Main Article Content
Vaccine hesitancy is one of the leading reasons for non-vaccination. World Health Organization has defined vaccine hesitancy as a delay in acceptance or refusal of vaccines despite the availability of vaccination services. Thus, any lack of convenience, confidence, and complacency may lead to vaccine hesitancy. The trend of vaccination hesitancy and refusal is snowballing due to the spreading of false information on the internet and social media. In this study, we focus on an exploratory qualitative study that investigates the youth perspective in Malaysia. The recruitment of the participants was based on a convenience sampling method. The in-depth interviews among youth from Universiti Malaysia Pahang aged between 18-27 years were conducted with adopted thematic analysis. Codes and themes were generated with investigator triangulation. The emerging themes were summarized into a conceptual model. In this study, 33 participants were interviewed. The majority of the participants were below 20 years of age (54.5%), and most of them were female participants (63.6%) of Malay ethnicity (72.7%). 93.9% of them were studying at the bachelor’s degree level and they were all living with other students. Most of the participants (78.8%) used smartphone/tablet as the main platform for exchanging information and 69.7% of them spent about 4 to 6 hours on social media per day. A total of 5 themes and 12 sub-themes were extracted from 101 codes and 12 subcategories. Three themes stipulated by participants were 1) knowledge on infectious diseases, 2) knowledge on the vaccine, 3) information evaluation contributed to confidence issues in vaccine hesitancy. Whereas the other two themes were 4) perception of the vaccine and 5) perception on hesitancy issue contributed to factors influencing complacency in vaccine hesitancy. None of the participants mentioned factors contributing to convenience issues. In conclusion, these five themes contributed to three main components of vaccine hesitancy in Malaysia.
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
2. Salmon DA, Dudley MZ, Glanz JM, Omer SB. Vaccine hesitancy: Causes, Consequences, and a call to action. American Journal Preventive Medicine. 2015; 49: 391-398.
3. Benin AL, Wisler-Scher DJ, Colson E, Shapiro ED, Holmboe ES. Qualitative analysis of mothers' decision-making about vaccines for infants: the importance of trust. Paediatrics. 2006; 117(5): 1532-1541.
4. Opel DJ, Taylor JA, Mangione-Smith R, Solomon C, Zhao C. Validity and reliability of a survey to identify vaccine-hesitant parents. Vaccine 2011; 29(38): 6598-6605.
5. Dubé E, Gagnon D, Zhou Z, and Deceuninck G. Parental vaccine hesitancy in Quebec (Canada). PLoSCurr Version 1, 2016.
6. Dubé E, Laberge C, Guay M. Vaccine hesitancy: an overview. Human Vaccines &Immunotherapeutics. 2013; 9(8): 1763-1773.
7. Hobson-West P. Trusting blindly can be the biggest risk of all: organized resistance to childhood vaccination in the UK. Social Health I. 2017; 29:198-215.
8. Oladejo O, Allen K, Amin A. Comparative analysis of the parent attitudes about childhood vaccines (PACV) short scale and the five categories of vaccine acceptance identified by Gust. Vaccine 2016; 34: 4964-4968.
9. Mohd Azizi FS, Kew Y, Moy FM. Vaccine hesitancy among parents in a multi-ethnic country, Malaysia. Vaccine 2017; 35(22): 2955-2961.
10. Dubé E, Gagnon D, Nickels E, Jeram S, Mapping vaccine hesitancy--country-specific characteristics of a global phenomenon. Vaccine 2014; 32(49): 6649-6654.
11. Phadke VK, Bednarczyk RA, Salmon DA, Omer SB. Association between vaccine refusal and vaccine-preventable diseases in the United States: a review of measles and pertussis. JAMA 2016; 315(11): 1149-1158.
12. Ahmed M, Alorinan B, Al Yemni A, Albakri M, Alahmari M. Vaccines for adults: a review of recent literature. Int J Community Med Public Health 2018; 5(11): 4947-4952.
13. Omer S, Salmon DA, Orenstein WA, De Hart MP, Halsey N. Vaccine refusal, mandatory immunization, and the risks of vaccine-preventable diseases. N Engl J Med 2009; 360: 1981-1988.
14. Dubé E, Gagnona D, MacDonald NE. SAGE working group on vaccine hesitancy. Strategies intended to address vaccine hesitancy: a review of published reviews. Vaccine 2015; 33: 4191-4203.
15. Ruijs WLM, Hautvast JLA, IJzendoorn GV, Ansem WJC, Velden KVD. How orthodox protestant parents decide on the vaccination of their children: a qualitative study. BMC Public Health 2012; 408.
16. Hilton S, Petticrew M, Hunt K, Combined vaccines are like a sudden onslaught to the body's immune system': parental concerns about vaccine 'overload' and 'immune-vulnerability'. Vaccine 2016; 24(20): 4321-4327.
17. Kennedy A, Lavail K, Nowak G, Basket M, Landry S. Confidence about vaccines in the United States: understanding parents' perceptions. Health Aff (Millwood). 2011;30(6): 1151-1159.
18. Cooper LZ, Larson HJ, Katz SL. Protecting public trust in immunization. Pediatrics. 2008;122(1): 149-1453.
19. Hobson-West P. Understanding vaccination resistance: moving beyond risk. Health Risk Soc 2003; 5(3): 273-283.
20. Ruiz JB, Bell RA.Understanding vaccination resistance: vaccine search term selection bias and the valence of retrieved information. Vaccine 2014; 32(44): 5776.
21. Ma J, Stahl L. A multimodal critical discourse analysis of anti-vaccination information on Facebook. Lib Inf Sci Res 2017; 39(4): 303-310.
22. Institute for Public Health, Ministry of Health Malaysia. National health and morbidity survey: maternal and child health (maternal and child health findings) 2016.
23. Director General of Health Malaysia (DGHM). Increased measles cases in Malaysia up to June 26, 2016 [internet]. Available from: https://kpkesihatan. com/2016/06/26/peningkatan-kes-measles-demam-campak-di-malaysia-status-sehingga-26-Jun-2016]. Last viewed on 13 November 2017
24. Director General of Health Malaysia. Increased measles cases in Malaysia up to June 26, 2016 [internet]. Available from: https://kpkesihatan.com/2016/ 06/26/peningkatan-kes-measles-demam-campak-di-malaysia-status-sehingga-26-Jun-2016]. Last viewed on 13 November 2017
25. Larson HJ, Figueiredo AD, Xiahong Z, Schulz WS, Verger P. The state of vaccine confidence 2016: Global insights through a 67-country survey. EBioMedicine. 2016; 12: 295-301.
26. Guest G, MacQueen KM, Namey EE. Applied thematic analysis. SAGE Publications. 2012.
27. Hasni NHM, Osman IF, Techasrivichien T, Musumari PM, Suguimot P, Kihara MO, Larson HJ, Kihara M. Childhood vaccine hesitancy among pregnant women in rural Malaysia: a qualitative study on socio-cultural and contextual factors, 12th Vaccine Congress. 2018.
28. Zabudin NF, Hasni NHM, Adib MAHM, Vaccine hesitancy as an impact of urbanization among youth in Malaysia: University students’ perspective as a future parent, Malays J Public Health Med 19 (Suppl 2), 47. 2019.
29. MO, Larson HJ, Kihara M. Socio-cultural and contextual factors related to vaccine hesitancy issues on childhood immunization programs: A Malaysian parents’ experience, 2017 Kyoto Global Conference for Rising Public Health Researchers: Interdisciplinary Approach and Collaboration for Health for All (12). 2017.