Conflict-driven veterinary vaccine hesitancy and professional immobilization in Amhara Sayint, Ethiopia

Background: The conflict in Ethiopia\'s Amhara region has triggered a parallel collapse of veterinary services, threatening food security. This study measured veterinary vaccine hesitancy (VVH) and its conflict-related drivers in Amhara Sayint. Results: A mixed-methods study (197 surveys; 29 interviews) found a VVH prevalence of 64.5%. Vaccine coverage plummeted to 36.0% for foot-and-mouth disease and 27.4% for peste des petits ruminants. Key drivers were logistical barriers (48.2%), mistrust in efficacy (46.2%), and conflict-specific fears like veterinarian kidnapping (57.5%). Significant predictors of hesitancy were illiteracy (aOR 2.74, 95% CI 1.39–5.41), rural residence (aOR 2.31, 95% CI 1.20–4.45), distance >15 km to a clinic (aOR 2.52, 95% CI 1.33–4.78), and high perceived insecurity (aOR 2.22, 95% CI 1.19–3.09). Hesitant households reported more disease outbreaks (2.44 vs. 1.11/year, p