The role of vaccinations in protecting children from life-threatening diseases is not fully understood by many parents in the UAE, research in Sharjah has revealed.
Only 40 per cent of the 550 parents polled by researchers at the University of Sharjah admitted to knowing why they are important, while 14 per cent were vaccine-hesitant.
The 60-question survey, conducted between March and April, aimed to check what parents understood about why it's important to vaccinate their children.
Despite the lack of awareness, 94 per cent of respondents ensured their children got all the mandated vaccines, with 95 per cent showing positive attitudes towards measles, meningitis and pertussis vaccines.
pulmonologist at Aster Hospital Mankhool
Common themes for vaccine hesitancy include a perceived lack of need, safety concerns, trust and other cultural reasons.
According to Unicef, around 2,000 children in the UAE were unvaccinated in 2023 and considered "zero-dose" (those who failed to receive any routine vaccination).
“Vaccination obviously is highly important, and I think generally in the population here there is a lot of trust in the immunisation programme,” said Dr Rachel Herbert, an infectious diseases consultant at Burjeel Medical City in Abu Dhabi. This was highlighted in the high uptake for vaccinations in the survey, she added.
“However, vaccine hesitancy, which is indecisiveness about whether to receive a vaccination or whether to have your child receive one, is an interesting topic. More research is necessary to delve into it as the reasons for vaccine hesitancy are multifactorial.”
Post-natal schedule
Routine child vaccination begins in the UAE shortly after birth, when they are given protection against tuberculosis and hepatitis B. For the first six months, babies are vaccinated against HiB, Diphtheria, Tetanus, Accellular Pertussis, Polio and pneumococcal infections.
Vaccines to offer protection against measles, mumps and rubella, along with a jab to protect against varicella, or chickenpox, continue through childhood. Children get vaccine boosters until they are in grade 11, or aged 16, under the UAE’s mandatory immunisation programme.
The research found most parents were reliant on education by healthcare providers to find out more about the vaccines given to children.
“As clinicians, we must keep the dialogue going and talk to our patients about any fears they may have regarding vaccination,” said Dr Herbert, who referred to children recently arriving in the UAE from Gaza as being the only "zero-dose" children she had treated.
“The traditional vaccines are very well evidenced, generally, and the population is much more digitally literate now. But we need to be aware of information that isn't necessarily evidence-based being circulated on social media. And as clinicians, we need to ask our patients if they have concerns and where they have got that information from.”
Declining uptake
According to the World Health Organisation, national immunisation programmes are the most cost-effective public health intervention, saving 4.4 million lives annually.
The diphtheria-tetanus-pertussis (DTP3) vaccine is used as a global benchmark to assess attitudes and the success of immunisation programmes. Worldwide, global uptake peaked at around 86 per cent pre-pandemic, falling slightly to 84 per cent in 2023.
In 2015, the UAE recorded 99 per cent of children had taken the second dose of the measles vaccine, that fell to 94 per cent in 2023. Meanwhile, 96 per cent of children had the DPT-3 vaccine, also down from the 99 per cent coverage recorded in 2019.
An estimated 21 million children remained unvaccinated or under-vaccinated in 2023, according to the WHO, while the number of "zero-dose" children increased from 12.8 million in 2019 to 14.5 million.
Recent global outbreaks of polio and measles have been blamed on reduced protection and compromised immunity programmes in areas hit by conflict or climate change. Coverage of 95 per cent is considered necessary to prevent community outbreaks of disease.
Measles vaccination rates fell well below that figure in 2023, with 83 per cent of children protected worldwide, leaving 22.2 million unvaccinated, and 27 countries reporting immunisation rates below 80 per cent for the diphtheria-tetanus-pertussis vaccine (DTP1).
Of these nations, seven were in Latin America and the Caribbean, with six in west and central Africa and six more in the Middle East and North Africa.
In the UAE, most parents said they fully supported vaccines for children but relied on medics to inform them of when they should be given.
“I didn’t hesitate at all to get my two children vaccinated,” said Emily Fox, a British mum of two who lives in Dubai. “Even though it can be difficult to trust all the information that is out there, doctors are trustworthy so we have always gone along with that advice.
“I don’t know anyone in my circle of parents who did question their safety or who were hesitant in getting their children immunised.”
Flu season
The UAE is about to roll out its annual influenza vaccination programme. The influenza virus changes each year, requiring nations to deliver booster vaccines to those most vulnerable, including children, the elderly, pregnant women and anyone who may be immunocompromised or already affected by a chronic disease, such as diabetes, cardiac disease or respiratory disorder.
Flu season generally runs from October to May in the UAE, with vaccines usually offered from September.
In a survey published in April, of 401 people asked by Ajman University, just 28 per cent had taken the flu vaccine, or were intending to get it.
Seasonal influenza affects around a billion people each year, making it the most common infectious respiratory virus after the common cold.
The WHO estimates around 3-5 million of those cases result in serious illness and up to 650,000 deaths.
Dr Vineeth Alexander, a specialist in Pulmonology at Aster Hospital Mankhool and Aster Day Surgery Centre, said doctors play an important role in educating about the role of vaccines.
“Even before the pandemic, there were people who were hesitant about vaccines, but it all depends on how well the doctor has explained their importance,” he said.
“Patients with multiple diseases, like diabetes, hypertension, or any cardiac issues definitely need to be vaccinated.
"There can be a lot of questions regarding their benefits and side effects. But many studies have proven vaccines definitely decrease the burden of disease and that will definitely help in health care improvement. That is particularly important for children.”
