ANALYSIS OF THE REASON AND IMPACT OF HESITANCY AMONG PARENTS REGARDING ACCEPTABILITY OF MMR VACCINE

Abstract

This study shed light on importance of MMR vaccine by addressing its acceptability and advantages to the public. It is identified that the mentioned vaccine is not so much popular among the public due to lack of awareness program in the society. In this regard, literature review helps to identify its reason behind lack of acceptance in the society. Primary data collection method has chosen to address the aim of the topic. A statistical analyse is done to meet the goal of the topic. In this regards, descriptive statistic and correlation of different factors of acceptance of vaccines has introduce in this study. Finally, results of the study show that there is a strong relationship in terms of ITV with VCS and VAS composite.

Vaccine has been the most successful public health intervention started in the 20th century, which has increased morbidity and mortality rate by creating important prevention provided to humanity. Recent advancement in advanced healthcare science and technology has developed various essential features to the vaccination process and improved its efficiency based on disability and disease prevention origin. Challenges in this section can be considered as the difficulty of attaining disease-free status for various countries through delay or refusal of vaccination (Rossen, Hurlstone & Lawrence, 2016). Lack of education and improper understanding of vaccination for deadly diseases including Measles, Mumps, and Rubella is the main reason behind this several disease outbreaks in recent times through lack of awareness spread (ourworldindata.org, 2017). Analysing the rate of vaccines acceptance in a global context is increasing in expected rate for western countries; however, Africa, Ethiopia, and a few other countries are showing a slow rate of vaccination acceptance.

Acceptance of the vaccination can be considered as the complex decision-making process for following a potential range of causes. In this case, conceptual model is developed for determining vaccine hesitance determinants. Model complications, global perspective, and this model were first proposed by WHO and it can be viewed by the three-factor model and effectiveness of the vaccine system (Larson

et al.

2015). Policymaker’s motivation was decided on the vaccine requirement and in included perceived risk for preventive action. Three different parts of this model were Complacency, which includes perceived risk for vaccine-preventable disease and, which are low and seemed a necessary action. Confidence is considered as the system for delivering reliability and health service competency. Convenience is another factor, which incorporated physical availability and geographical diversity and immunization service harms and delivery of vaccination services through affecting the decision for obtaining vaccine or not.

Internet has changed the entire concept of communication-based on presentation of various opportunities and initiated an anti-vaccination activity for defining opposition to vaccination change, this has resulted in the minority usage for anti-vaccination content, has been included for allowing proper sources. Activity learning through an internet gained health information based on the problems and issues based on the anti-vaccine comments for increasing concern. In the year 2012, reportedly 244 billion users accessed the internet, which seems a drastic change from 2000 (Rossen

et al.

2016). It includes internet-based health solutions seeking and it provided with both positive and negative impact. Online new groups, blogs, and other related sources described in this immunisation effort for the development of the intended reason for incoming parts and varying resistance.

The Internet has been identified as the primary source for parents regarding immunization information collection and it has been applied in different ways based on the relevancy with the disease symptoms and self-prescribed medicinal usage. Parental use of such sources and influence of the children demonstrates the viewing trend o anti-vaccine websites and false ideas of immunization (Dubé

et al.

2015). Campaign and pre-vaccination websites are diminished due to the presence of such anti-vaccination ideas and reduced vaccine coverage rates among the children.

Anti-vaccination movement beholds the history of initiation in France 1763 and it is progress as a significant issue for public health on a global basis. Accurate information and listening to the bias story can differentiate the concept of vaccination, which can be better understood through an infographic developed but Mark Kirkpatrick, who was a health journalist and dietician (Davies

et al.

2002). As per the starting day’s o immunization, dependency and believing on the vaccines were not seen in many cases and no such quarantine method was discovered along with lack of sanitation and disease prevention. Evolution of medical science has created a huge change to humankind and created scope for effective medical tools and defensive strategy construction for fighting against global health issues such as Mumps, Measles, and Rubella virus and so on. Anti-vaccination movements are included in the long term of history however; this can be included through a timeline. First inoculation was done in ancient China in 10th Century B.C and it was invented in the Ancient china through smallpox intervention, which resulted in the survival factor of the patient.

Vaccination Act 1853

was enacted for mandatory vaccination of the infants up to 3 years old and the penalty for refusal, however, this has been immediately opposed trough the vaccine refusal. Vaccination helped the USA to free from the Measles virus from the year 2000, which again returned in the year 2013 recording 159 cases and increased to a death toll for 668 cases and 188 in the year 2015 (measlesrubellainitiative.org, 2019). Reason for such an outbreak, which resulted in the countrywide return of the disease, was identified as the religious and philosophical belief of not being vaccinated.

Various reasons can be identified regarding vaccination acceptance lack, which includes major portion of children vaccination lacking on a global basis, which can be seen above (MacDonald, 2015). In case of such vaccination effort, parental control plays a major role and it can be verified through the conduction of in-depth analysis, based on the Vaccination Attitude Scale (Hussain

et al.

2018). Characteristic influences based on the ineffectiveness of the vaccine, safety issue, unnatural components included in the vaccine are the primary obligation to vaccination acceptance.

Aim of the study is to identify the reasons and its similarities with the known vaccination attitudes based on Vaccination Confidence Scale and its reliability along with convergent validity through Vaccination Attitude Scale (VAS). Additionally, the parent’s willingness to vaccinate a child and future aspects of using MMR vaccine is also included in this study.

Development of a knowledge source based on the study prediction is categorised in four different sections for understanding based on the necessity of VCS evaluation. Factor analysis is discussed in this study through single or multiple reliability factors. Three other predictions in this study are the correlation between participants and total scores, total score and VCS score of correlation and finally correlation of the VAS and total scores. Scope of the study revolves around the impact of the VAS and VCS of such vaccination concern and creates a motivational pathway for increasing concern in this topic.

Method

Participants

In this study, primary data collection method will be sued based on a questionnaire and questionnaire format, which includes 8 VAS and 22 VCS related questions. All these questions are designed based on the relevancy of applying vaccination for Measles, Mumps and Rubble Virus prevention. Respondent selection based on the general information for Diseases and vaccination awareness for this study developed through a paid survey as this needed in-depth analysis of the questionnaire and parental care and other medical arrangements. Participants filled out the survey through online medium and from personal devices, which was done based on involvement consent and payment confirmation.

Materials

Questionnaire preparation based on the survey was done from a general basis of collecting personal information and demographics including location, gender, age, and number of children. Questionnaire formation was a major part of this study as this needed to include the questions, which clarifies the intent of the respondent to accept vaccination. Single item measure for indicating a point scale to satisfy the likelihood of the participants to be vaccinated by the MMR vaccine is the main aspect. Additional attributes were added to the questionnaire through validation of the vaccination attitude measurement and VAS inclusion.

Procedure

VAS is a concept developed for understanding the attitude for the respondent to attain vaccination VCS, on the other hand, was introduced for this study for creating a guideline based on the vaccination acceptance gained from the study and it also directed towards administering VAS and VCS through reliability, descriptive analysis, correlation of various factors.

Results

Analysis of the observations stated a clear view of the mean, maximum, and standard deviation based on the VAS and VCS score and ITV analysis. Highest number of standard deviation is seen in case of a parental right to refuse vaccination, which are 2.003. This analysis shows the interrelations of the components, which are parental control of vaccination rejection. Above stated literature shows a major relation of the tendency due to various factors such as lack of education, anti-vaccination websites, and other reformations and cultural misbelieves. This misbelieve is inhibiting natural vaccination process. In the case of MMR, vaccines vaccination need to be provided at an early stage of life and it includes parental control of activities for the child. In this case, it is not possible for children to understand the necessity of such awareness regarding these diseases, which makes parents as the only controller of this activity. VCS composition in this case provided with a result of .063, which seems positive as shows ethical responsibility along with public health responsibility for assessing the child to vaccination.

In this case, resulting Cronbach alpha value can be seen as .825and all the scale items are entirely dependent from another due to exclusion of any inter-item correlation. As per this result Alpha’s value seems dimensional depending on the maximum range of 1 and it has shown that ball the variables are reversely worded. In case of such situation, reliability is very high which is <.95 thus poses multiple coefficient and risks for redundancy of such items and dimensional item responses based on the input of the VCS composite value.

In this 30-item composite quiz, different variables were stated with the convergence reliability and item ranged from .663 to .869, thus it has differentiated ideas based on the deficient result, and exclusion of the inter-item correlation stated the consequently stated minimal acceptable rate based on the parental control and distinguishable notes for delivering various component.

Estimation of the interrelations with the composite and non-composite for conscience- based level and determination of the quiz item for 8 VAS and 22 VCS consequences based on the Strong co-relation of the composite scores. These scores can be used to differentiate variances and different level of psychometric representation for sharing and finding different items for estimation of the proper relationships

Validity questionnaire testing through different level of convergent validity based on the Initial Eigen value and differentiable communalities states the extraction method. Different techniques and modes used states 81% co variance level of the VAS composites with ITV and 95% covariance with VCS composites with ITV. Determination of the complex item level based on factor matrix for composite with .946, composite 2 with .919 and ITV for .701

Conclusion

In this entire study, vaccination decision making based on the VAS and VCS was the main aim, which can help understanding increasing rate of such disease outbreaks based on the parental decision making. In this case, 403 respondents, which care mostly parents, are surveyed through a close-ended questionnaire for information collection and it showed strong relationship of ITV with both VAS and VCS Composite. This study has also reflected the demarcation of the literature review for ignition of such anti-vaccination websites and different allegations based on child security and parental control. Pharmaceutical companies are also involved in these questions, which represent necessity of a vaccination depending on critical situation or a profitable marketing option regarding health emergency. In both the cases, correspondence of such activity and public health decisions are dependent on the decision making and influence of external; factors. Apart from that, this study further diagnosed the necessity of awareness increase and education regarding MMR vaccines for eradication of these diseases on a global basis.

Reference

• cdc.gov (2019).
  
  Measles, Mumps, and Rubella (MMR) Vaccination: What Everyone Should Know
  
  . Retrieved from: https://www.cdc.gov/vaccines/vpd/mmr/public/index.html
• Davies, P., Chapman, S., & Leask, J. (2002). Antivaccination activists on the world wide web.
  
  Archives of disease in childhood
  
  ,
  
  87
  
  (1), 22-25. Retrieved from: https://adc.bmj.com/content/archdischild/87/1/22.full.pdf
• Dubé, E., Gagnon, D., & MacDonald, N. E. (2015). Strategies intended to address vaccine hesitancy: Review of published reviews.
  
  Vaccine
  
  ,
  
  33
  
  (34), 4191-4203. Retrieved from: https://www.sciencedirect.com/science/article/pii/S0264410X15005058
• Jain, A., Marshall, J., Buikema, A., Bancroft, T., Kelly, J. P., & Newschaffer, C. (2016). Correction of Description of MMR Vaccine Receipt Coding and Minor Errors in MMR Vaccine and Autism Study.
  
  Jama
  
  ,
  
  315
  
  (2), 202-204. Retrieved from: https://doi:10.1001/jama.2015.17065
• Larson, H. J., Jarrett, C., Schulz, W. S., Chaudhuri, M., Zhou, Y., Dube, E., … & Wilson, R. (2015). Measuring vaccine hesitancy: the development of a survey tool.
  
  Vaccine
  
  ,
  
  33
  
  (34), 4165-4175. Retrieved from: https://www.sciencedirect.com/science/article/pii/S0264410X15005010
• MacDonald, N. E. (2015). Vaccine hesitancy: Definition, scope and determinants.
  
  Vaccine
  
  ,
  
  33
  
  (34), 4161-4164. Retrieved from: https://www.sciencedirect.com/science/article/pii/S0264410X15005009
• measlesrubellainitiative.org (2019).
  
  The anti-vaccination movement
  
  . Retrieved from: https://measlesrubellainitiative.org/anti-vaccination-movement/
• ourworldindata.org (2017).
  
  Vaccinated Children for Measles on a global basis
  
  . Retrieved from:
  
  https://ourworldindata.org/exports/share-of-children-vaccinated-against-measles_v7_850x600.svg
  
• Rossen, I., Hurlstone, M. J., & Lawrence, C. (2016). Going with the grain of cognition: applying insights from psychology to build support for childhood vaccination.
  
  Frontiers in psychology
  
  ,
  
  7
  
  , 1483. Retrieved from:
  
  https://www.frontiersin.org/articles/10.3389/fpsyg.2016.01483
  
• Wolfe, R. M., Sharp, L. K., & Lipsky, M. S. (2002). Content and design attributes of antivaccination web sites.
  
  Jama
  
  ,
  
  287
  
  (24), 3245-3248. Retrieved from: https://jamanetwork.com/journals/jama/fullarticle/195044