Dengue Vaccine Controversy Awareness, Vaccine Health Literacy, and Vaccine Acceptability among Mothers in Select Rural Communities

  • Earl Francis Sumile College of Nursing, University of Santo Tomas, Manila, Philippines
  • John Howell Diric College of Nursing, University of Santo Tomas, Manila, Philippines
  • Zariah Monica Dorado College of Nursing, University of Santo Tomas, Manila, Philippines
  • Kate Dumaua College of Nursing, University of Santo Tomas, Manila, Philippines
  • Monica Julia Ryven Ecura College of Nursing, University of Santo Tomas, Manila, Philippines
  • Jose Maria Dumaya College of Nursing, University of Santo Tomas, Manila, Philippines
Keywords: health literacy, vaccination, preventive health services, vaccination coverage, public health


Background: Immunization is a vital public health service that reduces transmission of communicable diseases among population groups. In the Philippines, reports of adverse reaction from the dengue vaccine raised doubts about its safety and efficacy. This in turn can bring about a decline in vaccine acceptability among mothers and later on result to reduced vaccine coverage in the country.

Methods: Descriptive cross-sectional correlational design were used to explicate the influence of dengue vaccine controversy awareness and vaccine health literacy on vaccine acceptability among mothers. Data were collected among 200 mothers from August – November 2018 in rural communities of Bulacan. Stepwise forward and backward multiple linear regression were done to determine the relationships between the variables of interest.

Results: Majority of the mothers who participated belong to 26-35 year old age bracket and received basic education. Mothers’ functional health literacy (B=0.189, p=0.006) and critical health literacy (B=0.247, p=0.000) revealed a significant relationship to vaccine acceptability. However, the communicative health literacy (B=0.008, p=0.917) showed no significant relationship to vaccine acceptability. Moreover, the dengue vaccine controversy awareness (B=0.057, p=0.415) had no significant relationships to the mothers’ vaccine acceptability.

Conclusion: Health literacy favorably influences vaccine acceptability. Likewise, awareness of controversies surrounding dengue vaccination is not a deterrent to the decision of mothers to continue submitting their children to immunization. Hence, nurses should invest more in educational interventions to promote compliance of communities to the national immunization program and engage stakeholders to support its implementation.



Download data is not yet available.


Aharon, A., Nehama, H., Rishpon, S. & Baron-Epel, O. (2016). Parents with high levels of communicative and critical health literacy. Patient Education and Counseling.100(4), 768-775.

Chhabra, R., Chisolm, D., Bayldon, B., Quadri, M., Sharif, I., Velasquez, J., ENcalada, K., Rivera, A., Harris, M., Levites-Agababa, E., & Yin, H. (2018). Evaluation of Pediatric Human Papillomavirus Vaccination Provider Counseling Written Materials: A Health Literacy Perspective. Academic Pediatrics, 18(2), S28-S36.

CNN Philippines. (2018). Doctors: Parents Refusing Vaccines Due to Dengvaxia Scare.

Department of Health Philippines. (2020a). Expanded Program on Immunization.

Department of Health Philippines. (2018). DOH Identifies Vaccine Hesitancy as one of the reasons for measles outbreak.

Dubé, E., Laberge, C., Guay, M., Bramadat, P., Roy, R., & Bettinger, J. (2013). Vaccine hesitancy: an overview. Human vaccines & immunotherapeutics, 9(8), 1763–1773.

Eilers, R., de Melker, H. E., Veldwijk, J., & Krabbe, P. (2017). Vaccine preferences and acceptance of older adults. Vaccine, 35(21), 2823–2830.

Lorini, C., Santomauro, F., Donzellini, M., Capecchi, L., Bechini, A., Boccalini, S., Bonanni, P., & Bonaccorsi, G. (2018). Health literacy and vaccination: A systematic review. Human vaccines & immunotherapeutics, 14(2), 478–488.

McClure, C. C., Cataldi, J. R., & O’Leary, S. T. (2017). Vaccine Hesitancy: Where We Are and Where We Are Going. Clinical Therapeutics, 39(8), 1550–1562.

Phimmasane, M., Douangmala, S., Koffi, P., Reinharz, D., & Buisson, Y. (2010). Factors affecting compliance with measles vaccination in Lao PDR. Vaccine, 28(41), 6723–6729.

Pugliese-Garcia, M., Heyerdahl, L. W., Mwamba, C., Nkwemu, S., Chilengi, R., Demolis, R., Guillermet, E., & Sharma, A. (2018). Factors influencing vaccine acceptance and hesitancy in three informal settlements in Lusaka, Zambia. Vaccine, 36(37), 5617–5624.

Rowlands, G. (2014). Health literacy. Human Vaccines & Immunotherapeutics, 10(7), 2130– 2135.

Sarathchandra, D., Navin, M., Largent, M., McCright, A. (2018). A survey instrument for measuring vaccine acceptance. Preventive Medicine, 109, 1–7.

Smith, L. E., Amlôt, R., Weinman, J., Yiend, J., & Rubin, G. J. (2017). A systematic review of factors affecting vaccine uptake in young children. Vaccine, 35(45), 6059–6069.

Taber, K. S. (2017). The Use of Cronbach’s Alpha When Developing and Reporting Research Instruments in Science Education. Research in Science Education, 48(6), 1273–1296.

United Nations Children’s Emergency Fund Philippines. (2020). Philippines (PHL) - Demographics, Health & Infant Mortality.

Valido, E. M., Laksanawati, I. S. & Utarini, A. (2018). Acceptability of the dengue vaccination among parents in urban poor communities of Quezon City, Philippines before and after vaccine suspension. BMC Research Notes 11, 661.

World Health Organization. (2014). Report of the SAGE Working Group on Vaccine Hesitancy.

World Health Organization. (2016). The Mandate for Health Literacy.

Yousif, M. A., Albarraq, A., Abdallah, M., Elbur, A. (2014). Parents′ Knowledge and Attitudes on Childhood Immunization, Taif, Saudi Arabia. Journal of Vaccines & Vaccination, 5(1).

How to Cite
Sumile, E. F., Diric, J. H., Dorado, Z. M., Dumaua, K., Ecura, M. J. R., & Dumaya, J. M. (2020). Dengue Vaccine Controversy Awareness, Vaccine Health Literacy, and Vaccine Acceptability among Mothers in Select Rural Communities. Journal of Health and Caring Sciences, 2(2), 123-134.