Causes And Effect Of Negative Attitude To Immunization Among Couples

Project and Seminar Material for Sociology

Causes And Effect Of Negative Attitude To Immunization Among Couples


Abstract


Background:

Lack of information has been associated with couples anxiety or concern in a number of healthcare areas.

Objectives:

  1. Identify the proportion of parents who agreed, were neutral, and disagreed that they had access to enough information to make a decision about immunizing their child;
  2. Examine how parents who agreed and disagreed differed with respect to sociodemographic characteristics, and their attitudes about immunizations, their child’s healthcare provider, immunization requirements/exemptions, and immunization policymakers; and
  3. Identify if differences exist in specific immunization concerns.

Methods:

A sample of parents with at least one child aged < or =6 years (n=642) was analyzed using data from the Health Styles survey conducted during July and August 2003. Odds ratios and the Mantel-Haenszel chi-square test were used for analysis.

Results:

Response rate for Health Styles was 69% (4035/5845). The largest proportion of parents agreed they had access to enough information (67%) compared to parents who were neutral (20%) or who disagreed (13%). Compared to parents who agreed, parents who disagreed were more likely to be less confident in the safety of childhood vaccines (odds ratio [OR]=5.4, 95% confidence interval [CI]=3.3-8.9), and to disagree that their child’s main healthcare provider is easy to talk to (OR=10.3, 95% CI=3.7-28.1). There was a significant linear trend in the percentage of parents expressing immunization concerns among those who agreed, were neutral, and who disagreed they had access to enough information (p<0.05; df=1).

Conclusions:

While most parents agreed that they had access to enough immunization information, approximately a third did not. Perceived lack of information was associated with negative attitudes about immunizations and toward healthcare providers. Basic information about the benefits and risks of vaccines presented by a trusted provider could go a long way toward maintaining and/or improving confidence in the immunization process.


Chapter One


Introduction

Immunization is recognized as a safe and effective method of preventing disease (National Advisory Committee on Immunization, 1998); however, not all parents choose to immunize their children and not all couples choose to maintain or update their own immunization status. The goal of this thesis is to understand why young couples (parents or future parents) make the decisions they do and how they arrive at those decisions. Health scientists need to acquire an understanding of the experience of people in relation to their environments for the purpose of increasing their potential for health. Improved health policies may be developed if we can understand how to serve our populations better as a whole. It is more useful to put into place policy that will be meaningful and followed, than blanket statements that do not put the population’s needs first. This study contributes to a better understanding of the thought processes behind persons who choose to delay or refuse immunizations irrespective of the policy environment.

The area of immunization is as complex as a mosaic, and true to this metaphor, every tile of information contributes to the overall picture while remaining distinct. This thesis is presented as another tile. Currently in Amuzi community in Obowo L.G.A, mainstream immunization is voluntary, though strongly encouraged and freely dispensed to all citizens. Changes are on-going in mandatory immunization policy provincially. Alberta and Saskatchewan pride themselves in not having moved to mandatory laws due to the public health delivery systems in place. (Personal communication, P. Hasselback, January, 2002).

As long as most people comply, the herd immunity remains strong and the risk for developing vaccine reventable diseases remains low. However, certain groups in the population do not agree with immunization for a variety of reasons. Some of these reasons include theological constraints, belief structures that favor “natural” immunity, beliefs that immunization is dangerous to children, mistrust in pharmaceutical companies and a belief in alternative health therapies such as provided by naturopaths and chiropractors.

What about apathy? Funk and Wagnells (1982) describe this as indifference and lack of interest. Do couples feel immunization is important? Do they think about it during their daily lives? What will our future generation of parents do to contribute to herd immunity when they have never seen the diseases the vaccines are designed to prevent? What will happen when the next generation feels overly confident that they will not be touched by these diseases because they are perceived as a “Third World problem” or when they do not understand the ramifications of the diseases? Lack of knowledge of our own immune systems in the general population is high. Because of the complexity of interactions between anatomical structures and biochemistry most laypersons shrug their shoulders when asked how basic immunological functions occur.

Policies encouraging health education may emphasize the importance of citizens taking a pro-active role in understanding their bodies and what they can do to remain healthy. In this day of reduced health care budgets more emphasis needs to be placed on prevention of disease. Immunization is an integral cog to the wheel. An analysis of this issue indicates a need for more knowledge to guide health care workers and policy-makers in contributing to immunization.


Description Of The Project

The purpose of this project is to ascertain the beliefs of young couples regarding immunization for their children or future children.

The overall objectives of this qualitative study are to:

  1. Determine the theological constructs of young couples who refuse or delay immunization among their children or future children for religious beliefs.
  2. Determine the beliefs of young couples who engage in alternative health practices and refuse or delay their children’s or future children’s immunizations.
  3. Determine whether youngcouples (non-parents) are thinking ahead regarding immunization.
  4. Determine if there are gender differences between perspectives regarding immunization.
  5. Determine if there are vocational/academic differences between groups regarding immunization.
  6. Determine the relationship between various groups who do not immunize regarding their decision-making.

Objectives

The main objective of the study was to deepen our understanding of the knowledge, attitudes, practices, fears and beliefs about immunization among children.

Specifically the objectives were:

  1. To identify myths and misconceptions about immunization among couples.
  2. To identify knowledge, attitudes, practices, fears and beliefs (KAPBF) about childhood immunization.
  3. To determine motivating and de-motivating factors in parents seeking immunization amoung couples.

Research Questions

The aim of this study was to answer the following research questions in order to describe and explain:

  1. What are the theological constructs of young couples who choose not to immunize their children or future children? What is the relationship between these beliefs and the young couples’ decision-making regarding immunization?
  2. What are the beliefs of young couples who engage in alternative health practices and choose not to immunize their children or future children? What is the relationship between these beliefs and the young couples’ decision-making regarding immunization?
  3. What are the beliefs of young couples who are concerned about vaccine safety and choose not to immunize their children or future children? What is the relationship between these beliefs and the young couples’ decision-making regarding immunization?

Definitions

In the context of this study, the following theoretical definitions were used:

Understanding

Is the process of interpreting, knowing and comprehending the meaning that is felt, intended and expressed by another (Denzin, 1989, p. 120);

Immunization

Is the process of being immunized against a particular disease;

Health care workers

Include individuals from the disciplines of medicine, public health, physical and social science and nursing;

Health scientists

Are researchers concerned with aspects of health science and health care from multiple disciplines of medicine, public health, physical and social science, education and nursing; and,

Informants

Are defined as the people interviewed in this study who provided information about personal immunization experiences.


Chapter Five


Conclusions

Many couples have little knowledge and/or interest about the immune system and immunizations. Understanding the differences between real risks and benefits of immunization is paramount. This apathy combined with known barriers to immunization like adherence to religious or philosophical beliefs and negative influences from people close to them may present a challenge to health care workers and future policy-makers. Policy recommendations designed to facilitate health care professionals were presented and include improved educational strategies.
The goal of this thesis was to understand why youngcouples as parents or future parents make the decisions they do and how they came about those decisions. The common theme that emerged from the data was apathy. This study’s findings cannot and must not be generalized beyond this sample. Various tiles of information were presented illustrate the mosaic complexity of studying immunization and peoples’ beliefs, perceptions and attitudes towards it. It was hoped by the author that this work would contribute to the body of knowledge of public health care.


Summary

In conclusion, the purpose of this study was to explore and describe the beliefs and behaviors of youngcouples with regards to immunization. Due to the trend of increased numbers of citizens opting to refuse or delay immunization, the need to understand why compliance with recommended immunization has changed over the last 10 years is important. This study contributes a tile to the body of knowledge mosaic regarding citizens’ beliefs about immunization, where a shared understanding is necessary for effective care. Apathy about immunization only serves to decrease herd immunity which will ultimately decrease the quality of life for all citizens.


Recommendations

  1. Health messages should use local terminologies for immunization and immunisable diseases. These terminologies vary according to ethnic group.
  2. Awareness should be raised about immunization schedules and immunisable diseases. The public needs to be informed and educated about the importance of immunization, the diseases, the ages at which immunizations should be given, the contents of the vaccine, and the side effects of immunization.
  3. Rumors about immunization need to be dispelled in communities. The first immunization campaign that is referred to constantly in the research needs to be addressed to communities so that they can understand the details surrounding the event. Health workers and local leaders need to begin explaining what has been done to prevent such a situation in the future and why immunization is safe.
  4. Fathers need to be sensitised on immunization and need to be motivated to become involved in their children’s immunization.
  5. Communities need to be sensitized that NIDs only immunized against polio and that they must take their children for routine immunization in order to receive immunizations for the other diseases. The difference between NIDs and routine immunization; and the purpose of NIDs needs to be further explained.
  6. Caretakers need to be aware that those children over the age of 1 should still receive immunizations.
  7. The common side effects need to be explained. Currently caretakers believe that children can become lame or die as a result of immunization. Health workers need to ensure caretakers that immunization is safe and need to give clear instructions on steps to take if the child should experience a side effect.
  8. Caretakers need to be encouraged to sit down with their spouses and explain the child health card in detail. Currently, fathers do not know the contents of the child health card and rarely look at it.

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