ACCEPTABILITY OF THE DENGUE VACCINATION PROGRAM AMONG PARENTS AND GUARDIANS IN AN URBAN POOR SETTING IN QUEZON CITY, PHILIPPINES: AN IMPLEMENTATION STUDY

Ezra Mauricio Valido, S2

2018 | Tesis | S2 Ilmu Kesehatan Masyarakat

Background: Dengue is a global public health problem. The Philippines introduced a public dengue vaccination program in 2016. Initial coverage was 51% with only 56% have parental and guardian consent in Metro Manila. In December 2017, the program has been suspended amidst a dengue vaccine controversy. Objective: To illustrate the acceptability of the dengue vaccination, determinants to refusal and communication among parents and guardians before and after program suspension in an urban poor setting. Methods: The research used a qualitative study triangulated with a convergent mixed method. The research setting was in the urban poor communities of Quezon City, Philippines. Initially, 12 in-depth interviews were conducted with those who consented and refused to vaccination. Purposive criterion sampling was used. The results were used to design a questionnaire with 27-point true or false questions on vaccine coherence, a 4-point multiple choice questions for communication and a discussion guide. All instruments were used in 5 focus group discussions in 5 locations after the dengue program suspension among those who previously consented. The discussion participants were the same as questionnaire respondents. Thematic analysis was used for qualitative data and descriptive statistics for quantitative data. Results: Three key themes were identified that affects dengue vaccine acceptability. These were parental and guardian�s trust in public health institutions, parental experience in dealing with dengue and vaccination and the communication received by parents. The dengue vaccine controversy led to a low vaccine acceptability. There were 41 respondents for the questionnaire. Respondents have good dengue knowledge on dengue, dengue prevention and post-suspension information. They have moderate knowledge on dengue symptoms and the dengue vaccine and vaccination details. The mass media and community-based approaches were believed to be the fastest and best understood form for communication. The local health staff was the most trusted information source and information need centered on vaccine safety. There is mismatch on information received as to what parents and guardians need that is reassurance that their children are safe. Trust on the vaccine, the vaccinators and the vaccination program has been eroded due to widespread negative vaccine messages. Conclusions: Dengue vaccine acceptability is linked to determinants that is integrated to the disease, the vaccine, the public health institutions and communication. Communication strategies needs to be targeted and tailor fitted to specific populations and respond to needs and mitigate effects of vaccine controversies.

Background: Dengue is a global public health problem. The Philippines introduced a public dengue vaccination program in 2016. Initial coverage was 51% with only 56% have parental and guardian consent in Metro Manila. In December 2017, the program has been suspended amidst a dengue vaccine controversy. Objective: To illustrate the acceptability of the dengue vaccination, determinants to refusal and communication among parents and guardians before and after program suspension in an urban poor setting. Methods: The research used a qualitative study triangulated with a convergent mixed method. The research setting was in the urban poor communities of Quezon City, Philippines. Initially, 12 in-depth interviews were conducted with those who consented and refused to vaccination. Purposive criterion sampling was used. The results were used to design a questionnaire with 27-point true or false questions on vaccine coherence, a 4-point multiple choice questions for communication and a discussion guide. All instruments were used in 5 focus group discussions in 5 locations after the dengue program suspension among those who previously consented. The discussion participants were the same as questionnaire respondents. Thematic analysis was used for qualitative data and descriptive statistics for quantitative data. Results: Three key themes were identified that affects dengue vaccine acceptability. These were parental and guardian�s trust in public health institutions, parental experience in dealing with dengue and vaccination and the communication received by parents. The dengue vaccine controversy led to a low vaccine acceptability. There were 41 respondents for the questionnaire. Respondents have good dengue knowledge on dengue, dengue prevention and post-suspension information. They have moderate knowledge on dengue symptoms and the dengue vaccine and vaccination details. The mass media and community-based approaches were believed to be the fastest and best understood form for communication. The local health staff was the most trusted information source and information need centered on vaccine safety. There is mismatch on information received as to what parents and guardians need that is reassurance that their children are safe. Trust on the vaccine, the vaccinators and the vaccination program has been eroded due to widespread negative vaccine messages. Conclusions: Dengue vaccine acceptability is linked to determinants that is integrated to the disease, the vaccine, the public health institutions and communication. Communication strategies needs to be targeted and tailor fitted to specific populations and respond to needs and mitigate effects of vaccine controversies.

Kata Kunci : Keywords: Acceptability, Dengue Vaccine, Communication, Implementation, Philippines