Medical Journal of Malaysia

MJM, Vol 70 Supplement 1 September 2015

Barriers in accessing measles vaccination service in Sarawak: a qualitative study

Chai Phing Tze 

Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur


Background: Since 2009, Malaysia has maintained 95% coverage of national measles immunisation coverage as recommended by the World Health Organization, and moving towards measles elimination.  However, in 2011, Malaysia suffered a nationwide outbreak of measles. Twenty eight per cent of the measles sufferers were not vaccinated, denoting gaps in vaccine provision and outreach. This study aimed to explore parents’ perception and views on measles vaccination in Sarawak. Scope of study included parental decision-making process regarding measles vaccine and barriers in accessing vaccination services.

Methods: This was an in-depth interview to explore parents’ experience, needs and barriers in accessing measles vaccination service.  Parents of children aged between 1 and 7 years, who had history of defaulting measles-mumps-rubella vaccine for minimum 3 months were recruited.

Results: 12 defaulter parents from Sarawak were interviewed.  Majority parents were uninformed about measles, its infectivity and consequences in unimmunised children. Decision on immunisation was frequently the end product of interaction between a parent’s personality, demographic characteristics, previous encounter with medical professionals, while actual access to vaccination service could be hampered by various socio-politico-economic factors.  Vaccine refusal and hesitancy was observed among well-educated parents.

Conclusion: A more aggressive childhood vaccination promotive approach, by early engagement of parents in vaccine-related dialogue and addressing concerns about vaccine safety may be beneficial in improving public trust and vaccine uptake. On the other hand, strong political and financial commitment in order to improve access for parents from lower socioeconomic classes.

Keyword: Measles; vaccination; parent; decision; barriers.