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Knowledge, Attitudes and Perceptions About Routine Childhood Vaccinations Among Jewish Ultra-Orthodox Mothers Residing in Communities with Low Vaccination Coverage in the Jerusalem District

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Abstract

Background and aims Childhood vaccinations are an important component of primary prevention. Maternal and Child Health (MCH) clinics in Israel provide routine vaccinations without charge. Several vaccine-preventable-diseases outbreaks (measles, mumps) emerged in Jerusalem in the past decade. We aimed to study attitudes and knowledge on vaccinations among mothers, in communities with low immunization coverage. Methods A qualitative study including focus groups and semi-structured interviews. Results Low immunization coverage was defined below the district’s mean (age 2 years, 2013) for measles-mumps-rubella-varicella 1st dose (MMR1\MMRV1) and diphtheria-tetanus-pertussis 4th dose (DTaP4), 96 and 89%, respectively. Five communities were included, all were Jewish ultra-orthodox. The mothers’ (n = 87) median age was 30 years and median number of children 4. Most mothers (94%) rated vaccinations as the main activity in the MCH clinics with overall positive attitudes. Knowledge about vaccines and vaccination schedule was inadequate. Of vaccines scheduled at ages 0–2 years (n = 13), the mean number mentioned was 3.9 ± 2.8 (median 4, range 0–9). Vaccines mentioned more often were outbreak-related (measles, mumps, polio) and HBV (given to newborns). Concerns about vaccines were obvious, trust issues and religious beliefs were not. Vaccination delay was very common and timeliness was considered insignificant. Practical difficulties in adhering to the recommended schedule prevailed. The vaccinations visits were associated with pain and stress. Overall, there was a sense of self-responsibility accompanied by inability to influence others. Conclusion Investigating maternal knowledge and attitudes on childhood vaccinations provides insights that may assist in planning tailored intervention programs aimed to increase both vaccination coverage and timeliness.

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Abbreviations

VPD:

Vaccine-Preventable Diseases

MCH:

Maternal and Child Health

DTaP-IPV-Hib:

Diphtheria-Tetanus-acellular Pertussis-Polio-Haemophilus influenza B vaccine

HBV:

Hepatitis B vaccine

PCV:

Pneumococcal vaccine

RV:

Rotavirus vaccine

MMRV:

Measles-Mumps-Rubella-Varicella vaccine

HAV:

Hepatitis A vaccine

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Authors and Affiliations

  1. Faculty of medicine, the Hebrew University and Hadassah Braun School of Public and Community Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel

    Chen Stein Zamir

  2. Jerusalem District Health Office, Ministry of Health, Jerusalem, Israel

    Chen Stein Zamir

  3. Faculty of medicine, the Hebrew University and Hadassah Braun School of Public and Community Medicine, Department of Health Policy and Management, The Hebrew University of Jerusalem, Jerusalem, Israel

    Avi Israeli

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  2. Avi Israeli
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Correspondence to Chen Stein Zamir.

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Stein Zamir, C., Israeli, A. Knowledge, Attitudes and Perceptions About Routine Childhood Vaccinations Among Jewish Ultra-Orthodox Mothers Residing in Communities with Low Vaccination Coverage in the Jerusalem District. Matern Child Health J 21, 1010–1017 (2017). https://doi.org/10.1007/s10995-017-2272-5

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  • DOI: https://doi.org/10.1007/s10995-017-2272-5

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