Browsing by Author "Wong, Li Ping"
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Item Chinese mothers' intention to vaccinate daughters against human papillomavirus (HPV), and their vaccine preferences: a study in Fujian Province(Taylor & Francis, 2021) Lin, Yulan; Su, Zhitai; Chen, Fulian; Zhao, Qinjian; Zimet, Gregory D.; Alias, Haridah; He, Shuqiong; Hu, Zhijian; Wong, Li Ping; Pediatrics, School of MedicineLittle is known regarding Chinese mothers' intention to vaccinate their daughters against human papillomavirus (HPV) since the HPV vaccine was approved for use in China in 2016. The aim was to explore maternal HPV vaccination acceptance, preference for 2-, 4- or 9-valent HPV vaccine and acceptance of domestically manufactured HPV vaccines. Study participants were mothers of primary school children in Southeastern region of Fujian. An online cross-sectional survey was undertaken between June and August 2019. Among the total of 3,586 completed responses (response rate 28.5%), the intention to vaccinate daughter against HPV was high (83.3%). Higher maternal education and perceived benefit and barriers were associated with greater intention to vaccinate. Among mothers who did not intend to vaccinate their daughters, the three most common reasons were daughter being too young to receive HPV vaccination (40.6%), fear of side effects (31.9%) and vaccine price is too high (16.0%). The largest proportion (41.4%) preferred their daughter to be vaccinated with the 9-valent HPV vaccine (9vHPV). Greater preference for 9vHPVwas strongly associated with higher maternal education level and annual household income. The majority of mothers expressed a preference for imported HPV vaccine (56.3%). Our result indicates that lower intentions to vaccinate daughters against HPV among less educated and lower-income mothers may lead to significant social inequalities in HPV vaccine uptake in the country.Item Cost-based COVID-19 vaccination and willingness to pay: A post-pandemic review(Taylor & Francis, 2024) Wong, Li Ping; Lee, Hai Yen; Alias, Haridah; Zimet, Gregory; Liu, Tongyu; Lin, Yulan; Hu, Zhijian; Pediatrics, School of MedicineThe primary objective of this paper is to serve as a valuable resource for policymakers who are confronted with the evolving landscape of the coronavirus disease 2019 (COVID-19), considering both free and cost-based vaccination approaches. The potential consequences of shifting from free to cost-based vaccination are explored, encompassing its impact on global vaccine equity and prioritization, economic well-being, healthcare systems and delivery, public health policies, and vaccine distribution strategies. Examining past studies on willingness to pay for the initial COVID-19 vaccine dose and booster shots provides insights into how individuals value COVID-19 vaccinations and underscores the significance of addressing issues related to affordability. If COVID-19 vaccinations incur expenses, using effective communication strategies that emphasize the importance of vaccination and personal health benefits can increase willingness to pay. Making COVID-19 vaccines accessible through public health programs or health insurance can help alleviate financial barriers and increase vaccination rates.Item COVID-19 vaccination intention and vaccine characteristics influencing vaccination acceptance: a global survey of 17 countries(BMC, 2021-10) Wong, Li Ping; Li Ping, Haridah; Danaee, Mahmoud; Ahmed, Jamil; Lachyan, Abhishek; Cai, Carla Zi; Lin, Yulan; Hu, Zhijian; Tan, Si Ying; Lu, Yixiao; Cai, Guoxi; Nguyen, Di Khanh; Seheli, Farhana Nishat; Alhammadi, Fatma; Madhale, Milkar D.; Atapattu, Muditha; Quazi-Bodhanya, Tasmi; Mohajer, Samira; Zimet, Gregory D.; Zhao, Qinjian; Pediatrics, School of MedicineBACKGROUND: The availability of various types of COVID-19 vaccines and diverse characteristics of the vaccines present a dilemma in vaccination choices, which may result in individuals refusing a particular COVID-19 vaccine offered, hence presenting a threat to immunisation coverage and reaching herd immunity. The study aimed to assess global COVID-19 vaccination intention, vaccine characteristics influencing vaccination acceptance and desirable vaccine characteristics influencing the choice of vaccines. METHODS: An anonymous cross-sectional survey was conducted between 4 January and 5 March 2021 in 17 countries worldwide. Proportions and the corresponding 95% confidence intervals (CI) of COVID-19 vaccine acceptance and vaccine characteristics influencing vaccination acceptance were generated and compared across countries and regions. Multivariable logistic regression analysis was used to determine the factors associated with COVID-19 vaccine hesitancy. RESULTS: Of the 19,714 responses received, 90.4% (95% CI 81.8-95.3) reported likely or extremely likely to receive COVID-19 vaccine. A high proportion of likely or extremely likely to receive the COVID-19 vaccine was reported in Australia (96.4%), China (95.3%) and Norway (95.3%), while a high proportion reported being unlikely or extremely unlikely to receive the vaccine in Japan (34.6%), the U.S. (29.4%) and Iran (27.9%). Males, those with a lower educational level and those of older age expressed a higher level of COVID-19 vaccine hesitancy. Less than two-thirds (59.7%; 95% CI 58.4-61.0) reported only being willing to accept a vaccine with an effectiveness of more than 90%, and 74.5% (95% CI 73.4-75.5) said they would accept a COVID-19 vaccine with minor adverse reactions. A total of 21.0% (95% CI 20.0-22.0) reported not accepting an mRNA vaccine and 51.8% (95% CI 50.3-53.1) reported that they would only accept a COVID-19 vaccine from a specific country-of-origin. Countries from the Southeast Asia region reported the highest proportion of not accepting mRNA technology. The highest proportion from Europe and the Americas would only accept a vaccine produced by certain countries. The foremost important vaccine characteristic influencing vaccine choice is adverse reactions (40.6%; 95% CI 39.3-41.9) of a vaccine and effectiveness threshold (35.1%; 95% CI 33.9-36.4). CONCLUSIONS: The inter-regional and individual country disparities in COVID-19 vaccine hesitancy highlight the importance of designing an efficient plan for the delivery of interventions dynamically tailored to the local population.Item COVID-19 vaccination intention and vaccine characteristics influencing vaccination acceptance: a global survey of 17 countries(Springer Nature, 2021-10-07) Wong, Li Ping; Alias, Haridah; Danaee, Mahmoud; Ahmed, Jamil; Lachyan, Abhishek; Cai, Carla Zi; Lin, Yulan; Hu, Zhijian; Tan, Si Ying; Lu, Yixiao; Cai, Guoxi; Nguyen, Di Khanh; Seheli, Farhana Nishat; Alhammadi, Fatma; Madhale, Milkar D.; Atapattu, Muditha; Quazi‑Bodhanya, Tasmi; Mohajer, Samira; Zimet, Gregory D.; Zhao, Qinjian; Pediatrics, School of MedicineBackground: The availability of various types of COVID-19 vaccines and diverse characteristics of the vaccines present a dilemma in vaccination choices, which may result in individuals refusing a particular COVID-19 vaccine offered, hence presenting a threat to immunisation coverage and reaching herd immunity. The study aimed to assess global COVID-19 vaccination intention, vaccine characteristics influencing vaccination acceptance and desirable vaccine characteristics influencing the choice of vaccines. Methods: An anonymous cross-sectional survey was conducted between 4 January and 5 March 2021 in 17 countries worldwide. Proportions and the corresponding 95% confidence intervals (CI) of COVID-19 vaccine acceptance and vaccine characteristics influencing vaccination acceptance were generated and compared across countries and regions. Multivariable logistic regression analysis was used to determine the factors associated with COVID-19 vaccine hesitancy. Results: Of the 19,714 responses received, 90.4% (95% CI 81.8-95.3) reported likely or extremely likely to receive COVID-19 vaccine. A high proportion of likely or extremely likely to receive the COVID-19 vaccine was reported in Australia (96.4%), China (95.3%) and Norway (95.3%), while a high proportion reported being unlikely or extremely unlikely to receive the vaccine in Japan (34.6%), the U.S. (29.4%) and Iran (27.9%). Males, those with a lower educational level and those of older age expressed a higher level of COVID-19 vaccine hesitancy. Less than two-thirds (59.7%; 95% CI 58.4-61.0) reported only being willing to accept a vaccine with an effectiveness of more than 90%, and 74.5% (95% CI 73.4-75.5) said they would accept a COVID-19 vaccine with minor adverse reactions. A total of 21.0% (95% CI 20.0-22.0) reported not accepting an mRNA vaccine and 51.8% (95% CI 50.3-53.1) reported that they would only accept a COVID-19 vaccine from a specific country-of-origin. Countries from the Southeast Asia region reported the highest proportion of not accepting mRNA technology. The highest proportion from Europe and the Americas would only accept a vaccine produced by certain countries. The foremost important vaccine characteristic influencing vaccine choice is adverse reactions (40.6%; 95% CI 39.3-41.9) of a vaccine and effectiveness threshold (35.1%; 95% CI 33.9-36.4). Conclusions: The inter-regional and individual country disparities in COVID-19 vaccine hesitancy highlight the importance of designing an efficient plan for the delivery of interventions dynamically tailored to the local population.Item Human papillomavirus (HPV) vaccination intent and its associated factors: a study of ethnically diverse married women aged 27 to 45 in Malaysia, a Southeast Asian country(Taylor & Francis, 2022) Wong, Li Ping; Alias, Haridah; Seheli, Farhana Nishat; Zimet, Gregory D.; Hu, Zhijian; Lin, Yulan; Pediatrics, School of MedicineIntroduction: This study aimed to investigate HPV vaccination intention among adult married women aged 27 to 45 years and its associated factors, and their spouse/partner's influence on HPV vaccination decision-making. Methods: This is a cross-sectional, questionnaire-based study. Study participants were recruited through simple random sampling of patients attending obstetrics and gynecology outpatient clinics in a university teaching hospital. Participants were selected based on a computer-generated list of a random list of patients attending the clinic. Results: A total of 794 complete responses were received (response rate 88.2%). The mean age of the respondents was 32.2 years with a standard deviation (SD) of ±3.9 years.The vast majority (85.3%) would communicate with their spouse/partner with regard to HPV vaccination decision-making. Nearly 30% (over half were of the Malay ethnic group) perceived their spouse/partner would not consent to their HPV vaccination. Over half (54.9%) reported joint decision-making, and 9.1% (the majority of whom were Malay) reported that HPV vaccination was dependent on their spouse/partner's decision. Intention to vaccinate against HPV was high (74.5%). Factors influencing HPV vaccination intention were spouse/partner's consent to HPV vaccination (odds ratio [OR] = 4.51; 95% confidence interval [CI], 3.08-6.62), being a postgraduate student (OR = 4.55; 95% CI, 2.13-9.72 vs. unemployed/housewife), average household income MYR2000-4000 (OR = 2.09; 95%CI, 1.16-3.78 vs. below MYR2000), and an HPV-related knowledge score of 9-20 (OR = 1.60; 95% CI, 1.10-2.32 vs. score 0-8). Conclusion: Findings highlight the importance of culture-centered interventions to enhance male partner's awareness and support for the HPV vaccination of married women.Item Human Papillomavirus (HPV) Vaccine Uptake and the Willingness to Receive the HPV Vaccination among Female College Students in China: A Multicenter Study(MDPI, 2020-01-16) You, Dingyun; Han, Liyuan; Li, Lian; Hu, Jingcen; Zimet, Gregory D.; Alias, Haridah; Danaee, Mahmoud; Cai, Le; Zeng, Fangfang; Wong, Li Ping; Pediatrics, School of MedicineBackground: This study aimed to determine human papillomavirus (HPV) vaccine uptake and willingness to receive HPV vaccination among female college students, in China, and its associated factors. Methods: An online cross-sectional survey of female college students across the eastern, central, and western regions of China was undertaken between April and September 2019. Partial least squares structural equation modeling (PLS-SEM) was used to examine factors associated with the HPV vaccine uptake and willingness to receive the HPV vaccine. Results: Among the total 4220 students who participated in this study, 11.0% reported having been vaccinated against HPV. There are direct effects of indicators of higher socioeconomic status, older age (β = 0.084 and p = 0.006), and geographical region (residing in Eastern China, β = 0.033, and p = 0.024) on HPV vaccine uptake. Higher knowledge (β = 0.062 and p < 0.000) and perceived susceptibility (β = 0.043 and p = 0.002) were also predictors of HPV vaccine uptake. Of those who had not received the HPV vaccine, 53.5% expressed a willingness to do so. Likewise, social economic status indicators were associated with the willingness to receive the HPV vaccine. Total knowledge score (β = 0.138 and p < 0.001), both perceived susceptibility (β = 0.092 and p < 0.001) and perceived benefit (β = 0.088 and p < 0.001), and sexual experience (β = 0.041 and p = 0.007) had a positive and significant direct effect on the willingness to receive the HPV vaccine, while perceived barriers (β = −0.071 and p < 0.001) had a negative effect on the willingness to receive the HPV vaccine. Conclusions: Geographical region and socioeconomic disparities in the HPV vaccination uptake rate and willingness to receive the HPV vaccine provide valuable information for public health planning that aims to improve vaccination rates in underserved areas in China. The influence of knowledge and perceptions of HPV vaccination suggests the importance of communication for HPV immunization.Item A Nationwide Study Comparing Knowledge and Beliefs about HPV among Female Students before and after HPV Vaccination(Elsevier, 2018) Wong, Li Ping; Alias, Haridah; Sam, I-Ching; Zimet, Gregory D.; Pediatrics, School of MedicineStudy Objective To assess the knowledge and beliefs regarding HPV and the HPV vaccine among girls before and after vaccination in the Malaysian HPV Immunisation Programme. Design A nationwide longitudinal survey. Setting Thirty-two randomly selected schools from 13 states and 3 federal territories in Malaysia from February to March 2013, and October to November 2013. Participants Form One female students (13-year-old). Interventions None. Main Outcome Measures Mean knowledge score of HPV infection. Results A total of 2,644 students responded to the pre-vaccination survey, of whom 2,005 (70%) completed the post-vaccination survey. The mean knowledge score was 2.72 (SD ± 2.20) out of a maximum score of 10 in the pre-vaccination survey, which increased significantly to 3.33 (SD ± 1.73) after the 3 doses of HPV vaccine (p = 0.001). Many answered incorrectly that, ‘Only females can get HPV infection’ (91.5% pre-vaccination versus 96.1% post-vaccination), and only a few were aware that, ‘Vaccinating boys helps to protect girls against HPV infection’ (11.7% for pre-vaccination versus 10.2% for post-vaccination). The mean knowledge score was significantly higher post-vaccination among higher-income families and those with parents of a higher occupational status. Regarding beliefs about the HPV vaccine, 89.4% in the pre-vaccination survey held the view that they would not get a HPV infection, and the percentage remained similar in the post-vaccination survey. Perceived severity of HPV infection also remained low in both pre- and post-intervention groups. Only 21.5% reported receiving health information about HPV along with the provision of the HPV vaccine; those who received health information showed higher levels of knowledge. Conclusion Findings revealed a general lack of knowledge and erroneous beliefs about HPV and the HPV vaccine even after receiving vaccination. This suggests that imparting accurate knowledge about HPV along with vaccine administration is essential. Specifically, girls from lower socioeconomic groups should be a target of educational intervention.Item Nationwide Survey of Knowledge and Health Beliefs regarding Human Papillomavirus among HPV-Vaccinated Female Students in Malaysia.(PLOS, 2016) Wong, Li Ping; Raja Muhammad Yusoff, Raja Nur Amalina; Edib, Zobaida; Sam, I.-Ching; Zimet, Gregory D.; Department of Pediatrics, IU School of MedicineThe National HPV Immunization Programme, which offers free human papillomavirus (HPV) vaccines to teenaged female students, was launched in Malaysia in 2010. HPV vaccination paired with adequate knowledge about HPV infection provides the best protection against cervical cancer. To identify the level of knowledge and the health beliefs towards HPV and the HPV vaccine among HPV-vaccinated female students in Malaysia. A nationwide cross-sectional survey among 14 years old female students who had received three doses of the HPV vaccine was conducted in 32 randomly selected schools from 13 states and 3 federal territories in Malaysia between February 2013 and April 2013. Among 2482 respondents, knowledge about HPV infection and the HPV vaccine was extremely poor. The mean total knowledge score was only 3.56 (SD ± 1.76), out of a possible score of 10. The majority of respondents were unaware that vaccinating boys with HPV can help protect girls against HPV infection (91.6%), HPV cannot be cured (81.6%) and that HPV is a sexually transmitted infection (70.3%). Most of the respondents had the misconception that only females get HPV (95.1%), and that the HPV vaccine eliminates the need for Pap smear tests (68.3%). Most respondents (91.6%) believed that they would not get an HPV infection. Almost half of the respondents (42.9%) held the misconception that HPV infection could not lead to serious illness. Findings revealed poor knowledge about both HPV and the HPV vaccine, low perceived susceptibility to HPV infection and misinformation about HPV infection among HPV-vaccinated girls. Therefore, it is essential to increase the knowledge and awareness of health risks regarding HPV infection among teenaged girls who have received the HPV vaccine.Item The influence of men on HPV vaccination of their spouse/partner in China(Taylor & Francis, 2022) Lin, Yulan; Cai, Carla Zi; Hu, Zhijian; Zimet, Gregory D.; Alias, Haridah; Wong, Li Ping; Pediatrics, School of MedicineMen involvement in HPV vaccine advocacy is important in a patriarchal society. This study aimed to investigate the influence of men on HPV vaccination of adult women. An online cross-sectional survey was undertaken between June and August 2019. Participants were fathers of children enrolled in schools in Fujian Province. A total of 1953 participants responded to our survey. Just over 60% reported they would definitely or likely support their spouse/partner to receive HPV vaccine. Physician recommendation (adjusted odds ratio [aOR] = 5.68, 95%CI = 3.89-6.86) and spouse/partner communication about HPV vaccination (aOR = 5.30, 95%CI = 3.72-7.55) were significant covariates associated with higher willingness to support women's HPV vaccination. Perceiving HPV vaccination as only for women who have had multiple sex partners and HPV vaccination as a sensitive topic were significantly associated with lower willingness to support HPV vaccination. Over two-thirds (67.3%) reported joint HPV vaccination decision-making and 2.8% reported that it was entirely the man's decision. The role of men in HPV vaccine acceptance and hesitancy among adult women is evident in China and warrants educational interventions to target men to enhance women's HPV vaccination uptake.