Understanding vaccine acceptance and demand-and ways to increase them
Understanding vaccine acceptance and demand-and ways to increase them
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DOI：
10.1007/s00103-019-03063-0
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发表时间：
2019-12-04
影响因子：
1.7
通讯作者：
Jackson, Cath
中科院分区：
文献类型：
--
作者：
Habersaat, Katrine Bach;Jackson, Cath
疫苗接种可以挽救数百万人的生命，世界卫生组织 (WHO) 欧洲区域在 2018 年庆祝了创纪录的高覆盖率。尽管如此，国家或次国家覆盖率仍不足以阻止疫苗可预防疾病的传播。卫生当局越来越意识到需要优先考虑疫苗接种的“需求”方面。在所有人群中实现高且公平的疫苗接种率并不是一个快速解决方案；它需要根据目标群体的研究对多方面干预措施进行长期投资。世界卫生组织重点关注疫苗接种行为的个人和环境决定因素。个人决定因素包括风险认知、（不）信任和感知限制；心理学的见解可以帮助我们理解这些。背景决定因素包括社会规范、社会经济地位和教育水平，以及卫生系统的设计、运作和融资方式。世界卫生组织建议使用经过验证的理论模型来了解疫苗接种行为，并针对其定制免疫计划 (TIP) 方法采用了“COM-B 模型”。文章中描述了这种改编模型。通过深入了解影响疫苗接种行为的因素，可以规划干预措施和政策以提高疫苗接种率。一些证据表明已经证明可以做到这一点。在个人层面，一些干预措施被认为可以提高疫苗接种率，实验研究评估了某些信息或行为如何影响疫苗接种认知。在背景层面上，有更多关于有效策略的文档，包括那些侧重于使疫苗接种成为简单、方便和默认行为的策略，以及侧重于护理人员和卫生工作者之间互动的策略。
Vaccination saves millions of lives, and the World Health Organization (WHO) European Region celebrated record high coverage in 2018. Still, national or sub-national coverage is insufficient to stop the spread of vaccine-preventable diseases. Health authorities are increasingly aware of the need to prioritize the "demand" side of vaccination. Achieving high and equitable vaccination uptake in all population groups is not a quick-fix; it requires long-term investment in multifaceted interventions, informed by research with the target groups. The WHO focuses on both individual and context determinants of vaccination behaviours. Individual determinants include risk perceptions, (dis)trust and perceived constraints; insights from psychology help us understand these. Context determinants include social norms, socioeconomic status and education level, and the way health systems are designed, operate and are financed. The WHO recommends using a proven theoretical model to understand vaccination behaviours and has adapted the "COM-B model" for their Tailoring Immunization Programmes (TIP) approach. This adapted model is described in the article. Informed by insights into the factors affecting vaccination behaviours, interventions and policies can be planned to increase vaccination uptake. Some evidence exists on proven methods to do this. At the individual level, some interventions have been seen to increase vaccination uptake, and experimental studies have assessed how certain messages or actions affect vaccination perceptions. At the context level, there is more documentation for effective strategies, including those that focus on making vaccination the easy, convenient and default behaviour and that focus on the interaction between caregivers and health workers.