Prevalence of Parental refusal rate and its associated factors in routine immunization by using WHO Vaccine Hesitancy tool: a Cross sectional study at district Bannu, KP, Pakistan

TY - JOUR

T1 - Prevalence of Parental refusal rate and its associated factors in routine immunization by using WHO Vaccine Hesitancy tool

T2 - a Cross sectional study at district Bannu, KP, Pakistan

AU - Khattak, Farhad Ali

AU - Rehman, Khalid

AU - Shahzad, Muhammad

AU - Arif, Numan

AU - Ullah, Naeem

AU - Kibria, Zeeshan

AU - Arshad, Muhammad

AU - Afaq, Saima

AU - Ibrahimzai, Arsalan Khan

AU - Haq, Zia Ul

N1 - Crown Copyright © 2020. Published by Elsevier Ltd. All rights reserved.

PY - 2021/3

Y1 - 2021/3

N2 - OBJECTIVE: To determine the vaccination refusal rate, associated factors and perceptions of parents who refused routine immunization for their children using the World Health Organization (WHO) SAGE Working Group on Vaccine Hesitancy Survey Tool.MATERIALS AND METHODS: A cross-sectional survey was conducted using multi-stage cluster sampling in Bannu District, Khyber Pakhtunkhwa Province, Pakistan from March 2019 to July 2019. A WHO validated questionaire was used. The outcome variable was parental refusal of routine immunization of their children. Logistic regression was performed for associations, and multi-regression was applied to identify any confounders.RESULTS: Of 610 parents, 170 (27.9%) refused vaccination of their children. Of these, the majority of mothers had no education [n = 145 (85.3%); p = 0.03], and mothers were less likely to own a mobile phone than fathers [24 (14.1%) vs 152 (89.4%); p ≤ 0.001]. The vaccination refusal rate was higher in parents with food security [n = 88 (51.8%)] compared with parents with minimal food insecurity [n = 62 (36.5%)] and high food insecurity [20 (11.8%); p ≤ 0.05)]. On multi-variate logistic regression, fathers who were employed [adjusted odds ratio (OR) 0.59, 95% confidence interval (CI) 0.37-0.94; p = 0.02] and had a high level of education (adjusted OR 0.21, 95% CI 0.08-0.50; p ≤ 0.001) were less likely to refuse vaccination of their children. Parents with high food insecurity were more likely to refuse vaccination of their children (adjusted OR 2.2, 95% CI 1.0-0.50; p = 0.04) compared with parents with minimal food insecurity (adjusted OR 1.6, 95% CI 1.0-2.5; p = 0.02).CONCLUSION: The vaccination refusal rate was very high among parents, and this was associated with inability to read or write, no education, owning a mobile phone, unemployment and food security.

AB - OBJECTIVE: To determine the vaccination refusal rate, associated factors and perceptions of parents who refused routine immunization for their children using the World Health Organization (WHO) SAGE Working Group on Vaccine Hesitancy Survey Tool.MATERIALS AND METHODS: A cross-sectional survey was conducted using multi-stage cluster sampling in Bannu District, Khyber Pakhtunkhwa Province, Pakistan from March 2019 to July 2019. A WHO validated questionaire was used. The outcome variable was parental refusal of routine immunization of their children. Logistic regression was performed for associations, and multi-regression was applied to identify any confounders.RESULTS: Of 610 parents, 170 (27.9%) refused vaccination of their children. Of these, the majority of mothers had no education [n = 145 (85.3%); p = 0.03], and mothers were less likely to own a mobile phone than fathers [24 (14.1%) vs 152 (89.4%); p ≤ 0.001]. The vaccination refusal rate was higher in parents with food security [n = 88 (51.8%)] compared with parents with minimal food insecurity [n = 62 (36.5%)] and high food insecurity [20 (11.8%); p ≤ 0.05)]. On multi-variate logistic regression, fathers who were employed [adjusted odds ratio (OR) 0.59, 95% confidence interval (CI) 0.37-0.94; p = 0.02] and had a high level of education (adjusted OR 0.21, 95% CI 0.08-0.50; p ≤ 0.001) were less likely to refuse vaccination of their children. Parents with high food insecurity were more likely to refuse vaccination of their children (adjusted OR 2.2, 95% CI 1.0-0.50; p = 0.04) compared with parents with minimal food insecurity (adjusted OR 1.6, 95% CI 1.0-2.5; p = 0.02).CONCLUSION: The vaccination refusal rate was very high among parents, and this was associated with inability to read or write, no education, owning a mobile phone, unemployment and food security.

KW - Adolescent

KW - Adult

KW - Cell Phone

KW - Child

KW - Child, Preschool

KW - Cross-Sectional Studies

KW - Educational Status

KW - Fathers

KW - Female

KW - Food Insecurity

KW - Food Security

KW - Humans

KW - Infant

KW - Infant, Newborn

KW - Literacy

KW - Logistic Models

KW - Male

KW - Mothers

KW - Pakistan

KW - Surveys and Questionnaires

KW - Unemployment

KW - Vaccination

KW - Vaccination Refusal/statistics & numerical data

KW - World Health Organization

KW - Young Adult

U2 - 10.1016/j.ijid.2020.12.029

DO - 10.1016/j.ijid.2020.12.029

M3 - Article

C2 - 33340667

SN - 1201-9712

VL - 104

SP - 117

EP - 124

JO - International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases

JF - International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases

ER -