Parents hesitant to receive foreign-made COVID-19 vaccines

Many parents remain reluctant about COVID-19 vaccines, with majority of them refusing to receive vaccines coming from other countries relative to domestic ones, a study in Turkey has found.

“The development of effective vaccines will be an important milestone for public health and combating the COVID-19 pandemic,” the researchers said. “In this respect, it is essential to know the frequency and reasons for vaccine hesitancy and refusal and to develop a national vaccination strategy accordingly.”

A survey consisting of 16 questions about COVID-19 vaccination was carried out either face-to-face or online with 428 parents whose children were inpatients or outpatients at the Children’s Hospital of Ankara City Hospital in Ankara, Turkey. The survey asked participants about family sociodemographic characteristics, opinions on domestic and foreign COVID-19 vaccines, and reasons for vaccine refusal.

Of the parents, 66.1 percent were hesitant to receive foreign COVID-19 vaccines, while only 37.4 percent were unwilling to receive domestic COVID-19 vaccines. The participants’ preference for domestic vaccines was significantly higher for themselves and their children (p<0.05). [Pediatr Infect Dis J 2021;40:e134-e136]

Women were also more reluctant than men to receive foreign vaccines (p<0.05). However, as the education level increased, fewer parents preferred the domestic vaccine for themselves (p=0.046) and their children (p=0.005). Interestingly, parents with high anxiety levels about COVID-19 injection showed higher acceptability of both domestic and foreign vaccines for themselves and their children (p<0.05).

The most common reasons for refusal were as follows: anxiety about vaccine side effects, lack of knowledge about vaccine effectiveness, and distrust of vaccines made by other countries.

“Vaccine hesitancy and refusal mean delaying or refusing to accept vaccination despite the availability of vaccination services,” the researchers said. “As seen around the world, cases of vaccine rejection are increasing in Turkey, and the impact of the COVID-19 pandemic on vaccine hesitancy and refusal is not yet known.” [Vaccine 2015;33:4161-4164]

In contrast to the current findings, those by Reiter and colleagues found nearly 70 percent of adults in the US who would be willing to accept a COVID-19 vaccine, while those by Yilmazbas and colleagues reported about 74 percent of participants who were willing to get vaccinated. [Vaccine 2020;38:6500-6507; Erciyes Med J 2020;doi:10.14744/etd.2020.85451]

“In the present study, the preference of participants with a history of vaccine rejection for the domestic vaccine was significantly higher,” the researchers said. “Since there are vaccine development studies underway in different centres in Turkey, it is essential for the national immunization program to recognize the preference for the domestic vaccine, which was demonstrated in this study.”

Several factors affect vaccine hesitancy and refusal. A study by Opel and colleagues showed that parents with higher education levels were about four times more likely to worry about vaccine safety than those with lower education levels. In contrast, the team of Bertoncello found that a low education level was associated with vaccine refusal. [Vaccine 2011;29:6598-6605; Vaccines 2020;8:276]

“There was no significant relationship between education level and foreign vaccine preference in this study, but when the relationship between education and domestic vaccine acceptance was examined, it was found that vaccine rejection increased significantly as the education level increased,” the researchers said.

“Previous studies have indicated that the reasons for vaccine hesitancy and refusal include thoughts that the chemical substances in vaccines are harmful to human health, distrust of the companies producing vaccines, and that it is possible to protect against these diseases … by consuming certain foods,” they noted. [Turk Pediatr Ars 2019;54:1-2; Turkish J Pediatr Dis 2020;14:1-4; Front Psychol 2020;11:575950]