AUTHOR=Al Bashir Lama , Ismail Aniza , Aljunid Syed Mohamed 

TITLE=Parents‘ and healthcare professionals’ perception toward the introduction of a new fully liquid hexavalent vaccine in the Malaysian national immunization program: a cross-sectional study instrument development and its application

JOURNAL=Frontiers in Immunology

VOLUME=Volume 14 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2023.1052450

DOI=10.3389/fimmu.2023.1052450

ISSN=1664-3224

ABSTRACT=A newly developed fully liquid combined vaccine that comprises six antigens for Diphtheria, Tetanus, acellular Pertussis, Inactivated Poliomyelitis, Haemophilus Influenza type b. and Hepatitis B, is proposed to be introduced in the Malaysian national immunization program, instead of the non-fully liquid pentavalent combined vaccine and monovalent Hepatitis B vaccine that is currently employed in the immunization schedule. Although the introduction of new vaccine is commonly recognized as a needed intervention, it still requires the acceptance of both parents/caregivers and health care professionals (nurses and physicians). Hence, this study aimed to develop three structured questionnaires and to investigate the participants’ perception and acceptability toward the incorporation of the new fully liquid combined vaccine. A cross-sectional study using a structured questionnaires was conducted among a sample of 346 parents, 100 nurses and 50 physicians attending twenty-two primary health care centers in the states of Selangor and Federal Territory of Kuala Lumpur and Putrajaya during 2019-2020. The study found that Cronbach’s alpha coefficients for the study instruments ranged from 0.825 to 0.918. Principal components analysis produced a good fit with KMO>0.6. For the parents’ perception, the only extracted factor explained 73.9 % of the total variance; for the nurses’ perception toward non-fully and fully liquid combined vaccine, there was sole extracted factor that explained 65.2 % and 79.2% of the total variance, respectively. Whereas for the physicians’ perception, there was one factor extracted that explains 71.8 % of the total variance. Median score for all the questionnaire items ranged from 4 to 5 (Q1 and Q3 varies between 3-5). Parents ethnicity was significantly associated (P-value ≤ 0.05) with the perception that the new fully liquid hexavalent vaccine would reduce their transportation expenses. Moreover, a significant weak negative correlation (P-value ≤ 0.05, rs = - 0.309) was found between physicians age and the perception toward the fully liquid ability of decreasing patient overcrowding in the primary healthcare centers. The instruments were valid and reliable for the setting where it was used. Most of the study participants had a positive perception towards and supported the fully liquid hexavalent vaccine introduction  in the immunization program