Factors favoring vaccination in Philippine villages (paraphrased from Appendix 1 page 142 and Table 1 page 137):
(1) knowledge of disease and symptoms
(2) father thought to favor immunization
(3) belief in vaccination benefits outweigh pain
(4) parent on the rice council (farmer co-operative group sponsored by the International Institute of Rural Reconstruction in the Philippines)
(5) well-advertised
(6) followup visits by the immunization teams
(7) no or 1 sibling under 6 years of age
(8) better education
Adversity index reflected the number of items that reduced the vaccination rate:
(1) travel to immunization site > 0.5 kilometers
(2) mother considered the time of day inappropriate
(3) no followup visits to the village by the vaccination team
(4) miscellaneous problems on vaccination day (harvest time, failure to advertise)
(5) poor weather conditions
where:
• The authors assigned 1 point for each factor that interfered vaccination.
• Although there are only 5 items, the maximum score was given as 6.
• Children of parents who thought immunizations should be done door-to-door were less likely to be vaccinated. I include these with need to travel "too far".
I modified the index to include the following:
(1) split miscellaneous problems into "harvest time or holiday" and "failure to advertise".
(2) changed distance to travel to "too far" from a specific distance
(3) added time inconvenient (from Table 1, page 137)
(4) added fear or dislike of potential pain (from Table 1, page 137)
(5) added failure to believe that vaccination prevents disease (from Table 1, page 137)
(6) added use of traditional pediatric health care provider ("hilot")
(7) added considered expensive (from page 135; in this study the vaccinations were free)
If 1 point is assigned for each factor, the modified adversity score would range from 0 to 11.
