Objective: To assess socio-demographic attributes, healthcare workers’ encouragement and income status as predictors of vaccine hesitancy among adults in Peshawar, Pakistan.

Methods: The study was a cross-sectional design employing an online survey to obtain data from participants from Peshawar, Pakistan. We used binary logistic regression to ascertain the extent of the association between vaccine hesitancy and independent predictors including age, gender, marital status, education, healthcare worker encouragement, and income level. We set the level of significance at p≤.05.

Results: The study sample consisted of 398 participants with a mean age of approximately 48.05 years. The gender distribution was relatively balanced, with 205 males (51.5%) and 193 females (48.5%). Out of the total participants, 270 individuals (67.8%) accepted the vaccine, while 128 individuals (32.2%) declined it. Males were more likely to be vaccine hesitant than females (OR=2.42,95%CI:1.34-4.38). Healthcare worker encouragement reduced vaccine hesitancy (OR = 0.11, 95% CI: 0.06-0.20). Individuals aged 46-60 showed higher vaccine hesitancy compared to those aged 18-30 (OR = 3.55, 95% CI: 1.44-8.73). Low-income earners were more likely to be vaccine-hesitant than higher-income earners (OR = 5.34, 95% CI: 2.07-13.80). Marital status and education level were not significantly associated with vaccine hesitancy.

Conclusion: This study highlights the complex interplay of factors influencing vaccine hesitancy in Peshawar, Pakistan. Gender, age, income level, and healthcare worker encouragement significantly influence vaccine acceptance. These findings call for targeted interventions to tackle vaccine hesitancy pragmatically and promote vaccine uptake in the Peshawar region of Pakistan