Skip to content
Log in
Review

Parental Knowledge, Attitudes, and Practices on Pediatric Vaccination in Honduras: Insights and Challenges for Improving Immunization Coverage

María José Reyes Cáceres Astrid Mariam Enamorado Ortega Astrid Pamela Romero Monday Dinora Mariela Flores Cruz Ayleen Daniela Cruz Avilez Sara Alejandra Romero Galeano Stephanie Patricia López Godoy Pamela Zacasa Vargas Sara Eloisa Rivera Molina
Aug 2026 · Journal of the Pediatric Infectious Diseases Society · 0 citations

TL;DR

Strong trust in vaccines among parents is revealed, with high support for their safety, effectiveness, and mandatory implementation, as well as recognition of their community-wide benefits, however, gaps in knowledge and barriers to vaccination access underscore the need for professional communication.

Abstract

Vaccines are the second most effective public health intervention after clean water. However, global vaccine coverage has declined in recent years. In 2019, the WHO identified vaccine hesitancy as one of the top ten public health challenges. In Honduras, data from the Expanded Program on Immunization showed a decline in fully vaccinated children under five, from 89% in 2019 to 77% in 2022. Addressing parental concerns, reducing misinformation, and promoting vaccine acceptance are critical responsibilities for health professionals. This descriptive study aimed to assess and analyze parents' knowledge, attitudes, and practices concerning pediatric vaccination. The study was carried out between August and October 2024 in the outpatient departments of four health centers in two regions of Honduras. Data collection was conducted using a structured questionnaire administered by trained medical personnel, who also reviewed vaccination cards to determine their completeness. Visual scales were incorporated to enhance understanding of the Likert scales. The information was analyzed in STATA version 16.1. Frequencies and percentages were calculated for qualitative variables. The study received ethics committee approval. A total of 178 interviews were conducted with parents across four healthcare facilities, with the majority (3/4) being public institutions. Regarding religious affiliation, 61% of parents identified as evangelical, and 30% identified as Catholic. Knowledge: When asked, "What is a vaccine?" only 71% (127/178) of parents provided a correct answer. Additionally, 81% (144/178) believed that receiving vaccines to build "defenses" is better than acquiring immunity through natural infection; 10% (18/178) of parents were uncertain about the best approach. Twelve percent of parents were unsure about vaccine timing, while 75% followed the national vaccination schedule. Notably, when asked about vaccine-preventable diseases included in Honduras vaccination schedule, 30% were unable to provide a correct response. Most parents strongly agreed that vaccines are effective (75.6%), safe (75.9%), and important for community health (72%). Attitudes: Most parents (82.2%) supported mandatory vaccinations, while 45.5% dismissed others' opinions as irrelevant in vaccination decisions. Practices: Among the parents who presented their child's vaccination card during the interview (123/178), 93.5% had a complete immunization record in accordance with the guidelines of the Honduras´ EPI. Healthcare personnel were the main source of vaccine information (92.6%), followed by the internet and social media (30%). Additionally, 19% of parents reported being denied vaccination services at public healthcare facilities. The reasons provided included upper respiratory tract symptoms (35%), fever (38%), and other factors, such as restrictions on opening vaccine vials without additional patients, low weight, and anemia. Forty-one percent of parents expressed interest in receiving more information about vaccines through educational sessions specifically designed for parents. They also emphasized the need to identify reliable sources of information to enhance their knowledge about vaccines. The findings reveal strong trust in vaccines among parents, with high support for their safety, effectiveness, and mandatory implementation, as well as recognition of their community-wide benefits. However, gaps in knowledge and barriers to vaccination access underscore the need for professional communication to sustain vaccine acceptance, reinforce trust in immunization programs, and address these challenges effectively.

DOI Semantic Scholar
View source

Similar papers

Review Open access Aug 2026

Parental Polio Vaccine Attitude, Disease Knowledge, and Characteristics

Parental knowledge and attitudes towards vaccination impact vaccine uptake, which is essential in maintaining population immunity. We assessed the psychometric validity of a questionnaire assessing parental knowledge, attitudes, and practices regarding polio immunization. A questionnaire assessing polio disease knowledge and attitudes was designed and administered to parents of children receiving care at a hospital-based metropolitan primary care pediatric clinic. Psychometric analysis using RStudio (Version 2025.05) was performed to validate domains of disease knowledge and vaccine attitudes, including exploratory factor analysis (EFA) to identify underlying constructs and group questions by construct for cumulative scoring. Relationships between demographic characteristics, questionnaire constructs, and vaccination status, were evaluated using mean comparison tests. Delayed polio immunization status was defined as no doses by 2 months of age, <2 doses by 4 months, <3 doses by 18 months, and <4 doses by 6 years of age. Of the 228 parental participants, 82% self-identified their child participant as Black/African-American; the mean age of the children of enrolled participants was 3.83 [± 3.29] years. EFA supported two underlying construct groups (disease knowledge and vaccine attitude) with a strong model fit (RMSEA < 0.001; TLI=1.009). Parents with lower educational attainment (F = 3.095, p = 0.018) and non-full-time employment (F = 4.034, p = 0.004) had significantly lower knowledge scores. On-time polio immunization was associated with more responses of “I Don’t Know” or “Prefer Not to Say” (p < 0.001) and from respondents with older children (p < 0.001) compared to delayed polio-immunization (Table 1). The responses from parents of children with on-time polio immunization had higher polio knowledge scores (p = 0.001) and differed from those who were polio vaccine delayed by employment status (p = 0.033, Table 1). Higher composite vaccine attitude scores (indicating more vaccine concerns) were strongly associated with total vaccine refusal (p = 0.012), supporting the convergent validity of this instrument in distinguishing polio vaccine acceptance behaviors (Figure 1). Concerns about vaccine safety and efficacy, as well as patterns of ambiguous responding, reflected caregiver hesitancy, attitudes, and knowledge gaps, which may have contributed to delayed or complete avoidance of polio vaccination of their children. Our results suggest that this 6-item survey could be administered to identify families who might benefit from targeted vaccine resources, education, and counseling. Identifying and addressing the needs of parents with knowledge gaps and concerns is critical to improving polio vaccine uptake and reaching polio eradication.

Unknown authors · 0 citations
Review Open access Aug 2026

Parental Attitudes and Beliefs Toward Childhood Vaccination in Osh, Kyrgyz Republic: a Cross-Sectional Study

Vaccination remains a key tool for reducing the incidence of infectious diseases in children. Despite the proven effectiveness of immunization, vaccine hesitancy among parents has been increasing in recent years, which may negatively impact immunization coverage. This study aims to examine parents' attitudes toward vaccination, assess their awareness, identify reasons for refusal and postponement of vaccinations, and determine the sources of information that influence immunization decisions. The study was conducted as a cross-sectional study based on an online survey of 710 parents living in Osh, Kyrgyz Republic. The questionnaire included sections on socio-demographic characteristics, attitudes toward vaccination, vaccination practices, awareness, reasons for refusal and postponement, as well as sources of information and their level of trust. Statistical processing of the data was performed using descriptive and comparative statistics, correlation and multivariate analysis. It was found that 66.6% of parents fully support vaccination, but 19.6% express concerns, and 8.3% oppose it. Furthermore, 34.4% of respondents have postponed vaccination, and 18.2% have refused it. The average level of knowledge about vaccination was 2.88 out of 5. The main factors associated with refusal were fear of adverse reactions, anxiety about complications, and lack of information. Healthcare professionals were the most significant and trusted source of information. These findings indicate that vaccine hesitancy among parents is influenced by a combination of information gaps, concerns about vaccine safety, and trust in healthcare professionals. This justifies the need to strengthen pre-vaccination counseling and develop informational activities that address the main causes of parental hesitancy and refusal.

M. Manaskyzy, A. Turusbekova, T. Dautov · 0 citations
Review Jul 2026

Factors affecting parental practices and attitudes toward influenza vaccination for children in China.

Investigation of parents' knowledge, attitudes, and practices regarding childhood influenza vaccination in Jiangsu showed moderate knowledge and positive attitudes but low actual vaccination rates, suggesting targeted interventions are needed to reduce the cognition-practice gap and improve childhood influenza vaccination coverage.

Zhaohan Wei, Xiaolei Feng, Qin Sun et al. · 0 citations
Review Aug 2026

Household Vaccination Status and Attitudes toward Pediatric COVID-19 Vaccination: A Survey at Four New Jersey Clinic-Based Pediatric Practices.

Despite the documented safety and efficacy of the COVID-19 vaccination, parental pediatric vaccine hesitancy is common. Little is known about the concerns and beliefs held by caregivers that impact COVID vaccination decision-making on behalf of their minor children, as underlying attitudes toward pediatric COVID-19 vaccination have not been well described. Unvaccinated children and their caregivers underwent antibody testing and completed an electronic survey at four clinic-based practices in Northern and Central New Jersey from August 2022 to June 2023. Caregivers were grouped into four attitudinal classes based on how safe, effective, useful, and necessary they believed COVID-19 vaccination were. Caregivers in the lowest vaccine acceptance classes (1 and 2) were significantly less likely to plan to vaccinate their children compared to those in the higher classes (3 and 4) (8.9% and 5.6% vs. 30.4% and 61%). Those in Class 2 were significantly less likely to have at least one adult household member fully vaccinated or boosted against COVID-19 than those in higher classes and marginally more likely to be from households where at least one adult had been diagnosed with COVID-19 in the past year than those in Class 3 (52% vs. 40%). The majority of caregivers viewed their pediatrician as a trusted source of information (89%). Caregiver attitudes toward vaccination are associated with household vaccination status and family COVID-19 infection history. Pediatricians play an important role in aiding vaccine uptake among children. Educational efforts should target differing caregiver profiles to address vaccine hesitancy and make future pediatric vaccine programming more successful.

Božena J Katić, Aspasia Katragkou, Uzma N. Hasan et al. · 0 citations
Review Open access Aug 2026

Level of Compliance with the Vaccination Scheme in Children Under 1 Year

Adherence to the vaccination schedule among children younger than one year was insufficient, highlighting the need to strengthen educational interventions for parents, improve access to vaccination services, and implement strategies that promote timely childhood immunization in primary healthcare settings.

Mejia Chiquinquira, Pina Alberto · 0 citations