Cultural and Demographic Socialization Determinants of Mothers’ Decisions on DTP Vaccination in Thailand’s Southernmost Border Provinces
Keywords:
DTP vaccination, knowledge paradox , socio-cultural socialization , Southernmost Thailand, vaccine hesitancyAbstract
This study investigated the transition from demographic to sociocultural determinants of vaccine uptake. A cross-sectional survey was conducted among 1,200 mothers aged 20–50 years in Pattani, Yala, and Narathiwat, using multi-stage stratified random sampling. Data from structured interviews were cross-verified with official Vaccination Record Books. Hierarchical binary logistic regression was employed to assess the incremental explanatory power of socio-cultural socialization variables over baseline demographic factors. The integrated sociocultural model demonstrated substantially higher explanatory power than the demographic-only model, with Nagelkerke R² increasing from 0.224 to 0.498. The strongest predictor of vaccination completion was maternal perception of spousal support (OR = 5.95; 95% CI: 3.15–11.25; p < .001), followed by high maternal education (OR = 9.24) and positive engagement with Village Health Volunteers (OR = 2.09). Notably, a “knowledge paradox” emerged: mothers possessing technical knowledge of vaccine ingredients (e.g., gelatin) were significantly less likely to complete the vaccination series (OR = 0.38; p < .01), reflecting deep-seated Halal-related concerns. In addition, maternal COVID-19 booster status was strongly associated with child DTP completion (OR = 4.37), suggesting a transfer of vaccine confidence across generations. Overall, DTP vaccination completion in this region is driven more by socio-cultural socialization processes than by demographic characteristics. Maternal agency is substantially moderated by domestic contexts and religio-cultural interpretations of biomedical information. Public health interventions should therefore move beyond maternal-centric outreach toward family-centered and religiously sensitive strategies that directly address theological and ingredient-based concerns.
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