A Systematic Literature Review of the Relationship Between Knowledge Deficiency, Vaccine Negativity and Trust Among Identified Malaysian Stakeholders and the MMR Vaccine

Abstract

The communication between the government; non-government health agencies and Malaysian parents has presented a challenge to public health campaigns in general and the Measles, Mumps, and Rubella (MMR) vaccine immunisation programme specifically, resulting in the postponement of the immunisation target from 2012 to 2023. Conventionally, government, non-government agencies, and medical practitioners have facilitated scientific knowledge from researchers and scientists directly to the general public through media (both traditional and online media). However, over the time the emergence of digital media and easy accessibility of internet has decreased the need of traditional media because it enabled public to join social societies within their neighbourhoods, and across geographical boundaries. Eventually, the lay public have directly mediated the discussions of scientific information through online presenting serious challenges to the policy makers' initiative to educate the parents to immunise their children through various public health campaigns. Henceforth, parents find themselves in the state of confusion and problem-solving situation of vaccine administration to their children causing less confidence towards the information from legitimate sources. This study is an effort to investigate the possible appearance of mediating effects towards the consumption of health information about specific issue on hand between Malaysian stakeholders and individuals as decision makers. A Systematic Literature Review (SLR) was conducted. A total of 109 records were identified through scopus database and analysed, which includes the combination of journal articles, proceedings from conferences, and books. A thorough screening of the records were conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) evaluation criteria. An extensive search strategy, built to capture multiple dimensions of trust among public was applied in scopus database. Peer-reviewed studies were selected for inclusion that were focused on childhood vaccines (Measles, Mumps, and Rubella - MMR vaccine) and were published between 2010 and November 2021. Through literature analysis, it was identified that individuals of different working classes, with different educational background, religious background, and ethnicity pose a varied understanding towards the consumption of vaccine-related health information through various sources. The studies relieve that knowledge-deficient, vaccine-negative individuals exhibit higher levels of issue activeness than those who are not knowledge deficient and issue negative. Knowledge-deficient, vaccine-negative individuals exhibited higher levels of perceptions, motivations, and active communicative behaviours about vaccines. However, it was alarming to find that most individuals trusted the information about vaccine from internet even though they trusted the information from their children's doctors. These individuals showed less trust towards the information from pharmaceutical industries. Moreover, these individuals become vocal and active about an issue without the requisite knowledge to back up their attitudes thus indulging in various communication behavior. However, this study is the first review study, which was conducted to thoroughly examine the trust levels and individual activism towards the vaccine related information from Malaysian stakeholders. Henceforth, it was observed that most studies discussed about association between ethnicity and vaccine hesitation/ vaccine refusal and did not show much relation between both. It was also found that the information from Islamic bodies (JAKIM, Malaysia) and Ministry of Health, Malaysia., regarding the vaccine and Halal seems to contribute great importance to the Muslim community, but decision-making behaviour among non-Muslim parents are not addressed in any of the studies reviewed. Therefore, this research shall contribute to public relations literature and is helpful to understand the Malaysian parents' communication behavior (activism) during the process of consuming and managing the information to solve an issue-specific problem such as MMR vaccine administration to their children.