Determinants of Children Vaccine Hesitancy among the Parents of Newly Merged Districts of Khyber Pakhtunkhwa
DOI:
https://doi.org/10.54183/jssr.v2i4.59Keywords:
Vaccine Hesitancy, Newly Merged Districts (FATA), Expended Program of Immunization (EPI), Public HealthAbstract
Vaccine hesitancy for children immunization vaccine programs in parents is one of key topics in public health in the Global South including most of Pakistan. However, in the erstwhile Federally Administered Areas (FATA) which are now merged in Khyber Pakhtunkhwa, known as Newly Merged Districts (NMDs), there is a dearth of such research. This study aimed to fill this void. Through two-staged sampling, 384 participants were selected and administered with WHO SAGE Vaccine Hesitancy Scale along with open-ended question for quantum and determinants of vaccine hesitancy. The study found that more than one third of the parents (35.41%) are severely hesitant regarding their children routine immunization while more than half (55.72) are moderately resistant which is alarming. Major factors affecting vaccine hesitancy are negative perceptions about vaccination (22.14%), religious conspiracies (14.06%), lack of information about vaccination (11.72%), fears of adverse effects (11.7%), Western funding for vaccination (6.25%) demand of other life necessities from the Government (7.81%) and few others. Interestingly, Odd Ratios (OR) values revealed that sever hesitancy is more prevalent in those who has both formal education and religious education (OR=19.4, p>.001) than only formally educated or religiously educated parents, this point need further investigation. Similarly, parents who has availed Seht Sahulat Card, sever hesitancy (OR=1.5, p>.001) in them was less than those who didn’t avail it (OR=1.3, p>.001). Results also showed that moderate hesitancy is more prevalent in high-income parents than middle- and lower-income parents. Expanded Program of Immunization – EPI was operational in NMDs (former FATA), but it got momentum recently, still there is alarming vaccine hesitancy in these areas. This call for a comprehensive and all-stakeholders inclusive strategy to eradicate this vaccine hesitancy in these vulnerable tribal areas of Pakistan.
References
Agrawal, A., Kolhapure, S., Di Pasquale, A., Rai, J., & Mathur, A. (2020). Vaccine Hesitancy as a Challenge or Vaccine Confidence as an Opportunity for Childhood Immunisation in India. Infectious Diseases and Therapy, 9(3), 421–432.
Ali, A., Ali, L., Shah, M., Khan, N., Shafee, M., & Jan, S. K. (2018). Polio vaccination: An analysis of cultural and traditional barriers. The Professional Medical Journal, 25(01), 67-72.
Butt, M., Mohammed, R., Butt, E., Butt, S., & Xiang, J. (2020). Why have immunization effforts in Pakistan failed to achieve global standards of vaccination uptake and infectious disease control? Risk Management and Healthcare Policy, 13, 111–124.
Butt, M., Mohammed, R., Butt, E., Butt, S., & Xiang, J. (2020). Why have immunization efforts in Pakistan failed to achieve global standards of vaccination uptake and infectious disease control? Risk Management and Healthcare Policy, 13,111–124.
Dasgupta, P., Bhattacherjee, S., Mukherjee, A., & Dasgupta, S. (2018). Vaccine hesitancy for childhood vaccinations in slum areas of Siliguri, India. Indian Journal of Public Health, 62(4), 253-258.
Dean, A. G., Sullivan, K. M., & Soe, M. M. (2013). OpenEpi: Open Source Epidemiologic Statistics for Public Health. http://www.openepi.com/SampleSize/SSPropor.htm
Geoghegan, S., O’Callaghan, K. P., & Offit, P. A. (2020). Vaccine safety: myths and misinformation. Frontiers in Microbiology, 11, 372.
MacDonald, N. E. (2015). Vaccine hesitancy: Definition, scope and determinants. Vaccine, 33(34), 4161-4164.
Malik, A. S. (2021). Millions of children vaccinated against Typhoid in Pakistan.UNICEF Pakistan. https://www.unicef.org/pakistan/stories/millions-children-vaccinated-against-typhoid-pakistan
Malik, M. N., Awan, M. S., & Saleem, T. (2020). Social mobilization campaign to tackle immunization hesitancy in Sargodha and Khushab districts of Pakistan. Journal of Global Health, 10(2), 021302
Murtaza, F., Mustafa, T., & Awan, R. (2016). Determinants of nonimmunization of children under 5 years of age in Pakistan. Journal of Family & Community Medicine, 23(1), 32-37
Noh, J. W., Kim, Y. M., Akram, N., Yoo, K. B., Park, J., Cheon, J., Kwon, Y. D., & Stekelenburg, J. (2018). Factors affecting complete and timely childhood immunization coverage in Sindh, Pakistan; A secondary analysis of cross-sectional survey data. PloS one, 13(10), e0206766.
Nuwarda, R. F., Ramzan, I., Weekes, L., & Kayser, V. (2022). Vaccine hesitancy: Contemporary issues and historical background. Vaccines, 10, 1595
Orenstein, W. A., & Ahmed, R. (2017). Simply put: Vaccination saves lives. Proceedings of the National Academy of Sciences, 114(16), 4031-4033.
Pakistan Federal Directorate of Immunization (2022). Immunization Schedule. http://www.epi.gov.pk/immunization-schedule/
Pakistan: the latest coronavirus counts, charts and maps. https://graphics.reuters.com/world-coronavirus-tracker-and-maps/countries-and-territories/pakistan/
Shah, S. S. H. ., Aalia, B. ., Zeb, M., & Ullah, I. (2022). Determinants of vaccine hesitancy and refusal in children of District Swabi Khyber Pakhtunkhwa, Pakistan. Journal of Gandhara Medical and Dental Science, 9(2), 65–69.
Soofi, S. B., Hilbi, I.H., Habib, M. A., Ansari, U. Rizvi, A., & Ahmad, I. (2022). Third-Party Verification of Immunization Coverage Survey (TPVICS). Report No. 001, Aga Khan University, Karachi
Strategic Advisory Group of Experts – SAGE (2014). Report of the SAGE Working Group on vaccine hesitancy. https://www.asset-scienceinsociety.eu/sites/default/files/sage_working_group_revised_report_vaccine_hesitancy.pdf
Tanzil, S., Suleman, Y., Akram, D., Baig, L., & Khalid, F. (2021). Strengthening supportive supervision: A case study of the Expanded Programme on Immunization in Sindh, Pakistan. Journal of Global Health, 11,06004
UNICEF (2022). Immunization. https://www.unicef.org/immunization
World Health Organization. (2015). Health in 2015: from MDGs, millennium development goals to SDGs, sustainable development goals. https://apps.who.int/iris/bitstream/handle/10665/200009/?sequence=1
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