Childhood Vaccination Views Across Genders: What Do Mothers and Fathers Really Think?
DOI:
https://doi.org/10.24191/jas.v22i2.7966Keywords:
Immunisation, Childhood Vaccination , Parental Attitudes , Gender Differences , Gender Schema Theory , MalaysiaAbstract
Childhood vaccination is a crucial public health endeavour aimed at preventing infectious illnesses and decreasing child mortality. Although vaccine uptake in Malaysia is generally high, disparities may occur among different demographic groups, including gender. This study evaluates parental views regarding childhood vaccination in Pahang, Malaysia, and assesses whether these attitudes significantly differ between male and female parents. The target population comprised parents who have at least one child under 15 years of age. A quantitative cross-sectional design was utilised, involving 333 parents from Pahang. Data were gathered via a structured questionnaire assessing views regarding childhood vaccination. Descriptive statistics and an independent samples t-test were performed to assess attitudes and gender differences, respectively. The independent t-test revealed a statistically significant disparity between male and female parents, with female parents exhibiting more favourable attitudes toward childhood vaccination. The findings highlight the significance of gender in influencing parental perspectives on immunisation. This study advances the application of Gender Schema Theory in public health research and highlights the need for gender-sensitive strategies to improve vaccine acceptance, particularly among male parents
References
Abd Halim, H., Abdul-Razak, S., Md Yasin, M., & Isa, M. R. (2020). Validation study of the parent attitudes about childhood vaccines (PACV) questionnaire: The Malay version. Human Vaccines & Immunotherapeutics, 16(5), 1040-1049. https://doi.org/10.1080/21645515.2019.1674112
Abd Rahman, N. A. S., Ju, S. Y., Razali, J. R., Hamdan, N. H., Ridzuan, M. R., & Kong, L. K. (2024). Post-COVID-19 Malaysian parents’ views on children’s vaccination: Subjective norms analysis. International Journal of Evaluation and Research in Education, 13(5), 2801. https://doi.org/10.11591/ijere.v13i5.29396
Abd Rahman, N. A. S., Ju, S. Y., Razali, J. R., Ridzuan, M. R., & Kong, L. K. (2021). The influence of attitude, subjective norms, and perceived behavioral control on vaccination intention among teachers: The moderating role of perceived policy effectiveness. Journal of Nusantara Studies, 9(1), 224-244. http://dx.doi.org/10.24200/jonus.vol9iss1pp224-244
Al-Hanawi, M. K., Angawi, K., Alshareef, N., Qattan, A. M., Helmy, H. Z., Abudawood, Y., ... & Alsharqi, O. (2020). Knowledge, attitude and practice toward COVID-19 among the public in the Kingdom of Saudi Arabia: A cross- sectional study. Frontiers in Public Health, 8, 217. https://doi.org/10.3389/fpubh.2020.00217
Alnasser, A. H. A., Al-Tawfiq, J. A., Al-Kalif, M. S. H., Shahadah, R. F. B., Almuqati, K. S. A., Al-Sulaiman, B. S. A., ... & Almashama, I. K. I. (2021). Public knowledge, attitudes, and practice towards COVID-19 pandemic in Saudi Arabia: A web-based cross-sectional survey. Medical Sciences, 9(1), 11. https://doi.org/10.3390/medsci9010011
Amarie, A., Udijono, A., Kusariana, N., & Saraswati, L. D. (2020). Description of knowledge, attitude, and practice of coronavirus disease-19 prevention based on gender and age in Java island community. Journal of Public Health for Tropical and Coastal Region, 3(2), 26-30.https://doi.org/10.14710/jphtcr.v3i2.9487
Anaam, M. S., & Alsahali, S. (2023). Gender differences in knowledge, attitudes, and practices toward COVID-19 in Saudi Arabia: A cross-sectional study. Diseases, 11(2), 63.https://doi.org/10.3390/diseases11020063
Ansari, M. T., Jamaluddin, N. N., Ramlan, T. A., Zamri, N., Majeed, S., Badgujar, V., ... & Balbir Singh, H. K. (2021). Knowledge, attitude, perception of Muslim parents towards vaccination in Malaysia. Human Vaccines & Immunotherapeutics, 17(3), 785-790. https://doi.org/10.1080/21645515.2020.1800325
Asghar, K., Shehazadi, I., Naseem, S., & Shamim, I. (2025). Assessment of parent’s attitude, knowledge and practices regarding their child vaccination. Journal of Asian Development Studies, 14(1), 1373-1383. https://doi.org/10.62345/jads.2025.14.1.109
Bem, S. L. (1981a). Gender Schema Theory: A cognitive account of sex typing. Psychological review, 88(4), 354. https://doi.org/10.1037//0033-295x.88.4.354
Bem, SL. (1981b). The BSRI and gender schema theory: A reply to Spence and Helmreich. Psychol Rev, 88, 369–371. https://doi.org/10.1037/0033- 295X.88.4.369
Cunningham, J. B., & Aldrich, J. O. (2012). Using SPSS: An interactive hands-on approach (5th ed.). SAGE.
Demir Pervane, V., Erten Bucaktepe, P. G., Yıldız, İ., Kardaş, S., Tekay, S. E., Atik, Y., ... & Çelepkolu, T. (2025). Parents’ attitudes about childhood vaccines before and after the COVID-19 pandemic: A cross-sectional study. Medicina, 61(3), 421. https://doi.org/10.3390/medicina61030421
El Bilbeisi, A. H., El Afifi, A., Abuzerr, S., Alwahedy, I. K., & Alwahedy, S. K. (2025). Knowledge, attitudes, and practices of polio vaccination among mothers attending vaccination sites in Gaza during the conflict. Frontiers in Pediatrics, 13, 1569650.https://doi.org/10.3389/fped.2025.1569650
Elbur, A., Yousif, M., Albarraq, A., & Abdallah, M. (2014). Knowledge and attitudes on childhood vaccination a survey among Saudi parents in Taif region, Saudi Arabia. Int J Pharm Pract Drug Res, 4, 92-7. https://doi.org/10.21276/sjmps.2016.2.6.3
Field, A. (2013). Discovering statistics using SPSS. Sage Publications.
Field, A. (2018). Discovering statistics using IBM SPSS statistics (5th ed.). SAGE Publications.
Frenkel, L. D. (2021). The global burden of vaccine-preventable infectious diseases in children less than 5 years of age: Implications for COVID-19 vaccination. How can we do better? Allergy and Asthma Proceedings, 42(5), 378–385. https://doi.org/10.2500/aap.2021.42.210065
Gao, H., Hu, R., Yin, L., Yuan, X., Tang, H., Luo, L., ... & Jiang, Z. (2020). Knowledge, attitudes and practices of the Chinese public with respect to coronavirus disease (COVID-19): An online cross-sectional survey. BMC Public Health, 20(1), 1816.https://doi.org/10.1186/s12889-020-09961-2
Gravetter, F., & Wallnau, L. (2014). Essentials of statistics for the behavioral sciences. Wadsworth
Hatem, G., Zeidan, J., Goossens, M., & Moreira, C. (2022). Normality testing methods and the importance of skewness and kurtosis in statistical analysis. BAU Journal-Science and Technology, 3(2), 7. https://doi.org/10.54729/ktpe9512
Jadoo, S. A. A., Danfour, O. M., Zerzah, M., Abujazia, M. A., Torun, P., Al-Samarrai, M. A. M., & Yaseen, S. M. (2021). Knowledge, attitude, and practice towards COVID-19 among Libyan people-a web-based cross-sectional study. Journal of Ideas in Health, 4(Special1), 348-356. https://doi.org/10.47108/jidhealth.vol4.issspecial1.97
Kang, H. (2021). Sample size determination and power analysis using the G* Power software. Journal of Educational Evaluation for Health Professions, 18. 1-17. https://doi.org/10.3352/jeehp.2021.18.17
Khan, Z. H., Manzoor, I., & Qureshi, I. (2020). Gender differences in knowledge, attitude and perceptions re-garding COVID-19 among general population of Punjab, Pakistan. Br. J. Pharm. Med, 5, 2576-2586.
Lavrakas, P. J. (2008). Encyclopedia of survey research methods. SAGE Publications, Thousand Oaks.
Lièvre, G., Sicsic, J., Galmiche, S., Charmet, T., Fontanet, A., & Mueller, J. (2025). Are psychological attitudes towards vaccination an expression of personality? A cross-sectional study on COVID-19 vaccination in France. BMC Public Health, 25(1), 209. https://doi.org/10.1186/s12889-025-21364-9
Loeb, S., Dynarski, S., McFarland, D., Morris, P., Reardon, S., & Reber, S. (2017). Descriptive Analysis in Education: A Guide for Researchers. NCEE 2017-4023. National Center for Education Evaluation and Regional Assistance. http://files.eric.ed.gov/fulltext/ED573325.pdf
MacDonald, N. E., Harmon, S., Dube, E., Steenbeek, A., Crowcroft, N., Opel, D. J., ... & Butler, R. (2018). Mandatory infant & childhood immunization: Rationales, issues and knowledge gaps. Vaccine, 36(39), 5811-5818. https://doi.org/10.1016/j.vaccine.2018.08.042
Mat Daud, M. R. H., Yaacob, N. A., Ibrahim, M. I., & Wan Muhammad, W. A. R. (2022). Five-year trend of measles and its associated factors in Pahang, Malaysia: A population-based study. International Journal of Environmental Research and Public Health, 19(13), 8017. https://doi.org/10.3390/ijerph19138017
Matta, P., El Mouallem, R., Akel, M., Hallit, S., & Fadous Khalife, M. C. (2020). Parents’ knowledge, attitude and practice towards children’s vaccination in Lebanon: Role of the parent-physician communication. BMC Public Health, 20(1), 1439. https://doi.org/10.1186/s12889-020-09526-3
Ministry of Health Malaysia [MOHM] (2019). Annual Report Ministry of Health 2019; Ministry of Health Malaysia: Putrajaya, Malaysia.
Mohd Rosman, H. W. M., Yong, C. L., Azman, M. U., & Ishar, M. I. M. (2020). The health issue in orang Asli community. Malaysian Journal of Social Sciences and Humanities (MJSSH), 5(2), 36-41. https://doi.org/10.47405/mjssh.v5i2.360
Okello, G., Izudi, J., Teguzirigwa, S., Kakinda, A., & Van Hal, G. (2020). Findings of a cross‐sectional survey on knowledge, attitudes, and practices about COVID‐19 in Uganda: Implications for public health prevention and control measures. BioMed Research International, 2020(1), 5917378. https://doi.org/10.1155/2020/5917378
Opel, D. J., Taylor, J. A., Mangione-Smith, R., Solomon, C., Zhao, C., Catz, S., & Martin, D. (2011). Validity and reliability of a survey to identify vaccine- hesitant parents. Vaccine, 29(38), 6598-6605. https://doi.org/10.1016/j.vaccine.2011.06.115
Oyo-Ita, A., Wiysonge, C. S., Oringanje, C. et al. (2023). Interventions for improving coverage of childhood immunisation in low- and middle-income countries. Cochrane Database Syst Rev, 7.
Pallant, J. (2020). SPSS survival manual: A step by step guide to data analysis using IBM SPSS. Routledge.
Petu, A., Masresha, B., Wiysonge, C. S., Mwenda, J., Nyarko, K., Bwaka, A., ... & Moeti, M. R. (2025). Reflections on 50 years of immunisation programmes in the WHO African region: An impetus to build on the progress and address the unfinished immunisation business. BMJ Global Health, 10(5). https://doi.org/10.1136/bmjgh-2024-017982
Rainey, J. J., Watkins, M., Ryman, T. K., Sandhu, P., Bo, A., & Banerjee, K. (2011). Reasons related to non-vaccination and under-vaccination of children in low and middle income countries: Findings from a systematic review of the published literature, 1999–2009. Vaccine, 29(46), 8215-8221. https://doi.org/10.1016/j.vaccine.2011.08.096
Ridzuan, M. R., Abd Rahman, N. A. S., Manas, N. H. N., Rabun, M. N., & Ju, S. Y. (2022). A descriptive study on the malaysian parents' HPV vaccination intentions. Journal of Academia, 10(1), 132-140
Sendekie, A. K., Abate, B. B., Adamu, B. A., Tefera, A. M., Mekonnen, K. T., Ashagrie, M. A., ... & Bizuneh, G. K. (2025). Human papillomavirus vaccination hesitancy among young girls in Ethiopia: Factors and barriers to uptake. Frontiers in Public Health, 13, 1507832. https://doi.org/10.3389/fpubh.2025.1507832
Shati, A. A., Alqahtani, S. M., Asser, A. A., Alhanshani, A. A., Alqahtani, Y. A., Alshahrani, A. O., ... & Alamri, M. S. (2021). Mothers’ knowledge and attitude towards childhood immunization in Aseer region, Southwestern Saudi Arabia. Ethiopian Journal of Health Development, 35(4), 289–96.
Shattock, A. J., Johnson, H. C., Sim, S. Y., Carter, A., Lambach, P., Hutubessy, R. C., ... & Bar-Zeev, N. (2024). Contribution of vaccination to improved survival and health: Modelling 50 years of the Expanded Programme on Immunization. The Lancet, 403(10441), 2307-2316. https://doi.org/10.1016/s0140-6736(24)00850-x
Sinnokrot, Z., Zeidan, S., Abu Salah, K., Zuaiter, B., & Hallak, H. (2025). Knowledge of Neonatal Danger Signs Among Mothers Attending Vaccination Centers in Central West Bank: A Cross‐Sectional Study. Health Science Reports, 8(5), e70765. https://doi.org/10.22541/au.171786042.25136149/v1
Smith, P. J., Chu, S. Y., & Barker, L. E. (2004). Children who have received no vaccines: Who are they and where do they live?. Pediatrics, 114(1), 187-195. https://doi.org/10.1542/peds.114.1.187
Soveri, A., Karlsson, L. C., Mäki, O., Antfolk, J., Waris, O., Karlsson, H., ... & Lewandowsky, S. (2020). Trait reactance and trust in doctors as predictors of vaccination behavior, vaccine attitudes, and use of complementary and alternative medicine in parents of young children. PloS one, 15(7), e0236527. https://doi.org/10.1371/journal.pone.0236527
Szalast, K., Nowicki, G. J., Pietrzak, M., Mastalerz-Migas, A., Biesiada, A., Grochans, E., & Ślusarska, B. (2025). Parental attitudes, motivators and barriers toward children’s vaccination in Poland: A scoping review. Vaccines, 13(1), 41. https://doi.org/10.3390/vaccines13010041
Torun, G., Ar, I., Akgenҫ, F., & Karahan, A. (2025). The mediating effect of E-health literacy on health belief model-based vaccine attitudes among parents in Türkiye: A cross-sectional study. BMC Public Health, 25(1), 1952. https://doi.org/10.1186/s12889-025-23135-y
Toshkov, D. (2023). Explaining the gender gap in COVID-19 vaccination attitudes. European Journal of Public Health, 33(3), 490-495. https://doi.org/10.31219/osf.io/m6qkn
United Nations International Children’s Emergency Fund. (2023). Health. https://www.unicef.org/health
United Nations. (2023). Transforming our world: The 2030 agenda for sustainable development. https://sdgs.un.org/2030agenda
Verulava, T., Jaiani, M., Lordkipanidze, A., Jorbenadze, R., & Dangadze, B. (2019). Mothers’ knowledge and attitudes towards child immunization in Georgia. The Open Public Health Journal, 12, 232-237. https://doi.org/10.2174/1874944501912010232
Wang, T. C. L., Zhang, M. J., & Zhang, H. (2025). Examining the impact of sex-biased information on health behaviors: A study of HPV vaccination among male college students based on the extended theory of planned behavior. Frontiers in Public Health, 13, 1525547. https://doi.org/10.3389/fpubh.2025.1525547
Wilson, J. B., Deckert, A., Shah, R., Kyei, N., Dahn, L. C., Doe-Rogers, R., ... & Thomas-Connor, I. (2021). COVID-19-related knowledge, attitudes and practices: A mixed-mode cross-sectional survey in Liberia. BMJ Open, 11(7), e049494. https://doi.org/10.1136/bmjopen-2021-049494
Zhou, F. (2024). Health and economic benefits of routine childhood immunizations in the era of the Vaccines for Children program—United States, 1994–2023. MMWR. Morbidity and Mortality Weekly Report, 73, 682–685. https://doi.org/10.15585/mmwr.mm7331a2
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Nur Hidayahtul Nabihah Manas, Mohd Rozaimy Ridzuan, Noor Amira Syazwani Abd Rahman, Muhammad Redzuan Osman, Muhammad Iqbal M. Pd

This work is licensed under a Creative Commons Attribution 4.0 International License.




