Factors affecting vaccine hesitancy among families with children 2 years old and younger in two urban communities in Manila, Philippines
DOI:
https://doi.org/10.5365/wpsar.2019.10.2.006Abstract
Objective: The study aimed to determine the factors that influence vaccine hesitancy among parents and caregivers of children 2 years old and younger in selected urban communities in Manila, Philippines.
Methods: The study used a cross-sectional study design with a modified questionnaire adapted from the SAGE Working Group on Vaccine Hesitancy. Self-administered surveys were conducted in two highly urbanized barangays (smallest administrative divisions) in Manila, Philippines.
Results: The survey was completed by 110 respondents, comprised mostly of 20–39-year-old mothers. Most respondents (95.5%) believed that vaccines are protective however vaccine hesitancy rates among the respondents reached 36.4%. Respondents who believed in the protective nature of vaccines were less likely to report vaccine hesitancy and were nine times less likely to refuse vaccination for their children because of negative media exposure. The main reasons identified for vaccine hesitancy were exposure to negative media information and concerns about vaccine safety. The main negative media information identified by the respondents was related to the dengue vaccine, Dengvaxia®. Health-care workers and political leaders were the main supporters of vaccination in the community.
Discussion: The recent events surrounding the Dengvaxia® controversy contributed to a decrease in vaccine confidence. The role of mass media in vaccine hesitancy was highlighted in this study, supporting previous evidence that vaccine-hesitant parents tend to be more susceptible to media reports. The lack of association between sociodemographic factors and vaccine hesitancy implies that the determinants of vaccine hesitancy can be highly varied depending on context and setting.
References
WHO. Ten threats to global health in 2019 [Internet]. World Health Organization. 2019 [cited 2019 May 9]. Available from: https://www.who.int/emergencies/ten-threats-to-global-health-in-2019
Doherty M, Buchy P, Standaert B, Giaquinto C, Prado- Cohrs D. Vaccine impact: Benefits for human health. Vaccine. 2016 Dec 20;34(52):6707–14.
FE Andre, R Booy, HL Bock, J Clemens, SK Datta, TJ John, et al. Vaccination greatly reduces disease, disability, death and inequity worldwide. Bulletin of the World Health Organization. 2008 Feb;86(2):140–6.
WHO. Global and regional immunization profile [Internet]. World Health Organization. 2018 [cited 2019 May 9]. Available from: https://www.who.int/immunization/monitoring_surveillance/data/gs_gloprofile.pdf?ua=1
WHO. Questions and answers on the measles outbreak in the Philippines [Internet]. World Health Organization. 2019 [cited 2019 May 8]. Available from: https://www.who.int/philippines/news/feature-stories/detail/questions-and-answers-on-the-measles-outbreak-in-the-philippines
UNICEF, WHO. Situation Report 9: Measles Outbreak - Philippines [Internet]. Philippines: UNICEF-WHO; 2019 Apr [cited 2019 May 8]. (Measles Outbreak). Report No.: 9. Available from: https://reliefweb.int/sites/reliefweb.int/files/resources/UNICEF%20WHO%20PHL%20SitRep9_Measles%20Outbreak_14Apr2019.pdf
Fatima K, Syed NI. Dengvaxia controversy: impact on vaccine hesitancy. J Glob Health [Internet]. 2018 Dec [cited 2019 May 8];8(2). Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6214489/
DOH. DOH identifies vaccine hesitancy as one of the reasons for measles outbreak [Internet]. Department of Health. 2019 [cited 2019 May 8]. Available from: https://www.doh.gov.ph/node/16721
Tomacruz S. Parents still scared of govt’s free vaccines a year after Dengvaxia scare [Internet]. Rappler. 2018 [cited 2019 May 8]. Available from: http://www.rappler.com//nation/212927-child-vaccination-rate-philippines-as-of-september-2018
Larson HJ, Hartigan-Go K, de Figueiredo A. Vaccine confidence plummets in the Philippines following dengue vaccine scare: why it matters to pandemic preparedness. Human Vaccines & Immunotherapeutics. 2019 Mar 4;15(3):625–7.
WHO. Report of the SAGE working group on vaccine hesitancy [Internet]. World Health Organization; 2014 Nov [cited 2019 May 8]. Available from: https://www.who.int/immunization/sage/meetings/2014/october/SAGE_working_group_revised_report_vaccine_hesitancy.pdf?ua=1
WHO. Vaccine Hesitancy Survey Questions Related to SAGE Vaccine Hesitancy Matrix [Internet]. Vaccine Hesitancy Survey Questions Related to SAGE Vaccine Hesitancy Matrix. 2018 [cited 2018 Nov 19]. Available from: http://www.who.int/immunization/programmes_systems/Survey_Questions_Hesitancy.pdf
Yaqub O, Castle-Clarke S, Sevdalis N, Chataway J. Attitudes to vaccination: A critical review. Social Science & Medicine. 2014 Jul 1;112:1–11.
Larson HJ, Jarrett C, Schulz WS, Chaudhuri M, Zhou Y, Dube E, et al. Measuring vaccine hesitancy: The development of a survey tool. Vaccine. 2015 Aug 14;33(34):4165–75.
IndexMundi. Philippines Demographics Profile 2018 [Internet]. IndexMundi. 2018 [cited 2019 May 10]. Available from: https://www.indexmundi.com/philippines/demographics_profile.html
Montemayor MaT. Measles outbreak due to vaccine hesitancy: DOH [Internet]. Philippine News Agency. 2019 [cited 2019 May 8]. Available from: https://www.pna.gov.ph/articles/1061526
Dubé È, Farrands A, Lemaitre T, Boulianne N, Sauvageau C, Boucher FD, et al. Overview of knowledge, attitudes, beliefs, vaccine hesitancy and vaccine acceptance among mothers of infants in Quebec, Canada. Hum Vaccin Immunother. 2019;15(1):113–20.
Tran BX, Boggiano VL, Nguyen LH, Latkin CA, Nguyen HLT, Tran TT, et al. Media representation of vaccine side effects and its impact on utilization of vaccination services in Vietnam. Patient Prefer Adherence. 2018 Sep 6;12:1717–28.
The Lancet. Vaccine hesitancy: a generation at risk. The Lancet Child & Adolescent Health. 2019 May 1;3(5):281.
Dubé E, Gagnon D, Nickels E, Jeram S, Schuster M. Mapping vaccine hesitancy—Country-specific characteristics of a global phenomenon. Vaccine. 2014 Nov 20;32(49):6649–54.
Vrdelja M, Kraigher A, Verčič D, Kropivnik S. The growing vaccine hesitancy: exploring the influence of the internet. European journal of public health. 2018 Jul 4;28.
Punzalan J. PAO sees “pattern” in deaths of 4 Dengvaxia recipients [Internet]. ABS-CBN News. 2018 [cited 2019 May 13]. Available from: https://news.abs-cbn.com/news/01/10/18/pao-sees-pattern-in-deaths-of-4-dengvaxia-recipients
Geronimo JY. DOH: Over 3,000 students hospitalized after Dengvaxia shot [Internet]. Rappler.com. 2018 [cited 2019 May 13]. Available from: http://www.rappler.com//nation/200187-doh-students-hospitalized-dengvaxia
Aurelio JM. DOH says 62 kids may have died after receiving Dengvaxia [Internet]. Inquirer.net. 2018 [cited 2019 May 13]. Available from: https://newsinfo.inquirer.net/980755/doh-says-62-kids-may-have-died-after-receiving-dengvaxia
Merten S, Hilber AM, Biaggi C, Secula F, Bosch-Capblanch X, Namgyal P, et al. Gender Determinants of Vaccination Status in Children: Evidence from a Meta-Ethnographic Systematic Review. PLOS ONE. 2015 Aug 28;10(8):e0135222.
