethnic minority population in Vietnam.

## Key findings

- Only 9.4% of children received at least one dose of rotavirus vaccine, with 16.9% of mothers reporting uptake or intent.
- Positive attitudes and social support were associated with higher vaccine intent, while geographic inaccessibility was a major barrier.
- Low knowledge about rotavirus and vaccination was observed, with a median score of 3 out of 7.

## Abstract

This study aimed to assess rotavirus vaccine (RVV) intent/uptake among rural ethnic minority Vietnamese populations and identify the key drivers influencing vaccination decisions using the World Health Organization's Behavioral and Social Drivers of vaccination framework.

We conducted a community-based cross-sectional study in a rural region of Vietnam in 2025. The study surveyed 384 mothers of children under five using a structured, interviewer-administered questionnaire. The primary outcome was RVV uptake/intent. Associated factors were explored using Poisson regressions, guided by a directed acyclic graph.

Only 9.4 % of children had received at least one dose of RVV, with a total of 16.9 % of mothers reporting either vaccine uptake or intent to vaccinate. Knowledge about rotavirus and vaccination was limited (median score of 3 out of a possible 7), while attitudes toward vaccination were favourable (median score of 12 out of 16). Higher knowledge and positive attitudes, social support from family, peers, community leaders, and healthcare workers were positively associated factors. Conversely, structural barriers such as geographic inaccessibility, and lack of communication were negative associated factors.

RVV uptake among ethnic minority populations remains low. To close this gap, public health strategies must integrate culturally tailored communication, community-level engagement, and improved service accessibility.

•A total of 16.9% of mothers reported either vaccine uptake or intent to vaccinate.•Knowledge about rotavirus and vaccination was generally low among mothers.•Positive attitudes and social support promoted vaccine uptake or intent.•Distance and poor infrastructure were key barriers to vaccination.•Culturally tailored communication and access improvements are essential.

A total of 16.9% of mothers reported either vaccine uptake or intent to vaccinate.

Knowledge about rotavirus and vaccination was generally low among mothers.

Positive attitudes and social support promoted vaccine uptake or intent.

Distance and poor infrastructure were key barriers to vaccination.

Culturally tailored communication and access improvements are essential.