Parents’ attitudes toward children’s vaccination as a marker of trust in health systems

Figures & data

Table 1. Demographics N (%) or mean (SD) by vaccination

		All population					Arabs
		No	Partial	Full	Total	p	No	Partial	Full	Total	P
Total		36 (3.6)	153 (15.1)	821 (81.3)	1010		7 (11.5)	3 (4.9)	51 (83.6)	61
Gender	Male	11 (5.7)	31 (16.1)	151 (78.2)	193 (19.1)	0.178^a	5 (14.7)	1 (2.9)	28 (82.4)	34 (55.7)	0.52^a
	Female	25 (3.1)	122 (14.9)	670 (82.0)	817 (80.9)		2 (7.4)	2 (7.4)	23 (85.2)	27 (44.3)
Religion/Culture	Jewish	29 (3.1)	150 (15.8)	770 (81.1)	949 (94.0)	0.001^a
	Arabic	5 (15.6)	1 (3.1)	26 (81.2)	32 (3.2)
	Other	2 (6.9)	2 (6.9)	25 (86.2)	29 (2.9)
Religiosity	Secular	18 (3.3)	81 (15.1)	439 (81.6)	538 (53.3)	0.42^a	2 (5.9)	3 (8.8)	29 (85.3)	34 (55.7)	0.42^a
	Traditional	5 (4.3)	18 (15.5)	93 (80.2)	116 (11.5)		4 (23.5)	0 (0.0)	13 (76.5)	17 (27.8)
	Religious	9 (2.9)	43 (14.1)	254 (83.0)	306 (30.3)		1 (14.3)	0 (0.0)	6 (85.7)	7 (11.5)
	Orthodox	4 (8.0)	11 (22.0)	35 (70.0)	50 (4.9)		0 (0.0)	0 (0.0)	3 (100.0)	3 (4.9)
Family Status	Single	1 (4.8)	1 (4.8)	19 (90.5)	21 (2.1)	0.26^a	0 (0.0)	0 (0.0)	2 (100.0)	2 (3.3)	0.96^a
	Married or in a relationship	33 (3.5)	150 (15.8)	767 (80.7)	950 (94.1)		7 (12.1)	3 (5.2)	48 (82.8)	58 (95.0)
	divorced	2 (5.1)	2 (5.1)	35 (89.7)	39 (3.9)		0 (0.0)	0 (0.0)	1 (100.0)	1 (1.6)
Education	Non-academic degree	12 (7.2)	33 (19.9)	121 (72.9)	166 (16.4)	0.002^a	1 (10.0)	1 (10.0)	8 (80.0)	10 (16.4)	0.72^a
	Academic degree	24 (2.8)	120 (14.2)	700 (82.9)	844 (83.6)		6 (11.8)	2 (3.9)	43 (84.3)	51 (83.6)
Type of social community	Rural	16 (5.4)	42 (14.1)	239 (80.5)	297 (29.4)	0.120^a	6 (20.7)	3 (10.3)	20 (69.0)	29 (47.5)	0.012^a
	Urban	20 (2.8)	111 (15.6)	582 (81.6)	713 (70.6)		1 (3.1)	0 (0.0)	31 (96.9)	32 (52.5)
Number of children	Mean (SD)	2.6 (1.8)	2.7 (1.4)	2.6 (1.6)	2.6 (1.5)	0.20^b	3.3 (2.3)	2.3 (1.5)	2.0 (1.4)	2.2 (1.6)	0.24^b
Age	Mean (SD)	41.8 (8.1)	40.0 (11.0)	37.1 (8.2)	37.7 (8.8)	<0.001^b	41.7 (4.6)	37.3 (7.5)	35.9 (6.7)	36.6 (6.7)	0.019^b
Child with Special Needs	No	35 (3.7)	140 (14.8)	773 (81.5)	948 (93.9)	0.32^a	7 (12.3)	2 (3.5)	48 (84.2)	57 (93.4)	0.133^a
	Yes	1 (1.6)	13 (21.0)	48 (77.4)	62 (6.1)		0 (0.0)	1 (25.0)	3 (75.0)	4 (6.6)
Diet	Vegetarian	1 (1.1)	22 (25.3)	64 (73.6)	87 (8.6)	0.049^a	1 (25.0)	0 (0.0)	3 (75.0)	4 (6.6)	<0.001^a
	Vegan	2 (6.7)	5 (16.7)	23 (76.7)	30 (3.0)		0 (0.0)	1 (100.0)	0 (0.0)	1 (1.6)
	All kind of food	33 (3.7)	126 (14.2)	730 (82.1)	889 (88.0)		6 (10.7)	2 (3.6)	48 (85.7)	56 (91.8)
Utilizing Alternative Medicine	No	16 (3.1)	53 (10.3)	444 (86.5)	513 (50.7)	<0.001^a	4 (10.0)	2 (5.0)	34 (85.0)	40 (65.6)	0.88^a
	Yes	20 (4.0)	100 (20.1)	377 (75.9)	497 (49.3)		3 (14.3)	1 (4.8)	17 (81.0)	21 (34.4)

^aChi-square test.

^bANOVA.

Table 2. Vaccination status (full, partial, no) of study participants, by screening opinions and trusting variables. n (%)

		Total population			Arabs
Children’s vaccination		No	Partial	Full	Total	P (chi-square test)	No	Partial	Full	Total	P (chi-square test)
Trusting variables
Trust the Ministry of Health	don’t believe	13 (9.0)	37 (25.7)	94 (65.3)	144 (14.3)	<0.001	2 (40.0)	1 (20.0)	2 (40.0)	5	0.025
	partial	19 (4.3)	73 (16.4)	352 (79.3)	444 (44.0)		5 (16.1)	1 (3.2)	25 (80.6)	31
	believe	4 (0.9)	43 (10.2)	375 (88.9)	422 (41.8)		0 (0.0)	1 (4.0)	24 (96.0)	25
Trust Doctor	don’t believe	7 (16.7)	10 (23.8)	25 (59.5)	42 (4.2)	<0.001	1 (25.0)	0 (0.0)	3 (75.0)	4	0.58
	partial	10 (4.2)	50 (21.1)	177 (74.7)	237 (23.5)		3 (20.0)	1 (6.7)	11 (73.3)	15
	believe	19 (2.6)	93 (12.7)	619 (84.7)	731 (72.4)		3 (7.1)	2 (4.8)	37 (88.1)	42
Trust Internet groups	don’t believe	18 (4.3)	55 (13.1)	348 (82.7)	421 (41.7)	0.32	3 (10.0)	1 (3.3)	26 (86.7)	30	0.013
	partial	16 (3.3)	77 (15.9)	390 (80.7)	483 (47.8)		4 (16.0)	0 (0.0)	21 (84.0)	25
	believe	2 (1.9)	21 (19.8)	83 (78.3)	106 (10.5)		0 (0.0)	2 (33.3)	4 (66.7)	6
Screening options
Height Weight follow-up	All the children	22 (2.4)	127 (13.8)	774 (83.9)	923 (91.4)	<0.001	4 (7.4)	1 (1.9)	49 (90.7)	54	<0.001
	Some of the children	9 (14.5)	21 (33.9)	32 (51.6)	62 (6.1)		3 (50.0)	2 (33.3)	1 (16.7)	6
	No one	5 (20.0)	5 (20.0)	15 (60.0)	25 (2.5)		0 (0.0)	0 (0.0)	1 (100.0)	1
Development follow-up	All the children	22 (2.4)	129 (14.0)	768 (83.6)	919 (91.0)	<0.001	4 (7.5)	1 (1.9)	48 (90.6)	53	0.001
	Some of the children	6 (9.2)	19 (29.2)	40 (61.5)	65 (6.4)		2 (33.3)	2 (33.3)	2 (33.3)	6
	No one	8 (30.8)	5 (19.2)	13 (50.0)	26 (2.6)		1 (50.0)	0 (0.0)	1 (50.0)	2
Doctor Follow-up	All the children	21 (2.5)	111 (13.2)	712 (84.4)	844 (83.6)	<0.001	4 (7.7)	1 (1.9)	47 (90.4)	52	0.003
	Some of the children	6 (5.1)	28 (23.7)	84 (71.2)	118 (11.7)		2 (28.6)	2 (28.6)	3 (42.9)	7
	No one	9 (18.8)	14 (29.2)	25 (52.1)	48 (4.8)		1 (50.0)	0 (0.0)	1 (50.0)	2
Fecal Occult Blood	don’t believe	3 (6.2)	6 (12.5)	39 (81.2)	49 (4.9)	0.63	0 (0.0)	0 (0.0)	3 (100.0)	3	0.90
	partial	6 (5.1)	16 (13.7)	95 (81.2)	115 (11.4)		1 (14.3)	0 (0.0)	6 (85.7)	7
	believe	27 (3.2)	131 (15.5)	687 (81.3)	846 (83.8)		6 (11.8)	3 (5.9)	42 (82.4)	51
Mammography	don’t believe	2 (6.7)	5 (16.7)	23 (76.7)	29 (2.9)	0.84	0 (0.0)	0 (0.0)	5 (100.0)	5	0.77
	partial	2 (2.5)	11 (13.6)	68 (84.0)	81 (8.0)		0 (0.0)	0 (0.0)	3 (100.0)	3
	believe	32 (3.6)	137 (15.2)	730 (81.2)	900 (89.1)		7 (13.2)	3 (5.7)	43 (81.1)	53
Newborn hearing screening test	don’t believe	2 (11.1)	6 (33.3)	10 (55.6)	18 (1.8)	0.008	0 (0.0)	0 (0.0)	2 (100.0)	2	0.088
	partial	7 (7.7)	14 (15.4)	70 (76.9)	89 (8.8)		3 (42.9)	0 (0.0)	4 (57.1)	7
	believe	27 (3.0)	133 (14.8)	741 (82.2)	903 (89.4)		4 (7.7)	3 (5.8)	45 (86.5)	52
Routine tests at school	don’t believe	1 (2.8)	3 (8.3)	32 (88.9)	36 (3.6)	0.140	0 (0.0)	0 (0.0)	3 (100.0)	3	0.46
	partial	9 (7.2)	19 (15.2)	97 (77.6)	127 (12.6)		3 (25.0)	1 (8.3)	8 (66.7)	12
	believe	26 (3.1)	131 (15.4)	692 (81.5)	847 (83.9)		4 (8.7)	2 (4.3)	40 (87.0)	46

Table 3. Univariable and multivariable statistical model results for vaccination. Vaccination yes vs. not or partial

		Univariable		Multivariable
		OR (Confidence)	p-Value	OR (Confidence)	p-Value
Gender	Male		.23		.030
	Female	0.04 (−0.02,0.10)		0.06 (0.00,0.13)
Religion/Culture	Jewish		.77		.70
	Arab	0.00 (−0.14,0.14)		0.02 (−0.12,0.16)
	Other	0.05 (−0.09,0.20)		0.06 (−0.08–0.20)
Religiosity	Secular		.22		.83
	Traditional	−0.01 (−0.09,0.06)		0.02 (−0.06,0.10)
	Religious	0.01 (−0.04,0.07)		0.03 (−0.03,0.09)
	Orthodox	−0.12 (−0.23,0.00)		−0.03 (−0.14,0.09)
Family status	Single		.159		.069
	Married or in relationship	−0.10 (−0.27,0.07)		−0.05 (−0.21,0.12)
	Divorced	−0.01 (−0.21,0.20)		0.09 (−0.11,0.29)
Education	Non-academic degree		.003		.104
	Academic degree	0.10 (0.04,0.17)		0.05 (−0.01,0.12)
Type of social community	Rural		.67		.75
	Urban	0.01 (−0.04,0.06)		−0.00 (−0.06,0.05)
Number of Children		−0.01 (−0.02,0.01)	.32	0.00 (−0.02,0.02)	.79
age		−0.01 (−0.01,0.00)	<.001	−0.01 (−0.01,0.00)	<.001
Child with special needs	No		.43		.188
	Yes	−0.04 (−0.14,0.06)		−0.06 (−0.16,0.04)
Diet	Vegetarian		.141		.22
	Vegan	0.03 (−0.13,0.19)		0.05 (−0.10,0.21)
	All kind of food	0.09 (−0.00,0.17)		0.07 (−0.01,0.16)
Alternative Medicine	No		<.001		<.001
	Yes	−0.11 (−0.15,-0.06)		−0.08 (−0.13,-0.04)
Trust the Ministry of Health	don’t trust		<.001		.003
	Partial	0.14 (0.07,0.21)		0.07 (−0.01,0.14)
	Trust	0.24 (0.16,0.31)		0.13 (0.05,0.21)
Trust Doctor	don’t trust		<.001		.159
	Partial	0.15 (0.02,0.28)		0.07 (−0.06,0.20)
	Trust	0.25 (0.13,0.37)		0.12 (−0.01,0.25)
Trust Internet group	don’t trust		.54		.36
	Partial	−0.02 (−0.07,0.03)		−0.03 (−0.08,0.02)
	Trust	−0.04 (−0.13,0.04)		−0.05 (−0.13,0.03)
Height and weight follow-up	All the children		<.001		.004
	Some of the children	−0.32 (−0.42,-0.22)		−0.25 (−0.38,-0.12)
	No one	−0.24 (−0.39,-0.09)		0.00 (−0.23–0.23)
Development follow-up	All the children		<.001		.65
	Some of the children	−0.22 (−0.32,-0.12)		0.05 (−0.09,0.19)
	No one	−0.34 (−0.49,-0.19)		−0.03 (−0.27,0.21)
Doctor follow-up	All the children		<.001		.011
	Some of the children	−0.13 (−0.21,-0.06)		−0.03 (−0.12,0.06)
	No one	−0.32 (−0.43,-0.21)		−0.23 (−0.36,-0.09)
Fecal occult blood	don’t trust		.99		.55
	Partial	−0.00 (−0.13,0.13)		0.02 (−0.12,0.15)
	Trust	0.00 (−0.11,0.11)		−0.02 (−0.15,0.10)
Mammography	don’t trust		.67		.82
	Partial	0.07 (−0.09,0.24)		−0.01 (−0.18,0.15)
	Trust	0.05 (−0.10,0.19)		−0.03 (−0.19,0.13)
Newborn hearing screening testring screening	don’t trust		.019		.012
	Partial	0.21 (0.02,0.41)		0.23 (0.04,0.42)
	Trust	0.27 (0.09,0.45)		0.30 (0.11,0.49)
Routine tests at school	don’t trust		.27		.34
	Partial	−0.11 (−0.26,0.03)		−0.07 (−0.22,0.07)
	Trust	−0.07 (−0.20,0.06)		−0.09 (−0.23,0.05)

Table 4. Univariable and multivariable statistical model results for trusting the ministry of health and trusting internet groups

		Trust the Ministry of Health					Trust the internet group
		Mean (SD)	Univariable		Multivariable		Mean (SD)	Univariable		Multivariable
			Coefficient (Confidence Interval)	p-Value	Coefficient (Confidence Interval)	p-Value		Coefficient (Confidence Interval)	p-Value	Coefficient (Confidence Interval)	p-Value
Gender	Male	6.8 (2.0)		.50		.66	4.9 (2.3)		.59		.56
	Female	6.7 (2.1)	−0.11 (−0.43,0.21)		−0.08 (−0.41,0.26)		4.8 (2.1)	−0.09 (−0.43, 0.24)		−0.11 (−0.46,0.25)
Religion/Culture	Jewish	6.7 (2.1)		.91		.97	4.8 (2.1)		.67		.56
	Arab	6.8 (1.9)	0.16 (−0.56,0.88)		−0.05 (−0.81,0.72)		4.8 (1.9)	−0.09 (−0.84, 0.67)		−0.12 (−0.92,0.67)
	Other	6.7 (2.1)	0.01 (−0.75,0.77)		−0.08 (−0.85,0.68)		4.5 (2.3)	−0.35 (−1.14, 0.43)		−0.43 (−1.22,0.37)
Religiosity	Secular	6.8 (2.0)		.111		.068	4.8 (2.1)		.85		.91
	Traditional	6.8 (2.0)	−0.00 (−0.41,0.41)		0.04 (−0.39,0.46)		4.7 (2.1)	−0.11 (−0.54, 0.32)		−0.10 (−0.53,0.34)
	Religious	6.5 (2.1)	−0.32 (−0.61,-0.04)		−0.36 (−0.69,-0.04)		4.8 (2.2)	−0.03 (−0.32, 0.27)		0.01 (−0.31,0.32)
	Orthodox	6.9 (2.0)	0.16 (−0.43,0.76)		0.25 (−0.38,0.89)		5.0 (2.1)	0.21 (−0.41, 0.83)		0.17 (−0.47,0.80)
Family status	Single	6.9 (1.9)		.60		.51	4.6 (2.3)		.88		.70
	Married or in relationship	6.7 (2.0)	−0.16 (−1.05,0.73)		−0.03 (−0.93,0.87)		4.8 (2.1)	0.21 (−0.71, 1.13)		0.40 (−0.53,1.34)
	Divorced	6.4 (2.4)	−0.47 (−1.56,0.62)		−0.42 (−1.51,0.67)		4.7 (2.2)	0.12 (−1.01, 1.26)		0.34 (−0.79,1.48)
Education	Non-Academic degree	6.6 (2.0)		.50		.37	5.1 (2.2)		.044		.018
	Academic degree	6.7 (2.1)	0.12 (−0.22,0.46)		0.16 (−0.19,0.51)		4.8 (2.1)	−0.36 (−0.72, −0.01)		−0.44 (−0.81,-0.07)
Type of social community	Rural	6.7 (2.0)		.80		.53	4.8 (2.2)		.98		.70
	Urban	6.7 (2.1)	0.04 (−0.24,0.31)		−0.10 (−0.39,0.20)		4.8 (2.1)	−0.00 (−0.29, 0.29)		−0.06 (−0.37,0.24)
Age		6.7 (2.1)	−0.03 (−0.04,-0.01)	<.001	−0.03 (−0.04,-0.01)	<.001	4.8 (2.1)	0.02 (0.00, 0.03)	.032	0.02 (0.00,0.03)	.029
Child with special needs	No	6.7 (2.1)		.38		.44	4.9 (2.1)		.109		.125
	Yes	6.5 (1.9)	−0.23 (−0.76,0.29)		−0.21 (−0.75,0.32)		4.4 (2.1)	−0.45 (−0.99, 0.10)		−0.43 (−0.99,0.12)
Diet	Vegetarian	6.6 (2.1)		.143		.130	4.7 (2.0)		.37		.39
	Vegan	7.4 (1.7)	0.83 (−0.03,1.68)		0.87 (0.02,1.72)		5.3 (2.0)	0.63 (−0.25, 1.52)		0.60 (−0.28,1.48)
	All kind of food	6.7 (2.1)	0.10 (−0.35,0.56)		0.16 (−0.30,0.62)		4.8 (2.1)	0.16 (−0.31, 0.63)		0.08 (−0.40,0.55)
Alternative medicine	No	6.7 (2.1)		.60		.58	4.8 (2.2)		.82		.82
	Yes	6.7 (2.0)	0.07 (−0.19,0.32)		0.07 (−0.19,0.33)		4.8 (2.0)	−0.03 (−0.29, 0.23)		−0.03 (−0.30,0.24)
Number of Children		6.7 (2.1)	−0.03 (−0.11,0.05)	.44	0.00 (−0.09,0.10)	.92
First child							4.8 (2.1)		.005		.004
								0.43 (0.13, 0.73)		0.46 (0.15,0.77)