Scared, powerless, insulted and embarrassed: hesitancy towards vaccines among caregivers in Cavite Province, the Philippines.
Scared, powerless, insulted and embarrassed: hesitancy towards vaccines among caregivers in Cavite Province, the Philippines.
复制标题
害怕，无能为力，侮辱和尴尬：菲律宾卡维特省的照顾者犹豫不决。
DOI：
10.1136/bmjgh-2021-006529
复制
发表时间：
2021-09
影响因子：
8.1
通讯作者：
McMahon SA
中科院分区：
文献类型：
--
作者：
Landicho-Guevarra J;Reñosa MDC;Wachinger J;Endoma V;Aligato MF;Bravo TA;Landicho J;Bärnighausen K;McMahon SA
几项研究强调，疫苗犹豫是全球健康面临的最重要威胁之一，特别是在包括菲律宾在内的低收入和中等收入国家。然而，缺乏探讨儿童接种疫苗的家庭经历或相关问题的文献，这些文献为幼儿的疫苗犹豫看护者（vhc）提供了发言权。在这里，我们介绍来自菲律宾的vhc的见解。本研究采用了对菲律宾Cavite省农村和城市社区44个家庭卫生保健者的深度访谈（IDIs），这些家庭卫生保健者以前曾延迟或拒绝为其儿童接种疫苗。在COVID-19大流行期间，我们通过受访者选择的在线平台（即Facebook messenger call， Skype和Zoom）进行了IDIs。根据建构主义理论的原则，对所有访谈进行了记录、转录、翻译和分析。我们使用社会生态模型来构建我们的结果。在推迟或拒绝接种儿童疫苗的原因中，对副作用的恐惧成为最突出的担忧，2017年登革热疫苗争议造成的负面经历（包括创伤）加剧了这一担忧。答复者列举了登革热疫苗争议，因为他们表示不愿意（对任何新疫苗）和怀疑（对以学校为基础的疫苗接种，即登革热疫苗的分销渠道）。反对接种疫苗的户主、认为疫苗不是必不可少的观念以及来自社会和传统媒体或邻居的影响导致了进一步的拒绝和拖延。在调查后，vhc叙述了卫生系统的问题，特别是卫生保健工作者有时无法回答他们的问题，并且可能对照顾者的问题不屑一顾或不尊重。从vhc的角度理解VH突出了重新获得信任和增强对疫苗信心的干预途径。我们的研究结果可能成为VH干预措施发展的关键，旨在改变人口规模的行为。
Several studies have highlighted that vaccine hesitancy (VH) is among the most important threats to global health, especially in low- and middle-income countries, including the Philippines. However, there is a dearth of literature exploring family experiences of—or concerns related to—childhood vaccinations that gives voice to vaccine hesitant caregivers (VHCs) of small children. Here, we present insights from VHCs from the Philippines. This research draws on in-depth interviews (IDIs) with 44 VHCs who had previously delayed or refused vaccination for their children in rural and urban communities in Cavite Province, the Philippines. Amid the COVID-19 pandemic, we conducted IDIs via an online platform of the respondents’ choosing (ie, Facebook messenger call, Skype and Zoom). All interviews were recorded, transcribed, translated and analysed drawing from the tenets of constructivist grounded theory. We use the social ecological model to structure our results. Among the reasons for delay or refusal of childhood vaccinations, a fear of side effects emerged as the most salient concern, exacerbated by previous negative experiences (including trauma) from a dengue vaccine controversy in 2017. Respondents cited the dengue vaccine controversy as they expressed reluctance (regarding any new vaccines) and suspicion (towards school-based vaccination, the distribution channel used for the dengue vaccine). Heads of households opposing vaccines, perceptions that vaccines are non-essential and influences from the social and traditional media or neighbours contributed to further refusal and delay. Upon probing, VHCs recounted health system concerns particularly with regards to healthcare workers who are sometimes unable to answer their questions and can be dismissive or disrespectful regarding caregivers’ concerns. Understanding VH from the lens of VHCs highlights pathways for interventions to regain trust and bolster confidence towards vaccines. Our findings may serve as linchpins in the development of VH interventions aiming at changing behaviour on a population scale.
登录
查看更多内容
影响因子：
5.5
作者：
Ashkenazi, Shai;Livni, Gilat;Berkowitz, Oren
通讯作者：
Berkowitz, Oren
影响因子：
2.9
作者：
Helps, Catherine;Leask, Julie;Carter, Stacy
通讯作者：
Carter, Stacy
影响因子：
4.9
作者：
Gesser-Edelsburg, Anat;Walter, Nathan;Rosenblat, Shira
通讯作者：
Rosenblat, Shira
影响因子：
5.5
作者：
Giambi, Cristina;Fabiani, Massimo;Rota, Maria Cristina
通讯作者：
Rota, Maria Cristina
影响因子：
1.3
作者：
Caudal, H.;Briend-Godet, V;Huon, J. F.
通讯作者：
Huon, J. F.