Caregivers’ Sources of Information About Immunization as Predictors of Delayed Childhood Vaccinations in Saudi Arabia During the COVID-19 Pandemic: A Cross-Sectional Questionnaire Study

Leena R Baghdadi,1 Marwah M Hassounah,1 Afnan Younis,1 Hessah I Al Suwaidan,1 Reem Al Khalifah2 1Department of Family and Community Medicine, College of Medicine, King Saud University, Riyadh, 11362, Saudi Arabia; 2Paediatric Endocrinology Division, Paediatrics Department, College of Medicine, King Saud University, Riyadh, 11362, Saudi ArabiaCorrespondence: Leena R BaghdadiDepartment of Family and Community Medicine, College of Medicine, King Saud University, Riyadh, Saudi ArabiaTel/Fax +966 114670836Email lbaghdadi@ksu.edu.saPurpose: This study compared the most used sources of information by caregivers for scheduled childhood vaccination in Saudi Arabia before and during the COVID-19 pandemic and examined the effect of this decision-making.Methods: An electronic survey was administered to 577 caregivers of children aged ≤ 2 years residing in Saudi Arabia during the COVID-19 pandemic curfew. The sources of information on childhood vaccination considered by the caregivers and their influence on the caregivers’ decision to delay scheduled vaccination were assessed and statistically analyzed.Results: Most participants (90.8%) were mothers aged 32.6 ± 5.7 years. Before the pandemic, most caregivers sought information about children’s vaccinations personally from the healthcare workers, or trustworthy sources, including the Ministry of Health (MOH), MOH call center 937, and MOH Sehha app. However, during the pandemic, there was a noticeable decrease in the searches for health information through professional consultations (in person and health websites) and a significant increase in the use of social media platforms. Twitter was the most used platform (29.9%) and the use of Snapchat was significantly higher during the lockdown period compared to its use before the pandemic (21.9% vs 17.2%, P < 0.001). The use of social media not only increased the level of fear among the caregivers but also had a negative effect on their decisions about children’s vaccinations. Searches on YouTube and Facebook particularly increased the odds of delaying vaccinations by 2.63 times (P = 0.008) and 3.66 times (P = 0.025), respectively.Conclusion: During the pandemic, caregivers’ health-information seeking behavior was directed towards social media networking. In Saudi Arabia, YouTube and Facebook, in particular, played an important role in the caregivers’ decision-making about childhood vaccinations. The results of this survey provide valuable information on how to reach the Saudi population and launch an effective awareness campaign using the most commonly accessed and influential sources of information.Keywords: caregivers’ decision, COVID-19, pandemic, immunization, social media, telehealth, health app