Abstract In the past few years, a significant decline in vaccination coverage has been noted, leading to measles outbreaks. Mothers’ adherence or reluctance to undergo childhood immunization is a major contributing factor to a substantial population of children who remain unvaccinated or inadequately vaccinated.

摘要在过去几年中，疫苗接种率显着下降，导致麻疹爆发。母亲坚持或不愿意接受儿童免疫接种是造成大量儿童未接种疫苗或疫苗接种不足的主要因素。

This study aimed to investigate adherence to children’s vaccination by investigating mothers’ personal and contextual factors in addition to knowledge and attitudes scores. A cross-sectional analytical design was employed, and data were collected from a sample of 533 mothers in Jordan between May and July 2023.

这项研究旨在通过调查母亲的个人和背景因素以及知识和态度评分来调查儿童接种疫苗的依从性。采用横断面分析设计，并从2023年5月至7月期间约旦533名母亲的样本中收集数据。

The statistical analysis included descriptive analysis, t-test, ANOVA, and Pearson r correlation. The results demonstrated that adherence to vaccination was associated with several factors, including knowledge score (r = 0.33, p < 0.01), the ability to access and understand health information (r = 0.16, p < 0.01), income level (F = 11.88, p < 0.01), education level (F = 5.71, p < 0.01), employment (t = 2.41, p < 0.05), and working in a medical field (t = 4.5, p < 0.01).

统计分析包括描述性分析，t检验，ANOVA和Pearson r相关性。结果表明，坚持接种疫苗与几个因素有关，包括知识得分（r=0.33，p<0.01），获取和理解健康信息的能力（r=0.16，p<0.01），收入水平（F=11.88，p<0.01），教育水平（F=5.71，p<0.01）.01），就业（t=2.41，p<0.05）和在医学领域工作（t=4.5，p<0.01）。

Scheffe post hoc analysis was performed to evaluate adherence outcomes according to the different categories of education and income levels. Mothers’ adherence to vaccination needs improvement, with special attention given to contributing factors. Strategies should be developed to target mothers with low incomes and educational levels and limited ability to access and understand health information to enhance maternal knowledge and eventually adherence to children’s vaccination.

根据不同类别的教育和收入水平，进行Scheffe事后分析以评估依从性结果。母亲坚持接种疫苗的情况需要改进，并特别注意促成因素。应制定战略，以低收入和受教育程度以及获取和理解健康信息能力有限的母亲为目标，以提高母亲的知识，并最终坚持儿童接种疫苗。

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IntroductionChildren’s vaccination is a cornerstone of public health efforts worldwide and plays a pivotal role in the prevention of infectious diseases for which an effective vaccine is available, also called vaccine-preventable diseases (VPDs)1. It is considered the most efficient and cost-effective way to protect the health and well-being of children and, by extension, the entire community1.

引言儿童疫苗接种是全球公共卫生工作的基石，在预防可获得有效疫苗（也称为疫苗可预防疾病（VPD））的传染病方面发挥着关键作用1。它被认为是保护儿童以及整个社区健康和福祉的最有效和最具成本效益的方法1。

Vaccination programs significantly contribute to reducing the prevalence of life-threatening illnesses, leading to increased life expectancy and improved quality of life for millions of people globally2.In the past few years, the COVID-19 pandemic has led to negative consequences, as demonstrated by a significant decrease in children’s vaccination coverage3,4.

疫苗接种计划大大有助于降低威胁生命的疾病的流行率，从而提高全球数百万人的预期寿命和生活质量2。在过去几年中，新型冠状病毒（COVID-19）大流行已导致负面后果，儿童疫苗接种覆盖率显着下降3,4。

In 2020 and 2021, the COVID-19 pandemic strained healthcare systems and led to setbacks in vaccinations. For example, in 2022, approximately 22 million children missed their first measles vaccine dose, an increase from 19 million in 20191. Additionally, the US reported an outbreak of measles in a total of 1486 patients between 2019 and 20235.

2020年和2021年，新型冠状病毒（COVID-19）大流行给医疗保健系统带来了压力，并导致疫苗接种遭遇挫折。例如，2022年，大约2200万儿童错过了第一剂麻疹疫苗，比20191年的1900万有所增加。此外，美国报告称，2019年至20235年间，共有1486名患者爆发麻疹。

This alarming outbreak necessitates global attention to vaccination adherence in children.Parents’ reluctance, refusal, and delays in adhering to regular childhood immunizations are major contributing factors to a substantial population of children who remain unvaccinated or inadequately vaccinated6,7.

这种令人担忧的疫情需要全球关注儿童接种疫苗的依从性。父母不愿意，拒绝和延迟坚持定期儿童免疫接种是导致大量儿童未接种疫苗或疫苗接种不足的主要因素6,7。

However, investigations of parental adherence or hesitancy are needed to provide children with the necessary vaccination programs. Mothers are widely acknowledged as the primary caregivers for most children; therefore, their knowledge, attitudes, and adherence to children’s vaccinations demand comprehensive evaluation8.

然而，需要对父母的依从性或犹豫进行调查，以便为儿童提供必要的疫苗接种计划。母亲被广泛认为是大多数儿童的主要照顾者；因此，他们对儿童疫苗接种的知识，态度和依从性需要全面评估8。

Exploring this issue plays a pivotal role in developing effective st.

探索这个问题对于开发有效的st起着关键作用。

Data availability

数据可用性

The datasets generated during and analyzed during the current study are available from the corresponding author upon reasonable request.

在本研究期间生成和分析的数据集可根据合理要求从通讯作者处获得。

ReferencesWorld Health Organization (WHO). Vaccines and immunization. [Internet]. WHO;2023 [cited 2024 July 15] https://www.who.int/health-topics/vaccines-and-immunization#tab=tab_1Burnett, E., Parashar, U. D. & Tate, J. E. Global impact of rotavirus vaccination on diarrhea hospitalizations and deaths among children < 5 years old: 2006–2019.

参考世界卫生组织（WHO）。疫苗和免疫。[互联网]。世卫组织；2023年[引自2024年7月15日]https://www.who.int/health-topics/vaccines-and-immunization#tab=tab_1Burnett，E.，Parashar，U.D。和Tate，J.E。轮状病毒疫苗接种对5岁以下儿童腹泻住院和死亡的全球影响：2006-2019年。

J. Infect. Dis. 222 (10), 1731–1739 (2020).Article .

J、 感染。Dis。222（10），1731-1739（2020）。文章。

PubMed

PubMed

Google Scholar

谷歌学者

Abu-Rish, E. Y., Bustanji, Y. & Abusal, K. Nationwide Routine Childhood Vaccination Coverage during the COVID-19 pandemic in Jordan: current Situation, reasons, and predictors of vaccination. Int. J. Clin. Pract. 2022 (1), 7918604 (2022).PubMed

Abu Rish，E.Y.，Bustanji，Y。＆Abusal，K。约旦新型冠状病毒肺炎大流行期间全国常规儿童疫苗接种覆盖率：疫苗接种的现状，原因和预测因素。国际J.临床。实践。2022（1），7918604（2022）。PubMed出版社

PubMed Central

公共医学中心

Google Scholar

谷歌学者

Muhoza, P. Routine vaccination coverage—worldwide, 2020. MMWR. Morbidity and Mortality Weekly Report. ;70. (2021).Centers for Disease Control and Prevention (CDC). Measles (Rubeola): Cases and Outbreaks.[Internet] CDC;2023 [cited 2024 July 12] https://www.cdc.gov/measles/cases-outbreaks.htmlHoffman, B.

Muhoza，P。全球常规疫苗接种覆盖率，2020年。MMWR公司。发病率和死亡率周报；70（2021年）。。麻疹（Rubeola）：病例和爆发。[互联网]疾病预防控制中心；2023年[引自2024年7月12日]https://www.cdc.gov/measles/cases-outbreaks.htmlHoffman，B。

L. et al. COVID-19 vaccine hesitancy, acceptance, and promotion among healthcare workers: a mixed-methods analysis. J. Community Health. 47 (5), 750–758 (2022).Article .

五十、 等。医护人员对新型冠状病毒疫苗的犹豫，接受和推广：混合方法分析。J、 社区卫生。47（5），750-758（2022）。文章。

PubMed

PubMed

Google Scholar

谷歌学者

Olusanya, O. A., Bednarczyk, R. A., Davis, R. L. & Shaban-Nejad, A. Addressing parental vaccine hesitancy and other barriers to childhood/adolescent vaccination uptake during the coronavirus (COVID-19) pandemic. Front. Immunol. 12, 663074 (2021).Article

Olusyania，O.A.，Bednarczyk，R.A.，Davis，R.L。和Shaban Nejad，A。解决冠状病毒（COVID-19）大流行期间父母疫苗犹豫和儿童/青少年接种疫苗的其他障碍。正面。免疫。12663074（2021）。文章

PubMed

PubMed

PubMed Central

公共医学中心

Google Scholar

谷歌学者

Alagsam, E. H. & Alshehri, A. A. Knowledge, attitude, and practice of parents on childhood immunization schedule in Saudi Arabia. Age (Years). 20 (30), 31–40 (2019).

Alagsam，E.H.＆Alshehri，A.A.父母对沙特阿拉伯儿童免疫计划的知识，态度和实践。年龄（岁）。20（30），31-40（2019）。

Google Scholar

谷歌学者

Mphaka, M. R., Moshime, M., Reddy, C. A. & Cross-Sectional Study on caregivers Knowledge, attitudes and practices about the Routine Immunisation Program in Tshwane Sub-district 2, Gauteng, South Africa: 2015. J. Environ. Sci. Public. Health. 2 (4), 221–231 (2018).Article

Mphaka，M.R.，Moshime，M.，Reddy，C.A。&关于南非豪登茨瓦内第二分区常规免疫接种计划护理人员知识，态度和实践的横断面研究：2015年。J、 环境。科学。公众。健康。2（4），221-231（2018）。文章

Google Scholar

谷歌学者

Ali, A. H., Abdullah, M. A., Saad, F. M. & Mohamed, H. A. Immunisation of children under 5 years: mothers’ knowledge, attitude and practice in Alseir locality, Northern State, Sudan. Sudan. J. Paediatrics. 20 (2), 152 (2020).Article

Ali，A.H.，Abdullah，M.A.，Saad，F.M。和Mohamed，H.A。5岁以下儿童的免疫接种：母亲在苏丹北部州阿尔赛尔地区的知识，态度和实践。苏丹。J、 儿科。20（2），152（2020）。文章

Google Scholar

谷歌学者

Zeng, Y. et al. Factors affecting parental intention to vaccinate kindergarten children against influenza: a cross-sectional survey in China. Vaccine. 37 (11), 1449–1456 (2019).Article

Zeng，Y.等人。影响父母接种幼儿园儿童流感疫苗意愿的因素：中国的横断面调查。疫苗。。文章

PubMed

PubMed

Google Scholar

谷歌学者

Wagner, A. L., Shotwell, A. R., Boulton, M. L., Carlson, B. F. & Mathew, J. L. Demographics of vaccine hesitancy in Chandigarh, India. Front. Med. 7, 585579 (2021).Article

Wagner，A.L.，Shotwell，A.R.，Boulton，M.L.，Carlson，B.F。＆Mathew，J.L。印度昌迪加尔疫苗犹豫的人口统计学。正面。医学杂志7585579（2021）。文章

Google Scholar

谷歌学者

Savitz, D. A. & Wellenius, G. A. Can cross-sectional studies contribute to causal inference? It depends. Am. J. Epidemiol. 192 (4), 514–516 (2023).Article

Savitz，D.A。和Wellenius，G.A。横断面研究是否有助于因果推断？视情况而定。美国流行病学杂志。。文章

PubMed

PubMed

Google Scholar

谷歌学者

Almutairi, W. M. et al. Assessment of mothers’ knowledge, attitudes, and practices regarding childhood vaccination during the first five years of life in Saudi Arabia. Nurs. Rep. 11 (3), 506–516 (2021).Article

Almutairi，W.M.等人，《沙特阿拉伯母亲在出生后五年内对儿童接种疫苗的知识、态度和做法的评估》，Nurs。代表11（3），506-516（2021）。文章

MathSciNet

MathSciNet

PubMed

PubMed

PubMed Central

公共医学中心

Google Scholar

谷歌学者

Louangrath, P. I. & Sutanapong, C. Validity and reliability of survey scales. International Journal of Research & Methodology in Social Science. ;4(3):99–114MoH. Guide to vaccination and monitoring the diseases for which vaccines are administered. Jordan: Ministry of Health; 2017. (2018).

Louangrath，P.I。和Sutanapong，C。调查量表的有效性和可靠性。国际社会科学研究与方法杂志；4（3）：99-114MoH。接种疫苗和监测接种疫苗的疾病指南。约旦：卫生部；2017年（2018年）。

https://www.unicef.org/jordan/media/12741/file/MOH_Vac_ManualA.pdfMiron, V. D., Toma, A. R., Filimon, C., Bar, G. & Craiu, M. Optional vaccines in children—Knowledge, attitudes, and practices in Romanian parents. Vaccines. 10 (3), 404 (2022).Article .

https://www.unicef.org/jordan/media/12741/file/MOH_Vac_ManualA.pdfMiron。疫苗。10（3），404（2022）。文章。

PubMed

PubMed

PubMed Central

公共医学中心

Google Scholar

谷歌学者

Hussain, A. et al. Assessment of parents’ perceptions of childhood immunization: a cross-sectional study from Pakistan. Children. 8 (11), 1007 (2021).Article

Hussain，A.等人，《评估父母对儿童免疫接种的看法：来自巴基斯坦的横断面研究》。孩子们。8（11），1007（2021）。文章

PubMed

PubMed

PubMed Central

公共医学中心

Google Scholar

谷歌学者

Mohammed, M. B. & Al-Zahrani, A. Knowledge, attitude and practice of mothers toward children’s vaccination at Alfatih one in Sudan. Open. J. Nurs. 11 (7), 557–565 (2021).Article

。打开。J、 护士。11（7），557-565（2021）。文章

Google Scholar

谷歌学者

Balbir Singh, H. K. et al. Assessment of knowledge and attitude among postnatal mothers towards childhood vaccination in Malaysia. Hum. Vaccines Immunotherapeutics. 15 (11), 2544–2551 (2019).Article

Balbir Singh，H.K.等人，《马来西亚产后母亲对儿童疫苗接种的知识和态度评估》。嗯。疫苗免疫疗法。15（11），2544-2551（2019）。文章

Google Scholar

谷歌学者

Abor, J., Kabunga, A. & Nabasirye, C. K. Predictors of adherence to routine immunization schedule among caretakers of children aged 10 to 18 months in Lira City, Uganda. Global Pediatr. Health. 9, 2333794X221140518 (2022).Article

Abor，J.，Kabunga，A。＆Nabasirye，C.K。乌干达利拉市10至18个月大儿童看护者遵守常规免疫计划的预测因素。全球儿科。健康。92333794x221140518（2022）。文章

Google Scholar

谷歌学者

Kaufman, J. et al. Face-to‐face interventions for informing or educating parents about early childhood vaccination. Cochrane Database Syst. Reviews.(5) (2018).Seal, A. J. et al. Use of an adapted participatory learning and action cycle to increase knowledge and uptake of child vaccination in internally displaced persons camps (IVACS): a cluster-randomised controlled trial.

Kaufman，J.等人。面对面的干预措施，用于告知或教育父母有关幼儿疫苗接种的信息。Cochrane数据库系统。评论。（5） （2018年）。Seal，A.J.等人，《使用适应性参与式学习和行动周期来增加国内流离失所者营地（IVACS）儿童疫苗接种的知识和吸收：一项集群随机对照试验》。

Vaccine. 41 (19), 3038–3046 (2023).Article .

疫苗。41（19），3038–3046（2023）。文章。

PubMed

PubMed

Google Scholar

谷歌学者

Download referencesAcknowledgementsThe authors are thankful to the Deanship of Research at Jordan University of Science and Technology for supporting the study (Research Number: 20230501).FundingThis project received no funding.Author informationAuthors and AffiliationsDeputy Manager, Center of Excellence and Innovation Projects; Associate Professor, Department of Community and Mental Health Nursing, Faculty of Nursing, Jordan University of Science and Technology, P.O.

下载参考文献致谢作者感谢约旦科技大学的研究院长支持这项研究（研究编号：20230501）。资金这个项目没有得到资金。作者信息作者和所属机构卓越与创新项目中心办公室经理；约旦科技大学护理学院社区与心理健康护理系副教授。

Box 3030, Irbid, 22110, JordanWafa’a F. Ta’anMSc graduate, Faculty of Medicine, Jordan University of Science and Technology, Irbid, JordanRand A. Al-rashdanMSc Graduate, Department of Community and Mental Health Nursing, Faculty of Nursing, Jordan University of Science and Technology, Irbid, JordanRawan M.

信箱3030，Irbid，22110，约旦科技大学医学院JordanWafa'a F.Ta'anMSc毕业生，Irbid，JordanRand a.Al-rashdanMSc毕业生，约旦科技大学护理学院社区与心理健康护理系，Irbid，JordanRawan M。

ShatnawiMSc Graduate, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, JordanAseel Ai-zenatiDepartment of Paramedicine, Monash University, Clayton, VIC, 3800, AustraliaBrett WilliamsFaculty of Pharmacy, Jordan University of Science and Technology, Irbid, JordanTareq L.

ShatnawiMSc毕业生，约旦科技大学应用医学院，Irbid，JordanAseel Ai Zenati莫纳什大学护理医学系，维多利亚州克莱顿，3800，澳大利亚阿布雷特·威廉姆斯药学系，约旦科技大学，Irbid，JordanTareq L。

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PubMed Google ScholarContributionsAuthor contributions: Study design: WFT, RAA, RMS, BW, AA, TLM; Data collection: WFT, RAA; Data analysis: WFT, RAA, TLM; Study supervision: WFT, RAA, RMS, BW, TLM; Manuscript writing: WFT, RAA, RMS, BW, AA, TLM; Critical revisions for important intellectual content: WFT, RAA, RMS, BW, AA, TLM.Corresponding authorCorrespondence to.

PubMed谷歌学术贡献：研究设计：WFT，RAA，RMS，BW，AA，TLM；数据收集：WFT，RAA；数据分析：WFT，RAA，TLM；研究监督：WFT，RAA，RMS，BW，TLM；手稿撰写：WFT，RAA，RMS，BW，AA，TLM；重要知识内容的关键修订：WFT、RAA、RMS、BW、AA、TLM。对应作者对应。

Wafa’a F. Ta’an.Ethics declarations

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Competing interests

相互竞争的利益

The authors declare no competing interests.

。

Ethical considerations

道德考虑

Prior to the conduction of the study, ethical approval was obtained from the Institutional Review Board at Jordan University of Science and Technology (ID: 20230501). The study adhered to the Declaration of Helsinki; participants were offered a cover letter that appeared upon starting the questionnaire with a brief description of the study’s purpose and an explanation that there are no foreseeable risks to participating.

在进行研究之前，已获得约旦科技大学机构审查委员会的道德批准（ID:20230501）。该研究遵守了《赫尔辛基宣言》；参与者在开始调查问卷时收到了一封求职信，其中简要描述了研究的目的，并解释了参与不存在可预见的风险。

Informed consent was obtained from all participants. Participation was voluntary and participants had the right to withdraw from the study at any time without penalty..

获得了所有参与者的知情同意。参与是自愿的，参与者有权随时退出研究而不受惩罚。。

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Reprints and permissionsAbout this articleCite this articleTa’an, W.F., Al-rashdan, R.A., Shatnawi, R.M. et al. Determinants of maternal adherence to child vaccination in jordan: A cross-sectional study.

转载和许可本文引用本文Ta'an，W.F.，Al-rashdan，R.A.，Shatnawi，R.M。等人。约旦母亲坚持儿童疫苗接种的决定因素：横断面研究。

Sci Rep 14, 24635 (2024). https://doi.org/10.1038/s41598-024-74183-0Download citationReceived: 04 August 2024Accepted: 24 September 2024Published: 20 October 2024DOI: https://doi.org/10.1038/s41598-024-74183-0Share this articleAnyone you share the following link with will be able to read this content:Get shareable linkSorry, a shareable link is not currently available for this article.Copy to clipboard.

科学报告1424635（2024）。https://doi.org/10.1038/s41598-024-74183-0Download引文接收日期：2024年8月4日接受日期：2024年9月24日发布日期：2024年10月20日OI：https://doi.org/10.1038/s41598-024-74183-0Share本文与您共享以下链接的任何人都可以阅读此内容：获取可共享链接对不起，本文目前没有可共享的链接。复制到剪贴板。

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KeywordsAdherenceAttitudeChildKnowledgeVaccine

关键词坚持态度儿童知识疫苗