Barriers to measles mumps rubella vaccine acceptance in the three southern border provinces of Thailand

PURPOSE: This qualitative study utilizing phenomenological methodology aimed to depict parental measles mumps rubella (MMR) vaccine acceptance through the work experiences of health personnel. MATERIALS AND METHODS: Twenty-two public health workers working as vaccination providers in the three southern border provinces of Thailand were recruited. In-depth, face-to-face, semi-structured interviews were conducted. Data were analyzed using thematic analysis. RESULTS: Four main themes emerged: (1) religious beliefs, (2) personal disagreements, (3) fear and mistrust regarding potential vaccine side effects, and (4) misperceptions about the potential severity of measles. Four subthemes were identified: (1) haram (prohibited), (2) the will of Allah, (3) spousal disagreement, and (4) disagreement from a religious leader. The results of this study indicated that perceived religious prohibition was the most important reason for refusing to vaccinate among Muslim parents. Vaccine-hesitant parents were concerned that the vaccine might contain gelatin derived from pig products. Also, halal certification of the vaccine was required from Muslim parents to ensure that vaccine has been approved for Muslims. Meanwhile, a lack of knowledge and positive attitudes concerning immunizations of vaccine-hesitant parents were also found as predominant reasons for incomplete childhood immunizations in the deep south of Thailand. CONCLUSION: Health education and engagement by religious leaders to endorse the vaccination and bridge the gap between religious beliefs and vaccine acceptance is needed to overcome this issue. This study findings could be effectively applied to improve vaccination uptake in a Muslim majority context.