Exploring immunisation refusal by parents in the Malaysian context

Figures & data

Figure 1. Methodology flow chart.

Figure 2. Flow chart for sample recruitment and response rate.

Table 1. Characteristics and immunisation profile by parental refusal and defaulter group

	Refusal (n = 8)	Defaulter (n = 31)	Total (n = 39)
Respondent demographics
Respondent, n (%)
Father	1 (12.5)	3 (10.0)	4 (10.3)
Mother	7 (87.5)	28 (90.0)	35 (89.7)
Age of respondent in years, mean (SD)	31.8 (5.5)	31.1 (6.1)	31.2 (5.9)
Education level of respondent, n (%)
Primary	0 (0.0)	1 (3.2)	1 (2.6)
Secondary	8 (100.0)	16 (51.6)	24 (61.5)
Tertiary	0 (0.0)	14 (45.2)	14 (35.9)
Occupation of respondent, n (%)^a
A (high managerial, administrative or professional)	0 (0.0)	1 (3.2)	1 (2.6)
B (intermediate managerial, administrative or professional)	0 (0.0)	2 (6.5)	2 (5.1)
C1 and C2 (supervisory and skilled manual)	3 (37.5)	15 (48.4)	18 (46.2)
D (semi- and unskilled manual workers)	2 (25.0)	1 (3.2)	3 (7.7)
E (pensioners, casual/lowest grade, unemployed with benefits)	3 (37.5)	12 (38.7)	15 (38.5)
Child demographics
Age of child in months, mean (SD)	18.5 (4.4)	19.0 (3.3)	18.9 (3.5)
Gender of child, n (%)
Male	4 (50.0)	16 (51.6)	20 (51.3)
Female	4 (50.0)	15 (48.4)	19 (48.7)
Ethnicity of child, n (%)
Malay	8 (100.0)	23 (74.2)	31 (79.5)
Chinese	0 (0.0)	4 (12.9)	4 (10.3)
Indian	0 (0.0)	4 (12.9)	4 (10.3)
Number of children alive in household, n (%)
1	1 (12.5)	0 (0.0)	1 (2.6)
2–4	2 (25.0)	23 (74.2)	25 (64.1)
≥5	5 (62.5)	8 (25.8)	13 (33.3)
Immunisation profile
Number of vaccines missed, n (%)
1	1 (12.5)	19 (61.3)	20 (51.3)
2–5	4 (50.0)	12 (38.7)	16 (41.0)
>5	3 (37.5)	0 (0.0)	3(6.1)
Types of vaccines missed, n (%)
BCG	1 (12.5)	0 (0.0)	1 (2.6)
HepB first dose	1 (12.5)	0 (0.0)	1 (2.6)
HepB second dose	3 (37.2)	0 (0.0)	3 (7.7)
HepB third dose	6 (75.0)	13 (41.9)	19 (48.7)
DTaP/IPV/Hib first dose	4 (50.0)	2 (6.5)	6 (15.4)
DTaP/IPV/Hib second dose	4 (50.0)	8 (25.8)	12 (30.8)
DTaP/IPV/Hib third dose	6 (75.0)	11 (35.5)	17 (43.6)
Measles	1 (12.5)	0 (0.0)	1 (2.6)
MMR	7 (87.5)	30 (96.8)	37 (94.9)
Contraindication to vaccine(s), n (%)	0 (0.0)	0 (0.0)	0 (0.0)
Follow-up initiatives by clinic staff, n (%)
Yes	6 (75.0)	9 (29.0)	15 (38.5)
No	2 (25.0)	22 (71.0)	24 (61.5)

Notes: SD = standard deviation; BCG = Bacillus Calmette–Guérin vaccine; HepB = Hepatitis B vaccine; DTaP = diphtheria–tetanus–pertussis vaccine; IPV = inactivated poliovirus vaccine; and Hib = Haemophilus influenzae type B vaccine; MMR = measles, mumps and rubella vaccine.

^a Social grading derived from the British National Readership Survey (NRS) 2008.14.

Table 2. Parental reasons for refusing immunisation^a

	n (%)
Alternative treatment (homoeopathy)	6 (75.0)
Assume vaccines have no effect	3 (37.5)
Doubtful of the vaccine contents	2 (25.0)
Did not receive information about vaccine/immunisation from doctor/nurse	1 (12.5)
Information from family members	1 (12.5)
Information from TV, radio, newspaper, etc.	1 (12.5)
Religious influence	1 (12.5)
Personal belief	1 (12.5)
Long waiting time at the clinic	1 (12.5)

^a Respondents may provide more than one reason.

Table 3 Parental reasons for defaulting immunisation^a

	n (%)
Busy with work	10 (32.3)
Long waiting time at the clinic	7 (22.6)
Child not well	7 (22.6)
Forgot the immunisation date	5 (16.1)
No transportation	4 (12.9)
Unhappy with the service provided at the clinic	3 (9.7)
Did not receive information about vaccine/immunisation from doctor/nurse	2 (6.5)
Others (e.g. overseas, etc.)	5 (16.1)

^a Respondents may provide more than one reason.