Perceptions of measles, pneumonia, and meningitis vaccines among caregivers in Shanghai, China, and the health belief model: a cross-sectional studyReportar como inadecuado

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BMC Pediatrics

, 17:143

Global and public health and healthcare


BackgroundIn China, the measles vaccine is offered for free whereas the pneumococcal vaccine is a for-fee vaccine. This difference has the potential to influence how caregivers evaluate whether a vaccine is important or necessary for their child, but it is unclear if models of health behavior, such as the Health Belief Model, reveal the same associations for different diseases. This study compares caregiver perceptions of different diseases measles, pneumonia and meningitis; and characterizes associations between Health Belief Model constructs and both pneumococcal vaccine uptake and perceived vaccine necessity for pneumonia, measles, and meningitis.

MethodsCaregivers of infants and young children between 8 months and 7 years of age from Shanghai n = 619 completed a written survey on their perceptions of measles, pneumonia, and meningitis. We used logistic regression models to assess predictors of pneumococcal vaccine uptake and vaccine necessity.

ResultsOnly 25.2% of children had received a pneumococcal vaccine, although most caregivers believed that pneumonia 80.8% and meningitis 92.4%, as well as measles 93.2%, vaccines were serious enough to warrant a vaccine. Perceived safety was strongly associated with both pneumococcal vaccine uptake and perceived vaccine necessity, and non-locals had 1.70 times higher odds of pneumonia vaccine necessity than non-locals 95% CI: 1.01, 2.88.

ConclusionsMost factors had a similar relationship with vaccine necessity, regardless of disease, indicating a common mechanism for how Chinese caregivers decided which vaccines are necessary. Because more caregivers believed meningitis needed a vaccine than pneumonia, health care workers should emphasize pneumococcal vaccination’s ability to protect against meningitis.

KeywordsHealth belief model Immunization coverage China Measles Pneumococcus AbbreviationsCIconfidence interval

dfdegrees of freedom

DTPdiphtheria-tetanus-pertussis vaccine

EPIExpanded Program on Immunization

GEEGeneralized Estimating Equations

HBMHealth Belief Model

HibHaemophilus influenzae type b

OROdds ratio

PCV77-valent pneumococcal conjugate vaccine

PPSProbability proportionate to size

PPSV2323-valent pneumococcal polysaccharide vaccine


SEstandard error

Electronic supplementary materialThe online version of this article doi:10.1186-s12887-017-0900-2 contains supplementary material, which is available to authorized users.

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Autor: Abram L. Wagner - Matthew L. Boulton - Xiaodong Sun - Bhramar Mukherjee - Zhuoying Huang - Irene A. Harmsen - Jia Ren -


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