Barriers to vaccination for coronavirus disease 2019 (COVID-19) control: experience from the United States.
Barriers to vaccination for coronavirus disease 2019 (COVID-19) control: experience from the United States.
复制标题
DOI：
10.1016/j.glohj.2021.02.005
复制
发表时间：
2021-03
期刊：
影响因子：
--
通讯作者：
Fisk RJ
中科院分区：
文献类型：
--
作者：
Zhang Y;Fisk RJ
迄今为止，美国（U.S.）中国是受2019冠状病毒病（COVID-19）影响最严重的国家。截至2020年11月30日，当这篇论文撰写时，美国报告了1350万例病例，死亡人数超过26.8万。从历史上看，疫苗一直是控制传染病的最有效和最高效的技术工具之一。虽然这些疫苗的开发肯定是一个挑战，但由于存在许多障碍，实现疫苗的强劲吸收可能更具挑战性。在本次审查中，我们重点关注了美国长期经验中记录的两种类型的障碍：结构和态度。结构性障碍是影响一个人获得服务的能力的系统性问题，包括时间、交通、费用和诊所或网点位置;而态度性障碍是影响风险个人寻求和/或接受服务的意愿的信念或看法。在疫苗接种的背景下，它们包括对传染病的信念，对疫苗的信念，恐惧以及对医疗保健和政府机构的信任。在态度障碍中，公众信任是一个特别重要的障碍。除了影响疫苗接种外，它还可能加剧差异，降低疫苗接种计划成功的可能性。提出了克服态度障碍的建议，以帮助提高美国COVID-19控制疫苗接种计划的有效性，例如通过两党支持建立公众支持，利用社交媒体平台促进疫苗接种。
To date, the United States (U.S.) has been the most heavily impacted country by the coronavirus disease 2019 (COVID-19). By November 30, 2020, when this paper was written, 13.5 million cases were reported in the U.S. with over 268 000 deaths. Historically, vaccines have been one of the most effective and efficient technical tools for controlling a communicable disease. While the development of these vaccines has certainly been a challenge, it could be more challenging to achieve robust vaccine uptake because of many barriers. In this review, we focused on two types of barriers documented from long-term experience in the U.S.: structural and attitudinal. Structural barriers are systemic issues that impact one's ability to access a service, and they include time, transportation, cost, and clinic or outlet location; while attitudinal barriers are beliefs or perceptions that impact the willingness of at-risk individuals to seek out and/or accept a service. In the context of vaccination they include beliefs about the communicable disease, beliefs about vaccines, fear, and trust in healthcare and governmental agencies. Of the attitudinal barriers, public trust is a barrier that is of particular importance. In addition to affecting reception of vaccines, it may exacerbate disparities and reduce the likelihood of success of a vaccination program. Recommendations are made to overcome attitudinal barriers to help improve the effectiveness of vaccination programs for COVID-19 control in the U.S., such as building public support through bipartisan endorsements and leveraging social media platforms to promote vaccination.