Associations between maternal attitudes and their decisions to vaccinate their children

Abstract

Background and aims: Pneumonia and diarrhoea are common causes of hospitalisation in Hong Kong children. Rotavirus (RVV), Haemophilus influenzae type b (HibV), influenza (FluV) and varicella (VV) vaccines are licensed in Hong Kong. VV was incorporated in Hong Kong Childhood Immunisation Programme in 2014 but the other three vaccines are only available in the private sector. We investigated associations between maternal attitudes and their decisions to vaccinate their children. Methods: 500 mother-infant pairs were recruited postnatally from two public hospitals in 2014. Demographic information was collected at recruitment and 1 month later mothers completed a telephone questionnaire based on Health Belief Model (HBM) about their attitudes towards pneumonia and diarrhoea and the respective vaccines. Vaccine uptake or intention to vaccinate were documented when children were 6-10 months old. Univariate and multivariate logistic regressions analyses examined associations between different components of HBM for specific vaccines/vaccines in general and vaccine uptake/intention to vaccinate using statistical software R version 3.2.1. Results: Uptakes of RVV and HibV were 47% and 28% and vaccination intention of FluV and VV were 33% and 86% respectively. After adjusting for socio-economic status, monthly household income (RVV, HibV, VV) and mothers’ place of birth (FluV), cues to action for specific vaccines were found to be significantly associated with uptake of RVV (OR=1.77; 95%CI: 1.24, 2.62), vaccination intention of FluV (OR=1.50; 95%CI: 1.05, 2.16) and VV (OR=2.14; 95%CI: 1.46, 3.16). Mothers with higher self-efficacy for vaccines in general (OR=2.21; 95%CI: 1.42, 3.47), perceived chickenpox to be more severe (OR=1.47; 95%CI: 1.06, 2.04) and perceived more benefits to VV (OR=2.31; 95%CI: 1.13, 4.73) were more likely to plan to vaccinate their children with VV. Mothers who perceived more benefits to FluV were more likely to intend to give FluV to their children (OR=2.12; 95%CI: 1.29, 3.66). Conclusions: Mothers’ self-efficacy for vaccines in general, cues to action and perceived benefits for specific vaccines and perceived severities of the disease were the factors most strongly associated with their decisions to vaccinate their children.