PARENTS’ATTITUDES, THEIR ACCEPTANCE OF THE COVID-19 VACCINES FOR CHILDREN AND THE CONTRIBUTING FACTORS IN NAJRAN, SAUDI ARABIA

Main Article Content

Khaled Ali Alrashah
Tariq Nasser Haqawi
Mohsen Abdullah Alrashah
Ahmed Saleh Alkhiwani
Ibahim Ahmed Alrashah
Naif Salem Aljamaher
Naif Abdullah Alrashah
Layla Hussain Mohammed Awaji

Keywords

COVID-19, children, vaccine acceptance, vaccination, Saudi Arabia

Abstract

Background: The COVID-19 pandemic is still ongoing, so it is critical to immunize the majority of people, including children, to achieve herd immunity against the pandemic. As parents are the ones who ultimately decide whether or not to vaccinate their children, this study was conducted to determine parental acceptance and hesitancy toward vaccinating their children against COVID-19, as well as their knowledge of and concerns regarding vaccination against COVID-19, as well as factors that might influence their willingness to vaccinate in Najran city, Saudi Arabia. Methods: In February 2022, a cross-sectional, questionnaire-based study using a convenient and snowball sampling technique was carried out. Parents of children between the ages of 5 and 11 were given access to an online self-administered survey. The poll was, however, open to parents of children under the age of 5. Using the Raosoft sample size calculator, the minimum necessary sample size was determined to be 384 under the assumptions of a 5% margin of error and a 95% confidence level. A p value of less than 0.05 was deemed significant for the statistical analysis, which was carried out using SPSS version 27. To examine the relationship between demographic factors and how drivers affect parents’ willingness to vaccinate their children against COVID-19, a chi-square test was performed. Through multivariate regression analysis, the predictors of vaccine hesitancy were identified. Results: A total of 464 responses were collected and subjected to data analysis. More than half of the parents were male (56.9%) and between the ages of 26 and 40 (56.7%). Most parents have children aged between 5–11 years (73.5%). Of parents, 72.2% showed vaccine hesitancy and were 9.5 times less likely to immunize their children against COVID-19. About 27.8% of the parents were ready to vaccinate their children against COVID-19 as soon as possible, compared to 15.51% of parents who were not at all interested in vaccinating their children. Parents under 25 (34.48%) and over 41 (37.79%), non-Saudi (40.59%), holding postgraduate and higher degrees (39.5%), earning more than 10,000 SAR per month (34.96%), working as healthcare professionals (40.36%) and in government sectors (33.93%), self-employed (33.33%), with three to five children (35.26%) and male (31.33%) demonstrated significantly high willingness to vaccinate their children against the COVID-19 vaccine compared to their counterparts. Parents who concur that COVID-19 vaccination may have serious adverse effects in children, who believe that COVID-19 is an uncommon disease and does not require vaccination, have had a family member infected withCOVID-19 with severe symptoms, who were unvaccinated and had severe to moderate symptoms after vaccination, showed significantly higher unwillingness to vaccinate their children against COVID-19. Parents who take safety precautions and do not believe that new vaccines provide an increased risk had higher vaccination intentions for their children. A positive impact of mandatory childhood vaccination was noted on the COVID-19 vaccination. Parents with children suffering from any chronic disease exhibited a 9.9 times higher hesitancy to vaccinate their children against COVID-19. A total of 47.8% of parents had come across or heard about anti-COVID-19 vaccination campaigns. A lack of adequate safety data, potential future consequences, and vaccine efficacy were the main concerns with COVID-19 vaccines. The primary information source for COVID-19-related information was the Saudi Ministry of Health (MOH). Conclusions: Parents’ hesitation to get the COVID-19 vaccine at a significant rate may compromise the success of the ongoing vaccination campaign. The development and implementation of multi-component interventions are required. Hospital- and community-based programs must be used to get in touch with parents.


 

Abstract 159 | PDF Downloads 121

References

1. Huang, C.; Wang, Y.; Li, X.; Ren, L.; Zhao, J.; Hu, Y.; Zhang, L.; Fan, G.; Xu, J.; Gu, X.; et al. Clinical Features of Patients Infected with 2019 Novel Coronavirus in Wuhan, China. Lancet 2020, 395, 497–506. [CrossRef]
2. WHO Coronavirus (COVID-19) Dashboard. Available online: https://covid19.who.int/ (accessed on 2 March 2022).
3. Pak, A.; Adegboye, O.A.; Adekunle, A.I.; Rahman, K.M.; McBryde, E.S.; Eisen, D.P. Economic Consequences of the COVID-19 Outbreak: The Need for Epidemic Preparedness. Front. Public Health 2020, 8, 241. [CrossRef]
4. Kim, L.; Whitaker, M.; O’Halloran, A.; Kambhampati, A.; Chai, S.J.; Reingold, A.; Armistead, I.; Kawasaki, B.; Meek, J.; Yousey- Hindes, K.; et al. Hospitalization Rates and Characteristics of Children Aged <18 Years Hospitalized with Laboratory-Confirmed COVID-19-COVID-NET, 14 States, March 1–July 25, 2020. MMWR Morb. Mortal. Wkly. Rep. 2020, 69, 1081–1088. [CrossRef]
5. Viner, R.M.; Mytton, O.T.; Bonell, C.; Melendez-Torres, G.J.; Ward, J.; Hudson, L.; Waddington, C.; Thomas, J.; Russell, S.; van der Klis, F.; et al. Susceptibility to SARS-CoV-2 Infection among Children and Adolescents Compared with Adults: A Systematic Review and Meta-Analysis: A Systematic Review and Meta-Analysis. JAMA Pediatr. 2021, 175, 143–156. [CrossRef]
6. Tsankov, B.K.; Allaire, J.M.; Irvine, M.A.; Lopez, A.A.; Sauvé, L.J.; Vallance, B.A.; Jacobson, K. Severe COVID-19 Infection and Pediatric Comorbidities: A Systematic Review and Meta-Analysis. Int. J. Infect. Dis. 2021, 103, 246–256. [CrossRef]
7. Pierce, C.A.; Preston-Hurlburt, P.; Dai, Y.; Aschner, C.B.; Cheshenko, N.; Galen, B.; Garforth, S.J.; Herrera, N.G.; Jangra, R.K.; Morano, N.C.; et al. Immune Responses to SARS-CoV-2 Infection in Hospitalized Pediatric and Adult Patients. Sci. Transl. Med. 2020, 12, eabd5487. [CrossRef]
8. Dewi, R.; Kaswandani, N.; Karyanti, M.R.; Setyanto, D.B.; Pudjiadi, A.H.; Hendarto, A.; Djer, M.M.; Prayitno, A.; Yuniar, I.; Indawati, W.; et al. Mortality in Children with Positive SARS-CoV-2 Polymerase Chain Reaction Test: Lessons Learned from a Tertiary Referral Hospital in Indonesia. Int. J. Infect. Dis. 2021, 107, 78–85. [CrossRef]
9. Dawood, F.S.; Porucznik, C.A.; Veguilla, V.; Stanford, J.B.; Duque, J.; Rolfes, M.A.; Dixon, A.; Thind, P.; Hacker, E.; Castro, M.J.E.; et al. Incidence Rates, Household Infection Risk, and Clinical Characteristics of SARS-CoV-2 Infection among Children and Adults in Utah and New York City, New York. JAMA Pediatr. 2022, 176, 59–67. [CrossRef]
10. Paul, L.A.; Daneman, N.; Schwartz, K.L.; Science, M.; Brown, K.A.; Whelan, M.; Chan, E.; Buchan, S.A. Association of Age and Pediatric Household Transmission of SARS-CoV-2 Infection. JAMA Pediatr. 2021, 175, 1151–1158. [CrossRef]
11. Munoz, F.M. If Young Children’s Risk of SARS-CoV-2 Infection Is Similar to That of Adults, Can Children Also Contribute to Household Transmission? JAMA Pediatr. 2022, 176, 19–21. [CrossRef]
12. Farronato, M.; Tadakamadla, S.K.; Ali Quadri, M.F.; Acharya, S.; Tadakamadla, J.; Love, R.M.; Jamal, M.; Mulder, R.; Maspero, C.; Farronato, D.; et al. A Call for Action to Safely Deliver Oral Health Care during and Post COVID-19 Pandemic. Int. J. Environ. Res. Public Health 2020, 17, 6704. [CrossRef] [PubMed]
13. Sayed, A.A. The Progressive Public Measures of Saudi Arabia to Tackle COVID-19 and Limit Its Spread. Int. J. Environ. Res. Public Health 2021, 18, 783. [CrossRef]
14. Chakraborty, C.; Sharma, A.R.; Bhattacharya, M.; Agoramoorthy, G.; Lee, S.-S. The Drug Repurposing for COVID-19 Clinical Trials Provide Very Effective Therapeutic Combinations: Lessons Learned from Major Clinical Studies. Front. Pharmacol. 2021, 12, 704205. [CrossRef] [PubMed]
15. Assessment of the Further Spread and Potential Impact of the SARS-CoV-2 Omicron Variant of Concern in the EU/EEA, 19th Update. Available online:
http://www.ecdc.europa.eu/en/publications-data/covid-19-omicron-risk-assessment-further- emergence-and-potential-impact (accessed on 21 March 2022).
16. Harris, R.J.; Hall, J.A.; Zaidi, A.; Andrews, N.J.; Dunbar, J.K.; Dabrera, G. Effect of Vaccination on Household Transmission of SARS-CoV-2 in England. N. Engl. J. Med. 2021, 385, 759–760. [CrossRef]
17. COVID-19 Vaccines. Available online: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/covid-19-vaccines (accessed on 21 March 2022).
18. EMA COVID-19 Vaccines: Development, Evaluation, Approval and Monitoring. Available online:https://www.ema.europa.eu/en/human-regulatory/overview/public-health-threats/corona virus-disease-covid-19/treatments-vaccines/vaccines-covid- 19/covid-19-vaccines-development-evaluation-approval-monitoring (accessed on 21 March 2022).
19. COVID 19 Dashboard: Saudi Arabia. Available online: https://covid19.moh.gov.sa/ (accessed on 21 March 2022).
20. Joudah, G. Saudi Arabia Promotes Safety of COVID-19 Vaccine for Those Aged 5–11. Arab News, 22 December 2021.
21. MacDonald, N.E. SAGE Working Group on Vaccine Hesitancy Vaccine Hesitancy: Definition, Scope and Determinants. Vaccine 2015, 33, 4161–4164. [CrossRef]
22. Ten Health Issues WHO Will Tackle This Year. Available online: https://www.who.int/news-room/spotlight/ten-threats-to- global-health-in-2019 (accessed on 25 March 2022).
23. Domek, G.J.; O’Leary, S.T.; Bull, S.; Bronsert, M.; Contreras-Roldan, I.L.; Bolaños Ventura, G.A.; Kempe, A.; Asturias, E.J. Measuring Vaccine Hesitancy: Field Testing the WHO SAGE Working Group on Vaccine Hesitancy Survey Tool in Guatemala. Vaccine 2018, 35, 5273–5281. [CrossRef]
24. Dubé, E.; Gagnon, D.; Nickels, E.; Jeram, S.; Schuster, M. Mapping Vaccine Hesitancy—Country-Specific Characteristics of a Global Phenomenon. Vaccine 2014, 32, 6649–6654. [CrossRef]
25. Temsah, M.-H.; Alhuzaimi, A.N.; Aljamaan, F.; Bahkali, F.; Al-Eyadhy, A.; Alrabiaah, A.; Alhaboob, A.; Bashiri, F.A.; Alshaer, A.; Temsah, O.; et al. Parental Attitudes and Hesitancy about COVID-19 vs. Routine Childhood Vaccinations: A National Survey. Front. Public Health 2021, 9, 752323. [CrossRef]
26. Babicki, M.; Pokorna-Kałwak, D.; Doniec, Z.; Mastalerz-Migas, A. Attitudes of Parents with Regard to Vaccination of Children against COVID-19 in Poland. A Nationwide Online Survey. Vaccines 2021, 9, 1192. [CrossRef]
27. Bell, S.; Clarke, R.; Mounier-Jack, S.; Walker, J.L.; Paterson, P. Parents’ and Guardians’ Views on the Acceptability of a Future COVID-19 Vaccine: A Multi-Methods Study in England. Vaccine 2020, 38, 7789–7798. [CrossRef]
28. Skjefte, M.; Ngirbabul, M.; Akeju, O.; Escudero, D.; Hernandez-Diaz, S.; Wyszynski, D.F.; Wu, J.W. COVID-19 Vaccine Acceptance among Pregnant Women and Mothers of Young Children: Results of a Survey in 16 Countries. Eur. J. Epidemiol. 2021, 36, 197–211. [CrossRef]
29. Ennaceur, S.; Al-Mohaithef, M. Parents’ Willingness to Vaccinate Children against COVID-19 in Saudi Arabia: A Cross-Sectional Study. Vaccines 2022, 10, 156. [CrossRef]
30. Altulahi, N.; AlNujaim, S.; Alabdulqader, A.; Alkharashi, A.; AlMalki, A.; AlSiari, F.; Bashawri, Y.; Alsubaie, S.; AlShahrani, D.; AlGoraini, Y. Willingness, Beliefs, and Barriers Regarding the COVID-19 Vaccine in Saudi Arabia: A Multiregional Cross-Sectional Study. BMC Fam. Pract. 2021, 22, 247. [CrossRef]
31. Alfieri, N.L.; Kusma, J.D.; Heard-Garris, N.; Davis, M.M.; Golbeck, E.; Barrera, L.; Macy, M.L. Parental COVID-19 Vaccine Hesitancy for Children: Vulnerability in an Urban Hotspot. BMC Public Health 2021, 21, 1662. [CrossRef]
32. Yılmaz, M.; Sahin, M.K. Parents’ Willingness and Attitudes Concerning the COVID-19 Vaccine: A Cross-Sectional Study. Int. J. Clin. Pract. 2021, 75, e14364. [CrossRef]
33. Szilagyi, P.G.; Shah, M.D.; Delgado, J.R.; Thomas, K.; Vizueta, N.; Cui, Y.; Vangala, S.; Shetgiri, R.; Kapteyn, A. Parents’ Intentions and Perceptions about COVID-19 Vaccination for Their Children: Results from a National Survey. Pediatrics 2021, 148, e2021052335. [CrossRef]
34. azalghamdi 16-2017. Available online: https://www.stats.gov.sa/en/915 (accessed on 24 July 2022).
35. Larson, H.J.; Jarrett, C.; Schulz, W.S.; Chaudhuri, M.; Zhou, Y.; Dube, E.; Schuster, M.; MacDonald, N.E.; Wilson, R. SAGE Working Group on Vaccine Hesitancy Measuring Vaccine Hesitancy: The Development of a Survey Tool. Vaccine 2015, 33, 4165–4175. [CrossRef]
36. Kempe, A.; Saville, A.W.; Albertin, C.; Zimet, G.; Breck, A.; Helmkamp, L.; Vangala, S.; Dickinson, L.M.; Rand, C.; Humiston, S.; et al. Parental Hesitancy about Routine Childhood and Influenza Vaccinations: A National Survey. Pediatrics 2020, 146, e20193852. [CrossRef]
37. Greenwood, B. The Contribution of Vaccination to Global Health: Past, Present and Future. Philos. Trans. R. Soc. Lond. B Biol. Sci.2014, 369, 20130433. [CrossRef]
38. Schaffer DeRoo, S.; Pudalov, N.J.; Fu, L.Y. Planning for a COVID-19 Vaccination Program. JAMA 2020, 323, 2458. [CrossRef]
39. Almalki, O.S.; Alfayez, O.M.; Al Yami, M.S.; Asiri, Y.A.; Almohammed, O.A. Parents’ Hesitancy to Vaccinate Their 5–11-Year-Old Children against COVID-19 in Saudi Arabia: Predictors from the Health Belief Model. Front. Public Health 2022, 10, 842862. [CrossRef] [PubMed]
40. Alsubaie, S.S.; Gosadi, I.M.; Alsaadi, B.M.; Albacker, N.B.; Bawazir, M.A.; Bin-Daud, N.; Almanie, W.B.; Alsaadi, M.M.; Alzamil, F.A. Vaccine Hesitancy among Saudi Parents and Its Determinants. Result from the WHO SAGE Working Group on Vaccine Hesitancy Survey Tool: Result from the WHO SAGE Working Group on Vaccine Hesitancy Survey Tool. Saudi Med. J. 2019, 40, 1242–1250. [CrossRef] [PubMed]
41. Aldakhil, H.; Albedah, N.; Alturaiki, N.; Alajlan, R.; Abusalih, H. Vaccine Hesitancy towards Childhood Immunizations as a Predictor of Mothers’ Intention to Vaccinate Their Children against COVID-19 in Saudi Arabia. J. Infect. Public Health 2021, 14, 1497–1504. [CrossRef]
42. Williams, S.E. What Are the Factors That Contribute to Parental Vaccine-Hesitancy and What Can We Do about It? Hum. Vaccin. Immunother. 2014, 10, 2584–2596. [CrossRef] [PubMed]
43. Olusanya, O.A.; Bednarczyk, R.A.; Davis, R.L.; Shaban-Nejad, A. Addressing Parental Vaccine Hesitancy and Other Barriers to Childhood/Adolescent Vaccination Uptake during the Coronavirus (COVID-19) Pandemic. Front. Immunol. 2021, 12, 663074. [CrossRef]
44. Opel, D.J.; Taylor, J.A.; Mangione-Smith, R.; Solomon, C.; Zhao, C.; Catz, S.; Martin, D. Validity and Reliability of a Survey to Identify Vaccine-Hesitant Parents. Vaccine 2011, 29, 6598–6605. [CrossRef]
45. Average Household Monthly Income Saudi Arabia 2018 by Administrative Region. Available online: https://www.statista.com/ statistics/1124341/saudi-arabia-average-household-monthly-income-by-region/ (accessed on 24 July 2022).
46. Zhang, K.C.; Fang, Y.; Cao, H.; Chen, H.; Hu, T.; Chen, Y.Q.; Zhou, X.; Wang, Z. Parental Acceptability of COVID-19 Vaccination for Children under the Age of 18 Years: Cross-Sectional Online Survey. JMIR Pediatr. Parent. 2020, 3, e24827. [CrossRef]
47. Goldman, R.D.; Marneni, S.R.; Seiler, M.; Brown, J.C.; Klein, E.J.; Cotanda, C.P.; Gelernter, R.; Yan, T.D.; Hoeffe, J.; Davis, A.L.; et al. Caregivers’ Willingness to Accept Expedited Vaccine Research during the COVID-19 Pandemic: A Cross-Sectional Survey. Clin. Ther. 2020, 42, 2124–2133. [CrossRef]
48. Giambi, C.; Fabiani, M.; D’Ancona, F.; Ferrara, L.; Fiacchini, D.; Gallo, T.; Martinelli, D.; Pascucci, M.G.; Prato, R.; Filia, A.; et al. Parental Vaccine Hesitancy in Italy–Results from a National Survey. Vaccine 2018, 36, 779–787. [CrossRef]
49. Doustmohammadi, S.; Cherry, J.D. The Sociology of the Antivaccine Movement. Emerg. Top. Life Sci. 2020, 4, 241–245. [CrossRef]
50. Burki, T. The Online Anti-Vaccine Movement in the Age of COVID-19. Lancet Digit. Health 2020, 2, e504–e505. [CrossRef]
51. Gallè, F.; Sabella, E.A.; Roma, P.; De Giglio, O.; Caggiano, G.; Tafuri, S.; Da Molin, G.; Ferracuti, S.; Montagna, M.T.; Liguori, G.; et al. Knowledge and Acceptance of COVID-19 Vaccination among Undergraduate Students from Central and Southern Italy. Vaccines 2021, 9, 638. [CrossRef]
52. Gallè, F.; Sabella, E.A.; Roma, P.; Ferracuti, S.; Da Molin, G.; Diella, G.; Montagna, M.T.; Orsi, G.B.; Liguori, G.; Napoli, C. Knowledge and Lifestyle Behaviors Related to COVID-19 Pandemic in People over 65 Years Old from Southern Italy. Int. J. Environ. Res. Public Health 2021, 18, 10872. [CrossRef] [PubMed]
53. Gallè, F.; Sabella, E.A.; Roma, P.; Da Molin, G.; Diella, G.; Montagna, M.T.; Ferracuti, S.; Liguori, G.; Orsi, G.B.; Napoli, C. Acceptance of COVID-19 Vaccination in the Elderly: A Cross-Sectional Study in Southern Italy. Vaccines 2021, 9, 1222. [CrossRef] [PubMed]
54. Al-Hanawi, M.K.; Alshareef, N.; El-Sokkary, R.H. Willingness to Receive COVID-19 Vaccination among Older Adults in Saudi Arabia: A Community-Based Survey. Vaccines 2021, 9, 1257. [CrossRef]
55. Alqahtani, Y.S. Acceptability of the COVID-19 Vaccine among Adults in Saudi Arabia: A Cross-Sectional Study of the General Population in the Southern Region of Saudi Arabia. Vaccines 2021, 10, 41. [CrossRef]
56. Galanis, P.; Vraka, I.; Siskou, O.; Konstantakopoulou, O.; Katsiroumpa, A.; Kaitelidou, D. Uptake of COVID-19 Vaccines among Pregnant Women: A Systematic Review and Meta-Analysis. Vaccines 2022, 10, 766. [CrossRef]
57. Godinho, V. COVID-19: Over 90% of Students Aged 12 and over in Saudi Arabia Are Vaccinated. Available online: https:// gulfbusiness.com/covid-19-over-90-of-students-aged-12-and-over-in-saudi-arabia-are-vaccinated/ (accessed on 25 July 2022).
58. Saudi Arabia: WHO Coronavirus Disease (COVID-19) Dashboard with Vaccination Data. Available online: https://covid19.who. int/region/emro/country/sa (accessed on 25 July 2022).