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5 Assessing Current Approaches to Childhood Immunizations Department of Psychology, Grand Canyon University PSY 693: Professional Capstone Dr. Larry Katz July 28, 2021 Assessing Current Approaches to Childhood Immunizations Introduction Immunization is the practice that involves the vaccination of people to protect them from illnesses. Child immunization is the most critical public health approach which reduces child mortality and morbidity in most countries. This paper will discuss and evaluate the current approaches to childhood immunization globally; immunization is estimated to have prevented a 2.5million deaths of children every year from tetanus, measles, diphtheria, and pertussis (Dube et al., 2013). This research is essential in psychology as vaccination is among the most remarkable 20th-century achievements but still a public health issue, including inadequate, unstable, and delayed uptake of vaccines. Psychology provides three main prepositions to comprehend and intervene to increase uptake in places where vaccines are entirely within people’s means. This research is vital as, through thoughts and feelings, individuals will be motivated to get vaccinated (Brewer et al., 2017). During this research, peoples respect, beneficence, and justice will be upheld in various ways. Respect for persons will include treating participants as autonomous agents, and those with reduced autonomy will be given protection. For beneficence, peoples decisions are not only respected or protected but their general well-being will also be secured. No harm will be made, and maximum possible benefits will be made, thus minimizing probable damage. To maintain justice, the results of the research will be shared equally among the relevant authorities. Literature Review In developing countries, Immunization is still low than in those countries which are already developed. According to Gesser-Edelsburg et al., most parents lack education regarding Immunization. Many in these countries do not comply with immunization schedules as per the Expanded Program. According to Thapar et al., in 2014, around 18.7 million children could not get the third dose of the Diphtheria-Pertussis-Tetanus (DPT3) vaccine (Thepar et al., 2021). The total number of children who have received the DPT3 vaccine is a representation indicator concerning full Immunization. When it comes to service delivery, the DPT3 vaccination measures the performance of a health system and evaluates the effectiveness of an immunization program concerning service delivery. According to Thepar et al., the global coverage of measles was at 86 percent, while that of DPT and DPT3 was 90 and 86 percent. The above approximations do not clearly show the seen differences in vaccine coverage. The routine has been lower in India than in other countries (Girmay et al., 2019). After the 2013 outbreak in Israel, most parents became reluctant to take their children to receive Oral Polio Vaccine, and the frequent reoccurrence of poliomyelitis followed this. To achieve maximum immunization coverage, the global vaccine action plan (GAVP) ‘requested countries to attempt and reach it by 2020 for all vaccines. Despite this request, some countries with under-vaccinated children were hesitant from parents (Dubé et al., 2016). Many studies have been carried out, but there is no enough evidence concerning the factors associated with vaccine hesitance (Dubé et al., 2013). This study will assist in adopting a more panoramic lens for these factors to be put into focus and know how they are graded universally. Various factors are currently being induced by vaccine uptake among the children’s parents. Parents who refuse their children to be fully vaccinated always defend themselves based on their beliefs (Girmany and Dadi 2019). According to Gesser-Edelsburg et al., the public perception risk depends on context analysis. Also, those parents who give their children full Immunization of other vaccines but not oral polio do that because they lack faith in the healthcare system (Gesser-Edelsburg et al., 2016). Methods and Data Collection The study will use primary and secondary data to collect information. The primary data will be taken from individual structured interviews, which will be from the mothers. Telephone surveys will also be used in the collection of data. Secondary data will be taken from demographic and health survey programs. All children who will have received Immunization in the past year will be marked out. Simple random stratified sampling will choose those participants required to test the hypotheses (Wang et al., 2018). A community-based cross-sectional study will be used to carry out the analysis. It will help the researcher gather and analyze data, which is essential in addressing research questions (Thomas, 2020). Hypothetical Findings For all the mothers who will participate in the research, the mean and standard deviation of their age will be considered in terms of years to identify those stuck in beliefs and other factors, making them reluctant to take their children to finish vaccination as scheduled. After that, a correlation will be made to determine whether the mothers age and vaccine hesitance have a relationship. To conclude the mother’s vaccine hesitance, their beliefs, religion, and education level will be considered. Recommendations Future studies concerning the health conditions that occur when a child does not get full Immunization will rise if the study succeeds. If the survey recognizes these mothers to be reluctant in taking their children from vaccination, different studies may be arranged in the future. Those studies will thus determine various digital technologies which can be used to trace those mothers who do not take their children for complete Immunization. References Brewer, N. T., Chapman, G. B., Rothman, A. J., Leask, J., & Kempe, A. (2017). Increasing vaccination: putting psychological science into action. Psychological Science in the Public Interest, 18(3), 149-207. Dubé, E., Laberge, C., Guay, M., Bramadat, P., Roy, R., & Bettinger, J. A. (2013). Vaccine hesitancy: an overview. Human vaccines & immunotherapeutic, 9(8), 1763-1773. Dubé, E., Vivion, M., Sauvageau, C., Gagneur, A., Gagnon, R., & Guay, M. (2016). " Nature does things well; why should we interfere?" Vaccine hesitancy among mothers. Qualitative Health Research, 26(3), 411-425. Etikan, I., & Bala, K. (2017). Sampling and sampling methods. Biometrics & BiostatisticsInternational Journal, 5(6), 00149. Gesser-Edelsburg, A., Shir-Raz, Y., & Green, M. S. (2016). Why do parents who usually vaccinate their children hesitate or refuse? General good vs. individual risk. Journal of Risk Research, 19(4), 405-424. Girmay, A., & Dadi, A. F. (2019). Full immunization coverage and associated factors among children aged 12-23 months in hard-to-reach areas of Ethiopia. International Journal of pediatrics, 2019. Thapar, R., Kumar, N., Surendran, P., Shahdiya, A., Mahendran, V., Ramesh, R, & Kumar, A. (2021). Vaccine hesitancy among mothers of under-five children in Coastal South India: a facility-based cross-sectional study. F1000Research, 10(186), 186. Thomas, L. (2020, May 8). What is a cross-sectional study? Retrieved from Wang, N., Gao, X., & Li, J. (2018). Random sampling for fast face sketch synthesis. Pattern Recognition, 76, 215-227. 13 Assessing Current Approaches to Childhood Immunizations Department of Psychology, Grand Canyon University PSY-550: Research Methods Dr. Shari Schwartz May 19, 2021 Introduction Immunization is the process in which an individual is protected against disease, and it is done via vaccination. On the other hand, vaccination is the action of a vaccine being introduced into the body to produce immunity to a particular disease. A vaccine is a product that arouses the immune system of an individual, thus the production of immunity to a particular disease. The immunity thus protects the individual from that disease. Immunity is the protection from a disease that is infectious. Child immunization is the primary public health approach in the reduction of child mortality and morbidity. Assessment of the current approaches that are linked to the immunization of a child is essential. Globally, primary immunization is estimated to prevent approximately 2.5 million childhood deaths annually from tetanus, diphtheria, measles, and pertussis (Dube et al., 2013). Immunization succession is always accompanied by rejection of public health practices, and reasons for these have never been straightforward. Some of the motivations are religious, scientific, or even political. To reduce the incidence and prevalence of vaccine-preventable diseases, vaccination programs depend on a high uptake level. Vaccination offers protection for vaccinated individuals. When there are high vaccination coverage rates, the indirect protection rate is stimulated for the overall community (Dube et al., 2013). Literature Review Despite this massive use, immunization coverage in countries still developing has been reported to be still low. If mothers were educated on the importance of these vaccine services to their children, all the children would receive immunization as per the Expanded Program on the Immunization schedule, hence preventing mortality and morbidity. According to Thapar et al., in 2014, approximately an 18.7million children could not get the third dose of the Diphtheria-Pertussis-Tetanus (DPT3) vaccine. The total percentage of children who are one year and below and have to receive their dosses of DPT3 vaccine is seen as a proxy indicator regarding full immunization. The DPT3 estimates assess the health system performance and measure the immunization program effectiveness regarding service delivery. These strategies are thus used in the implementation of strategies for the elimination and eradication of diseases. According to Thapar et al., the global coverage for DPT1 and DPT3 was 90\% and 86\%, respectively, while that of measles first dose at 86\%. The above estimates thus do not replicate the seen differences in vaccine coverage. The coverage of DPT1 and DPT3 varied from 84\% and 76\% in Africa and 97\% and 94\% in the European countries. In India, the routine has been lower than in the rest of the countries. Following the 2013 outbreak in Israel, many parents were reluctant to take their children to vaccinate Oral Polio Vaccine afterward, and thus, poliomyelitis seemed to be reoccurring due to this. To attain maximum immunization coverage, the global vaccine action plan (GVAP) asked countries to try and accomplish 90percent immunization coverage by 2020 for all vaccines. Out of 194 country members of the world health organization, only 129 achieved the coverage goal of GVAP national vaccination. Immunization coverage in all the world countries has been stable since 2010, with 85 to 86 percent. Despite the high rate of childhood vaccination coverage, some estimates hide groups of under-vaccinated children due to parents hesitance. In recent years, a lot has been investigated, and the word vaccine hesitance has been formed, but evidence that has been found in regards to factors that link to vaccine hesitance has not been thoroughly investigated. This research will help adopt a more panoramic lens so that these factors can be brought into focus and know-how they look globally. Many factors are inducing the uptake of vaccines among the parents of the children. They include the pain, ethnic concerns of the vaccine, fever, and adverse effects of the vaccines that come about after a child has been immunized, and most of them lead to vaccine hesitancy in most countries. The spread of vaccine fear and ant vaccine has become common, mostly on online platforms and people. In terms of vaccine policy, vaccine attitudes and behaviors are differentiated from one another even though they might be slightly related. Attitudes towards vaccination may be different from actual behaviors as a mother who pursues vaccination for both her children, and she may be displaying pro-vaccine behavior, but at the same time, they may be hesitant to receive the same vaccines. In such a case, the mother’s behavior may be that it is just a school requirement that she is to follow; otherwise, she would not opt to receive the vaccine if it were not that way. Simultaneously, the attitudes that drive her to vaccine hesitancy may be due to science, influence in personalities she trusts, matters of religion, and skepticism. The primary focus of this proposal is the group of parents who hold vaccine-hesitant attitudes and exhibit non-vaccinating behaviors for their children. Parents who refuse their children to be vaccinated always defend their positions based on their beliefs (Girmay and Dadi 2019). Parents have their reasons for vaccinations; others believe that vaccines will ruin instead of helping their child, while others believe that natural immunity is better than an artificial one. According to Gesser-Edelsburg et al., the risk of the public perception is based on a dependent context analysis. According to Gesser-Edelsburg et al., the parents who give full immunization of other vaccines but fail with oral polio vaccine occurred due to lack of faith in the health system, reasons particularly to the polio outbreak concerns related to the safety of the vaccine. Most mothers believed that their children were to be protected when given the oral polio vaccine, but it was for societys well-being in an absolute sense. Methods Participants A sample of mentally stable parents who are 18 to 45 years will be invited to answer questions linked to immunization-related intention, beliefs, and even behaviors. These participants will be selected via the multistage sampling technique. Using multistage sampling, the population will be divided into groups then later into subgroups so that the appropriate ones are found. Several steps will be used to divide the groups to find the target population. The first step will include a random selection of seven clusters from the population. A selection of three households with children less than five years will be performed randomly. The community health information system (CHIS) registration log will be used as a sampling frame to select households with children less than five years. During the collection of data for the study, if participants will not be found a home, the researchers will have to go back there the next day (Etikan and Bala 2017). Apparatus This study will make use of both primary and secondary data. The primary data will be collected from personal structured interviews, which will be given to the mothers. After the participants have answered, the questions grading will be done against the predetermined scoring system. Telephone surveys will also collect data from the target population as trained interviewers will contact probable respondents to gather information. Demographic and health survey programs will be used as the secondary data collection data whereby children who have received immunization fully and partially will be traced. Procedure Simple random stratified sampling will be appropriate as it will ensure particular characteristics that will be represented proportionately in the sample. A simple random method is a technique that is to be used to choose the population that is to test the hypotheses concerning the entire population. This study will adopt a simple random procedure of mothers from each of the targeted populations. In general, non-probability sampling selects any member of the population indiscriminately. The population will first be defined then a sample size will be chosen. The lottery method, including the use of a computer program, will be considered to select the target population randomly. Data will then be collected from the chosen samples without bias (Wang et al., 2018). Research Design A community-based cross-sectional study will be used to conduct the study. This design will help the researcher collect and analyze data that is important in addressing the research question. A comprehensive analysis would provide an overview of variables, without their existence being determined (Thomas, 2020). Results The mean and standard deviation of the age of all the mothers who will participate in the study will be calculated in terms of years to find the majority who are confined to beliefs and other factors, thus reluctant to take their children for complete immunization. The mean age of the children who have not received complete vaccination due to the mothers hesitance and those who have received full immunization as per EPI will also be determined. The mothers level of education will also be accessed to see whether they are aware of the vaccines their children should get and the number of doses, thus choosing to ignore or whether they have no idea at all. The mothers religion will also be assed that is whether Muslim, Christian, or Hindu. The mothers monthly income will also be assessed to see whether they lack funds for taking them to an immunization facility. The mother’s antenatal clinic books will be assessed to determine whether they attended all the visits as required and if so, they received the tetanus vaccine and whether they gave birth in a health facility. This will determine whether the health care providers gave the mothers enough convincing information about the importance of being immunized. All of this information will help the researcher assess whether the participants have enough knowledge of their childs immunization. The correlation will be used to see if there is a relationship between the mothers age and vaccine hesitance. The relationship between the mother’s religion, level of education, and beliefs will be correlated with vaccination hesitance. The Pearson’s coefficient will be used to demonstrate the correlation between the two variables. A correlation coefficient of +1 will show a perfect correlation, while a zero correlation will show no relationship exists. IBM SPSS and strata program will be used to make this analysis which will show whether correlation will exist or not. A t table will then be used to compare the calculated t value with that of the critical t value to identify the statistical significance. Discussion The immunization programs success relies on high vaccine uptake rates and vaccination coverage. Maintenance of high vaccination coverage has resulted in effective control of diseases that can be prevented through vaccination. This study will access the current approaches to childhood immunization and the factors associated with partial immunization of children below five years. If the results obtained will be significant, they will provide a clue in the future if the same thing happens to someone else. If the same thing happens in a different place globally, the public will use the results to take proper preventive measures to protect themselves. Ethical Issues The research will follow the APA ethical guidelines, including informed consent, debriefing statement, deception, and obtaining IRB permission. Verbal informed consent will be attained from every participant before the process of data collection begins. The participants will be given a complete description of the hypotheses to be tested, the procedures to follow them, and other relevant information regarding the study. Ethical clearance will be acquired from the Institutional Review Board (IRB), and a permission letter to carry out the research will be obtained from the University. Participants will fully be educated about the main goals and objectives of the study, and they will be assured that all the data they provide will remain confidential. Study Limitations Limitations are the design characteristics that will influence or affect the interpretation of the findings of the research. Despite getting evidence that might be important, limitations such as follow-up on the effects of the health system factors that might influence immunization uptake might be hard to access, including the number of available, logistics, and the health care personnel. Mothers not remembering all the events that happened since the child was born is another limitation that might occur, especially when they do not have the immunization cards used. The amount of time needed to conduct the study is another limitation experienced in a cross-sectional study. Much time is needed to gather all the information. Conclusion Future studies regarding the health conditions caused when a child does not receive full immunization will arise after this study. If the study finds out that most of these mothers are reluctant to take their children for full immunization, various studies might be carried out in the future. Those studies will identify the digital technology used to track those mothers who do not take their children to the hospital. Time Frame Activities 1 2 3 4 5 6 7 Acceptance of the research proposal Talks with representatives in the study area Research tools development Training of interviewees Pilot study Data collection Data entry Analysis Information to community and authorities Proposal Budget ITEM AMOUNT Student Benefits $50 Education fees $80 Supplies $100 Training fees $200 Instrument fees $150 Traveling fees $300 Other expenses $500 TOTAL $1380 References Dubé, E., Laberge, C., Guay, M., Bramadat, P., Roy, R., & Bettinger, J. A. (2013). Vaccine hesitancy: an overview. Human vaccines & immunotherapeutics, 9(8), 1763-1773. Dubé, E., Vivion, M., Sauvageau, C., Gagneur, A., Gagnon, R., & Guay, M. (2016). Nature does things well; why should we interfere? Vaccine hesitancy among mothers. Qualitative Health Research, 26(3), 411-425. Etikan, I., & Bala, K. (2017). Sampling and sampling methods. Biometrics & Biostatistics International Journal, 5(6), 00149. Gesser-Edelsburg, A., Shir-Raz, Y., & Green, M. S. (2016). Why do parents who usually vaccinate their children hesitate or refuse? General good vs. individual risk. Journal of Risk Research, 19(4), 405-424. Girmay, A., & Dadi, A. F. (2019). Full immunization coverage and associated factors among children aged 12-23 months in hard-to-reach areas of Ethiopia. International Journal of pediatrics, 2019. Thapar, R., Kumar, N., Surendran, P., Shahdiya, A., Mahendran, V., Ramesh, R, & Kumar, A. (2021). Vaccine hesitancy among mothers of under-five children in Coastal South India: a facility-based cross-sectional study. F1000Research, 10(186), 186. Thomas, L. (2020, May 8). What is a cross-sectional study? Retrieved from https://www.scribbr.com/methodology/cross-sectional-study/ Wang, N., Gao, X., & Li, J. (2018). Random sampling for fast face sketch synthesis. Pattern Recognition, 76, 215-227. Can you please go over the power point you’ve provided & make sure these 3 corrections required are successfully completed please? If you can add in more cited references please. Assessing Current Approaches to Childhood Immunizations Department of Psychology, Grand Canyon University PSY-693: Professional Capstone Dr. Larry Katz August 4, 2021 1 Introduction Immunization is the method of vaccination that is designed to protect individuals against infections. An essential public health measure for reducing the child mortality rate in most countries is the immunization of children. A vaccination is a therapeutic substance that heightens immunity to a specific illness. When this immunity protects you from that illness, it is called immunity. Immunity is the ability to avoid contracting a transmissible disease. Public health measures to reduce child mortality and morbidity should include immunization. The first line of defense against infectious disease is immunization, but it must be followed by the complete rejection of public health methods to remain effective. Many of the reasons people provide for their creativity are religious, scientific, or even political. 2 Immunization involves vaccinating people It aims to protect individuals from illnesses A vaccine arouses the immune system of an individual to protect them against diseases Research Questions And Hypothesizes Research Questions What are the current approaches to childhood immunization from the global perspective? What is the number of deaths having immunization prevented? Hypothesizes There are many approaches to childhood immunization globally that are being carried out in many countries There are over 2.5 million deaths that have been prevented globally as a result of immunization This article will address and analyze the existing worldwide strategies for kid immunization; it is estimated that over 2.5 million child deaths per year have been avoided because of immunization (Dube et al., 2013). It is vital in psychology that vaccination be a public health problem, as vaccinations are one of the most amazing 20th-century breakthroughs, yet this remains an issue due to vaccine uptake that is incomplete, unstable, and delayed. Three major prepositions are commonly used in psychology to better grasp and intervene to boost uptake of vaccinations where they are affordable and accessible for everyone. This research is critical because it affects how people act and think, both of which influence vaccination decisions (Brewer et al., 2017). 3 Literature Review Immunization in underdeveloped nations is still lower than that in developed countries. Gesser-Edelsburg et al. discovered that the majority of parents were not properly educated about immunization. In many countries, people often do not adhere to immunization schedules because of the scope of the Expanded Program. Almost 18.7 million children in 2014 had not had the third dose of the Diphtheria-Pertussis-Tetanus (DPT3) vaccination, according to the findings of Thapar et al. (Thepar et al., 2021). An indication of complete immunization is the total number of children who have received the DPT3 vaccination. Service delivery: When it comes to service delivery, the DPT3 vaccination measures system performance and immunization regarding service delivery. Thepar et al. assert that worldwide coverage of measles was at 86\%, whereas DPT and DPT3 had global coverage of 90\% and 86\%. 4 Immunization is low in developing countries This is because most parents lack immunization education, according to Gesser-Edelsburg et al. The total number of children who have received a vaccine gives an indication of complete immunization DPT3 vaccination measures system performance when it comes to service delivery Literature Review Continued According to Girmay et al. (2019), India has lower in India Countries are requested to achieve maximum immunization by the year 2020 Despite this request, countries have not achieved maximum immunization due to non-cooperation from parents In contrast to the rest of the world, the routine in India has been lower than elsewhere (Girmay et al., 2019). This is because most parents refused to allow their children to have Oral Polio Vaccine after the 2013 outbreak in Israel, and due to the recurrent recurrence of poliomyelitis, parents hesitation in allowing their children to get vaccinated has remained ever since. According to the global vaccination action plan (GAVP), governments were asked to aim to provide everyone with complete immunization coverage by 2020 using various strategies. Even though she had requested it, certain nations with under-vaccinated children did not let parents get their children vaccinated (Dubé et al., 2016). A large number of research have been conducted. However, thus far, theres no strong proof about the things that may contribute to vaccination refusal (Dubé et al., 2013). The findings of this study will aid in the implementation of a more expansive lens to take into account elements such as these and know how they are distributed evenly. 5 The Literature Review Continued Parents who do not vaccinate their children due to beliefs Others do not immunize their children because they lack faith in the healthcare system There is also lack of enough immunization system in healthcare Many different variables influence the parents decisions to get their children vaccinated. These parents always rely on their beliefs while arguing against having their children vaccinated (Girmany and Dadi 2019). According to Gesser-Edelsburg et al., context analysis has a significant impact on public perception risk. Some parents who fully immunize their children against other vaccinations but neglect to immunize their children against oral polio have this belief: No one in the healthcare system can provide my immunization adequate medical care (Gesser-Edelsburg et al., 2016). 6 Methods and Data Collection Primary and secondary data will be used in the study to obtain information. Data from individual structured interviews will be used to get the primary data. Surveys over the phone will be utilized to gather data as well. Demographic and health survey programs will be the source of secondary data. Immunization will be noted on all youngsters who have received it in the last year. Participants that will need to test the hypotheses will be randomly selected from the population (Wang et al., 2018). In order to carry out the analysis, community-based cross-sectional research will be employed. The researcher will collect and evaluate data critical to resolving issues (Thomas, 2020). 7 The study will use both primary and secondary data Interviews will be used to collect the primary data Demographic and health survey programs will be used to collect secondary data Simple random stratified sampling was used to select participants for the study Ethical Considerations Before carrying out the study, the researcher will seek informed consent The study needs approval from university ethical committee The study will uphold the participants; respect, beneficence, and Justice Before the research starts, the study will seek approval from the universitys ethical committee. During this research, peoples respect, beneficence, and justice will be upheld in various ways. Respect for persons will include treating participants as autonomous agents, and those with reduced autonomy will be given protection. For beneficence, peoples decisions are not only respected or protected, but their general well-being will also be secured. No harm will be made, and maximum possible benefits will be made, thus minimizing probable damage. To maintain justice, the results of the research will be shared equally among the relevant authorities. There is need for informed consent before carrying the study. the 8 Hypothetical Findings The mean and standard deviation of the mothers who will participate will be considered A correlation will be made to determine whether the mothers age and vaccine hesitance have a relationship The education level of the mother will also be considered All of the mothers who join the study will have their age as measured in years (mean and standard deviation) as a variable, helping them identify those who are held back by bad beliefs and other inhibiting factors. These mothers then avoid vaccinating their children on time, thus prolonging their kids vaccination schedules. When that has been done, an analysis will be done to see if mothers age and vaccination refusal are linked. 9 Future Research Need to study health conditions if children fail to get immunized More studies should also focus on why mothers avoid taking their children to be vaccinated Digital technology should be employed to locate parents who do not vaccinate their children The long-term effects of immunization refusal on health remain unclear, and more research will look at this in the future if the project is successful. Other studies will be planned if the poll determines that they are hesitant about handing their children up to immunization. Thus, numerous digital technologies will be applied to find those parents who do not vaccinate their children. 10 Conclusion Limitations like follow-up effects of the health system factors might affect immunization Mothers may also lack clear memory of all the events that took place since the child was born There is also a need for more time to conduct the study While crucial evidence might have been obtained, follow-up on the possible influences of the health system on vaccination uptake (such as the number of availabilities, logistics, and the health care professionals) may be difficult to obtain. Another possible restriction is mothers failing to recall all the events that had occurred since the kid was born, especially if they do not have the vaccination certificates they were given when they were younger. Another restriction in cross-sectional research is the length of time needed to perform the investigation. It will take a lot of time to acquire all the relevant facts. 11 References Brewer, N. T., Chapman, G. B., Rothman, A. J., Leask, J., & Kempe, A. (2017). Increasing vaccination: putting psychological science into action. Psychological Science in the Public Interest, 18(3), 149-207. Dubé, E., Laberge, C., Guay, M., Bramadat, P., Roy, R., & Bettinger, J. A. (2013). Vaccine hesitancy: an overview. Human vaccines and immunotherapeutic, 9(8), 1763-1773. Dubé, E., Vivion, M., Sauvageau, C., Gagneur, A., Gagnon, R., & Guay, M. (2016). Nature does things well; why should we interfere? Vaccine hesitancy among mothers. Qualitative Health Research, 26(3), 411-425. Etikan, I., & Bala, K. (2017). Sampling and sampling methods. Biometrics & BiostatisticsInternational Journal, 5(6), 00149. Girmay, A., & Dadi, A. F. (2019). Full immunization coverage and associated factors among children aged 12-23 months in hard-to-reach areas of Ethiopia. International Journal of pediatrics, 2019. Thapar, R., Kumar, N., Surendran, P., Shahdiya, A., Mahendran, V., Ramesh, R, & Kumar, A. (2021). Vaccine hesitancy among mothers of under-five children in Coastal South India: a facility-based cross-sectional study. F1000Research, 10(186), 186. Thomas, L. (2020, May 8). What is a cross-sectional study? Retrieved from Wang, N., Gao, X., & Li, J. (2018). Random sampling for fast face sketch synthesis. Pattern Recognition, 76, 215-227. ADD A FOOTER 12