Department of Community Medicine, International Medical School, Management and Science University, Selangor, Malaysia.
Global Public Health, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, Malaysia.
Front Public Health. 2023 May 16;11:1091015. doi: 10.3389/fpubh.2023.1091015. eCollection 2023.
Vaccination programs have been rolled out across the globe to contain and mitigate the spread of the COVID-19 infection. Until recently, such programs were limited to adults and the older population, thereby limiting children from getting vaccinated. Recently, the Malaysian government rolled out vaccination for children aged 5-11 years. However, there are certain factors that might affect vaccination uptake among children. This study explores factors influencing parents' hesitancy to vaccinate children in Malaysia.
A nationwide online cross-sectional convenience sampling survey from April 21, 2022 to June 3, 2022 was conducted. The study used descriptive statistics to inform about vaccine hesitancy among parents. Cross-tabulation was performed to calculate the frequency and percentage of vaccine hesitancy, quality of life, e-health literacy, and the 5C psychological antecedents of vaccination among parents with children 5-11 years in Malaysia. Graphical methods were used to portray the levels of e-health literacy and levels of 5C psychological antecedents of vaccination. The study used both bi-variate and multivariate analysis to understand the relationship between vaccine hesitancy and the socio-demo-economic factors, quality of life, e-health literacy and 5C psychological antecedents.
Of 382 participants, almost one-third (33%) of participants reported vaccine hesitancy for their children. For 5C's psychological antecedents of vaccination, around one quarter (26.96%) reported disagreement for confidence in vaccination, almost half (52.36%) reported disagreement for vaccination complacency, three-fifths (60.99%) reported vaccination constraint, one quarter (25.92%) reported calculation antecedent, and almost one-third reported disagreement over collective responsibility antecedent (25.92%). Chi-square test revealed that gender, employment status, and parents' COVID-19 vaccination status were significantly associated (<0.05) with vaccine hesitancy among parents. Assessing the influence of transactional e-health literacy, only the communication component contained a significant association (<0.05). Among the 5C psychological antecedents, confidence, calculation, and collective responsibility were significantly associated (<0.05) with vaccine hesitancy. Parents with secondary [OR: 8.80; CI: 2.44-31.79, (<0.05)], post-secondary [OR: 5.21; CI: 2.10-13.41, (<0.05)], and tertiary education [OR: 6.77; CI: 2.25-20.35, (<0.05)] had significantly higher likelihood of vaccine hesitancy than those with primary education.
Highly educated parents are more skeptical and are more likely to perceive the vaccine as unsafe and ineffective for their children. It is critical to disseminate the required information about the vaccine safety to the educated group.
为了控制和减轻 COVID-19 感染的传播，全球范围内已经推出了疫苗接种计划。直到最近，此类计划仅限于成年人和老年人群体，从而限制了儿童接种疫苗的机会。最近，马来西亚政府推出了为 5-11 岁儿童接种疫苗的计划。然而，某些因素可能会影响儿童的疫苗接种率。本研究探讨了影响马来西亚父母对儿童疫苗接种犹豫不决的因素。
2022 年 4 月 21 日至 6 月 3 日进行了全国性的在线横断面便利抽样调查。研究使用描述性统计数据来了解父母对疫苗接种的犹豫情况。交叉表用于计算马来西亚 5-11 岁儿童父母的疫苗接种犹豫、生活质量、电子健康素养和疫苗接种的 5C 心理前因的频率和百分比。图形方法用于描绘电子健康素养水平和疫苗接种的 5C 心理前因水平。研究使用单变量和多变量分析来了解疫苗接种犹豫与社会人口经济学因素、生活质量、电子健康素养和 5C 心理前因之间的关系。
在 382 名参与者中，近三分之一（33%）的参与者表示对其孩子的疫苗接种犹豫不决。对于 5C 疫苗接种的心理前因，约四分之一（26.96%）表示对疫苗接种信心存在分歧，近一半（52.36%）表示对疫苗接种自满存在分歧，五分之三（60.99%）表示存在疫苗接种限制，四分之一（25.92%）表示存在计算前因，近三分之一（25.92%）表示对集体责任前因存在分歧。卡方检验显示，性别、就业状况和父母的 COVID-19 疫苗接种状况与父母对疫苗接种的犹豫有显著关联（<0.05）。评估交易型电子健康素养的影响时，只有沟通部分具有显著关联（<0.05）。在 5C 心理前因中，信心、计算和集体责任与疫苗接种犹豫有显著关联（<0.05）。与接受过小学教育的父母相比，接受过中等教育[OR：8.80；CI：2.44-31.79，(<0.05)]、中学后教育[OR：5.21；CI：2.10-13.41，(<0.05)]和高等教育[OR：6.77；CI：2.25-20.35，(<0.05)]的父母更有可能对疫苗犹豫不决。
受教育程度较高的父母更持怀疑态度，更有可能认为疫苗对其子女不安全且无效。向受教育群体传播疫苗安全性方面的必要信息至关重要。
