1

CHAPTER I

INTRODUCTION

The Corona Virus was considered an epidemic that commenced in

December 2019 in the city of Wuhan, which is located in the central region of

China, reported by the Department of Health1 (DOH). According to genomic

researchers, the COVID-19 virus originated in bats and was transmitted to

humans at the Wuhan seafood market in China via unknown definitive hosts.

The early symptoms of SARS and COVID‐19 are very similar, this includes

fever, cough, headache, shortness of breath, and breathing difficulties. The

rapid progression of this pandemic necessitates comparisons to preceding

epidemics in order to assess transmission and infection patterns. The rapid

spreading of the Corona virus caused turmoil. In 2020, January, the World

Health Organization (WHO) identified this coronavirus as the 2019-novel

coronavirus (2019-nCoV) and the organization declared the outbreak a Public

Health Emergency of International Concern on the 30 th of January 2020, and

a pandemic on the 11th of March 2020.

According to the United Nations Conference on Trade and

Development2 in 2020, as the COVID-19 turmoil started, the international

trade came to a halt and the worldwide economy was disrupted. The World

Health Organization has been extremely responsive, collaborating with

governments all across the world. International action plan towards the spread

of the virus included a high level of safety precaution severity including

restriction of travel and any means of transportation. Under Section 2 of

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Executive Order No.168 Series of 2014 the Inter Agency Task Force for the

Management of Emerging Infectious Diseases (IATF) is mandated to prevent

and minimize the local spread of emerging infectious diseases (EID) in the

country. In addition, the United Nations General Assembly proclaimed that

lawmakers need to take precautionary measures to control the condition of

international trade and the transport of goods aligned to the health safety of

the people.

Since COVID‐19 has spread around the world with nearly no region left

untouched, according to PMC3, the speed of the spread and the distressing

death rates have gotten many countries and jurisdictions to introduce

measures to prevent the spread of COVID‐19. During the COVID‐19

pandemic, handwashing indeed garnered a lot of attention. It is a primary

precautionary measure that most of us can do on our own. The first line of

defense in stopping the spread of infection is hand-washing with soap and

water for at least 20 seconds or the use of alcohol‐based hand sanitizers

when soap and water are not accessible (CDC 2020). Nevertheless, there is

sufficient proof that many years before the epidemic, hand-washing among

healthcare workers (HCW) remained an area that needed improvement (CDC

2019, Erasmus et al., 2010).

WHO4 made note that the public should wear masks, according to

who.int. Masks should be used as part of an overall strategy of measures to

subdue transmission and save or protect lives. In accordance with the

Republic Act 11469 or the act declaring the existence of a national emergency

arising from the Corona Virus Disease 2019 (COVID-19) situation, a national

policy and connection, therewith, authorizes the president of the Republic of

 3

the Philippines for a limited period and subject to restrictions and to exercise

power necessary to carry out the declared national policy. With that, it is

strictly advised to stay safe by taking some simple precautions other than

wearing a mask: such as physical distancing, keeping rooms well ventilated,

avoiding crowds, cleaning hands, and coughing into a bent elbow or tissue. It

is also important to check local advice where you live and work. The

appropriate use, storage and cleaning or disposal of masks is needed to make

masks more helpful and effective. However, the use of a mask and

implementation of these restrictions alone are not sufficient to provide an

adequate level of protection against COVID-19.

As a consequence, this worldwide health crisis urged society to

formulate a strategic immunization plan against the virus which we now

recognize as the vaccines. In conformity with an article from the Journal of

Biomedical Science written by Yen, D. et al.’s (2020) 5, the formulation of the

vaccines, considering the high mortality rate and rapid spread, requires the

immediate and critical attention to put a stop to the CoronaVirus. It led to the

development of various vaccines at an unprecedented pace. According to the

World Health Organization6, these vaccines consist of fragments of the

disease-causing organism alongside other ingredients to ensure the safety

and efficacy of the action. It is thoroughly tested with components such as

antigens, preservatives, stabilizers, surfactants, adjuvants, residuals, and

diluents all working together to provide the purpose of vaccines. To

understand how vaccines help in the prevention of the continuous spread of

COVID-19, cdc.gov (2021)7 explained that it challenges our bodies to create

antibodies against illnesses that will invade us through the shot of the vaccine.
 4

The vaccines are claimed to be safe since they underwent a number of clinical

trials. It offers protection through the “memory” of T-lymphocytes as well as B-

lymphocytes in fighting the virus in the future. The worldwide health sectors

also assure fair and rightful access to vaccines especially among the most

vulnerable. With this being said, there are numerous named vaccines already

available for citizens in respective countries.

Since the spread of COVID-19, the provision and development of

different vaccines are continuously introduced. Some of the vaccines

recognized and authorized widely by WHO, with the number of countries of

their full availability, are hereby as follows: Oxford-AstraZeneca (2), Pfizer-

BioNTech (11), Jannsen (2), Moderna (4), Sinopharm BIBP (4), Sputnik V (2),

CoronaVac (1), Convidecia (1), Sinopharm-WIBP (1), EpiVacCorona (1).

There are also inactivated vaccines such as Covaxin, Sputnik Light, Abdala,

Zifivax, Soberana 02, QazCovid-in, CoviVac, Minhai, COVIran Barekat,

Chinese Academy of Medical Sciences, Medigen, ZyCov-D, COVAX19,

CovaVax, NovaVax, and others. There are eight available and present

vaccines in the Philippines with Emergency Use Authorization (EUA)

approvals by Philippine Food and Drug Administration (DOH-Philippines,

2021). These are the Pfizer-BioNTech, Oxford AstraZeneca, CoronaVac

(SinoVac), Gamaleya Sputnik V, Johnson and Johnson’s Janssen, Bharat

BioTech, Moderna, and Sinopharm. Some of the developed vaccine requires

two shots or two doses to be granted as a fully vaccinated citizen. However,

vaccines alone won’t work towards the eventual end of this virus rampant.

Republic Act No. 11525—an act establishing the CORONAVIRUS DISEASE

(COVID-19) VACCINATION programs expediting the vaccine procurement

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with the allocated funds was administered in our country. Since the first

arrivals of the batch of vaccines, the immunization programs and vaccinations

in the Philippines started to roll in March 1, 2021— shortly after the conducted

dry-run. As of November 7, 2021, a total of 64,195,936 COVID-19 vaccine

doses have been already administered within our country and 29,477,961

individuals nationwide are now fully vaccinated as mentioned in an article by

Geducos8 (2021).

According to the Republic Act No. 7160, also known as Local

Government Act of 1991, under section 16— it mandates the LGU entity to

exercise the powers given, as well as powers necessary, appropriate, or

incidental for its efficient and effective governance, and those that are vital to

the promotion of the general welfare. Local government units must ensure and

support, among other things, the preservation and enrichment of culture, the

promotion of health and safety, the enhancement of the people's right to a

balanced ecology, the encouragement and support of the development of

appropriate and self-reliant scientific and technological capabilities, the

improvement of public morals, the enhancement of economic prosperity and

social justice, and the promotion of full employment among their residents

within their respective territorial jurisdictions. Filipino individuals' assistance

would aid in the recognition of vaccination as a viable and valuable response

to the global threat posed by this disease. It goes without saying that it would

also provide extra protection against COVID-19. With all of the new laws and

regulations circulating in our country, there are some concerns and

reservations about these specific health plans.

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According to Altulaihi et al (2021) 9, this is the parents’ acceptability

towards their children’s inoculation against COVID-19: 53.7% of the parents

were willing to vaccinate their children, on the other hand 27% were reluctant

to do so. Those who refused cited that the most common reasons for not

accepting COVID-19 vaccine are the lack of information and evidence each

with a percentage of 97.5% and 96.6%, respectively. With all of these being

said, the study aims to determine the extent of awareness of parents towards

their child’s vaccination, and its relation to their perception on their child’s

immunization. In addition, the research seeks to identify the factors that affect

their attitude towards the vaccination.

STATEMENT OF THE PROBLEM

This study is to determine the factors affecting parents perception

towards pediatric vaccination as basis in identifying programs and

interventions in improving vaccination awareness in Barangay Piot.

1. What is the extent of awareness of parents towards Pediatric

Vaccination?

2. What is the level of parent’s acceptability towards pediatric

vaccination?

3. Is there a significant difference between the level of parents’

acceptability towards Pediatric Vaccination and extent of awareness?

4. What are the gaps and issues encountered by the parents in Pediatric

Vaccination?
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5. What could be proposed based from the result of the study?

SCOPE AND DELIMITATION

This study focuses on the factors affecting the perception of parents

towards pediatric vaccination. It covers the extent of awareness, level of

acceptability and gaps and issues encountered by the respondents in

Barangay Piot, Sorsogon City, ranging through an estimated number of 85

participants. The study will involve parents with children who are 5 years old

up to 15 years old in the survey.

It does not cover children’s opinion, for it is already given that they are

not very much aware of this topic, thus, researchers will gather information

from the children’s parents instead. The participants are solely from Barangay

Piot, Sorsogon City, outside of this barangay are not included. This study does

not include other vaccines for immunization such as Dengvaxia, OPV, etc. for

this will only focus on the COVID 19 Vaccine implementation. .

SIGNIFICANCE OF THE STUDY

The Corona Virus Disease also known as Covid-19 had caused a

wicked impact to every individual and the society as a whole. The

development of vaccines was the start of abolishing the pandemic. This study

will aid in determining the level of awareness of parents towards child

vaccination. This is a guide for individuals to have a better apprehension of

parents’ opinion and existing knowledge about immunization.

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Parents - This study will serve as a guide for Parents to evaluate their

opinion, knowledge, and perception towards their child’s inoculation.

Pediatric Group - The result of the study will impact child’s immunization

towards Covid-19 aligned with their parent’s opinion, knowledge and level of

awareness.

Local Government Unit - The findings of the study will provide basis for the

LGU to improve their awareness campaign about vaccination.

Department of Health - This study will provide statistical record for the

department to innovate their administrator towards Covid-19 vaccination.

Researchers - This study may be used as reference in conducting new

researchers or in testing validity of other related findings.

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NOTES

1
Department of Health “WHERE DID THE COVID-19 ORIGINATE?”.2020.

2
United Nations Conference on Trade and Development (UNCTAD)

“COVID19: A 10-point action plan to strengthen international trade and

transport facilitation in times of pandemic”.

3
PMC “COVID‐19 reinforces the importance of handwashing”.2020.

4
World Health Organization (WHO) “Coronavirus disease (COVID-19) advice

for the public: When and how to use masks”.2020.

5
Der Li et al “Coronavirus vaccine development: from SARS and MERS to

COVID-19” .2020.

6
World Health Organization (WHO) “How are vaccines developed?”.2020.

7
CDC.GOV “Understanding How COVID-19 Vaccines Work”.2021.

8
Geducos “No vax, no 4Ps subsidy' policy is 'valid' but law must be amended,

says Roque”.2021.

9
Altulaihi et al “Perception of Parents Towards COVID-19 Vaccine for Children

in Saudi Population”.2021.
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CHAPTER II

REVIEW OF RELATED LITERATURE AND STUDY

This chapter includes a review of related literatures and studies that

are relevant to the current research. It also involves a synthesis of the state-

of-the-art, a study gap bridged, a conceptual framework, and a hypothesis.

RELATED LITERATURE

According to Buonsenso1 et al, COVID-19 is rarely severe in the

pediatric population, the pandemic's indirect costs which are related to the

measures put in place to combat the virus's spread may be greater than the

infection itself. To assess this issue, we count the number of children who

were vaccinated or evaluated for the most common diseases in a poor village

in Sierra Leone, finding a concerning drop in vaccinations and children who

are evaluated for acute diseases. Our preliminary findings indicated that

assistance is required to ensure basic services to children during the COVID-

19 pandemic, particularly in low-income settings where preventive measures

can be lifesaving in the long run. The key to controlling the COVID-19

pandemic is announced to be the availability of covid19 vaccine according to

the book, “Vaccine.” The willingness of the public to get vaccinated will

determine the success of COVID 19 vaccination programme.

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Ali2 states that the COVID-19 pandemic provides various significant

challenges, affecting not only public health but also economic systems,

sociocultural patterns, and political institutions. Several studies have been

conducted to investigate the links between complex emergencies and natural

disasters and outbreaks of infectious diseases. There is, however, a scarcity

of relevant literature on the impact of a global pandemic on vaccination

programs – an important topic because delays or halts in such programs are

likely to result in outbreaks and epidemics of other infectious diseases. As a

result, this article discusses the potential negative and positive effects of the

COVID-19 pandemic on vaccination for vaccine-preventable diseases

(VPDs). The increased risk of VPD outbreaks in low-resource countries,

where vaccination programs must be temporarily put on a halt to prevent

infection spread, is one of the negative consequences. Positive effects

included the strong possibility that the widely recognized need for a

coronavirus vaccine will increase people's appreciation for vaccines in

general, leading to increased vaccination uptake once the pandemic has

passed. Concerned stakeholders, such as governments and the World Health

Organization (WHO), should seize this opportunity to build on these positive

outcomes by planning renewed and revitalized post-COVID vaccination

programs.

According to Zimmermann3 et al, an on-going debate remains whether

all children under 12 years old should be vaccinated against the virus,

Covid19. The balance of risk and benefit of vaccination in this age is more

complicated since there was said to be low risk posed by severed covid19 in
 12

children and thus danger from vaccination and disease. Protecting them from

consequences that are said to be long-term were one of the main arguments

for vaccinating healthy children. And in the article, other reasons for

vaccinating children under the age of 12 states, “Other considerations include

population-level factors, such as reducing community transmission, vaccine

supply, cost, and the avoidance of quarantine, school closures and other

lockdown measures. The emergence of new variants of concern necessitates

continual re-evaluation of the risks and benefits. In this review, we do not

argue for or against vaccinating children against COVID-19 but rather outline

the points to consider and highlight the complexity of policy decisions on

COVID-19 vaccination in this age group.”

Accordance to this, Altulaihi4 et al states that vaccination s the

breakthrough solution for this pandemic. However, it is shown that as

pediatric vaccination is in the talk of getting established, a percentage of 27%

among parents claims reluctant to agree so. Among those opposed, 97.5%

and 96.6% cited lack of knowledge, information and evidence as their most

common reasons towards vaccine hesitancy. These parents, who are given a

chance to protect their children from the outbreak, also fear the possible

complications brought by these vaccines.

Temsah5 et al states that there is a significant increase in parental

anxiety arising due to newly emerged COVID vaccines. Common reasons are

inadequate safety information (69%) and doubts about the possible

complications that comes with the vaccine. In conclusion, parents are less
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confident towards the developed vaccines in COVID19 than in the routine

childhood vaccination process that they see more essential and effective.

In a journal by Dela Cruz 6 et al, it is stated that according to a recent

correspondence, two important characteristics of government officials are

public service and common good. These two characteristics ca help the

government promote the Philippines' vaccination program. This paper

proposes transparency as the third quality of good governance in building

people's confidence and trust in getting vaccinated as another fundamental

characteristic among government leaders. The local government unit of

Borongan City in the Philippines' Eastern Samar considers transparency to be

critical in boosting residents' confidence in the safety and efficacy of COVID-

19 vaccines.2 Citizens have the right to know what is going on in this public

health crisis, particularly government health programs. To alleviate public

fear, the government must also be vigilant in informing the public about the

results of clinical trials of the COVID-19 vaccines. People are hesitant to

receive the vaccine due to its potential side effects.3 In the Philippines,

people are hesitant due to the Dengvaxia controversy in February 2018, after

the alleged vaccine resulted in over 100 deaths.4 Thus, one way to regain

Filipinos' confidence in vaccination is for the government to be transparent in

the planning and implementation of the vaccination program.

According to Mendoza7 et al, while the rest of the world prepares for

and begins to distribute COVID-19 vaccines, the Philippines is still reeling

from the fallout from the Dengvaxia scandal in 2016. These highly political
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events eroded public trust in leaders and significantly harmed vaccine

confidence in the country, potentially affecting COVID-19 vaccine uptake. We

discuss how public trust and confidence can be restored through

accountability, transparency, and proper communication from the population's

most trusted sources. We also highlight key lessons for policymakers and

leaders on allowing science to take the lead and politics to follow in order to

ensure people's safety and well-being during this public health crisis.

According to Vallejo8 and Ong, uncertainties remain and questions are

continuously posed due to the rapid action of science expertise available. The

timescales of conducting research in a usual pace differs from the insinuated

practice for research (also in vaccines) during a crisis. This leads to the sole

measurement of positive outcomes based on lives saved, injuries reduced,

speed of recovery, development of mitigation tools for future disasters (or

vaccines), and more so. However, the collaborative practices in science are

said to be not suitable for the compressed time frames in a crisis which

sparks more doubt towards science communication.

Fatima and Syed9 highlights vaccine hesitancy raging from the impact

of the Dengvaxia controversy. After Sanofi, one of the biggest multinational

pharmaceutical companies, developed the first dengue vaccine called

Dengvaxia, it is already administered in almost 19 countries including the

Philippines and involved almost 800000 school children in our country alone.

Considering the dengue outbreaks’ infection rate rising up to 90%, most

parents trusts the Sanofi with their child’s inoculation. However, Sanofi’s
 15

recent discovery shook the hearts and minds of parents as they announced

that this protection was more apparent and would be more effective for

children who already had dengue. It means that those who did not have

dengue before are now facing risks of a more severe form of the disease and

hospitalizations brought by Dengvaxia. Ten percent or almost 80000 children

who did not have a prior history of dengue increased their risk of developing

severe dengue. Due to the fear instilled by the controversy, parents now

refuse or delay the acceptance of vaccines despite the availability of

vaccination services. They also associate emerging diseases of children to

the inoculation of the risky vaccine. Concern about the risk happening again is

their dominant reason. Here arises the phenomenon called “vaccine

hesitancy”. With this, mass education programs, awareness campaigns,

conferences, and media outlets work hand in hand to avoid confusion, fear,

misconceptions and skepticism especially in the linkage of this controversy to

the success rate of the decrease of mortality and morbidity of various

infectious diseases worldwide and to the acceptability of future vaccines in

presence of a crisis.

Coinciding with Yu10 et al, states that even though various anxiety

alters the perception towards child inoculation by spreading mistrust and fear

—in the advent of COVID-19 vaccinations, the involvement of responsible

journalism especially media, crisis communication and health and people-

centered paradigm(campaigns) exploring local contexts and lived experiences

of vaccine hesitancy is deemed important. Coinciding with Yu, Lasco, and

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David’s article in 2021, this suggests the apprehension of present and future

tackled crisis.

RELATED STUDIES

Almomani11 et al states that vaccine hesitancy was described by the

World Health Organization Strategic Advisory Group of Experts as the refusal

of vaccination despite the availability of the service. There were three factors

determined that assess the acceptability of vaccination. First, was confidence,

which is defined as the trust for the efficiency of the vaccines, healthcare

system and the policy-makers. Second, is convenience which is referred to

the availability, affordability, and accessibility of the vaccines. Lastly, are

vaccines complacency, which is determined as correlated with a low

perceived risk of a vaccine-preventable disease and, as a result, more

negative attitudes about the vaccine.

According to Bell12 et al, the majority of survey respondents say they

would most likely accept a COVID-19 vaccination for themselves, 55.8% were

definite; uncertain but leaning towards yes were 34.3% and for their children

48.2% were indefinite, while 40.9% were unsure. Only 4% of poll respondents

said they would never accept a COVID-19 vaccine. Participants in the survey

were more inclined than their child/children to accept a COVID-19 vaccine for

themselves. People who identified as Black, Asian, Chinese, Mixed, or other

ethnicity were nearly three times more likely than White British, White Irish,
 17

White, and other participants to reject the COVID-19 vaccine for themselves

and their children. Low-income survey participants were also more likely to

refuse the COVID-19 immunization. Self-protection against COVID-19 is cited

as the primary reason for vaccine acceptability in the conducted open-text

replies and interviews. The safety and efficiency of the COVID-19 vaccine

were among the most common concerns expressed in open-text replies and

interviews, owing to the vaccine's newness and rapid development.

As attested by Wake13 27.7% to 91.3% of the participants were willing

to receive the COVID-19 vaccine in Congo and China. The trust in healthcare

system, perceived vaccine barriers, self-efficacy, up-to-date on vaccinations,

tested for COVID-19 in the past, perceived efficacy of the COVID-19

vaccination, recommends for vaccination, political leaning, perceived severity

of COVID-19, perceived effectiveness of COVID-19 vaccine, and believing in

mandatory COVID-19 vaccination were some of the contributing factors that

affect the acceptability rate of COVID-19 vaccine.

Facc14 et al examine parents’ judgments about vaccine-preventable

diseases, specifically Pertussis, measles, and poliomyelitis. The vaccine

hesitancy and overview on parent’s opinions about vaccinations and possible

reasons for vaccine refusal could be correlated with the parents’ age and level

of education. The parents with a favorable opinion are highly influenced by

the physician's or a professional’s opinion. On the other hand, an unfavorable

parent's perspective appeared to be influenced by direct or indirect

knowledge of people who were harmed by the vaccination. Moreover, data

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analysis revealed that while parents were conceptually supportive of

immunizations, they have limited awareness about such activities.

Wang15 et al found that the development of COVID-19 vaccine in China

was progressing at an unprecedented rate. In order to document the

statistical acceptance of the public regarding the COVID-19 vaccination

during the pandemic, a survey was conducted containing questionnaires that

collected information concerning socio-demographic variables, risk

perception, the impact of COVID-19, attitudes, acceptability, and attribute

preferences for COVID-19 vaccines among 2,058 participants. The

acceptance of COVID-19 vaccination was evaluated and the results were;

1879 people (91.3%) said they would accept COVID-19 inoculation whenever

it became available, 980 (52.2%) said they wanted to get vaccinated as soon

as possible, and others (47.8%) stated that they would wait until the vaccine's

security and efficacy was confirmed. In conclusion, The Chinese people have

demonstrated a significant demand for and acceptance of COVID-19

immunization. The participants believing in the efficacy of COVID-19

vaccination or valuing doctor's guidelines may increase the chances of people

taking part accepting COVID-19 vaccination, whereas valuing inoculations

comfort or vaccine cost in decision-making might deter attendees from

receiving COVID-19 vaccination immediately.

Bautista16 et al stated that 71% of 137 willing participants of the study

wanted to take the COVID-19 vaccine if it becomes available, with similar

rates in Caloocan (82%), Malabon (83%), and Navotas (83%). More

respondents (82%) will take a COVID-19 vaccine if it was proven to be safe

 19

and effective. Furthermore, respondents' willingness or unwillingness to

obtain a vaccine is primarily based on their safety and effectiveness against

COVID-19, as well as the safety and effectiveness of vaccines. The findings

highlight the importance of effective messaging that promotes COVID-19

vaccination, with a focus on the vaccine's safety and effectiveness, as well as

its public health benefits, especially given that the vaccines that will be

delivered in the country in the coming months are not the respondents'

preferred brands.

Reñosa17 et al who’s focused in the Philippines said that vaccine trust

has dropped since a dengue vaccine issue erupted in late 2017, leading to

measles and polio epidemics in early 2019. The vaccine manufacturer's

release of fresh findings on a modest but elevated risk of severe dengue for

vaccinated seronegative patients sparked outrage, with many people claiming

that the vaccination was to blame for deaths and that health officials were

dishonest. The negative history of vaccination resulted in public trust in

vaccines to plummet, posing a serious threat to the public health system.

Migriño18 et al found out that 95.5% of mothers ages 20-39 years old,

perceived vaccines as protection, while the hesitancy rate reached 36.4%.

Respondents who believed vaccines were protective were less likely to

indicate vaccine reluctance, and nine times less likely to decline vaccination

for their children due to unfavorable media exposure. Exposure to negative

media material and concerns about vaccine safety were the most common

reasons for vaccine uncertainty. The dengue vaccine, Dengvaxia, was the
 20

biggest source of unfavorable media material cited by the respondents.

Vaccination was strongly supported in the community by health-care

personnel and political leaders.

According to Cardenas19, a vaccine introduction preparedness

assessment tool was created and promoted by the World Health

Organization. In implementing the government's COVID-19 immunization

program, it was stated that public officials should not take away the

constitutional right of human freedom. That is to say that the government's

primary responsibility in the acquisition and dissemination of COVID-19

vaccines is to be honest and systematic in order to build trust and persuade

the public in receiving the vaccine. Despite the said fundamental right of

freedom, the proposed bill of Philippines' recent House Bill 9252, also known

as the 'Mandatory COVID-19 Immunization Act of 2021,' said otherwise as the

bill included declaration of mandatory vaccination. All Filipinos are said to

receive the immunization available at any government hospital or health

center, except for those who are suffering from medical conditions. Since

vaccination is considered needed and a requirement, choices of vaccine were

encouraged.

As stated by Chootipongchaivat20 et al, every healthcare system relies

heavily on human resources which is why vulnerable low- and middle-income

countries are the countries susceptible to limited healthcare access. As the

demand for healthcare services rises, shortages might cause the healthcare

system to become unstable. Furthermore, adding health interventions or

technologies would always have an impact on human resource consumption.

 21

On the other hand, Vaccines were a fundamental development in human

resources considering that it was a long-term investment in the prevention of

various diseases. The findings highlight that investing in Vaccination

programs and agendas could raise the current demand for specific forms of

human resources while decreasing future demands for the healthcare system.

Evidence-based economic policies should consider both the HRH (Human

resources for Health) that were necessary and those that were saved as a

result of immunizations. As a result, the purpose of this research was to

estimate the human resources for health that would be required and reduced

as a result of the introduction of the pneumococcal conjugate vaccination

(PCV). As a result, the required vaccination would aid in avoiding the future

economy from plummeting.

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SYNTHESIS OF THE STATE-OF-THE-ART

The researchers presented various related literature and studies

regarding the study of the parent’s/guardian’s perception towards children’s

vaccination. To have a clearer understanding and in-depth analysis of these

literature and studies, the researchers made a synthesis on the succeeding

discussion.

The works of Almomani, Visalli, and Reñosa underscored the main

reasons for Vaccine Hesitancy. The stated main factors for vaccine hesitancy

are as follows: First, refusal of the vaccine despite the availability of service.

Vaccines are effective treatments that can help to lessen the global illness

impact. Public acceptance of the immunization is to be measured by its

efficiency, conveniency, and complacency of the vaccination. The awareness

and judgment of the parent being correlated with the parents age and level of

education. Negative history of vaccination resulted in public trust in vaccines

to plummet posing a severe threat to the public healthcare system.

Relevant to this, Migriño emphasized that the most common reasons

for vaccine uncertainty were exposure to negative media content and

concerns about vaccine safety. According to the investigated conducted

study, the result of the statistical data shows that 95.5% of mothers ages 20-

39 years old, perceived vaccines as protection and was favorable to the

vaccine, while 36.4% were hesitant about the vaccination. In addition, a local

study by Bautista highlighted that the respondents' inclination or reluctance to

receive the vaccine is mostly based on the vaccine's safety and effectiveness
 23

against COVID-19. The choices of the vaccine brand also affect their

acceptance of the inoculation.

Moreover, Altulaihi, Temsah, and Berenson explained another factor

that affects the acceptance of vaccination. Even though vaccines are the main

considered solution for this pandemic, it was discovered that while pediatric

vaccination is in the process of being implemented, the parents are hesitant to

accept it. The most common reasons for vaccine hesitancy among those

unfavorable were a lack of understanding, information, and evidence. These

parents, who have been given the opportunity to safeguard their children from

the outbreak, are equally concerned about the vaccines' potential side effects.

Berenson asserted in his work in "Unreported Truths About Covid-19 and

Lockdowns: Part 4: Vaccines" that pharmaceutical companies should be

transparent about the new vaccines because the public has little to no

knowledge about vaccines that began in 2020.

One of the considered key factors in instilling public confidence and

trust in government officials is transparency. It is considered as the third

element of good governance. Dela Cruz stated that such positive

characteristics of the government could help in promoting the vaccination to

the public. Furthermore, Mendoza, Fatima and Syed discussed the

controversy regarding Dengvaxia that resulted in vaccine hesitancy, which is

why in order to avoid further confusion, misunderstandings and fear. Mass

education programs, awareness campaigns, conferences, and media outlets

collaborated to avoid or at least lessen this negative reputation of vaccines

that might affect the future presence of vaccines. From these reviewed texts,
 24

the researcher was able to come up with a clear discussion of their work in

line with the cited texts. The researchers made a synthesis on the succeeding

discussion.

Gap Bridged by the Study

This study aims to determine factors affecting parents' perception

towards pediatric vaccination aligned with programs and interventions

heightening vaccination awareness.

There already have been numerous authors who studied and wrote

about vaccine hesitancy of parents concerning their child’s inoculation which

helped the researchers gain more knowledge towards this particular issue.

Their emphasis is more on the general aspect of vaccine development. Most

of the studies are limited tackling self-protection and general vaccine

programs alongside these factors that outraged and impacted the unanimous

say towards vaccination. On the other hand, this study differs from the

previous research since it will not only cover factors that influence parents’

perceptions towards pediatric vaccination alone but would also cover their

level of awareness and test the significant difference between the level of

awareness and parents acceptability. Moreover the researchers will provide a

community action plan to address the aforementioned issue.

THEORETICAL FRAMEWORK
 25

This research is premised on some of the theories reviewed in this

study.

This research is affiliated with the Belief Bias. The theory of belief bias

states that an individual’s beliefs might easily blind them and lead them to the

wrong conclusion. Various reasoning tasks, including conditional reasoning,

connection reasoning, and transitive reasoning, have been found to be

influenced by their personal hypothesis and belief bias. People tend to

interpret information that ‘only’ supports their knowledge about the subject

without considering the broad spectrum of the information that can be gained.

This concept focuses on motivated reasoning where an individual rationalizes

to throw aside arguments against their priors.

The second theory that this study is anchored in is the theories by

Fishbein and Ajzen’s, which is the Theory of Planned Behavior, wherein it

indicates that the changing of behavior is affected and influenced by beliefs.

Behavioral intent is a fundamental component of this theory; behavioral

intentions are impacted by one's perspective about the probability that the

conduct will produce the anticipated results, as well as one's personal

assessment of the risks and advantages of that occurrence. The hypothesis

was designed to describe all behaviors over which humans can exercise

consciousness. Hamill, Wilson and Nisbett (1980) theory partially supported

this with the Theory of Biased Sampling, wherein an individual will blithely

base our conclusion on the very restricted and therefore prejudiced sample

when an individual decides with very little actual information about the subject

being discussed. The Theory of Planned Behavior (TPB) was classified in

three core components namely, attitude, subjective norms, and perceived

 26

behavioral control. These three main aspects of TPB are the determining

factor of human social behavior. Attitude refers to the degree to which a

person views the activity of interest favorably or unfavorably. It requires

thinking about the consequences of executing the behavior. Subjective norms

refer to one's opinion on whether the majority of people agree or disapprove

of a particular conduct. It has to do with a person's ideas regarding whether or

not peers and important individuals in his or her life think he or she should

partake in the action. Perceived Behavioral Control refers to an individual's

sense of how challenging it is to do the desired behavior. Perceived

behavioral control fluctuates according to situations and acts, resulting in a

person's sense of behavioral control changing depending on the

circumstances.

In relation to this is the Social Cognitive Theory wherein according to

the hypothesis, humans acquire behaviors by watching others and picking

which ones to mimic. Rewarding actions are more probable to happen, but

punishing behaviors would be less likely to occur. This validates the concept

where external factors influence the decision of parents towards pediatric

vaccination. Factors such as Vaccination campaigns, and observing the

actions of the vaccinated and the results or benefits of such action. This

serves as a favorable head start to the parents before deciding.

The third theory is the Selective Perception Theory. The hypothesis

that an individual's understanding of media is dependent on their individual

conviction is known as selective perception theory, sometimes known as

selective exposure. The public freely chooses to absorb media that supports

their beliefs. These include: Media and Information- they obtain from viewing
 27

articles, news, or even social media platform posts concerning the pediatric

vaccination. Individual knowledge and conception of immunization can be

influenced by media representations and portrayals of vaccine debates. If a

parent purposely seeks for an information that is aligned with their own

perception about the vaccine, it would alter their actions whether to receive or

deny vaccination. This type of knowledge is obtained through self- research or

self-learning wherein they intentionally look for information regarding the

vaccination, or the data can be already handed to them by organizations such

as WHO. The awareness of parents is crucial when it comes to their

children’s immunization due to the fact that the lack of awareness can result

in either refusal of the vaccine or if already acquired, can result in potentially

serious complications associated with the vaccine which will lead in massive

spread of the negative news that rooted in lack of awareness. The wrong use

of media and information, not recognizing your informative level, lack of

personal knowledge, absence of impartial information and viewing of the

subject on only one vision can all lead to misconceptions.

The importance of this theory to this study is that it helps in analyzing

the factors resulting in vaccination hesitancy of the parents for their offspring.

This theory is the best model concept that explains how different occurrences

and factors affect the attitude and perception of the parents towards child’s

vaccination. According to the Theory, intentions are a direct forerunner to

conduct, which is influenced by attitudes and subjective standards. This

theoretical model helped in heightening awareness and capability of

understanding on how vaccination attitudes and behaviors are shaped by the

 28

individuals social, attitude, community, media presence and usage and other

internal and external factors.

The researchers articulated a theory that effective campaigns can

heighten the awareness towards vaccination, and aspects such as personal

knowledge, vaccine controversies, technological sources availability are the

occurrences or different factors that greatly impacts and determines how a

parent views pediatric vaccination.

 29

Figure 1.

CONCEPTUAL FRAMEWORK

The conceptual paradigm depicts a system approach in which inputs

are processed through a series of steps that serve as the foundation for the

output. Some questions would be asked to the participants in line with the

research questions to get the answers they needed for their research, one of

which would be about the Gaps and Issues encountered by parents regarding
 30

Child Vaccination, and it would be done through surveys. The researchers

can obtain the answers or data they necessitate through data analysis.

Further to that, the expected result or output would be the clearing of

misinformation regarding pediatric vaccination through the use of this

research because can be used as something they can read if they need to be

provided with pertinent and reliable data; nevertheless, the data gathered

during the process will still be analyzed to see the overall result. Figure 2

depicts the conceptual paradigm of this research study.

FIGURE 2 CONCEPTUAL PARADIGM

INPUT
PROCESS OUTPUT

 Vaccination campaign
Analysis of data through:  Increase the level of
encountered by the parents towards
pediatric vaccination.
a. Questionnaire
parents.  Clear misinformation
about pediatric
b. Statistical treatment
 Gaps and issues vaccination by
providing pertinent and
encountered by the reliable data.
 Address gaps and
parents in pediatric issues about pediatric
vaccination.
 Create a community
 31

DEFINITION OF TERMS

The following terms are deemed significant in the study and defined

conceptually and operationally.

Children. This refers to a young human being below the age of puberty or

below the legal age of majority. In this study, it refers to the group of

individuals ages 12-17 years old.

 32

COVID-19. It refers to an acute respiratory illness in humans caused by a

coronavirus, capable of producing severe symptoms and in some cases

death, especially in older people and those with underlying health conditions.

It was originally identified in China in 2019 and became pandemic in 2020.

Level of awareness. It is defined as the range of knowledge or perception of

a situation or fact. In this study, it is defined as the intensity of knowledge of

parents about COVID-19 vaccination campaign.

Mortality rate. This refers to the number of deaths in a given area or period,

or from a particular cause. In the study, it refers to the number of death rates

caused by COVID-19.

Parents. It refers to the one that begets or brings forth offspring. In the study,

it denotes the biological parents or guardians of children ages 12-17 years

old.

Pandemic. It refers to the disease prevalent over a whole country or the

world. In this study, it refers to a respiratory illness also known as COVID-19

that is prevalent in the world.

Vaccination. It is defined as a treatment with a vaccine to produce immunity

against a disease. In this study, it refers to the process of immunization at

ages 12-17 years old, using COVID-19 vaccines.

 33

NOTES:

1
Buonsenso, D. et al (2020) “Child Healthcare and Immunizations in Sub-

Saharan Africa During the COVID-19 Pandemic”. Coronavirus Disease

(COVID-19): Pathophysiology, Epidemiology, Clinical Management and

Public Health Response. 06 August 2020.

2
Ali, I. (2020) “Impact of COVID-19 on vaccination programs: adverse or

positive?”. Human Vaccines & Immunotherapeutic Volume 16, 2020 - Issue

11. 22 Sep 2020.

 34

3
Zimmerman, P. et al (2021) “Should children be vaccinated against COVID-

19?”. BMJ Journals. 2021.

4
Altulaihi, B. (2021) “Perception of Parents Towards COVID-19 Vaccine for

Children in Saudi Population”. National Library of Medicine. 28 Sep 2021.

5
Temsah, M. (2021) “Parental Attitudes and Hesitancy About COVID-19 vs.

Routine Childhood Vaccinations: A National Survey”. Front Public Health.

2021 Oct 13.

6
Dela Cruz, M. et al (2021) “Transparency of the National Government as key

in promoting the rollout of COVID-19 vaccine” Journal of Public Health. 30

March 2021.

7
Mendoza, R. (2021) “Public trust and the COVID-19 vaccination campaign:

lessons from the Philippines as it emerges from the Dengvaxia controversy”.

Health Planning and Management Volume36, Issue6 Pages 2048-2055. 19

August 2021.

8
Vallejo, B. and Ong, R. (2020) “Policy responses and government science

advise for the COVID-19 pandemic in the Philippines: January to April 2020”

Progress in Disaster Science. June 2020.

9
Fatima, K. and Syed, N. (2018) “Dengvaxia controversy: Impact on vaccine

hesitancy” Journal of global health. 31 Oct 2018.

10
Yu, V. et al (2021) “Fear, Mistrust, and vaccine hesitancy: Narratives of the

dengue vaccine controversy in the Philippines” Science Direct. 16 August

2021.
 35

11
Almomani, B, et al (2021) “Acceptance and attitudes toward COVID-19

vaccines: A cross-sectional study from Jordan” Journal Plos. 23 April 2021.

12
Bell, S. et al (2020) “Parent’s and Guardian’s views on the acceptability of a

future COVID-19 vaccine: A multi-methods study in England” Science Direct.

17 Nov 2020.
13
Wake, A. (2021) “The Willingness to Receive COVID-19 Vaccine and Its

Associated Factors: “Vaccination Refusal Could Prolong the War of This

Pandemic” – A Systematic Review” Risk Management and Healthcare Policy.

21 June 2020.
14
Facciola, A. et al (2019) “Vaccine hesitancy: An overview on parents’

opinions about vaccination and possible reasons of vaccine refusal” Semantic

Scholar. 11 March 2019.

15
Wang et al (2020) “Acceptance of COVID-19 Vaccination during the COVID-

19 Pandemic in China” Semantic Scholar. 27 Aug 2020.

16
Bautista, A. et al (2021) “Acceptability of Vaccination Against COVID-19

Among Selected Residents of the Cities of Caloocan, Malabon, and Navotas,

Philippines” 27 April 2021.

17
Reńosa et al (2021) “How can human-centered design build a story-based

video intervention that addresses vaccine hesitancy and bolsters vaccine

confidence in the Philippines? A mixed method protocol for project

SALUBONG” BMJ Journals. 2021.

 36

18
Migrino, J. et al (2020) “Factors affecting vaccine hesitancy among families

with children 2 years old and younger in two urban communities in Manila,

Philippines” College of Medicine, San Beda University, Manila, Philippines. 10

June 2020.

19
Cardenas, N. (2021) “Harnessing strategic policy on COVID-19 vaccination

rollout in the Philippines” Oxford University Press Pubic Health Emergency

Collection. 28 May 2021.

20
Chootipongchaivat, S. (2016) “Vaccination program in a resource-limited

setting: A case study in the Philippines” COVID-19 Information. 14 Sep 2016.

CHAPTER III

RESEARCH DESIGN

This study aims to identify factors affecting parents’ perception

towards pediatric vaccination. The primary objective of the researchers was to

discover how the group of respondents assessed COVID-19 vaccination

 37

campaign information and found out its effect on their perception about their

child inoculation.

This research will be utilizing the survey approach of conducting a

research, specifically, it used Quasi-Experimental and Descriptive. According

to Thomas1, Quasi-Experimental research aims to determine the cause and

effect relationship between a dependent and independent variable

McCombes2 defines a descriptive research design as an accurate and

systematic description of a population, situation or phenomenon.

SOURCES OF DATA

The researchers consider the following categories of data sources,

namely primary and secondary data sources. In this research regarding the

correlation between parents’ perception towards child vaccination, the

sources of data are from two different bases. First are the Primary data

sources which is the data collected from the survey questionnaire answered

by the Respondents, and the secondary data which is composed of sources

from various types of studies and literatures. In the Primary Data collection,

the researchers used Survey Questionnaire as a medium. Survey

Questionnaire is the process of gathering, analyzing, and interpreting

information from a large number of people. Its goal is to gain a better

understanding of a group of individuals and assess their response into

categories. The respondents were chosen base on their age, geographic

 38

location and other aspects that are measured in order to evaluate the data

from the appropriate sources.

The Secondary Data sources were collected by the use of online web

sources, articles and related studies and literatures. These sources were

thoroughly analyzed and evaluated in order to serve its purpose for the study.

The data collected are the foundation and basis of the developed statistics.

There are diverse sources of secondary data which aids in making the study’s

substance stronger such as the surveys, information and computerized

databases. In this study the articles and literature are categorized depending

on the idea that they convey regarding the Parent’s perception towards

vaccination.

RESPONDENTS

The respondents were chosen based on their geographical location

and other characteristics that must be taken into account in order for the data

to be collected to be relevant to the study's objectives. The proponents

selected the parents with children ages 5 years old to 15 years old in

barangay Piot Sorsogon City. The researchers come up with the overall

respondents of 85 parents.

The sampling technique used is Quota Sampling. According to

Saunders et al., a non-probability sampling method wherein the sample group

is made up of non-randomly selected members of the population, and not

everyone in the population has a probability to be part of the certain

respondents. The researchers used the sample size formula to come up to

 39

the proposed number of respondents. The margin of error used was 8% and

the overall household of barangay Piot is 555.

RESEARCH INSTRUMENT

The researchers will use online platforms, messaging applications,

video conversations, or any other media that can be used for virtual

interviews. For the researchers’ and respondents’ safety, it is critical to

conduct the interview electronically. We used a survey questionnaire as a

data collection tool for our research, which will serve as a guide for us as

researchers. To make it easier and time-saving for the respondents, all

questions and statements will be prepared ahead of time. The questions will

be structured and categorized in accordance with the subject.

The data were gathered through the use of survey questionnaires

formulated by the researchers, Mcleod defines questionnaire as a research

instrument that consists of a series of questions designed to collect data from

the respondents. The researchers prepared a set of questions that aims to

measure the extent of awareness of parents towards pediatric vaccination,

along with common perception. In addition, gaps and issues encountered by

parents are identified, as well as the significant relationship between the

parents’ perception towards pediatric vaccination and extent of awareness.

The language used is in English. Additionally, in order to validate and

substantiate the findings of the study, the questionnaire shall go through

content validation managed by a professional in the field of Education.

Moreover, the questions employed were pilot-tested for its reliability in eliciting
 40

responses from the informants. It is then modified and finalized to match the

objectives of the research.

DATA GATHERING PROCEDURE

According to Bhandari, a systematic procedure of obtaining data as

well as measurements is known as data collection. Data collection allows

researchers to gain first-hand information and a variety of perspectives as

details that are beneficial for a research. The main objective of our research

is to determine the extent of parents’ awareness and knowledge towards

child’s vaccination. This study also seeks to look into various perspectives

and factors that were causal to the parents’ stand on child inoculation.

In this conduct of study, the researchers developed a structured

survey questionnaire that serves as a tool for the acquisition of data from the

respondents. Furthermore, it will also be an instrument for examining and

scrutinizing the content of the responses. The researchers have

communicated and requested permission from respective authorities for the

approval of the conduction of the study to ensure credibility among the study

and to effectively build rapport between researchers and the participating

respondents of the barangay. The households of barangay Piot were

screened and 85 individuals who were qualified were selected through quota

sampling. A virtual meeting was also held for the orientation of the

researchers for an organized plan in data gathering. Pursuant to the Data

Privacy Act of 2012 and taking note of the ethical considerations in research,

the researchers effectively tackled to further guarantee the confidentiality of

the records to protect the privacy of every respondent. An informed consent

 41

form was also created and distributed to inform the involved parties about the

objectives of the study and to specify their involvements in the research. The

instrument was then pilot-tested and there implied adjusted modifications to

suit the purpose of the study. Explanations of how the data will be collected

were followed and disseminated among participants. With the granted

permission and coordination of the barangay officials, the questionnaires were

administered. After collecting the data, the researchers gathered and encoded

all the answers. The transcribed data will be tabulated then go under

evaluation and interpretation using appropriate statistical tests.

STATISTICAL TREATMENT

According to Kalla, statistical treatment of data is essential in order to

make use of the data in the right form. The collecting of raw data is simply

one component of any experiment; data management is equally crucial in

order to derive proper conclusions. Statistical computations are used by

researchers to enhance their assessments on the validity of experimental

data and empirical evidence. This consists of figuring out the confidence

interval, it’s a numerical range around a set of analytical results where the

population mean can be predicted to reside with a certain degree of certainty

and probability.

For Statement of the Problem number one. In summarizing and

determining the data point of the extent of awareness of Parents towards

Pediatric Vaccination. The researchers will use the General Weighted Mean
 42

in quantifying the level of awareness of parents in vaccination among the

respondents from Barangay Piot. We used the quantification –

Formula:

 Response X weight sum of the products per quantifications

`
For Statement of the Problem number two, the researchers will use

Frequency and Percentage in identifying and representing the variables and

categories of the common perceptions of Parents towards pediatric

vaccination from Barangay Piot.

Formula:

Where: % - percent

F – frequency

For Statement of the Problem number three in examining the

significant relationship between the Parents perception towards Pediatric

Vaccination and the extent of their vaccine awareness. The researchers will

use Chi square in judging the observed results from the variables in findings.

Formula:

For Statement of the Problem number four, the researchers will use

Frequency and Percentage in examining the gaps and issues encountered by

the parents in Pediatric Vaccination.

 43

NOTES

1
Thomas “Quasi=Experimental Design: Definition, Examples and Methods”.

2020.

2
McCombes “Descriptive Research Design | Definition, Methods and

Example”. 2019.
 44

3
Saunders, M., Lewis, P. & Thornhill, A. “Research Methods for Business

Students” 6th edition, Pearson Education Limited. 2012.

4
Mcleod “Questionnaire: Definition, Examples, Design and Types”.2018

5
Bhandari “Data Collection | A Step-by-Step Guide with Methods and

Examples”.2020

6
Kalla “Statistical Treatment Of Data”.2009

CHAPTER IV

PRESENTATION, ANALYSIS AND INTERPRETATION OF THE DATA

 45

This chapter presents the acquired data from the study's source which

was analyzed and interpreted. This chapter also includes a comparative study

of the values and measures.

The topics under this research are presented using appropriate tables

which are sequentially arranged to answer the problems presented in this

study. These are as follows: the extent of awareness of parents towards

pediatric vaccination; the level of parent’s acceptability towards pediatric

vaccination; significant difference between the level of parent’s acceptability

towards pediatric vaccination and extent of awareness; the gaps and issues

encountered by the parents in pediatric vaccination.

1. Extent of Awareness of Parents towards Pediatric Vaccination.

Table 1 presents the general written mean per indicators and their

corresponding interpretation. Based from the data gathered, the overall level

of awareness is 2.91 which can be interpreted as “moderately aware”. Among

the 10 indicators, preventive behavioral garnered the highest level of

awareness with a general weighted mean of 3.51, followed by Executive

Order No. 15 - 2021 emphasizing the value of Punong barangays in ensuring

that Health Protocols are strictly adhered with 3.49. While Resbakuna and

Bayanihan Bakuna accumulated 2.92 and 2.93 respectively.

Table 1.
 46

Extent of Awareness of Parents towards Pediatric Vaccination

Indicators Weighted Mean Interpretation

Resbakuna is campaigned by our 2.92 Moderately aware
barangay officials and health workers.
I am aware about the enforced 3.02 Moderately aware
Executive Order no. 10 – 2021
providing a national strategic
framework for COVID- 19 vaccine
deployment in Sorsogon City.
Bayanihan Bakuna is advertised in 2.93 Moderately aware
our barangay
Resbakuna sa botika is promoted in 2.54 Moderately aware
all social media platforms.
Vaccine Information Registry system 2.26 Slightly aware
can be accessed in Sorsogon City
website
I am well informed about the 2.79 Moderately aware
Executive Order 142021 implemented
in Sorsogon City which directs the
execution of the Universal Health
Care Act in order to ensure provincial
cooperation in the province of
Sorsogon
I have been introduced to the 3.51 Highly aware
execution of Preventive behavioral
practices during vaccination.
Government’s National three-day 2.91 Moderately aware
vaccination campaign aimed at
inoculating those aged 12 and above
in all regions
In support of the fast carrying out of 2.67 Moderately aware
COVID-19 the Hospital Emergency
Incident Command System was
activated.
I am informed about the Executive 3.49 Moderately aware
Order No. 15– 2021 underlines the
 47

value of Punong barangays in

ensuring that Health Protocols are
strictly adhered.
TOTAL 2.90 Moderately aware

Subsequently, Executive Order No. 10 - 2021 providing a national

strategic framework for COVID - 19 vaccine deployment in Sorsogon City

garnered a 3.04 general weighted mean. The Government’s National three-

day vaccination campaign aimed at inoculating those aged 12 and above in

all regions garnered a general weighted mean of 2.91 whereas Executive

Order No. 14 - 2021 a direct execution of Universal Health Care Act in

Sorsogon City accumulated 2.79. On the other hand, the fast carrying out of

COVID-19 Hospital Emergency Command System accumulate a mean of

2.67 and Resbakuna sa botika has a mean of 2.54. Furthermore, with a 2.26

general weighted mean, the access to the vaccine Information Registry

system in Sorsogon City website have the lowest degree of awareness.

This implies that parents are highly aware of preventive behavioral

practices during vaccination and moderately aware of the vaccination

campaigns in the community such as Resbakuna, Bayanihan Bakuna,

Resbakuna sa botika, Government National three-day vaccination, and

Hospital Emergency Incident Command System. Along with this, parents are

moderately aware in various Memorandum implemented in Sorsogon City

such as Executive Order No. 10 -2021 vaccination deployment in the

province, Executive Order No. 14 - 2021 execution of Universal Health Care

 48

Act and Executive Order No. 15 - 2021 highlighting the role of Punong

barangay in implementing health protocols. However, the parents in Barangay

Piot doesn’t have enough access to the internet resulting in low level of

awareness on vaccine information registry system. This is supported by the

study of Chootipongchaivat (2016) who mentioned that investing in

vaccination programs and agendas increase current demand for specific

types of human resources. In addition, it reduces future healthcare demands

or hospitalization.

2. Level of Parents Acceptability towards Pediatric Vaccination

Table 2 shows the overall mean range per indicators and their corresponding

explanation. Through the data gathered, it can be seen that the overall level

of acceptability of child vaccination among parents is 2.68 which can be

interpreted as “accepted.” Both the indicators "I allowed my child/ren to be

vaccinated," with a weighted mean of 2.36 and described as partially

accepted, and the indicator "Pediatric Vaccination is highly effective," with a

weighted mean of 2.4, also described as partially accepted, imply that parents

accept child vaccination and believe in its effectiveness, but only to an extent.

Table 2.

Level of Parents Acceptability towards Pediatric Vaccination

Indicators Weighted Mean Explanation

I allowed my child/ren to 2.36 Partially Accepted

 49

be vaccinated.
Pediatric Vaccination is 2.4 Partially Accepted
highly effective.
I presumed that the 2.67 Accepted
vaccines are safe.
I know that the Vaccine’s 3.08 Highly Accepted
side effects are normal.
Mandatory vaccination 2.55 Accepted
serves as a primary
measure to prevent the
spread of COVID-19.
Vaccines lessen the 3 Accepted
effect of the COVID-19
Overall level of 2.68 Accepted
acceptability

Next, under the indicators “I presumed that the vaccines are safe” with a

weighted mean of 2.67, “Mandatory vaccination serves as a primary measure

to prevent the spread of COVID-19” with a weighted mean of 2.55 and

“Vaccines lessen the effect of the COVID-19” with a weighted mean of 3, all

imply that the parents of those children have accepted that vaccines are safe

and it lessens the effect of the virus as well as accepting that making it

mandatory will help in preventing the spread of Covid-19. In addition, under

the indicator, "I know that the vaccine’s side effects are normal." with a

weighted mean of 3.08, described as Highly Accepted, implies that parents

have enough knowledge and high acceptance that it is only normal for one to

have side effects after getting vaccinated. Lastly, the parents' overall

acceptability of child vaccination with a weighted mean of 2.68, described as

 50

Accepted, indicates that they approve and accept their children being

immunized by vaccines that help prevent COVID-19.

This is also in accordance with the result of the research of Migriño

et.al (2020) found out that 95.5% of mothers ages 20-39 years old, perceived

vaccines as protection, while hesitancy rate reached 36.4%. And that

respondents who believed vaccines were protective were less likely to

indicate vaccine reluctance, and nine times less likely to decline vaccination

for their children due to unfavorable media exposure.

3. Significant Difference between the Level of Parents Acceptability

towards Pediatric Vaccination and Extent of Awareness

The table below shows significant difference of the level of acceptability

and extent of awareness of parents towards child inoculation. A mean of 2.90

is computed under extent of awareness which is just a little higher than the

computed mean of 2.68 for the level of acceptability. Known variance equal to

0.134 and 0.077 is also computed for both variables, respectively. At 0.05

level of significance and with a z-value which is equal to 1.35830075483, a p-

value of 0.174368 is computed from the data which is more than the alpha

level of 0.05. Even so, with all the data presented— it is found that there is no

significant difference between the two variables.

Table 3.

Significant Difference between the Level of Parents Acceptability

towards Pediatric Vaccination and Extent of Awareness

 51

Extent of Awareness Level of Acceptability

Mean 2.90 2.68

Known Variance 0.134 0.077

Observations 10 6

Hypothesized Mean Difference 0

Z 1.35830075483

P (Z<=z) two-tail 0.174368

Z Critical two-tail 1.959964

Decision Accept the Null Hypothesis

Interpretation There is no significant difference

At 0.05 level of significance and with a z-value which is equal to 1.358, a

p-value of 0.174 is computed from the data which is more than the alpha level

of 0.05. Therefore, there is no significant difference between the two

variables.

This shows that the mean for the extent of awareness is greater than the

mean for the level of acceptability, however, remains linear. There is no

significant difference thus a significant relationship is introduced. The result of

the measurement of the data deems that the greater number of the
 52

respondents that noted diverse programs and implementations in response to

this health pandemic also admit eagerness to consent to the vaccination of

their young children. Many parents are said to be knowledgeable enough to

know how child vaccination works and how it is implemented. Likewise, their

perceptions remain closely the same with the influence they attained from

materials in regards with this topic.

This implies that the level of awareness does have an effect on the

parents’ level of acceptability. Majority of the respondents who are willing to

vaccinate their children are informed and are given professional data about

the facts of pediatric vaccination. This also proves that most of them are

possibly convinced of the information presented upon them. Moreover, since

there is no evidence of any statistical significant difference was found, there

was no evidence to conclude effect of it, and this suggests that there is an

essential connection present between the two variables. Consequently, it

insinuates that a parents’ knowledge about the current health situation and its

proposed solutions such as these vaccines shows that there is a visible

relation between their awareness and their decision and/or judgment.

Accordingly, the relationship of the extent of awareness to the level of

acceptability in this research study is substantial.

Facciola A. et al ascertained vaccine acceptability (and refusal) having a

correlation with the parents’ age and level of knowledge. The parents with a

favourable opinion towards child vaccination are said to be highly influenced

by the physician’ or a professional’s opinion. Whilst, among those

respondents who refuse appeared some to be influenced by mistrust and

direct/indirect knowledge of failed vaccination experiences. Correspondingly,

 53

those who refuse to vaccinate their children still support immunizations

despite having limited information about such activities.

4. Gaps and Issues encountered by the Parents in Pediatric

Vaccination

Table 4 shows the significant factors that forms gaps and issues in the

Parents of Barangay Piot in their favorable reception of Pediatric Vaccination.

The table revealed that the utmost issue that is encountered by Parents that

causes hesitancy in their child/ren inoculation is the controversy in Dengvaxia

with a frequency of 59, 53 in the lack of Government’s transparency on

vaccines clinical trials as well as the fast development of vaccines, with a

frequency count of 46, parent’s agreeing that the coronavirus is only an

ordinary flu comes in third, 42 respondents stated that vaccines show an

extremely negative cases of side effect such as blood clot, 39 assumed that

the manufactures of the vaccination have an underlying intention.

Furthermore, 33 respondents stated that their Barangay’s unavailability of

their preferred vaccines is one of the reasons for their tentativeness, the 27

parent’s reason is due to their child/ren medical issue, 25 of the respondents

revealed that conspiracy theories rampage in social media platforms is one of

the factors that affects their decisions regarding the vaccination and the other

10 parent’s stated that the vaccination is a defilement of their belief.

 54

Table 4.

Gaps and Issues encountered by the Parents in Pediatric Vaccination as

Perceived by the Respondents from Barangay Piot

GAPS AND ISSUES FREQUENCY RANK

COUNT
Dengvaxia controversy fueled my doubt 59 1
towards the COVID-19 vaccination.
Coronavirus doesn’t exist, it is an 46 3
ordinary flu.
Official statements towards transparency 53 2
on vaccines clinical trials are not
released.
Some COVID-19 vaccines show an 42 4
extremely case of side effect of blood
clot.
Various conspiracy theory is circulating 25 8
in social media platforms such as; the
vaccine containing microchips.
The fast development of vaccines is one 53 2
of the factors that causes suspicion in its
effectiveness.
My child/ren is suffering from a medical 27 7
issue.
The lack of preferred vaccine resources 33 6
in my Barangay.
I presume that the manufactures of the 39 5
vaccination have an underlying intention.
Taking the vaccination is a violation of 10 9
my religious beliefs.
 55

The data implies that external aspects such as the government’s

transparency to the public, unprecedented rate of the development of vaccine,

and lack of the preferred vaccines in the particular health center. On the other

hand, internal gaps such as medical issues, beliefs, and mistrust in the

Government impacts the Parent’s perception of the vaccine. Add

This is supported by Reñosa et al (2021) who mentioned that vaccine

trust has dropped since a dengue vaccine issue erupted in late 2017, which

caused a lot of casualties. The negative history of vaccination resulted in

public trust in vaccines to plummet, posing a serious threat to the public

health system.

5. Action Plan to enhance the Parent’s awareness towards Pediatric

Vaccination.
56
 57

COMMUNITY ACTION PLAN

KEY RESULT PROJECT OBJECTIVES PERSONS INVOLVED TIMEFRAME BUDGETARY EXPECTED

AREA REQUIREMENT OUTCOME
Health CO:VID &  Identify fake  Parents or 1 day 2,000 Allow parents to
VAC-SEEN news and guardians identify fake
misinformati  Barangay news and
on officials become critical
 Municipal health users of social
care workers media
 Department of platforms.
health
Health Bibong  Abolish the  Vaccinated 1 day 2,000 Encourage
Magulang public children parents with
mistrust  Barangay unvaccinated
towards officials children to
pediatric  Municipal health reconsider
vaccination care workers pediatric
by providing  Department of vaccination by
actual health ensuring its
statement safety.
from the
vaccinated
children and
their
parents.
Health Konsulta sa  Free medical  Parents 1 week 10,000 With the
bakuna consultation  Unvaccinated guidance of
before the children medical
parents  Barangay professional
decide either officials pediatric
 58

to allow their  Municipal health vaccination

child to be care workers acceptability
vaccinated  Department of may increase
or not health
 Professional
doctors
Information Tarok sa Turok  Providing  Medical 1 week 10,000 Provide factual
Dissemination professional Professionals knowledge
services, or  Municipal Health about covid-19
services of a Center vaccination
specific campaigns.
expertise, to
a group of
people who
might not
otherwise
have access
to those
services. It is
performed
where those
in need are
located.
 59

CHAPTER V

SUMMARY, FINDINGS, CONCLUSIONS AND RECOMMENDATIONS

This chapter presents the summary, findings, conclusions and

recommendations based from the analysis and interpretation of the data

gathered.

Summary

This study is to determine the factors affecting parents’ perception towards

pediatric vaccination as basis in identifying programs and interventions in

improving vaccination awareness in Barangay Piot.

Specifically, it sought answers to the following questions:

1. What is the extent of awareness of parents towards Pediatric

Vaccination?

2. What is the level of Parent’s acceptability towards Pediatric

Vaccination?

3. Is there a significant difference between the level of parent’s

acceptability towards Pediatric Vaccination and extent of awareness?

4. What are the gaps and issues encountered by the parents in Pediatric

Vaccination?

5. What could be proposed based from the result of the study?

This study has utilized the survey approach of conducting research,

specifically, it used Quasi-Experimental and Descriptive, which can

establish the cause-and-effect relationship between a dependent and

independent variable. Survey Instruments were printed out and handed

 60

out to the parents with kids ages 5 – 15 years old in Piot, Sorsogon City.

The household of barangay Piot, were screened and 85 individuals who

were qualified were selected through quota sampling. All respondents

were asked to rate their level of awareness and acceptability of child

vaccination by selecting numbers 1-4 on each question in the

questionnaires. And through the use of the survey instrument designed

specifically for this study, data on the research problems posed in the first

chapter of this dissertation were gathered.

Findings

Based on the analysis of the data gathered, the following findings were

revealed:

1. The computed weighted mean on the extent of Awareness of Parent’s

towards Pediatric Vaccination is 2.90 which can be interpreted as

moderately aware.

2. Among the respondents, 2.36% of the parents had partially accepted

for their children to get vaccinated and 2.4% have partially accepted

that the vaccine is effective. While 2.67% were the parents who accept

that the vaccines are safe, 3.08% of the parents have high acceptance

about the vaccine’s side effects being normal. 2.55% accepts

mandatory vaccination as a primary measure to prevent the spread of

COVID-19, 3% accepts that vaccine lessen the effect of COVID-19.

3. The mean and the standard deviation of the extent of awareness of

parents towards their children’s vaccination were 2.90 and 0.37,

 61

respectively. The parent’s level of acceptability had a mean score of

2.68 and a standard deviation of 0.28. At 5% level of significance, the

z-value equates to 1.35830075483 which resulted a p-value of

0.174368. Since it exceeded the alpha level of 0.05, there is little to no

concluded significant difference between the two variables.

4. There were problems that were encountered by the respondents in

Pediatric Vaccination such as the Dengvaxia controversy fueling their

doubt towards the COVID-19 Vaccination (rank 1), fast development of

vaccines and lack of the Government’s transparency towards the

vaccine’s clinical trials (rank 2), and Coronavirus seen as a seasonal flu

placing (rank 3) and etc.

5. A community action plan was proposed to enhance the parents’

vaccination awareness.

Conclusions

Based from the revealed findings, the following conclusions are drawn:

1. Majority of the parents are moderately aware of the information

regarding Pediatric Vaccination.

2. The overall level of acceptability of the parents regarding child

vaccination is accepted by most of them.

3. There is no significant difference between the extent of awareness and

level of acceptability on parents’ perceptions towards pediatric

vaccination. Instead, there is a significant relationship.

4. The gaps and issues stated impact the respondent’s perception

towards pediatric vaccination.

 62

Recommendations

From the aforementioned conclusions above, the following recommendations

are made.

1. Increase the level of awareness of the parents the barangay health

center and official may provide handouts that contains factual

information about vaccination programs, interventions and campaigns.

2. The government may continue to seek provision in regards of the

programs related to child vaccination in order for more parents to allow

or accept their kids to get vaccinated.

3. Healthcare providers, as one of the most trusted sources of information

about the virus, may reach out to parents by showing and enlightening

them of the positive effects of the vaccine. They may engage mothers

and fathers in programs that would convince them of the safety and

efficacy of the COVID-19 vaccines.

4. The higher or local administration may increase and improve the

addressing of such issues by implementing an awareness system and

devoting certain programs and campaigns that would eradicate the

public’s suspicions and feeling of dubiety in vaccination, specifically in

the Pediatric group.

 63

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 64

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Appendix A
 69

Curriculum Vitae

NAME : Bea Jetajobe

DATE OF BIRTH: : November 13, 2003
CIVIL STATUS: : Single
PERMANENT ADDRESS: : 150 Purok 4 Piot Sorsogon City

EDUCATIONAL BACKGROUND
SENIOR HIGH SCHOOL : Sorsogon National High School
(August 2020 – Present)
JUNIOR HIGH SCHOOL : Sorsogon National High School
(June 2016 – April 2020)
ELEMENTARY : Sorsogon East Central School
(June 2010 - April 2016)

SEMINAR and ACHIEVEMENTS

: 2nd Place in 6th Documentary Film Festival
(School Level)
: Performatura: Pandemic Edition -
Balagtasan National Level
: Written, presented and completed
Research Studies.
: President of Debate Society
: Consistent general average of 90
: Certificate of Academic Excellence
 70

NAME : Rheamae Dollente

DATE OF BIRTH: : June 2, 2004
CIVIL STATUS: : Single
PERMANENT ADDRESS: : 521 Cogon Bibincahan Sorsogon
City

EDUCATIONAL BACKGROUND
SENIOR HIGH SCHOOL : Sorsogon National High School
(August 2020 – Present)
JUNIOR HIGH SCHOOL : Sorsogon National High School
(June 2016 – April 2020)
ELEMENTARY : Balogo Elementary School
(June 2010 - April 2016)

SEMINAR and ACHIEVEMENTS

: 2nd Place in Documentary Film Festival
(School Level)
: Seminar on Career Guidance Forum and
Active Involvement during the Humanities
and Social Sciences Week 2020 on
Testimonials of Social Engineers.
: Written, presented and completed
Research Studies.
: Volunteer Work
: Store Vendor
: Certificate of Academic Excellence
 71

NAME : Sophia Anne Sabdao

DATE OF BIRTH: : November 02, 2003

CIVIL STATUS: : Single

PERMANENT ADDRESS: : Bibincahan, Sorsogon City

EDUCATIONAL BACKGROUND

SENIOR HIGH SCHOOL : Sorsogon National High School

(August 2020 – Present)

JUNIOR HIGH SCHOOL : First Christian Baptist Academy

(June 2016 – March 2019)

ELEMENTARY : First Christian Baptist Academy

(June 2011 - March 2016)

SEMINAR and ACHIEVEMENTS

: Runner up for Ms. World Literati

:Written, presented and completed
Research Studies.
: Consistent general average of 90 in SHS
: Certificate of Academic Excellence
 72

NAME : Kherstein Dogillo

DATE OF BIRTH: : August 03, 2003
CIVIL STATUS: : Single
PERMANENT ADDRESS: : Sulucan Sorsogon City

EDUCATIONAL BACKGROUND
SENIOR HIGH SCHOOL : Sorsogon National High School
(August 2020 – Present)
JUNIOR HIGH SCHOOL : Sorsogon State College - Laboratory High
School
(June 2016 – May 2020)
ELEMENTARY : First Christian Baptist Academy
(June 2010 - April 2016)

SEMINAR and ACHIEVEMENTS

: Joined the Speech-Pod contest initiated by
the school’s English Club for the English
Literary Expo 2021
: Written, presented and completed
Research Studies.
: Joined essay competitions initiated by
former school
: Consistent general average of 90 in SHS
: Certificate of Academic Excellence