Barriers to immunisation among children under school age (0-5 years old) of Myanmar migrant parents living in Mueang District, Samut Sakhon Province, Thailand

Author: Palinrach Kaewmanorom

Kaewmanorom, Palinrach, 2021 Barriers to immunisation among children under school age (0-5 years old) of Myanmar migrant parents living in Mueang District, Samut Sakhon Province, Thailand, Flinders University, College of Nursing and Health Sciences

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Immunisation via vaccines is the most cost-effective health intervention to save and prevent children’s lives from acquiring infectious diseases. Although Thailand has launched a vaccination program for all children in the country, the National Expanded Program on Immunisations has not reached many migrant children. Since 2013, the coverage of routine vaccinations for children under five years old had not reached the 90% coverage target. There are outbreaks of vaccine-preventable diseases among migrant children. Myanmar nationals make up the largest group of migrant workers in Thailand. To improve immunisation coverage and service, it is crucial to examine barriers to immunisation among Myanmar migrant children.

Aim and objective

This study aims to examine barriers to immunisation encountered by under-school-age (zero to five-year-old) Myanmar migrant children living in Thailand. This aim will be achieved through the following research objectives: 1) identifying the barriers to immunisation and 2) examining the correlation between the demographic backgrounds and immunisation rates among under-school-age migrant children in Thailand.


This correlation study uses data collected from a web-based questionnaire survey regarding the parents’ demographics, Myanmar migrant children’s immunisation rates and barriers to immunisation in Myanmar migrant children. The correlations analysed the data for significant relationships between the variables impacting immunisation levels.


A total of 255 Myanmar parents living in Mueang District, Samut Sakhon Province, participated in the study. The barriers to immunisation divided into four themes, taken from the research literature, are as follows: the first theme–difficulties in accessing immunisation services. The exploration of the first theme found that travelling to healthcare centres, not having enough money and language barriers were obstacles. Findings concerning the second theme, knowledge and awareness of immunisation, showed that parents’ lack of knowledge about vaccine’s adverse effects, vaccination schedules, the benefits and the availability of immunisation services. The findings of the third theme, parents’ immunisation attitudes, showed that participants generally had a positive attitude. The fourth theme was issues relating to the healthcare service. The results pertaining to this theme indicated that the main problems were having to wait a long time to access the vaccination service. Regarding the correlation between the parents’ demographics and Myanmar children’s immunisation rates, there was a low negative correlation with statistical significance between the Myanmar children’s immunisation rates and the number of children living in Thailand with a parent (χ2 = −0.330, p < 0.001). Additionally, there was a low positive relationship between the Myanmar children’s immunisation rates and parent’s income sufficiency (χ2 = 0.257, p < 0.001). There was no correlation between the parent’s age, the number of years they had been living in Samut-Sakhon Province, their legal status, total family income, the parent’s education level and their children’s immunisation rates.


These findings, detailing the barriers to vaccination uptake, are important to service providers and can help inform policy-making regarding migrant children in Thailand. Additionally, the findings can assist healthcare providers in understanding the barriers to immunisation to develop nursing interventions that promote effective immunisation services to migrant children in the future.

Keywords: immunisation, vaccination, vaccine, children, paediatric, barriers, determinants, factors, migrant, immigrant, Myanmar, Thailand

Subject: Nursing thesis

Thesis type: Masters
Completed: 2021
School: College of Nursing and Health Sciences
Supervisor: Yvonne Parry