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Department of Preventive Medicine and Public Health, Ajou University School of Medicine, Suwon, Korea
©2019, Korean Society of Epidemiology
This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
The authors have no conflicts of interest to declare for this study.
AUTHOR CONTRIBUTIONS
Conceptualization: SYL, KC. Data curation: KC, SYL. Formal analysis: KC, SYL. Funding acquisition: None. Methodology: SYL, KC. Project administration: KC. Visualization: KC, SYL. Writing – original draft: KC, SYL. Writing – review & editing: SYL, KC.
Category | Outcome | No. of people | VH1 | VH2 | VH3 | VH4 | p-value1 |
---|---|---|---|---|---|---|---|
Sex | Female | 119 | 37 (88.1) | 19 (95.0) | 32 (100) | 31 (91.2) | 0.398 |
Male | 9 | 5 (11.9) | 1 (5.0) | 0 (0.0) | 3 (8.8) | ||
No response2 | 1 | 1 | 0 | 0 | 0 | ||
Age (yr) | Mean±SD | 38.1±3.7 | 37.5±3.6 | 38.9±4.0 | 38.5±4.2 | 37.8±3.2 | 0.4603 |
Minimum-Maximum | 28-46 | 30-46 | 29-44 | 28-46 | 32-45 | ||
Marital status | Married | 125 | 41 (95.3) | 19 (95.0) | 31 (100) | 34 (100) | 0.158 |
Divorced or widowed | 3 | 2 (4.7) | 1 (5.0) | 0 (0.0) | 0 (0.0) | ||
No response2 | 1 | 0 | 0 | 1 | 0 | ||
Education level | Graduated high school | 3 | 1 (2.3) | 1 (5.0) | 1 (3.1) | 0 (0.0) | 0.532 |
Graduated college or university | 95 | 31 (72.1) | 11 (55.0) | 26 (81.3) | 27 (79.4) | ||
Graduated graduate school | 31 | 11 (25.6) | 8 (40.0) | 5 (15.6) | 7 (20.6) | ||
Subjective income level | Upper | 3 | 3 (7.1) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0.006 |
Middle | 109 | 36 (85.7) | 19 (95.0) | 30 (93.8) | 24 (70.6) | ||
Lower | 14 | 3 (7.1) | 1 (5.0) | 2 (6.3) | 8 (23.5) | ||
No response2 | 3 | 1 | 0 | 0 | 2 | ||
No. of children | 1 | 47 | 17 (39.5) | 10 (50.0) | 8 (25.0) | 12 (35.3) | 0.355 |
2 | 69 | 22 (51.2) | 9 (45.0) | 20 (62.5) | 18 (52.9) | ||
3 | 13 | 4 (9.3) | 1 (5.0) | 4 (12.5) | 4 (11.8) | ||
Total | 129 (100) | 43 (33.3) | 20 (15.5) | 32 (24.8) | 34 (26.4) | - |
Values are presented as number (%).
VH1, vaccination without hesitancy; VH2, vaccination on time with hesitancy; VH3, vaccination with a deliberate delay of one month or longer (one or more); VH4, vaccination refusal (one or more); SD, standard deviation.
1 Chi-square for trend test.
2 No response are not included in the percentage.
3 Age– analysis of variance.
Questions | Agreed/respondents | VH1 | VH2 | VH3 | VH4 | p-value1 |
---|---|---|---|---|---|---|
Perceived susceptibility | 79/124 (63.7) | 39 (90.7) | 16 (80.0) | 14 (46.7) | 10 (32.3) | <0.001 |
If my child does not receive the required vaccinations, she/he could be affected by infectious diseases | ||||||
I don’t know2 | 5 | 0 | 0 | 2 | 3 | |
Perceived severity | 62/121 (51.2) | 36 (83.7) | 8 (50.0) | 11 (36.7) | 7 (21.9) | <0.001 |
If my child does not receive the required vaccinations, she/he could develop a severe condition (example: inpatient treatment at a medical facility) due to infectious diseases | ||||||
I don’t know2 | 8 | 0 | 4 | 2 | 2 | |
Even if my child does not receive the required vaccinations and is affected by infectious diseases, she/he can sufficiently recover naturally without medical treatment | 36/113 (31.9) | 6 (14.3) | 3 (20.0) | 12 (42.9) | 15 (53.6) | <0.001 |
I don’t know2 | 16 | 1 | 5 | 4 | 6 | |
Perceived benefits | 72/117 (61.5) | 41 (95.3) | 15 (78.9) | 12 (44.4) | 4 (14.3) | <0.001 |
If my child receives the required vaccinations, infectious diseases can be effectively prevented | ||||||
I don’t know2 | 12 | 0 | 1 | 5 | 6 | |
Perceived barriers | 104/120 (86.7) | 30 (76.9) | 16 (84.2) | 28 (93.3) | 30 (93.8) | 0.024 |
If my child receives the required vaccinations, adverse reactions might occur | ||||||
I don’t know2 | 9 | 4 | 1 | 2 | 2 | |
I have not received trustable and sufficient information about the required vaccinations for my child | 88/126 (69.8) | 23 (56.1) | 12 (63.2) | 27 (84.4) | 26 (76.5) | 0.019 |
I don’t know2 | 3 | 2 | 1 | 0 | 0 | |
Cues to action | 28/129 (21.7) | 2 (4.7) | 4 (20.0) | 11 (34.4) | 11 (32.4) | 0.001 |
Have your child actually had an experience of adverse reactions after receiving the required vaccination? | ||||||
I don’t know2 | 0 | 0 | 0 | 0 | 0 | |
Have you directly or indirectly heard of cases in which the child of some- one close to you has delayed or refused the required vaccination? | 101/129 (78.3) | 25 (58.1) | 17 (85.0) | 28 (87.5) | 31 (91.2) | <0.001 |
I don’t know2 | 0 | 0 | 0 | 0 | 0 | |
Have you directly or indirectly heard of cases in which the child of some- one close to you has experienced adverse reactions after receiving the required vaccination? | 52/129 (40.3) | 7 (16.3) | 10 (50.0) | 18 (56.3) | 17 (50.0) | 0.001 |
I don’t know2 | 0 | 0 | 0 | 0 | 0 | |
Self-efficacy | 54/102 (52.9) | 27 (81.8) | 10 (62.5) | 9 (34.6) | 8 (29.6) | <0.001 |
Even if my child experiences adverse reactions due to required vac- cinations, she/he can recover through sufficient medical treatment | ||||||
I don’t know2 | 27 | 10 | 4 | 6 | 7 | |
Total | 129 (100) | 43 (100) | 20 (100) | 32 (100) | 34 (100) |
Values are presented as number (%).
VH1, vaccination without hesitancy, in time; VH2, vaccination with hesitancy, in time; VH3, vaccination with hesitancy, intentionally, over 1 month delayed; VH4, vaccination refusal, intentionally, over one vaccine.
1 Chi-square for trend test.
2 Respondents of ‘I don’t know’ are not included in the percentage.
Questions | Unadjusted | Adjusted1 | |
---|---|---|---|
Perceived severity | |||
If my child does not receive the required vaccinations, she/he could develop a severe condition (example: inpatient treatment at a medical facility) due to infectious diseases. | Disagree | 1.0 (reference) | 1.0 (reference) |
Agree | 7.2 (3.2, 16.0) | 6.5 (1.1, 38.9) | |
Even if my child does not receive the required vaccinations and is affected by infectious diseases, she/he can sufficiently recover naturally without medical treatment. | Disagree | 1.0 (reference) | 1.0 (reference) |
Agree | 5.0 (2.1, 12.0) | 1.3 (0.2, 7.4) | |
Perceived benefits | |||
If my child receives the required vaccinations, infectious diseases can be effectively prevented. | Agree | 1.0 (reference) | 1.0 (reference) |
Disagree | 22.8 (8.2, 63.3) | 5.0 (0.9, 28.6) | |
Perceived barriers | |||
If my child receives the required vaccinations, adverse reactions might occur. | Disagree | 1.0 (reference) | 1.0 (reference) |
Agree | 3.8 (1.1, 12.5) | 2.7 (0.4, 18.1) | |
I have not received trustable and sufficient information about the required vaccinations for my child. | Disagree | 1.0 (reference) | 1.0 (reference) |
Agree | 2.9 (1.3, 6.4) | 1.0 (0.2, 4.8) | |
Cue to action | |||
Have your child actually had an experience of adverse reactions after receiving the required vaccination? | No | 1.0 (reference) | 1.0 (reference) |
Yes | 4.8 (1.8, 12.7) | 2.0 (0.2, 19.3) | |
Have you directly or indirectly heard of cases in which the child of someone close to you has delayed or refused the required vaccination? | No | 1.0 (reference) | 1.0 (reference) |
Yes | 4.2 (1.6, 10.8) | 4.1 (0.6, 28.0) | |
Have you directly or indirectly heard of cases in which the child of someone close to you has experienced adverse reactions after receiving the required vaccination? | No | 1.0 (reference) | 1.0 (reference) |
Yes | 3.1 (1.5, 6.4) | 3.4 (0.6, 20.0) | |
Self-efficacy | |||
Even if my child experiences adverse reactions due to required vaccinations, she/he can recover through sufficient medical treatment. | Agree | 1.0 (reference) | 1.0 (reference) |
Disagree | 6.5 (2.7, 15.6) | 1.3 (0.2, 7.4) |
Reasons for vaccine hesitancy |
Classification by vaccine hesitancy (responded “yes”)1 |
||
---|---|---|---|
VH2 | VH3 | VH4 | |
Because I do not think that vaccination meaningfully prevents infectious diseases | 4 (20.0) | 12 (38.7) | 20 (58.8) |
Because of concerns about the adverse reactions caused by vaccinations or because of prior experiences with small or large adverse reactions | 13 (65.0) | 22 (68.8) | 25 (75.8) |
Because I cannot trust the vaccination policies of the government | 5 (25.0) | 17 (53.1) | 18 (54.5) |
Because I cannot trust the vaccination safety management of pharmaceutical companies and medical institutions | 10 (50.0) | 15 (46.9) | 22 (68.8) |
Because of religious beliefs | 0 (0.0) | 0 (0.0) | 0 (0.0) |
Because I trust Korean traditional medicine or alternative medicine more than modern medical science, or because of naturalistic beliefs | 3 (15.0) | 7 (21.9) | 7 (21.2) |
Total | 20 (100) | 32 (100) | 43 (100) |
Person(s) who had an impact on the vaccine hesitancy |
Classification by vaccine hesitancy (responded with “yes”)1 |
||
---|---|---|---|
VH1 | VH2 | VH3 | |
Family (spouse, parents, male siblings, female siblings, cousins, etc.) | 1 (5.0) | 11 (34.4) | 6 (17.6) |
Acquaintances (friends, colleagues, neighbors, etc.) | 8 (40.0) | 11 (34.4) | 18 (52.9) |
Leaders or activists of a joined organization (social groups, civil society groups, etc.) | 2 (10.0) | 6 (18.8) | 13 (39.4) |
Leaders or activists of a joined organization (religious group) | 0 (0.0) | 0 (0.0) | 0 (0.0) |
Anti-vaccination activists whom I found through web, blogs, social network services, and broadcasts | 11 (55.0) | 12 (37.5) | 18 (54.5) |
Experts of Korean traditional medicine or alternative medicine | 1 (5.0) | 8 (25.0) | 10 (30.3) |
Decision made by myself | 10 (50.0) | 25 (78.1) | 25 (75.8) |
Total | 20 (100) | 32 (100) | 43 (100) |
Category | Outcome | No. of people | VH1 | VH2 | VH3 | VH4 | p-value |
---|---|---|---|---|---|---|---|
Sex | Female | 119 | 37 (88.1) | 19 (95.0) | 32 (100) | 31 (91.2) | 0.398 |
Male | 9 | 5 (11.9) | 1 (5.0) | 0 (0.0) | 3 (8.8) | ||
No response |
1 | 1 | 0 | 0 | 0 | ||
Age (yr) | Mean±SD | 38.1±3.7 | 37.5±3.6 | 38.9±4.0 | 38.5±4.2 | 37.8±3.2 | 0.460 |
Minimum-Maximum | 28-46 | 30-46 | 29-44 | 28-46 | 32-45 | ||
Marital status | Married | 125 | 41 (95.3) | 19 (95.0) | 31 (100) | 34 (100) | 0.158 |
Divorced or widowed | 3 | 2 (4.7) | 1 (5.0) | 0 (0.0) | 0 (0.0) | ||
No response |
1 | 0 | 0 | 1 | 0 | ||
Education level | Graduated high school | 3 | 1 (2.3) | 1 (5.0) | 1 (3.1) | 0 (0.0) | 0.532 |
Graduated college or university | 95 | 31 (72.1) | 11 (55.0) | 26 (81.3) | 27 (79.4) | ||
Graduated graduate school | 31 | 11 (25.6) | 8 (40.0) | 5 (15.6) | 7 (20.6) | ||
Subjective income level | Upper | 3 | 3 (7.1) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0.006 |
Middle | 109 | 36 (85.7) | 19 (95.0) | 30 (93.8) | 24 (70.6) | ||
Lower | 14 | 3 (7.1) | 1 (5.0) | 2 (6.3) | 8 (23.5) | ||
No response |
3 | 1 | 0 | 0 | 2 | ||
No. of children | 1 | 47 | 17 (39.5) | 10 (50.0) | 8 (25.0) | 12 (35.3) | 0.355 |
2 | 69 | 22 (51.2) | 9 (45.0) | 20 (62.5) | 18 (52.9) | ||
3 | 13 | 4 (9.3) | 1 (5.0) | 4 (12.5) | 4 (11.8) | ||
Total | 129 (100) | 43 (33.3) | 20 (15.5) | 32 (24.8) | 34 (26.4) | - |
Questions | Agreed/respondents | VH1 | VH2 | VH3 | VH4 | p-value |
---|---|---|---|---|---|---|
Perceived susceptibility | 79/124 (63.7) | 39 (90.7) | 16 (80.0) | 14 (46.7) | 10 (32.3) | <0.001 |
If my child does not receive the required vaccinations, she/he could be affected by infectious diseases | ||||||
I don’t know |
5 | 0 | 0 | 2 | 3 | |
Perceived severity | 62/121 (51.2) | 36 (83.7) | 8 (50.0) | 11 (36.7) | 7 (21.9) | <0.001 |
If my child does not receive the required vaccinations, she/he could develop a severe condition (example: inpatient treatment at a medical facility) due to infectious diseases | ||||||
I don’t know |
8 | 0 | 4 | 2 | 2 | |
Even if my child does not receive the required vaccinations and is affected by infectious diseases, she/he can sufficiently recover naturally without medical treatment | 36/113 (31.9) | 6 (14.3) | 3 (20.0) | 12 (42.9) | 15 (53.6) | <0.001 |
I don’t know |
16 | 1 | 5 | 4 | 6 | |
Perceived benefits | 72/117 (61.5) | 41 (95.3) | 15 (78.9) | 12 (44.4) | 4 (14.3) | <0.001 |
If my child receives the required vaccinations, infectious diseases can be effectively prevented | ||||||
I don’t know |
12 | 0 | 1 | 5 | 6 | |
Perceived barriers | 104/120 (86.7) | 30 (76.9) | 16 (84.2) | 28 (93.3) | 30 (93.8) | 0.024 |
If my child receives the required vaccinations, adverse reactions might occur | ||||||
I don’t know |
9 | 4 | 1 | 2 | 2 | |
I have not received trustable and sufficient information about the required vaccinations for my child | 88/126 (69.8) | 23 (56.1) | 12 (63.2) | 27 (84.4) | 26 (76.5) | 0.019 |
I don’t know |
3 | 2 | 1 | 0 | 0 | |
Cues to action | 28/129 (21.7) | 2 (4.7) | 4 (20.0) | 11 (34.4) | 11 (32.4) | 0.001 |
Have your child actually had an experience of adverse reactions after receiving the required vaccination? | ||||||
I don’t know |
0 | 0 | 0 | 0 | 0 | |
Have you directly or indirectly heard of cases in which the child of some- one close to you has delayed or refused the required vaccination? | 101/129 (78.3) | 25 (58.1) | 17 (85.0) | 28 (87.5) | 31 (91.2) | <0.001 |
I don’t know |
0 | 0 | 0 | 0 | 0 | |
Have you directly or indirectly heard of cases in which the child of some- one close to you has experienced adverse reactions after receiving the required vaccination? | 52/129 (40.3) | 7 (16.3) | 10 (50.0) | 18 (56.3) | 17 (50.0) | 0.001 |
I don’t know |
0 | 0 | 0 | 0 | 0 | |
Self-efficacy | 54/102 (52.9) | 27 (81.8) | 10 (62.5) | 9 (34.6) | 8 (29.6) | <0.001 |
Even if my child experiences adverse reactions due to required vac- cinations, she/he can recover through sufficient medical treatment | ||||||
I don’t know |
27 | 10 | 4 | 6 | 7 | |
Total | 129 (100) | 43 (100) | 20 (100) | 32 (100) | 34 (100) |
Questions | Unadjusted | Adjusted |
|
---|---|---|---|
Perceived severity | |||
If my child does not receive the required vaccinations, she/he could develop a severe condition (example: inpatient treatment at a medical facility) due to infectious diseases. | Disagree | 1.0 (reference) | 1.0 (reference) |
Agree | 7.2 (3.2, 16.0) | 6.5 (1.1, 38.9) | |
Even if my child does not receive the required vaccinations and is affected by infectious diseases, she/he can sufficiently recover naturally without medical treatment. | Disagree | 1.0 (reference) | 1.0 (reference) |
Agree | 5.0 (2.1, 12.0) | 1.3 (0.2, 7.4) | |
Perceived benefits | |||
If my child receives the required vaccinations, infectious diseases can be effectively prevented. | Agree | 1.0 (reference) | 1.0 (reference) |
Disagree | 22.8 (8.2, 63.3) | 5.0 (0.9, 28.6) | |
Perceived barriers | |||
If my child receives the required vaccinations, adverse reactions might occur. | Disagree | 1.0 (reference) | 1.0 (reference) |
Agree | 3.8 (1.1, 12.5) | 2.7 (0.4, 18.1) | |
I have not received trustable and sufficient information about the required vaccinations for my child. | Disagree | 1.0 (reference) | 1.0 (reference) |
Agree | 2.9 (1.3, 6.4) | 1.0 (0.2, 4.8) | |
Cue to action | |||
Have your child actually had an experience of adverse reactions after receiving the required vaccination? | No | 1.0 (reference) | 1.0 (reference) |
Yes | 4.8 (1.8, 12.7) | 2.0 (0.2, 19.3) | |
Have you directly or indirectly heard of cases in which the child of someone close to you has delayed or refused the required vaccination? | No | 1.0 (reference) | 1.0 (reference) |
Yes | 4.2 (1.6, 10.8) | 4.1 (0.6, 28.0) | |
Have you directly or indirectly heard of cases in which the child of someone close to you has experienced adverse reactions after receiving the required vaccination? | No | 1.0 (reference) | 1.0 (reference) |
Yes | 3.1 (1.5, 6.4) | 3.4 (0.6, 20.0) | |
Self-efficacy | |||
Even if my child experiences adverse reactions due to required vaccinations, she/he can recover through sufficient medical treatment. | Agree | 1.0 (reference) | 1.0 (reference) |
Disagree | 6.5 (2.7, 15.6) | 1.3 (0.2, 7.4) |
Reasons for vaccine hesitancy | Classification by vaccine hesitancy (responded “yes”) |
||
---|---|---|---|
VH2 | VH3 | VH4 | |
Because I do not think that vaccination meaningfully prevents infectious diseases | 4 (20.0) | 12 (38.7) | 20 (58.8) |
Because of concerns about the adverse reactions caused by vaccinations or because of prior experiences with small or large adverse reactions | 13 (65.0) | 22 (68.8) | 25 (75.8) |
Because I cannot trust the vaccination policies of the government | 5 (25.0) | 17 (53.1) | 18 (54.5) |
Because I cannot trust the vaccination safety management of pharmaceutical companies and medical institutions | 10 (50.0) | 15 (46.9) | 22 (68.8) |
Because of religious beliefs | 0 (0.0) | 0 (0.0) | 0 (0.0) |
Because I trust Korean traditional medicine or alternative medicine more than modern medical science, or because of naturalistic beliefs | 3 (15.0) | 7 (21.9) | 7 (21.2) |
Total | 20 (100) | 32 (100) | 43 (100) |
Person(s) who had an impact on the vaccine hesitancy | Classification by vaccine hesitancy (responded with “yes”) |
||
---|---|---|---|
VH1 | VH2 | VH3 | |
Family (spouse, parents, male siblings, female siblings, cousins, etc.) | 1 (5.0) | 11 (34.4) | 6 (17.6) |
Acquaintances (friends, colleagues, neighbors, etc.) | 8 (40.0) | 11 (34.4) | 18 (52.9) |
Leaders or activists of a joined organization (social groups, civil society groups, etc.) | 2 (10.0) | 6 (18.8) | 13 (39.4) |
Leaders or activists of a joined organization (religious group) | 0 (0.0) | 0 (0.0) | 0 (0.0) |
Anti-vaccination activists whom I found through web, blogs, social network services, and broadcasts | 11 (55.0) | 12 (37.5) | 18 (54.5) |
Experts of Korean traditional medicine or alternative medicine | 1 (5.0) | 8 (25.0) | 10 (30.3) |
Decision made by myself | 10 (50.0) | 25 (78.1) | 25 (75.8) |
Total | 20 (100) | 32 (100) | 43 (100) |
Values are presented as number (%). VH1, vaccination without hesitancy; VH2, vaccination on time with hesitancy; VH3, vaccination with a deliberate delay of one month or longer (one or more); VH4, vaccination refusal (one or more); SD, standard deviation. Chi-square for trend test. No response are not included in the percentage. Age– analysis of variance.
Values are presented as number (%). VH1, vaccination without hesitancy, in time; VH2, vaccination with hesitancy, in time; VH3, vaccination with hesitancy, intentionally, over 1 month delayed; VH4, vaccination refusal, intentionally, over one vaccine. Chi-square for trend test. Respondents of ‘I don’t know’ are not included in the percentage.
Values are presented as odds ratio (95% confidence interval). Adjusted: Logistic regression model (entered), explanatory power 67.1%, goodness-of-fit test p=0.509.
Values are presented as number (%). VH2, vaccination with hesitancy, in time; VH3, vaccination with hesitancy, intentionally, over 1 month delayed; VH4, vaccination refusal, intentionally, over one vaccine. Multiple responses possible per item.
VH1, Vaccination without hesitancy, in time; VH2, vaccination with hesitancy, in time; VH3, vaccination with hesitancy, intentionally, over 1 month delayed. Multiple responses possible per item.