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Barriers to measles mumps rubella vaccine acceptance in the three southern border provinces of Thailand

  • Uraiwan Sirithammaphan (Faculty of Public Health and Allied Health Sciences, Praboromarajchanok Institute, Sirindhorn College of Public Health Yala) ;
  • Ubontip Chaisang (Faculty of Public Health and Allied Health Sciences, Praboromarajchanok Institute, Sirindhorn College of Public Health Yala) ;
  • Kwanjit Pongrattanamarn (Faculty of Public Health and Allied Health Sciences, Praboromarajchanok Institute, Sirindhorn College of Public Health Yala)
  • Received : 2022.12.18
  • Accepted : 2023.08.26
  • Published : 2023.10.31

Abstract

Purpose: This qualitative study utilizing phenomenological methodology aimed to depict parental measles mumps rubella (MMR) vaccine acceptance through the work experiences of health personnel. Materials and Methods: Twenty-two public health workers working as vaccination providers in the three southern border provinces of Thailand were recruited. In-depth, face-to-face, semi-structured interviews were conducted. Data were analyzed using thematic analysis. Results: Four main themes emerged: (1) religious beliefs, (2) personal disagreements, (3) fear and mistrust regarding potential vaccine side effects, and (4) misperceptions about the potential severity of measles. Four subthemes were identified: (1) haram (prohibited), (2) the will of Allah, (3) spousal disagreement, and (4) disagreement from a religious leader. The results of this study indicated that perceived religious prohibition was the most important reason for refusing to vaccinate among Muslim parents. Vaccine-hesitant parents were concerned that the vaccine might contain gelatin derived from pig products. Also, halal certification of the vaccine was required from Muslim parents to ensure that vaccine has been approved for Muslims. Meanwhile, a lack of knowledge and positive attitudes concerning immunizations of vaccine-hesitant parents were also found as predominant reasons for incomplete childhood immunizations in the deep south of Thailand. Conclusion: Health education and engagement by religious leaders to endorse the vaccination and bridge the gap between religious beliefs and vaccine acceptance is needed to overcome this issue. This study findings could be effectively applied to improve vaccination uptake in a Muslim majority context.

Keywords

Acknowledgement

This study would not be completed without the invaluable supporters. I would like to express my sincere thanks and appreciation to the Sirindhorn College of Public Health, Yala, Faculty of Public Health and Allied Health Sciences, Praboromarajchanok Institute, Thailand, for research funding. I would also like to extend my thanks to all participants in this study for providing valuable information.

References

  1. Excler JL, Saville M, Berkley S, Kim JH. Vaccine development for emerging infectious diseases. Nat Med 2021;27:591-600.
  2. Health Information System Development Office. The return of measles in thailand [Internet]. Bangkok: Health information system development office; 2019 [cited 2022 Jun 20]. Available from: https://www.hiso.or.th/hiso/picture/reportHealth/ThaiHealth2019/eng2019_24.pdf
  3. Daya S, Lillahkul N, Noin J. Experience of parents of thai muslim childhood aged 0-5 years in yala province who rejected the service of expanded program immunization with vaccine. J Dep Med Serv [Internet] 2018 [cited 2022 Jun 20];43:137-41. Available from: https://he02.tci-thaijo.org/index.php/JDMS/article/view/247857
  4. Ministry of Public Health. Department of disease control, division of epidemiology. Reported cases of measles and rubella [Internet]. Bangkok: Department of Disease Control; 2020 [cited 2022 Jun 20]. Available from: https://ddc.moph.go.th/uploads/ckeditor2//files/DOE_measles_31dec63.pdf
  5. van Manen M. Phenomenology of practice: meaning-giving methods in phenomenological research and writing [Internet]. New York (NY): Routledge; 2016 [cited 2022 Jun 20]. Available from: https://doi.org/10.4324/9781315422657
  6. Boyatzis RE. Transforming qualitative information: thematic analysis and code development [Internet]. Thousand Oaks (CA): Sage; 1998 [cited 2022 Nov 30]. Available from: http://books.google.com/books?hl=en&lr=&id=_rfClWRhIKAC&oi=fnd&pg=PR6&dq=narrative+thematic+analysis&ots=EyvHynfh_k&sig=qbJaepOG0MltWYP0mCHpRczCUus%5Cnhttp://books.google.com/books?hl=en&lr=&id=_rfClWRhIKAC&oi=fnd&pg=PR6&dq=narrative+thematic+analysis&ots
  7. Wong LP, Wong PF, AbuBakar S. Vaccine hesitancy and the resurgence of vaccine preventable diseases: the way forward for malaysia, a Southeast Asian country. Hum Vaccin Immunother 2020;16:1511-20.
  8. Harapan H, Shields N, Kachoria AG, Shotwell A, Wagner AL. Religion and measles vaccination in Indonesia, 1991-2017. Am J Prev Med 2021;60(1 Suppl 1):S44-52.
  9. Padmawati RS, Heywood A, Sitaresmi MN, et al. Religious and community leader's acceptance of rotavirus vaccine introduction in Yogyakarta, Indonesia: a qualitative study. BMC Public Health 2019;19:368.
  10. Padela AI, Furber SW, Kholwadia MA, Moosa E. Dire necessity and transformation: entry-points for modern science in islamic bioethical assessment of porcine products in vaccines. Bioethics 2014;28:59-66.
  11. Elkalmi RM,Jamshed SQ, SuhaimiAM. Discrepancies and similarities in attitudes, beliefs, and familiarity with vaccination between religious studies and science students in malaysia: a comparison study.JRelig Health 2021;60:2411-27.
  12. Grabenstein JD. What the world's religions teach, applied to vaccines and immune globulins. Vaccine 2013;31:2011-23.
  13. Associated Press. Muslim concern about vaccine fuels measles outbreak. Bangkok Post [Internet]. 2018 Nov 6 [cited 2022 Jun 20]. Available from: https://www.bangkokpost.com/thailand/general/1571030/muslim-concern-about-vaccine-fuels-thai-measles-outbreak
  14. Khan TM, Sahibzada MU. Challenges to health workers and their opinions about parent's refusal of oral polio vaccination in the Khyber Pakhtoon Khawa (KPK) province, Pakistan. Vaccine 2016;34:2074-81.
  15. Nasir EF, Elhag AK, Almahdi HM. COVID-19 perceptional disparity among dental healthcare personnel at king Faisal university: applying health belief model. Eur J Dent 2020;14(S 01):S56-62.
  16. Khoo YS, Ghani AA, Navamukundan AA,Jahis R, Gamil A. Unique product quality considerations in vaccine development, registration and new program implementation in Malaysia. Hum Vaccin Immunother 2020;16:530-8.
  17. Netfa F, Tashani M, Booy R, King C, Rashid H, Skinner SR. Knowledge, attitudes and perceptions of immigrant parents towards human papillomavirus (HPV) vaccination: a systematic review. Trop Med Infect Dis 2020;5:58.
  18. Yigit E, Boz G, Gokce A, Aslan M, Ozer A. Knowledge, attitudes and behaviors of Inonu University faculty members regarding childhood vaccine refusal. Hum Vaccin Immunother 2021;17:5191-5.
  19. Puri N, Coomes EA, Haghbayan H, Gunaratne K. Social media and vaccine hesitancy: new updates for the era of COVID-19 and globalized infectious diseases. Hum Vaccin Immunother 2020;16:2586-93.
  20. Ortiz RR, Smith A, Coyne-Beasley T. A systematic literature review to examine the potential for social media to impact HPV vaccine uptake and awareness, knowledge, and attitudes about HPV and HPV vaccination. Hum Vaccin Immunother 2019;15:1465-75.