Bridging the knowledge gap: Thai parents' perspectives on dengue infection and its vaccination and the need for targeted promotion

Dengue infection is endemic in Thailand, with children being the most impacted group. Various measures, including the dengue vaccine (recently recommended in Thailand since 2017 for Dengvaxia and 2023 for Qdenga), have been implemented to prevent and manage the disease. However, the rate of infection among Thai children is still high. This study explored Thai parents' knowledge and attitudes toward dengue infection and its preventive vaccine, guided by the 4C Model for vaccine hesitancy.

This cross-sectional study employed a questionnaire survey, utilizing five investigator-developed instruments. Survey items were grouped into the components of the 4C Model. Data analysis involved descriptive, Pearson's correlations, and Binary Logistic Regression statistics.

Among 400 participating parents in this study, high positive attitudes toward general childhood vaccination (mean score = 41.18/60) and a high level of dengue infection knowledge (mean score = 9.08/12) were observed. Common prevention methods included destroying larval breeding sites and mosquito bite prevention. Most parents viewed dengue infection as a serious disease (mean score = 7.65/10), perceiving impacts like children's school absenteeism (93%) and parental work time off (80.75%). Regarding government management of dengue, a substantial proportion (~35%) expressed no opinion. Parents exhibited an intermediate level of dengue vaccine knowledge (mean score = 5.06/10), with most unaware of its effectiveness or complex recommendations. Most (63.5%) expressed dengue vaccine acceptance, with 9.75% having vaccinated their children and 59.56% planning to do so. All 4C model components except Calculation were weakly but significantly correlated with parents' dengue vaccine acceptance, with Complacency being the strongest (r = -.149, p = .05). Only Complacency independently predicted dengue vaccine acceptance among Thai parents (OR=0.897, p = .031).

This study provides insights into Thai parents' understanding of dengue and its vaccine in children. Findings offer a basis for developing targeted public health campaigns and communication strategies to promote dengue vaccine use in children, and to inform public policy on vaccine affordability.