Vaccination status among children in an urban area and its association with risk factors and some parent health practices: A cross-sectional study

The mediating effect of E-health literacy on health belief model-based vaccine attitudes among parents in Türkiye: a cross-sectional study

BACKGROUND

Vaccination constitutes one of the most efficacious public health interventions, preventing millions of fatalities annually. Nevertheless, vaccine hesitancy persists as a significant challenge, particularly among parents. The dissemination of misinformation via the internet, notably through social media platforms, has contributed to the escalation of vaccine hesitancy. E-health literacy, defined as the capacity to locate and utilize online health information, possesses the potential to influence vaccine attitudes. This study aimed to investigate the relationships among education level, e-health literacy and childhood vaccination attitude among parents.

METHODS

The cross-sectional study design was used. This study was guided by STROBE. Convenience sampling recruited 699 parents in Türkiye with an online survey. The data tools used in the study were the parental information form, Public Attitudes Towards Vaccination - Health Belief Model Scale (PAV-HBM) and E-health Literacy Scale. The collected data were analyzed using SPSS version 25.0, and the PROCESS macro in SPSS was employed to estimate path coefficients and assess the adequacy of the model. The mediating effects of e-health literacy on the pathway in which education level of the parents affects childhood vaccination were verified using model 4 of the SPSS PROCESS macro proposed by Hayes.

RESULTS

The E-Health literacy had significantly mediate the relationship between educational level and the PAVS-HBM sub-dimensions of perceived susceptibility (B = 0.044, 95% CI= [0.023-0.071]), severity (B = 0.045, 95% CI= [0.023-0.070]), benefits (B = 0.054, 95% CI= [0.029-0.086]), and health motivation (B = 0.045, 95% CI= [0.023-0.071]). However, e-health literacy did not mediate the relationship between education level and perceived barriers (B = - 0.013, 95% CI= [- 0.049- -0.023]).

CONCLUSION

The results revealed that education level among parents affect all vaccine attitudes without perceived barriers and the level of e-health literacy mediates this relationship. Therefore, health communication strategies, such as the development of e-health literacy by health authorities and the provision of reliable information about vaccination on digital platforms, including social media, may have potential benefits in promoting positive vaccination attitudes in the community.

CLINICAL TRIAL NUMBER

Not applicable.

Parental vaccine hesitancy: Recent evidences support the need to implement targeted communication strategies

In 2018, Europe experienced a surge in measles cases, revealing the consequences of suboptimal immunization coverage. This trend was exacerbated by long-standing vaccine hesitancy. Parental attitudes toward childhood vaccines have increasingly shifted, influenced by ethical, religious, and safety concerns. Vaccines hesitancy has substantially increased after the Covid-19 pandemic. Using PubMed, we reviewed cross-sectional studies, published during years 2023-2024, related to parents' vaccine hesitancy, with the aim to provide an overview of its prevalence, underlying reasons and consequences for public health. Data summarised highlight various factors contributing to vaccine hesitancy. These include socio-demographic factors, the impact of the Covid-19 pandemic, and widespread misinformation, particularly through social media. Several cross-sectional studies show that vaccine hesitancy is often linked to lower education levels, misinformation, and decreased trust in healthcare systems. The pandemic exacerbated this issue. This article underscores the need for targeted communication strategies to address vaccine hesitancy, focusing on specific populations, such as those in low-income settings or with limited access to healthcare information. It emphasizes the importance of countering misinformation to improve vaccination rates and public health outcomes.