Background Several studies have highlighted that vaccine hesitancy (VH) is among the most important threats to global health, especially in low- and middle-income countries, including the Philippines. However, there is a dearth of literature exploring family experiences of—or concerns related to—childhood vaccinations that gives voice to vaccine hesitant caregivers (VHCs) of small children. Here, we present insights from VHCs from the Philippines. Methods This research draws on in-depth interviews (IDIs) with 44 VHCs who had previously delayed or refused vaccination for their children in rural and urban communities in Cavite Province, the Philippines. Amid the COVID-19 pandemic, we conducted IDIs via an online platform of the respondents’ choosing (ie, Facebook messenger call, Skype and Zoom). All interviews were recorded, transcribed, translated and analysed drawing from the tenets of constructivist grounded theory. We use the social ecological model to structure our results. Results Among the reasons for delay or refusal of childhood vaccinations, a fear of side effects emerged as the most salient concern, exacerbated by previous negative experiences (including trauma) from a dengue vaccine controversy in 2017. Respondents cited the dengue vaccine controversy as they expressed reluctance (regarding any new vaccines) and suspicion (towards school-based vaccination, the distribution channel used for the dengue vaccine). Heads of households opposing vaccines, perceptions that vaccines are non-essential and influences from the social and traditional media or neighbours contributed to further refusal and delay. Upon probing, VHCs recounted health system concerns particularly with regards to healthcare workers who are sometimes unable to answer their questions and can be dismissive or disrespectful regarding caregivers’ concerns. Conclusion Understanding VH from the lens of VHCs highlights pathways for interventions to regain trust and bolster confidence towards vaccines. Our findings may serve as linchpins in the development of VH interventions aiming at changing behaviour on a population scale. All data relevant to the study are included in the article or uploaded as online supplemental information. The datasets generated in this study are not publicly available due to sensitive and personal nature of the information. Data may be available upon request to authors, with restrictions following ethical approval.

中文翻译：

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害怕、无力、侮辱和尴尬：菲律宾甲米地省看护者对疫苗的犹豫

背景 多项研究强调，疫苗犹豫 (VH) 是对全球健康最重要的威胁之一，尤其是在包括菲律宾在内的低收入和中等收入国家。然而，缺乏探索儿童接种疫苗的家庭经历或相关问题的文献，这些文献可以让犹豫不决的幼儿照料者 (VHC) 发表意见。在这里，我们展示了来自菲律宾的 VHC 的见解。方法 本研究利用对菲律宾甲米地省农村和城市社区的 44 名 VHC 的深入访谈 (IDI)，这些人之前曾延迟或拒绝为其子女接种疫苗。在 COVID-19 大流行期间，我们通过受访者选择的在线平台（即 Facebook 信使电话、Skype 和 Zoom）进行了 IDI。所有采访都被录音、转录，从建构主义扎根理论的原则翻译和分析图纸。我们使用社会生态模型来构建我们的结果。结果 在推迟或拒绝儿童接种疫苗的原因中，对副作用的恐惧成为最突出的担忧，而 2017 年登革热疫苗争议导致的先前负面经历（包括创伤）加剧了这一担忧。受访者在表达登革热疫苗争议时提到了这一问题不情愿（关于任何新疫苗）和怀疑（对基于学校的疫苗接种，登革热疫苗的分销渠道）。反对疫苗的户主、认为疫苗不是必需的以及来自社交和传统媒体或邻居的影响导致了进一步的拒绝和拖延。经过试探，VHC 讲述了卫生系统的担忧，特别是关于有时无法回答他们的问题并且可能对护理人员的担忧不屑一顾或不尊重的医护人员。结论 从 VHC 的角度了解 VH 突出了干预措施以重新获得信任和增强对疫苗的信心的途径。我们的发现可能成为开发旨在改变人口规模行为的 VH 干预措施的关键。与研究相关的所有数据都包含在文章中或作为在线补充信息上传。由于信息的敏感和个人性质，本研究中生成的数据集未公开提供。数据可应作者要求提供，但在获得伦理批准后有限制。