Parental Hesitancy on COVID-19 Vaccination for Children Under Five Years in Thailand: Role of Attitudes and Vaccine Literacy

Abstract

Global vaccination efforts to control the COVID-19 pandemic may be impeded by vaccine hesitancy. Attitudes and vaccine literacy are important factors that reduce vaccine hesitancy. The role of attitudes and vaccine literacy of parents on COVID-19 vaccine intention for their children under five years was unknown.Objective: This study aimed to assess parents' characteristics, vaccine literacy, attitudes toward the COVID-19 vaccine, and vaccine intention/hesitancy and to determine factors influencing parents' vaccine intention for their children under five years of age. Methods: A cross-sectional study was conducted using an online self-administered questionnaire before the authorization of the COVID-19 vaccine for very young children in Thailand. The sample consisted of 455 parents with children under five years old. The online questionnaire included parents' sociodemographic data, vaccine literacy, attitudes toward COVID-19 vaccine, and vaccine intention to get their children vaccinated. Results: About 98% of the parents received their COVID-19 vaccination, whereas only 45.1% reported they would have their children under five years old get vaccinated. About 54.9% were either not sure or refused their child's COVID-19 vaccination. A multiple logistic regression model identified factors that increased the odds of parents' vaccine intention: parents aged > 35 years, attitudes on safety and efficacy of COVID-19 vaccine for children, advice about the COVID-19 vaccines from healthcare personnel, and the belief that COVID-19 vaccine is helpful for their children. Attitudes that COVID-19 vaccination in children could be fatal decreased parents' vaccine intention. Need for more information about the COVID-19 vaccine for children and concern about the vaccine's side effects were the most frequent reasons for vaccine hesitancy and refusal. Conclusion: Parents should be provided with accurate information from healthcare personnel and media sources about the safety and effectiveness of the COVID-19 vaccine for young children under five years of age to overcome their hesitancy.

The Status and Influencing Factors of COVID-19 Vaccination for 3–7-Year-Old Children Born Prematurely

“…The results of this study show that parents with lower education levels are more willing to vaccinate their children, which is consistent with a previous meta-analysis. 18 It has also been shown that there is a positive correlation between parental knowledge and attitudes towards childhood vaccination and practice, 38 that a high level of education is a positive factor for vaccination. 39 On the one hand, this difference may be due to the deviation caused by the choice of samples, while on the other, it may also be affected by the occupation of the parents and the source of information reception.…”

Indicators of the National Immunization Program for children under one year old: time trend in Maranhão, Brazil, 2010 to 2021

“…Other factors are also identified as difficulties in achieving VC: society's complacency due to the PNI success since most of the population and health professionals have not experienced the complications caused by vaccine-preventable di-seases20; difficulties in accessing health services; misinformation and vaccine hesitancy [32][33][34] ; antivaccination actions and fake news; low national production and irregular distribution of vac-cines18. Moreover, the incomplete vaccination schedule was higher in white mothers, who had paid maternity leave, multiparous, with fewer prenatal care appointments, without partners, and babies who had access to daycare 35 .…”

Parental Vaccine Literacy: Attitudes towards the COVID-19 Vaccines and Intention to Vaccinate Their Children Aged 5–11 Years against COVID-19 in Thailand

“…Parents’ attitudes towards the COVID-19 vaccine: In this study, 10 questions were used to assess attitudes towards the COVID-19 vaccine including both positive and negative aspects [ 23 ]. These questions were validated by a pediatrician and two nurse educators in infectious disease and pediatric nursing.…”

“…Later, the COVID-19 vaccination program started for children aged 5–11 years in January and younger children aged 6 months to 5 years in August 2022 [ 19 ]. For younger children of this age, the parents’ vaccine intention or acceptance rate for their children could be lower than the parent’s own vaccine acceptance rate [ 20 , 21 , 22 , 23 ]. Literature reviews of existing studies from multiple countries on factors influencing COVID-19 vaccination for children/adolescents revealed the most highly reported factors included parents’ willingness to obtain vaccination for themselves and positive/negative attitudes towards the COVID-19 vaccine [ 24 , 25 ].…”