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Published in: BMC Infectious Diseases 1/2017

Open Access 01-12-2017 | Research article

Knowledge, attitudes, and behaviors of parents towards varicella and its vaccination

Authors: Luigi Vezzosi, Gabriella Santagati, Italo F. Angelillo

Published in: BMC Infectious Diseases | Issue 1/2017

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Abstract

Background

The aims of this cross-sectional survey were to examine the knowledge, the attitudes, and the behavior regarding the varicella infection and its vaccination and to get insight into their determinants among parents of children in Italy.

Methods

From May to June 2015 in the geographic area of Naples (Italy) a random sample of 675 parents of children aged 4-7 years received a self-administered anonymous questionnaire about socio-demographic characteristics, knowledge, attitudes, and behaviors towards varicella and its vaccination.

Results

A total of 414 parents responded to the questionnaire, for a response rate of 61.3%. A history of varicella was reported in 163 children (39.6%). Only 26.6% parents knew that the vaccine was available and the number of doses and this knowledge was significantly higher in those who had a university degree, in those who had received information on the vaccination from a health care provider, and in those who had vaccinated their child. The perceived utility towards vaccination had a mean value of 5.7. The positive attitude towards the utility of the vaccination was higher in parents with a level of education not higher than middle school, in those who had vaccinated their child, in those who considered the varicella a dangerous disease, and in those who had received information from a health care provider. More than one-third had vaccinated their child. Immunization was more frequent in parents who had knowledge about the vaccination, who beliefs that the immunization was useful, who believed that the disease was not dangerous, and who had not a history of varicella among their children.

Conclusions

Educational programs are needed among parents as support to improve knowledge about vaccination and immunization coverage.
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Literature
3.
go back to reference Ministero della Salute. Decreto del Direttore Generale del Servizio Farmaceutico, 31/10/1994, n. A/1226 /1994. 1994. Autorizzazione all’immissione in commercio di Varilrix (AIC) n. 028427019. Ministero della Salute. Decreto del Direttore Generale del Servizio Farmaceutico, 31/10/1994, n. A/1226 /1994. 1994. Autorizzazione all’immissione in commercio di Varilrix (AIC) n. 028427019.
6.
go back to reference Angelillo IF, Ricciardi G, Rossi P, Pantisano P, Langiano E, Pavia M. Mothers and vaccination: knowledge, attitudes, and behaviour in Italy. Bull World Health Organ. 1999;77(3):224–9.PubMedPubMedCentral Angelillo IF, Ricciardi G, Rossi P, Pantisano P, Langiano E, Pavia M. Mothers and vaccination: knowledge, attitudes, and behaviour in Italy. Bull World Health Organ. 1999;77(3):224–9.PubMedPubMedCentral
7.
go back to reference Impicciatore P, Bosetti C, Schiavio S, Pandolfini C, Bonati M. Mothers as active partners in the prevention of childhood diseases maternal factors related to immunization status of preschool children in Italy. Prev Med. 2000;31(1):49–55.CrossRefPubMed Impicciatore P, Bosetti C, Schiavio S, Pandolfini C, Bonati M. Mothers as active partners in the prevention of childhood diseases maternal factors related to immunization status of preschool children in Italy. Prev Med. 2000;31(1):49–55.CrossRefPubMed
8.
go back to reference Pandolfi E, Graziani MC, Ieraci R, Cavagni G, Tozzi AE. A comparison of populations vaccinated in a public service and in a private hospital setting in the same area. BMC Public Health. 2008;8:278.CrossRefPubMedPubMedCentral Pandolfi E, Graziani MC, Ieraci R, Cavagni G, Tozzi AE. A comparison of populations vaccinated in a public service and in a private hospital setting in the same area. BMC Public Health. 2008;8:278.CrossRefPubMedPubMedCentral
9.
go back to reference Coniglio MA, Platania M, Privitera D, Giammanco G, Pignato S. Parent’s attitudes and behaviours towards recommended vaccinations in Sicily. Italy BMC Public Health. 2011;11:305.CrossRefPubMed Coniglio MA, Platania M, Privitera D, Giammanco G, Pignato S. Parent’s attitudes and behaviours towards recommended vaccinations in Sicily. Italy BMC Public Health. 2011;11:305.CrossRefPubMed
10.
go back to reference Al-lela OQ, Bahari MB, Salih MR, Al-Abbassi MG, Elkalmi RM, Jamshed SQ. Factors underlying inadequate parents’ awareness regarding pediatrics immunization: findings of cross-sectional study in Mosul- Iraq. BMC Pediatr. 2014;14:29.CrossRefPubMedPubMedCentral Al-lela OQ, Bahari MB, Salih MR, Al-Abbassi MG, Elkalmi RM, Jamshed SQ. Factors underlying inadequate parents’ awareness regarding pediatrics immunization: findings of cross-sectional study in Mosul- Iraq. BMC Pediatr. 2014;14:29.CrossRefPubMedPubMedCentral
11.
go back to reference MacDonald SE, Schopflocher DP, Vaudry W. Parental concern about vaccine safety in Canadian children partially immunized at age 2: a multivariable model including system level factors. Hum Vaccin Immunother. 2014;10(9):2603–11.CrossRefPubMedPubMedCentral MacDonald SE, Schopflocher DP, Vaudry W. Parental concern about vaccine safety in Canadian children partially immunized at age 2: a multivariable model including system level factors. Hum Vaccin Immunother. 2014;10(9):2603–11.CrossRefPubMedPubMedCentral
12.
go back to reference Cronbach L. Coefficient alpha and the internal structure of tests. Psychometrika. 1951;16:297–334.CrossRef Cronbach L. Coefficient alpha and the internal structure of tests. Psychometrika. 1951;16:297–334.CrossRef
13.
go back to reference Stata Corporation. Stata reference manual, release 10.1, College Station, Tex, USA. 2007. Stata Corporation. Stata reference manual, release 10.1, College Station, Tex, USA. 2007.
15.
go back to reference Bechini A, Boccalini S, Baldo V, Cocchio S, Castiglia P, Gallo T, et al. Impact of universal vaccination against varicella in Italy. Hum Vaccin Immunother. 2015;11(1):63–71.CrossRefPubMed Bechini A, Boccalini S, Baldo V, Cocchio S, Castiglia P, Gallo T, et al. Impact of universal vaccination against varicella in Italy. Hum Vaccin Immunother. 2015;11(1):63–71.CrossRefPubMed
16.
go back to reference Freeman VA, Feed GL. Parental knowledge, attitudes, and demand regarding a vaccine to prevent varicella. Am J Prev Med. 1999;17(2):153–5.CrossRefPubMed Freeman VA, Feed GL. Parental knowledge, attitudes, and demand regarding a vaccine to prevent varicella. Am J Prev Med. 1999;17(2):153–5.CrossRefPubMed
17.
go back to reference De Courval FP, De Serres G, Duval B. Varicella vaccine: factors influencing uptake. Can J Public Health. 2003;94(4):268–71.PubMed De Courval FP, De Serres G, Duval B. Varicella vaccine: factors influencing uptake. Can J Public Health. 2003;94(4):268–71.PubMed
18.
go back to reference Streng A, Seeger K, Grote V, Liese JG. Varicella vaccination coverage in Bavaria (Germany) after general vaccine recommendation in 2004. Vaccine. 2010;28(35):5738–45.CrossRefPubMed Streng A, Seeger K, Grote V, Liese JG. Varicella vaccination coverage in Bavaria (Germany) after general vaccine recommendation in 2004. Vaccine. 2010;28(35):5738–45.CrossRefPubMed
19.
go back to reference Lee E, Turner J, Bate J. Parental opinions on childhood varicella and the varicella vaccine: a UK multicenter qualitative interview study. Arch Dis Child. 2011;96(9):901.CrossRefPubMed Lee E, Turner J, Bate J. Parental opinions on childhood varicella and the varicella vaccine: a UK multicenter qualitative interview study. Arch Dis Child. 2011;96(9):901.CrossRefPubMed
20.
go back to reference Niederhauser VP, Baruffi G, Heck R. Parental decision-making for the varicella vaccine. J Pediatr Health Care. 2001;15(5):236–43.CrossRefPubMed Niederhauser VP, Baruffi G, Heck R. Parental decision-making for the varicella vaccine. J Pediatr Health Care. 2001;15(5):236–43.CrossRefPubMed
21.
go back to reference Miron E, Abu-Foul N, Rishpon S. Factors affecting Varicella vaccine uptake among children 1-17 years old in the Haifa District in 2007. Hum Vaccin. 2010;6(10):849–53.CrossRefPubMed Miron E, Abu-Foul N, Rishpon S. Factors affecting Varicella vaccine uptake among children 1-17 years old in the Haifa District in 2007. Hum Vaccin. 2010;6(10):849–53.CrossRefPubMed
22.
go back to reference Adler A, Herring E, Babilsky H, Gazala E, Cohen A, Levy I. Parent-dependent barriers to varicella immunization in Israel: the importance of adequate information. Acta Paediatr. 2007;96(3):428–31.CrossRefPubMed Adler A, Herring E, Babilsky H, Gazala E, Cohen A, Levy I. Parent-dependent barriers to varicella immunization in Israel: the importance of adequate information. Acta Paediatr. 2007;96(3):428–31.CrossRefPubMed
23.
go back to reference Tam WW, Chan J, Lo KK, Lee A, Chan PK, Chan D, et al. Parental attitudes and factors associated with varicella vaccination in preschool and schoolchildren in Hong Kong: a cross-sectional study. Medicine (Baltimore). 2015;94(36):e1519.CrossRef Tam WW, Chan J, Lo KK, Lee A, Chan PK, Chan D, et al. Parental attitudes and factors associated with varicella vaccination in preschool and schoolchildren in Hong Kong: a cross-sectional study. Medicine (Baltimore). 2015;94(36):e1519.CrossRef
24.
go back to reference Vassiliki P, Ioanna K, Artemis V, Eleni K, Aglaia Z, Attilakos A, et al. Determinants of vaccination coverage and adherence to the Greek national immunization program among infants aged 2-24 months at the beginning of the economic crisis (2009-2011). BMC Public Health. 2014;14:1192.CrossRefPubMedPubMedCentral Vassiliki P, Ioanna K, Artemis V, Eleni K, Aglaia Z, Attilakos A, et al. Determinants of vaccination coverage and adherence to the Greek national immunization program among infants aged 2-24 months at the beginning of the economic crisis (2009-2011). BMC Public Health. 2014;14:1192.CrossRefPubMedPubMedCentral
25.
go back to reference Pavloupoulou ID, Michail KA, Samoli E, Tsiftis G, Tsoumakas K. Immunization coverage and predictive factors for complete and age-appropriate vaccination among preschoolers in Athens, Greece; a cross sectional study. BMC Public Health. 2013;13:908.CrossRef Pavloupoulou ID, Michail KA, Samoli E, Tsiftis G, Tsoumakas K. Immunization coverage and predictive factors for complete and age-appropriate vaccination among preschoolers in Athens, Greece; a cross sectional study. BMC Public Health. 2013;13:908.CrossRef
26.
go back to reference Keane MT, Walter MV, Patel BI, Moorthy S, Stevens RB, Bradley KM, et al. Confidence in vaccination: a parent model. Vaccine. 2005;23(19):2486–93.CrossRefPubMed Keane MT, Walter MV, Patel BI, Moorthy S, Stevens RB, Bradley KM, et al. Confidence in vaccination: a parent model. Vaccine. 2005;23(19):2486–93.CrossRefPubMed
27.
go back to reference Manthiram K, Blood EA, Kuppuswamy V, Martins Y, Narayan A, Burmeister K, et al. Predictors of optional immunization uptake in an urban south Indian population. Vaccine. 2014;32(27):3417–23.CrossRefPubMed Manthiram K, Blood EA, Kuppuswamy V, Martins Y, Narayan A, Burmeister K, et al. Predictors of optional immunization uptake in an urban south Indian population. Vaccine. 2014;32(27):3417–23.CrossRefPubMed
28.
go back to reference Gustafson R, Skowronski DM. Disparities in varicella vaccine coverage in the absence of public funding. Vaccine. 2005;23(27):3519–25.CrossRefPubMed Gustafson R, Skowronski DM. Disparities in varicella vaccine coverage in the absence of public funding. Vaccine. 2005;23(27):3519–25.CrossRefPubMed
29.
go back to reference Ganczak M, Dmytrzyk- Daniłów G, Karakiewicz B, Korzén M, Szych Z. Determinants influencing self-paid vaccination coverage, in 0-5 years old Polish children. Vaccine. 2013;31(48):5687–92.CrossRefPubMed Ganczak M, Dmytrzyk- Daniłów G, Karakiewicz B, Korzén M, Szych Z. Determinants influencing self-paid vaccination coverage, in 0-5 years old Polish children. Vaccine. 2013;31(48):5687–92.CrossRefPubMed
30.
go back to reference Gundogdu Z, Gundogdu O. Parental attitudes and varicella vaccine in Kocaeli, Turkey. Prev Med. 2011;52(3-4):278–80.PubMed Gundogdu Z, Gundogdu O. Parental attitudes and varicella vaccine in Kocaeli, Turkey. Prev Med. 2011;52(3-4):278–80.PubMed
31.
go back to reference Taylor JA, Newman RD. Parental attitudes toward varicella vaccination. The Puget Sound Pediatric Research Network. Arch Pediatr Adolesc Med. 2000;154(3):302–6.CrossRefPubMed Taylor JA, Newman RD. Parental attitudes toward varicella vaccination. The Puget Sound Pediatric Research Network. Arch Pediatr Adolesc Med. 2000;154(3):302–6.CrossRefPubMed
32.
go back to reference Boulianne NA, Duval B, Serres GD. Opinions of Quebec parents and vaccinators on the usefulness of chickenpox vaccine. Can J Infect Dis. 2001;12(3):153–6.CrossRefPubMedPubMedCentral Boulianne NA, Duval B, Serres GD. Opinions of Quebec parents and vaccinators on the usefulness of chickenpox vaccine. Can J Infect Dis. 2001;12(3):153–6.CrossRefPubMedPubMedCentral
33.
go back to reference Grabowsky M, Orenstein WA, Marcuse EK. The critical role of provider practices in undervaccination. Pediatrics. 1996;97(5):735–7.PubMed Grabowsky M, Orenstein WA, Marcuse EK. The critical role of provider practices in undervaccination. Pediatrics. 1996;97(5):735–7.PubMed
34.
go back to reference Freed GL, Clark SJ, Hibbs BF, Santoli JM. Parental vaccine safety concerns. The experiences of pediatricians and family physicians. Am J Prev Med. 2004;26(1):11–4.CrossRefPubMed Freed GL, Clark SJ, Hibbs BF, Santoli JM. Parental vaccine safety concerns. The experiences of pediatricians and family physicians. Am J Prev Med. 2004;26(1):11–4.CrossRefPubMed
35.
go back to reference Gust DA, Kennedy A, Shui I, Smith PJ, Nowak G, Pickering LK. Parent attitudes toward immunizations and healthcare providers the role of information. Am J Prev Med. 2005;29(2):105–12.CrossRefPubMed Gust DA, Kennedy A, Shui I, Smith PJ, Nowak G, Pickering LK. Parent attitudes toward immunizations and healthcare providers the role of information. Am J Prev Med. 2005;29(2):105–12.CrossRefPubMed
36.
go back to reference Heininger U. An internet-based survey on parental attitudes towards immunization. Vaccine. 2006;24(37-39):6351–5.CrossRefPubMed Heininger U. An internet-based survey on parental attitudes towards immunization. Vaccine. 2006;24(37-39):6351–5.CrossRefPubMed
37.
go back to reference Smith PJ, Kennedy AM, Wooten K, Gust DA, Pickering LK. Association between health care providers’ influence on parents who have concerns about vaccine safety and vaccination coverage. Pediatrics. 2006;118(5):e1287–92. Smith PJ, Kennedy AM, Wooten K, Gust DA, Pickering LK. Association between health care providers’ influence on parents who have concerns about vaccine safety and vaccination coverage. Pediatrics. 2006;118(5):e1287–92.
38.
go back to reference Liao SL, Huang T, Huang YC, Jiang DD. Survey of the status of self-paid varicella vaccination among children one to six years of age in Taiwan. J Microbiol Immunol Infect. 2007;40(2):112–5.PubMed Liao SL, Huang T, Huang YC, Jiang DD. Survey of the status of self-paid varicella vaccination among children one to six years of age in Taiwan. J Microbiol Immunol Infect. 2007;40(2):112–5.PubMed
39.
go back to reference Gust DA, Darling N, Kennedy A. Parents with doubts about vaccine: which vaccines and reasons why. Pediatrics. 2008;122(4):718–25.CrossRefPubMed Gust DA, Darling N, Kennedy A. Parents with doubts about vaccine: which vaccines and reasons why. Pediatrics. 2008;122(4):718–25.CrossRefPubMed
40.
go back to reference Salmon DA, Pan WK, Omer SB, Navar AM, Orenstein W, Marcuse EK, et al. Vaccine knowledge and practices of primary care providers of exempt vs. vaccinated children. Hum Vaccin. 2008;4(4):286–91.CrossRefPubMed Salmon DA, Pan WK, Omer SB, Navar AM, Orenstein W, Marcuse EK, et al. Vaccine knowledge and practices of primary care providers of exempt vs. vaccinated children. Hum Vaccin. 2008;4(4):286–91.CrossRefPubMed
41.
go back to reference Wu AC, Wisler-Sher DJ, Griswold K, Colson E, Shapiro ED, Holmboe ES, et al. Postpartum mothers’ attitudes, knowledge, and trust regarding vaccination. Matern Child Health J. 2008;12(6):766–73.CrossRefPubMed Wu AC, Wisler-Sher DJ, Griswold K, Colson E, Shapiro ED, Holmboe ES, et al. Postpartum mothers’ attitudes, knowledge, and trust regarding vaccination. Matern Child Health J. 2008;12(6):766–73.CrossRefPubMed
42.
go back to reference Allaert FA, Blanc A, Megard Y, Bertand Y. Parents’ attitudes towards varicella vaccination acceptance in France and Germany: effect of vaccine recommendation and reimbursement (a survey). J Public Health. 2009;17:71–6.CrossRef Allaert FA, Blanc A, Megard Y, Bertand Y. Parents’ attitudes towards varicella vaccination acceptance in France and Germany: effect of vaccine recommendation and reimbursement (a survey). J Public Health. 2009;17:71–6.CrossRef
43.
go back to reference Mergler MJ, Omer SB, Pan WK, Navar-Boggan AM, Orenstein W, Marcuse EK, et al. Association of vaccine-related attitudes and beliefs between parents and health care providers. Vaccine. 2013;31(41):4591–5.CrossRefPubMed Mergler MJ, Omer SB, Pan WK, Navar-Boggan AM, Orenstein W, Marcuse EK, et al. Association of vaccine-related attitudes and beliefs between parents and health care providers. Vaccine. 2013;31(41):4591–5.CrossRefPubMed
Metadata
Title
Knowledge, attitudes, and behaviors of parents towards varicella and its vaccination
Authors
Luigi Vezzosi
Gabriella Santagati
Italo F. Angelillo
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Infectious Diseases / Issue 1/2017
Electronic ISSN: 1471-2334
DOI
https://doi.org/10.1186/s12879-017-2247-6

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