1
|
Heyde S, Osmani V, Schauberger G, Cooney C, Klug SJ. Global parental acceptance, attitudes, and knowledge regarding human papillomavirus vaccinations for their children: a systematic literature review and meta-analysis. BMC Womens Health 2024; 24:537. [PMID: 39334328 PMCID: PMC11428909 DOI: 10.1186/s12905-024-03377-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Accepted: 09/18/2024] [Indexed: 09/30/2024] Open
Abstract
BACKGROUND This systematic literature review aims to summarize global research on parental acceptance, attitudes, and knowledge regarding human papillomavirus vaccinations. METHODS The literature search was conducted in PubMed, Web of Science and Scopus, and included publications from 2006 to 2023. Study quality was assessed using the Newcastle-Ottawa Scale. The Grading of Recommendations Assessment, Development, and Evaluation guidelines were used to assess the strength of evidence for the primary outcome. Meta-analyses were performed using random-effects models to estimate pooled parental acceptance of HPV vaccinations. Studies were stratified by study years, and a subgroup analysis was conducted to estimate vaccine acceptance rates by world regions. Additionally, sensitivity analyses examined the role of parents in accepting HPV vaccinations for children of different sexes. RESULTS Based on 86 studies, we found that parents generally supported HPV vaccinations for their children, yet HPV vaccine acceptance rates showed high variation (12.0 to 97.5%). The subgroup analysis revealed geographical variations in pooled parental HPV vaccine acceptance rates, with the highest rate observed in Africa (79.6%; 95% CI: 73.5-85.2; I² = 98.3%; p < 0.01) and the lowest in North America (56.7%; 95% CI: 49.3-64.0; I² = 99.4%; p < 0.01). Sensitivity analyses showed that acceptance was higher for daughters than for sons, with mothers more willing to get their daughters vaccinated. The proportion of parents reporting barriers or benefits regarding HPV vaccinations varied widely (0.3-95.8%) between study regions. Across all world regions, fear of adverse effects and concerns about vaccine safety were the main barriers, whereas the desire to protect their children from cancer was a significant predictor of vaccine acceptance. Knowledge levels varied widely (6.5 to 100%) between world regions and according to the questions asked. In most studies, knowledge e.g., that HPV is sexually transmitted, and that HPV vaccination provides protection against cervical cancer, ranged from moderate to high. CONCLUSIONS The results indicated moderate parental acceptance of HPV vaccines. Public knowledge of HPV infection should be promoted, and special efforts should be made to minimize the existing barriers and increase vaccination accessibility and uptake.
Collapse
Affiliation(s)
- Sophia Heyde
- TUM School of Medicine and Health, Chair of Epidemiology, Technical University of Munich, Munich, Germany.
| | - Vanesa Osmani
- TUM School of Medicine and Health, Chair of Epidemiology, Technical University of Munich, Munich, Germany
| | - Gunther Schauberger
- TUM School of Medicine and Health, Chair of Epidemiology, Technical University of Munich, Munich, Germany
| | - Claire Cooney
- TUM School of Medicine and Health, Chair of Epidemiology, Technical University of Munich, Munich, Germany
| | - Stefanie J Klug
- TUM School of Medicine and Health, Chair of Epidemiology, Technical University of Munich, Munich, Germany
| |
Collapse
|
2
|
Tengku Muhammad Fakhruddin TMF, Aminnuddin M, Shafei MN. Knowledge of the Malaysian National Immunisation Programme and its associated factors among parents in Dungun, Terengganu: A cross-sectional study. MALAYSIAN FAMILY PHYSICIAN : THE OFFICIAL JOURNAL OF THE ACADEMY OF FAMILY PHYSICIANS OF MALAYSIA 2023; 18:3. [PMID: 36969333 PMCID: PMC10038154 DOI: 10.51866/oa.188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Introduction The number of unvaccinated children and the rate of vaccination refusal among parents have recently increased despite the robust vaccination programme in Malaysia. The purpose of this study was to determine the level of knowledge of the Malaysian National Immunisation Programme among Malaysian parents as well as the variables that contribute to poor knowledge. Method Methods: This study used systematic random sampling to recruit 375 parents from seven health clinics in the Dungun District of Malaysia. The participants were asked to complete a selfadministered validated questionnaire that included sociodemographic and knowledge questions. A multiple logistic regression analysis was applied to determine the associated factors of poor knowledge of immunisation. P-values of <0.05 were considered statistically significant. Results A total of 189 (50.4%) respondents had poor knowledge of immunisation. The multiple logistic regression analyses revealed that a low educational level (adjusted odds ratio (OR): 1.92; 95% CI 1.25-2.95) was associated with poor knowledge while the age-group of 30-40 years old (adjusted OR: 0.56; 95% CI 0.34-0.93) was protected against it as compared to the age-group of <30 years old. Conclusion The prevalence of poor knowledge of immunisation among parents in Dungun, Terengganu, is relatively high. The focus of health promotion and education must be switched to increasing immunisation knowledge among the public, particularly among high-risk groups.
Collapse
Affiliation(s)
- Tengku Md Fauzi Tengku Muhammad Fakhruddin
- MD (USM), MComMed (Occupational Health)(USM), Department of Community Medicine, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia.
| | - Ma'pol Aminnuddin
- MD (UKM), MPH (UKM), DrPH(UKM), Level 3, District Health Office, Wisma Persekutuan, Maran, Pahang, Malaysia
| | - Mohd Nazri Shafei
- MD (USM), MComMed (Occupational Health)(USM), Department of Community Medicine, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia.
| |
Collapse
|
3
|
Knowledge, attitudes, and practices among Indonesian urban communities regarding HPV infection, cervical cancer, and HPV vaccination. PLoS One 2022; 17:e0266139. [PMID: 35552546 PMCID: PMC9098048 DOI: 10.1371/journal.pone.0266139] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 03/15/2022] [Indexed: 11/22/2022] Open
Abstract
Background Few studies explored Indonesian understanding of cervical cancer (CC) and the human papillomavirus (HPV) vaccination. We aimed to investigate the association between knowledge, attitudes, and practices (KAP) and socio-demographical influences related to HPV, CC, and vaccination among Indonesian urban citizens. Methods We conducted an online survey during March 2020-August 2021 using the Snowball sampling technique. The socio-demographic characteristic and KAP responses were collected via Google Forms from 400 respondents in Jakarta. The knowledge and attitudes were divided into HPV and CC (aspect 1) and HPV vaccination (aspect 2). Correlation between KAP scores was performed using Spearman’s test, and multiple logistic regression analyses were conducted to determine KAP predictors. Results Indonesian urban citizens in Jakarta were found to have poor knowledge in individual aspects of the inquiry but moderate knowledge overall, good attitude in inquiry both in each aspect and overall, and unsatisfying practices. Overall, in the general population, men, and women respectively: 50.8%, 32.4%, and 53.6% had good knowledge; 82.0%, 75.2%, and 84.4% expressed positive attitude; and 30.3%, 15.2%, and 35.6% applied favorable practice regarding questions inquired. Knowledge was weakly correlated towards attitude (ρ = 0.385) but moderately correlated with practice (ρ = 0.485); attitude was moderately correlated with practice (ρ = 0.577), all results: p<0.001. Significant odds ratio (OR) for predictors to good knowledge were female sex (OR = 2.99), higher education (OR = 2.91), and higher mother’s education (OR = 2.15). Factors related to positive attitudes were higher mother’s education (OR = 4.13), younger age (OR = 1.86), and better results in the knowledge inquiries (OR = 2.96). Factors that suggested better practices were female sex (OR = 2.33), being employed (OR = 1.68), excellent knowledge scores (OR = 4.56), and positive attitudes expressions (OR = 8.05). Having done one vaccination dose and intention to receive vaccines were significantly influenced by good KAP. Conclusions KAP had inter-association to successful CC and HPV prevention programs, and socio-demographical characteristics are critical to influencing better KAP.
Collapse
|
4
|
Sinshaw MT, Berhe S, Ayele SG. Knowledge and Attitude Towards Human Papillomavirus Vaccine and Associated Factors Among Mothers Who Have Eligible Daughters in Debre Markos Town, Northwest Ethiopia. Infect Drug Resist 2022; 15:781-793. [PMID: 35264861 PMCID: PMC8901188 DOI: 10.2147/idr.s352440] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Accepted: 02/25/2022] [Indexed: 11/30/2022] Open
Abstract
Purpose This study aimed to assess knowledge and attitude towards the human papillomavirus vaccine and associated factors among mothers who have eligible daughters. Methods A community-based cross-sectional study with a total sample of 601 study participants was conducted in Debre Markos town from February to March 2021. The study participants were selected using a multistage sampling technique from mothers who have eligible daughters. The data was collected using an interview administration questionnaire. The data were entered into EPI data version 3.1 then, exported to SPSS version 25 for analysis. Variables with a p-value of < 0.25 in bivariate were a candidate for multivariate and those variables with a p-value of <0.05 in multivariate binary logistic regression were considered as a statistically significant factor for knowledge and attitude of the HPV vaccine. Results A total of 601 study participants with a response rate of 100% were included in the study. Among participants in this study, 47.6% have good knowledge and 77.4% have a positive attitude towards the HPV vaccine. Knowledge of mothers about HPV vaccine was affected by having degree and above (adjusted odds ratio (AOR) =7.687; 95% CI=1.837–32.168; p=0.005), did not hear about HPV vaccine (AOR=0.172; 95% CI=0.098–0.302; P=0.000), and positive attitude towards HPV vaccine (AOR=2.959; 95% CI=1.580–5.539; P=0.001). Attitude of mothers towards HPV vaccine was affected by did not hear about HPV vaccine (AOR=0.285; 95% CI=0.163–0.499; P=000), and good knowledge about HPV vaccine (AOR=2.705; 95% CI=1.454–5.035; 0.002). Conclusion Knowledge of mothers who have eligible daughters about HPV vaccine was low. Maternal educational level, hearing about the HPV vaccine, and attitude towards HPV vaccine were significantly associated predictors with knowledge towards HPV vaccine. However, the attitude was high and factors associated with attitudes towards the HPV vaccine were knowledge about the HPV vaccine and hearing about the HPV vaccine. An integrated work should be considered by Debre Markos town health office with other non-governmental organizations working on health and health-related issues to improve knowledge about the importance of HPV vaccine for mothers who have eligible daughters.
Collapse
Affiliation(s)
- Melkam Tesfaye Sinshaw
- Debre Markos University, College of Health Sciences, Department of Midwifery, Debre Markos, Ethiopia
| | - Semarya Berhe
- Addis Ababa University, College of Health Sciences, School of Nursing and Midwifery, Department of Midwifery, Addis Ababa, Ethiopia
| | - Siraye Genzeb Ayele
- Addis Ababa University, College of Health Sciences, School of Nursing and Midwifery, Department of Midwifery, Addis Ababa, Ethiopia
- Correspondence: Siraye Genzeb Ayele, Addis Ababa University, College of Health Sciences, School of Nursing and Midwifery, Department of Midwifery, P.O.Box. 1176, Addis Ababa, Ethiopia, Tel +251951070730, Email
| |
Collapse
|
5
|
Mohamed NA, Solehan HM, Mohd Rani MD, Ithnin M, Che Isahak CI. Knowledge, acceptance and perception on COVID-19 vaccine among Malaysians: A web-based survey. PLoS One 2021; 16:e0256110. [PMID: 34388202 PMCID: PMC8362951 DOI: 10.1371/journal.pone.0256110] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 08/01/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Coronavirus disease 2019 or COVID-19 is caused by a newly discovered coronavirus, SARS-CoV-2. The Malaysian government has planned to procure COVID-19 vaccine through multiple agencies and companies in order to vaccinate at least 70% of the population. This study aimed to determine the knowledge, acceptance and perception of Malaysian adults regarding the COVID-19 vaccine. METHODOLOGY An online survey was conducted for two weeks in December 2020. A bilingual, semi-structured questionnaire was set up using Google Forms and the generated link was shared on social media (i.e., Facebook and WhatsApp). The questionnaire consisted of questions on knowledge, acceptance and perception of COVID-19 vaccine. The association between demographic factors with scores on knowledge about COVID-19 vaccine were analysed using the Mann-Whitney test for two categorical variables, and the Kruskal-Wallis test used for more than two categorical variables. RESULTS A total of 1406 respondents participated, with the mean age of 37.07 years (SD = 16.05) years, and among them 926 (65.9%) were female. Sixty two percent of respondents had poor knowledge about COVID-19 vaccine (mean knowledge score 4.65; SD = 2.32) and 64.5% were willing to get a COVID-19 vaccine. High knowledge scores associated with higher education background, higher-income category and living with who is at higher risk of getting severe COVID-19. They were more likely to be willing to get vaccinated if they were in a lower age group, have higher education levels and were female. CONCLUSION Even though knowledge about vaccine COVID-19 is inadequate, the majority of the respondents were willing to get vaccinated. This finding can help the Ministry of Health plan for future efforts to increase vaccine uptake that may eventually lead to herd immunity against COVID-19.
Collapse
Affiliation(s)
- Nurul Azmawati Mohamed
- Faculty of Medicine and Health Sciences, Universiti Sains Islam Malaysia, Nilai, Negeri Sembilan, Malaysia
| | - Hana Maizuliana Solehan
- Faculty of Medicine and Health Sciences, Universiti Sains Islam Malaysia, Nilai, Negeri Sembilan, Malaysia
| | - Mohd Dzulkhairi Mohd Rani
- Faculty of Medicine and Health Sciences, Universiti Sains Islam Malaysia, Nilai, Negeri Sembilan, Malaysia
| | - Muslimah Ithnin
- Faculty of Medicine and Health Sciences, Universiti Sains Islam Malaysia, Nilai, Negeri Sembilan, Malaysia
| | - Che Ilina Che Isahak
- Faculty of Medicine and Health Sciences, Universiti Sains Islam Malaysia, Nilai, Negeri Sembilan, Malaysia
| |
Collapse
|
6
|
Kalaij AGI, Sugiyanto M, Ilham AF. Factors Associated With Vaccination Compliance in Southeast Asian Children: A Systematic Review. Asia Pac J Public Health 2021; 33:479-488. [PMID: 34013786 DOI: 10.1177/10105395211014640] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Although vaccination coverage has reached a peak of 86% globally, around 19.9 million infants and children are yet to receive routine vaccinations-with Asia holding the highest prevalence of noncompliance. This implies notable gaps in vaccination coverage among some regions in the world. This study aims to analyze the factors associated with compliance toward childhood vaccination in Southeast Asia. A systematic review of observational studies was conducted using the following databases: PubMed, Scopus, and Cochrane. Included studies analyze factors affecting compliance with childhood vaccination in Southeast Asia, and assessed with Joanna Briggs Institute (JBI) and Newcastle-Ottawa Scale's criteria. Sixteen observational studies were included, with a total of 41 956 subjects, consisting of 15 cross-sectional studies and one case-control study. Our results suggested that parental personal-related, children and family status-related, socioeconomic, and health care-related factors strongly affected subjects' compliance with immunization. Prominent determinants were older maternal age, higher economics groups, parents in government or health care sectors, and frequent antenatal care visits. On the other hand, noncompliance were associated with younger age, large quantity of family members, lower economic groups, lower education, and unemployed parents. We hope that this comprehensive assessment thoroughly addresses challenges and inform strategies to raise compliance toward childhood vaccination in Southeast Asia.
Collapse
|
7
|
Wang L, Liang Y, Zhang X, Yang J. Vaccine attitudes among young adults in Asia: a systematic review. Hum Vaccin Immunother 2021; 17:1142-1155. [PMID: 33054512 DOI: 10.1080/21645515.2020.1810486] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Introduction: Young adults may be facing growing threats from vaccine-preventable diseases (VPDs). However, vaccination of young adults may not have drawn adequate attention. In Asia, adensely populated region with ahigh proportion of low-income countries, VPDs impose more of an economic and social burden than in western countries. However, knowledge about attitudes toward vaccines among young Asians is limited. This study aims to fill that gap by describing attitudes toward vaccines and how well they are accepted among young Asian adults through asystematic review of relevant Chinese and English publications.Methods: A three-stage searching strategy was adopted to identify eligible studies published during 2009-2019 according to the selection criteria, resulting in 68 articles being included.Results: The review finds that vaccination coverage among young Asians is generally lower than among their western peers, and there is a lack of relevant study in many Asian countries. Factors influencing young Asians' attitudes toward vaccines are categorized into contextual level, individual and social level, and vaccine-specific level.Conclusion: These suggest that there is a need to strengthen young adults' vaccination programs and to promote vaccine-related information and government.
Collapse
Affiliation(s)
- Li Wang
- School of Health Services Management, Anhui Medical University, Hefei, China.,NHC Key Laboratory of Health Economics and Policy Research, Shandong University, Jinan, China
| | - Yuanyuan Liang
- School of Health Services Management, Anhui Medical University, Hefei, China
| | - Xuan Zhang
- National Immunization Program, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jinxia Yang
- School of Health Services Management, Anhui Medical University, Hefei, China
| |
Collapse
|
8
|
Wong LP, Wong PF, Megat Hashim MMAA, Han L, Lin Y, Hu Z, Zhao Q, Zimet GD. Multidimensional social and cultural norms influencing HPV vaccine hesitancy in Asia. Hum Vaccin Immunother 2020; 16:1611-1622. [PMID: 32429731 PMCID: PMC7482900 DOI: 10.1080/21645515.2020.1756670] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Accepted: 04/11/2020] [Indexed: 12/27/2022] Open
Abstract
HPV vaccine hesitancy in Asia is unique compared to Western countries due to multidimensional social-cultural norms that influence beliefs regarding vaccination. Reviews on HPV vaccine hesitancy in Asia lack of in-depth discussion regarding the traditional and social-cultural norms dimensions. This paper puts forward opinions in which culture, normative beliefs, and religion influence HPV vaccine hesitancy in Asian countries. Issues surrounding HPV hesitancy among parents, young adult women, adult women, men and the sexual and gender minority people in Asian countries were highlighted. The shortage of HPV vaccine supply would soon be reduced as some Asian countries are on the way to producing the HPV vaccine which production is currently dominated by Western European countries. The culture of favoring imported Western products among many in Asia and in addition to long-existing fake vaccine crisis pose a challenge for the newly emerging HPV vaccine produced in Asia. Some recommendations, research gaps, and future research needs were discussed.
Collapse
Affiliation(s)
- Li Ping Wong
- Centre for Epidemiology and Evidence-Based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Pooi-Fong Wong
- Department of Pharmacology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | | | - Liyuan Han
- Zhejiang Provincial Key Laboratory of Pathophysiology, School of Medicine, Ningbo University, Ningbo, Zhejiang, China
| | - Yulan Lin
- Department of Epidemiology and Health Statistics, Fujian Provincial Key Laboratory of Environment Factors and Cancer, School of Public Health, Fujian Medical University, Fuzhou, Fujian Province, China
- Key Laboratory of Ministry of Education for Gastrointestinal Cancer, Fujian Medical University, Fuzhou, Fujian Province, China
| | - Zhijian Hu
- Department of Epidemiology and Health Statistics, Fujian Provincial Key Laboratory of Environment Factors and Cancer, School of Public Health, Fujian Medical University, Fuzhou, Fujian Province, China
- Key Laboratory of Ministry of Education for Gastrointestinal Cancer, Fujian Medical University, Fuzhou, Fujian Province, China
| | - Qinjian Zhao
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, School of Public Health, Xiamen University, Xiamen, Fujian Province, China
| | - Gregory D. Zimet
- Department of Pediatrics, School of Medicine, Indiana University, Indianapolis, IN, U.S
| |
Collapse
|