The effect of maternal decisional authority on children's vaccination in East Asia

Even though they are important determinants for increasing vaccination rates in advanced and developing nations alike, maternal capacity and decisional authority have not been fully elucidated in diverse countries and cultural spheres. This study examined the effects of South Korean, Chinese, and Japanese mothers’ health literacy, self-efficacy, mass media use, and decisional authority on their children’s vaccination after adjustment for their socioeconomic statuses. Computer-assisted web interviews were conducted with married women in their 20s-40s of South Korean, Chinese, or Japanese nationality (n = 1,571). Dependent variables were generated for the following four vaccinations: BCG, diphtheria+pertussis+tetanus (DPT), poliomyelitis (polio), and measles. For statistical processing, cases where all four types of vaccines had been recorded were scored as 1 and other cases were processed as 0. According to the results of the pooled model, we found that for East Asian mothers, decisional authority, self-efficacy, and health literacy all increased the likelihood that they would vaccinate their children. Furthermore, women who searched for health information through media such as the radio were more likely to vaccinate their children. However, when elaborate analyses were conducted by country, there were considerable differences in those characteristics by country. Therefore, this study showed that it is necessary to establish locally tailored strategies in order to raise vaccination rates in the Global Vaccine Action Plan. This study also showed that social contexts must be taken into consideration in order to raise vaccination rates.