Vaccine Hesitancy Causes, Consequences, and a Call to Action
Vaccine Hesitancy Causes, Consequences, and a Call to Action
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DOI：
10.1016/j.amepre.2015.06.009
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发表时间：
2015-12-01
影响因子：
5.5
通讯作者：
Omer, Saad B.
中科院分区：
文献类型：
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作者：
Salmon, Daniel A.;Dudley, Matthew Z.;Omer, Saad B.
对疫苗的犹豫反映了对自己或孩子接种疫苗的决定的担忧。造成疫苗犹豫的因素有很多，包括疫苗的强制性、疫苗与不良健康结果的巧合时间关系、对疫苗可预防疾病的不熟悉以及对企业和公共卫生机构缺乏信任。尽管疫苗接种在美国是一种常态，而且大多数父母都会给孩子接种疫苗，但许多人这样做是出于担忧。过去十年来，要求学校免疫要求非医疗豁免的家长比例一直在增加。拒绝疫苗与侵袭性 B 型流感嗜血杆菌疾病、水痘、肺炎球菌疾病、麻疹和百日咳的爆发有关，导致幼儿不必要的痛苦并浪费有限的公共卫生资源。疫苗犹豫是一个极其重要的问题，需要解决，因为有效控制疫苗可预防的疾病通常需要无限期地维持极高的及时接种率。疫苗犹豫的原因是多因素且复杂的，需要在个人、提供者、卫生系统和国家层面采取广泛的方法。其中包括标准化测量工具，用于量化和定位疫苗犹豫的聚集并更好地理解信任问题；对强化且资金充足的疫苗安全系统进行快速、独立和透明的审查；为医生办公室的疫苗风险沟通提供足够的报销；以及为有疫苗问题的父母（尤其是首次怀孕的女性）量身定制的信息。疫苗预防疾病和拯救生命的潜力从未如此之大。然而，这种潜力直接取决于父母对疫苗的接受程度，这需要对疫苗、推荐和管理疫苗的医疗保健提供者以及确保疫苗安全的系统有信心。 (C) 2015 年，美国预防医学杂志和 Elsevier Ltd. 保留所有权利。
Vaccine hesitancy reflects concerns about the decision to vaccinate oneself or one's children. There is a broad range of factors contributing to vaccine hesitancy, including the compulsory nature of vaccines, their coincidental temporal relationships to adverse health outcomes, unfamiliarity with vaccine-preventable diseases, and lack of trust in corporations and public health agencies. Although vaccination is a norm in the U.S. and the majority of parents vaccinate their children, many do so amid concerns. The proportion of parents claiming non-medical exemptions to school immunization requirements has been increasing over the past decade. Vaccine refusal has been associated with outbreaks of invasive Haemophilus influenzae type b disease, varicella, pneumococcal disease, measles, and pertussis, resulting in the unnecessary suffering of young children and waste of limited public health resources. Vaccine hesitancy is an extremely important issue that needs to be addressed because effective control of vaccine-preventable diseases generally requires indefinite maintenance of extremely high rates of timely vaccination. The multifactorial and complex causes of vaccine hesitancy require a broad range of approaches on the individual, provider, health system, and national levels. These include standardized measurement tools to quantify and locate clustering of vaccine hesitancy and better understand issues of trust; rapid, independent, and transparent review of an enhanced and appropriately funded vaccine safety system; adequate reimbursement for vaccine risk communication in doctors' offices; and individually tailored messages for parents who have vaccine concerns, especially first-time pregnant women. The potential of vaccines to prevent illness and save lives has never been greater. Yet, that potential is directly dependent on parental acceptance of vaccines, which requires confidence in vaccines, healthcare providers who recommend and administer vaccines, and the systems to make sure vaccines are safe. (C) 2015 by American Journal of Preventive Medicine and Elsevier Ltd. All rights reserved.