Peer-reviewed article
Parental attitudes toward routine childhood vaccination in the post-COVID-19 pandemic era
Ehab Elrewany, Ayat Diaa Eldeen Ashour, Hoda Ali Ahmed Shiba, Shaimaa Abdelaziz Abdelmoneim, Assem Gebreal et al. ·
Summary
Written by AI, not yet AICS's view · claude-sonnet-5This study surveyed over 2000 parents of young children in five Arab countries, including Egypt and Libya, about their attitudes toward routine childhood vaccination after the COVID-19 pandemic. About 19% of parents showed vaccine hesitancy. Hesitancy was higher among rural residents, unemployed parents, those whose child was born after the pandemic, families who lost someone to COVID-19, and parents who themselves were not vaccinated against COVID-19. Trust in the health system was strongly linked to lower hesitancy. The study suggests that rebuilding confidence in health systems could help maintain childhood immunisation rates.
Key points
- 18.8% of parents were classified as vaccine hesitant overall
- Living in Libya was linked to much lower hesitancy than Egypt (aPR 0.14)
- Rural residence, unemployment, and having a child born after the pandemic increased hesitancy
- Family history of COVID-19 death and lack of parental COVID-19 vaccination were linked to higher hesitancy
- Lower confidence in the health system was the strongest factor associated with hesitancy (aPR 2.24)
Limitations
The cross-sectional design means it cannot show cause and effect, and only two of the five countries studied (Egypt and Libya) are in Africa.
Abstract
Abstract This study assessed parental attitudes toward routine childhood vaccination in five Arab countries (Egypt, Jordan, Saudi Arabia, Syria, and Libya) and explored factors associated with vaccine hesitancy in the post-coronavirus disease 2019 (COVID-19) pandemic period. Using a cross-sectional design, 2095 parents or guardians of children aged ≤ 4 years were surveyed via online and face-to-face interviews. The Arabic version of the Parent Attitudes about Childhood Vaccines Scale was used to measure parental vaccine hesitancy. Overall, 18.8% of parents were classified as vaccine hesitant. In multivariable modified Poisson regression analysis, residing in Libya was associated with a significantly lower prevalence of vaccine hesitancy compared with Egypt (adjusted prevalence ratio (aPR): 0.14, 95% CI 0.07–0.28; p <0.001), whereas rural residence (aPR: 1.28, 95% CI 1.03–1.58; p = 0.024), unemployment (aPR: 1.26, 95% CI 1.01–1.56; p = 0.040), having a child born after the COVID-19 pandemic (aPR: 1.54, 95% CI 1.22–1.94; p <0.001), family history of COVID-19-related death (aPR: 1.34, 95% CI 1.08–1.65; p = 0.007), lack of parental COVID-19 vaccination (aPR: 1.56, 95% CI 1.26–1.92; p <0.001), and lower confidence in vaccinations provided by the health system (aPR: 2.24, 95% CI 1.77–2.83; p < 0.001) were independently associated with higher parental vaccine hesitancy. Mediation analyses found no significant indirect associations through parental vaccine hesitancy on the relationships between education, country income, parental COVID-19 vaccination or infection history, and childhood vaccination. However, education, country income, and parental COVID-19 infection demonstrated significant direct effects on childhood vaccination status. These findings emphasize the importance of strengthening confidence in health systems and addressing socioeconomic disparities to reduce parental vaccine hesitancy and support childhood immunization programs in the post-pandemic era.