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

Objective: 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. Methods: 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. Results: 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. Conclusions: 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.