DOI: https://doi.org/10.14710/jpki.19.2.120-128

The Correlation Between Behavioral and Psychological Factors with Booster Immunization Adherence for Children Aged <24 Months

*Ayun Sriatmi orcid scopus publons  -  Department of Health Policy and Administration, Faculty of Public Health, Universitas Diponegoro, Indonesia
Martini Martini orcid  -  Department of Epidemiology and Tropical Diseases, Faculty of Public Health, Universitas Diponegoro, Indonesia
Sutopo Patriajati orcid  -  Department of Health Policy and Administration, Faculty of Public Health, Universitas Diponegoro, Indonesia
Budiyono Budiyono orcid  -  Department of Environmental Health, Faculty of Public Health, Universitas Diponegoro, Indonesia
Open Access Copyright (c) 2024 Authors under http://creativecommons.org/licenses/by-sa/4.0.

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Abstract

Background: Immunization status is considered complete when children receive all antigens types as recommended, including booster immunization, ensuring optimal protection. The high level of non-adherence is the main obstacle to immunization programs, further added by the fact that the number of children who receive partial or no immunization remains high. This study aims to analyze the correlation between behavioral and psychological factors with booster immunization adherence in children aged <24 months.

Method: A quantitative study with a cross-sectional approach. The population consists of parents with children aged 18-23 months, totaling a sample of 522 children. The data were collected through interviews using structured questionnaires, and observations using MCH-Book to measure booster immunization adherence. The collected data was analyzed through univariate, bivariate, and multivariate approaches with multiple logistic regression tests to identify the dominant variables.

Results: Only 25.9% of children received two types of recommended booster vaccines (DPT/HB/HiB-4 and MR-2). Partially, behavioral factors that correlate with booster immunization adherence are knowledge, attitudes, and perceptions about multiple injections, while psychological factors that correlate are motivation and basic immunization status. Experience with previous basic immunization status is the most dominant factor influencing booster immunization adherence. The fear of disease infection and trust in healthcare providers are the keys to a successful immunization. Need to increase motivation through strengthening literacy and improving access to and health service system to reduce hesitation about, distrust, and refusal of immunization, while also providing a positive immunization experience.

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Keywords: booster immunization; adherence;behavioral factors;psychological factors;children aged <24 months

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Section: Research Article
Language : EN
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  1. Alghofaili MA, Aljuaid SO, Alqahtani N, Alghufaili M, Abd-Ellatif EE. Factors Contributing to the Delayed Vaccination Among Children in Riyadh City, Saudi Arabia: A Cross-Sectional Study. Cureus. 2023;15(Mcv):1–14
  2. Chu H, Rammohan A. Childhood immunization and age-appropriate vaccinations in Indonesia. BMC Public Health. 2022;22(1):1–12
  3. Ghosh A, Annigeri S, Hemram SK, Dey PK, Mazumder S, Ghosh P. Demography and determinants of incomplete immunization in children aged 1–5 years and vaccine-hesitancy among caregivers: An Eastern Indian perspective. Clin Epidemiol Glob Heal. 2022;17(April):101155
  4. Kanchan MI, Firoz M, Kurlikar PR, Chourase M, Yadav R, Biswas AB. Status and determinants of child immunisation coverage in three South Asian countries, India, Bangladesh and Nepal: Evidence from the Demographic and Health Survey. Sri Lanka J Child Heal. 2018;47(1):56–63
  5. Efendi F, Pradiptasiwi DR, Krisnana I, Kusumaningrum T, Kurniati A, Sampurna MTA, et al. Factors associated with complete immunizations coverage among Indonesian children aged 12–23 months. Child Youth Serv Rev. 2020;108(November 2019):104651
  6. Bausad AAP, Muchlisa N. Faktor yang Mempengaruhi Cakupan dan Ketepatan Waktu Imunisasi. J Kesehat Ilm Indones. 2022;7(2):161–6
  7. UNICEF. For Every Child: Vaccination (Regional Brief). In: East Asia and The Pacific-The State of The World’s Children 2023. 2023. p. 0–23
  8. Ji W yan, Liu D lei, Yu R, Miao L, Yuan QL, Suo L dan, et al. Vaccination coverage survey of children aged 1–3 years in Beijing, China, 2005–2021. Vaccine. 2023;41(43):6444–52
  9. Hirani JC, Wüst M. Reminder design and childhood vaccination coverage. J Health Econ. 2024;93(October 2023):102832
  10. Nair AT, Nayar KR, Koya SF, Abraham M, Lordson J, Grace C, et al. Social media, vaccine hesitancy and trust deficit in immunization programs: a qualitative enquiry in Malappuram District of Kerala, India. Heal Res Policy Syst. 2021;19 (Supp 2(56):1–8
  11. Destefano F, Bodenstab HM, Offit PA. Principal Controversies in Vaccine Safety in the United States. Clin Infect Dis. 2019;69(4):726–31
  12. Facciola A, Visalli G, Orlando A, Bertuccio MP, Spataro P, Squeri R, et al. Vaccine hesitancy: An overview on parents’ opinions about vaccination and possible reasons of vaccine refusal. J Public health Res. 2019;8(1):13–8
  13. Viggiano C, Occhinegro A, Siano MA, Mandato C, Adinolfi M, Nardacci A, et al. Analgesic effects of breast- and formula feeding during routine childhood immunizations up to 1 year of age. Pediatr Res. 2021;89(5):1179–84
  14. WHO. Leave no child behind: protecting the future of Indonesian children through immunization. 2022. Available from: https://www.who.int/indonesia/news/detail/27-07-2022-leave-no-child-behind--protecting-the-future-of-indonesian-children-through-immunization#:~:text=When children’s routine immunization is,type b%2C measles and rubella
  15. Agrawal A, Kolhapure S, Di Pasquale A, Rai J, Mathur A. Vaccine Hesitancy as a Challenge or Vaccine Confidence as an Opportunity for Childhood Immunisation in India. Infect Dis Ther. 2020;9(3):421–32
  16. Dubé È, Ward JK, Verger P, MacDonald NE. Vaccine Hesitancy , Acceptance , and Anti-Vaccination : Trends and Future Prospects for Public Health. Annu Rev Public Health. 2021;42:175–91
  17. Kemenkes RI. Peraturan Menteri Kesehatan Republik Indonesia Nomor 12 Tahun 2017 tentang Penyelenggaraan Imunisasi. Kemenkes RI. Jakarta Indonesia: Kementerian Kesehatan Republik Indonesia; 2017. Available from: http://hukor.kemkes.go.id/uploads/produk_hukum/PMK_No._12_ttg_Penyelenggaraan_Imunisasi_.pdf
  18. Hanson CM, Mirza I, Kumapley R, Ogbuanu I, Kezaala R, Nandy R. Enhancing immunization during second year of life by reducing missed opportunities for vaccinations in 46 countries. Vaccine. 2018;36(23):3260–8
  19. Vela LR, Sjaaf AC. Policy Implementation in Achieving Basic Complete Immunization and Universal Child Immunization Indicators in Kapuas District in 2018. J Indones Heal Policy Adm. 2020;5(1):14–9
  20. Sinuraya RK, Alfian SD, Abdulah R, Postma MJ, Suwantika AA. Comprehensive childhood vaccination and its determinants: Insights from the Indonesia Family Life Survey (IFLS). J Infect Public Health. 2024;17(3):509–17
  21. Talbird SE, Carrico J, La EM, Carias C, Marshall GS, Roberts CS, et al. Impact of Routine Childhood Immunization in Reducing Vaccine-Preventable Diseases in the United States. Pediatrics. 2022;150(3):1–12
  22. Syiroj ATR, Pardosi JF, Heywood AE. Exploring parents’ reasons for incomplete childhood immunization in Indonesia. Vaccine. 2019;37(43):6486–93
  23. Wallace AS, Wannemuehler K, Bonsu G, Wardle M, Nyaku M, Amponsah-Achiano K, et al. Development of a valid and reliable scale to assess parents’ beliefs and attitudes about childhood vaccines and their association with vaccination uptake and delay in Ghana. Vaccine. 2019;37(6):848–56
  24. Balgovind P, Mohammadnezhad M. Factors affecting childhood immunization: Thematic analysis of parents and healthcare workers’ perceptions. Hum Vaccines Immunother. 2022;18(6):1–15
  25. Joshi J, Das MK, Polpakara D, Aneja S, Agarwal M, Arora NK. Vaccine Safety and Surveillance for Adverse Events Following Immunization (AEFI) in India. Indian J Pediatr. 2018;85(2):139–48
  26. Crescitelli MED, Ghirotto L, Sisson H, Sarli L, Artioli G, Bassi MC, et al. A meta-synthesis study of the key elements involved in childhood vaccine hesitancy. Public Health. 2020;180:38–45
  27. Debela BG, Negassa B, Hareru HE, Sisay D, Soboksa NE. Maternal satisfaction on child immunization services of rural health extension workers in Dawie Harewa district, Northeast Ethiopia: A community based cross-sectional study. Environ Challenges. 2022;7(November 2021):100455
  28. Uwaibi NE, Omozuwa SE. Maternal satisfaction with childhood immunization services in primary health care centres in Edo State, Nigeria. Afr J Reprod Health. 2021;25(2):86–93
  29. Beavis AL, Meek K, Moran MB, Fleszar L, Adler S, Rositch AF. Exploring HPV vaccine hesitant parents’ perspectives on decision-making and motivators for vaccination. Vaccine X. 2022;12(100231):1–7
  30. Ahmad NA, Jahis R, Kuay LK, Jamaluddin R, Aris T. Primary Immunization among Children in Malaysia: Reasons for Incomplete Vaccination. J Vaccines Vaccin. 2017;08(03):1–8
  31. Mebrat A, Dube L, Kebede A, Aweke Z. Determinants of Incomplete Childhood Vaccination among Children Aged 12-23 Months in Gambela Region, Southwest Ethiopia: A Case Control Study. Ethiop J Health Sci. 2021;31(1):63–72
  32. Oku A, Oyo-Ita A, Glenton C, Fretheim A, Ames H, Muloliwa A, et al. Perceptions and experiences of childhood vaccination communication strategies among caregivers and health workers in Nigeria: A qualitative study. PLoS One. 2017;12(11):1–21
  33. Bangura JB, Xiao S, Qiu D, Ouyang F, Chen L. Barriers to childhood immunization in sub-Saharan Africa: A systematic review. BMC Public Health. 2020;20(1108):1–15
  34. Ahmad D, Afzal M, Imtiaz A. Effect of socioeconomic factors on malnutrition among children in Pakistan. Futur Bus J. 2020;6(1):1–11
  35. Simbolon D, Suryani D, Yorita E. Prediction Model and Scoring System in Prevention and Control of Stunting Problems in Under Five-Year-Olds in Indonesia. J Kesehat Masyarakat- KEMAS. 2019;15(2):160–70
  36. Pacheco CDR, Picauly I, Sinaga M. Health, Food Consumption, Social Economy, and Stunting Incidency in Timor Leste. J Kesehat Masyarakat-KEMAS. 2017;13(2):261–9
  37. Weithorn LA, Reiss DR. Legal approaches to promoting parental compliance with childhood immunization recommendations. Hum Vaccines Immunother. 2018;14(7):1610–7
  38. Navin MC, Wasserman JA, Ahmad M, Bies S. Vaccine Education, Reasons for Refusal, and Vaccination Behavior. Am J Prev Med. 2019;56(3):359–67
  39. Agushybana F, Mustofa SB, Jati SP, Martini M, Sriatmi A. Description of complete basic immunization coverage among infant. Int J Public Heal Sci. 2019;8(2):174–8
  40. Howell JL, Gasser ML, Kaysen D, Lindgren KP. Understanding parental vaccine refusal: Implicit and explicit associations about vaccines as potential building blocks of vaccine beliefs and behavior. Soc Sci Med. 2022;310(115275):1–10
  41. Sriatmi A, Martini M, Agushybana F, Jati SP, Astorina N, Handayani N, et al. Complete Basic Immunization Coverage among Infants in Temanggung Regency. J Aisyah J Ilmu Kesehat. 2021;6(4):645–50
  42. Smith LE, Amlôt R, Weinman J, Yiend J, Rubin GJ. A systematic review of factors affecting vaccine uptake in young children. Vaccine. 2017;35(45):6059–69
  43. Handy LK, Maroudi S, Powell M, Nfila B, Moser C, Japa I, et al. The impact of access to immunization information on vaccine acceptance in three countries. PLoS One. 2017;12(8):1–16
  44. Olson O, Berry C, Kumar N. Addressing parental vaccine hesitancy towards childhood vaccines in the united states: A systematic literature review of communication interventions and strategies. Vaccines. 2020;8(4):1–25

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