Qualitative Assessment of Vaccine Hesitancy in Romania
Qualitative Assessment of Vaccine Hesitancy in Romania
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DOI：
10.3390/medicina55060282
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发表时间：
2019-06-01
影响因子：
2.6
通讯作者：
Colosi, Ioana Alina
中科院分区：
文献类型：
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作者：
Miko, David;Costache, Carmen;Colosi, Ioana Alina
背景和目标：世界各地的卫生系统面临着令人震惊的病例增加，尽管可以提供优质的疫苗服务，但个人犹豫、推迟甚至拒绝接种疫苗。为了减轻和对抗这种被世界卫生组织（WHO）定义为疫苗犹豫（VH）的现象，我们首先必须了解在一个广泛获得安全有效疫苗的时代导致其发生的因素。为了实现这一目标，我们对疫苗犹豫量表 (VHS) 进行了现场测试，该量表是由罗马尼亚克卢日县克卢日纳波卡市的战略咨询专家工作组 (SAGE WG) 开发的。该量表旨在量化人群中 VH 的患病率，确定哪些疫苗产生最高比例的犹豫，并对个人犹豫的原因进行定性评估。材料和方法：我们进行了一项观察性横断面调查，其中包括有关 VH 的描述性、分析性和定性要素。必要的样本量为 452 人。 VHS 和决定因素矩阵（由 SAGE WG 推荐）通过定性主题分析 (QTA) 进行解释，以确保在不同文化背景下检测犹豫的有效性和可靠性，并允许进行全球比较。结果：我们发现 30.3% 的 VH 和 11.7% 的家长表示拒绝给孩子接种疫苗。在 VH 反应者中，水痘疫苗、麻疹疫苗、人乳头瘤病毒 (HPV) 和腮腺炎疫苗分别有 35%、27.7%、24.1% 和 23.4% 的人犹豫不决。一致性百分比的 QTA 值范围为 91% 到 100%。 Cohen 的 Kappa 值范围为 0.45 至 0.95。确定的 VH 背景影响包括媒体、领导者和游说团体以及对制药行业的看法。个人和群体对 VH 的影响包括信念、知识和风险/收益（感知）。 VH 的疫苗和疫苗接种具体问题是风险/收益（理性）和医疗保健从业者（可信度、能力）。结论：三分之一的调查人群表达了 VH，另外三分之一的人拒绝为其孩子接种疫苗。水痘、麻疹、腮腺炎、风疹 (MMR) 和 HPV 疫苗引起了最多的犹豫。媒体的负面信息是引发 VH 最常见的原因。
Background and objectives: Health systems all over the world are confronted with an alarming rise of cases in which individuals hesitate, delay, and even refuse vaccination, despite availability of quality vaccine services. In order to mitigate and combat this phenomenon, which are now defined by the World Health Organization (WHO) as vaccine hesitancy (VH), we must first understand the factors that lead to its occurrence in an era characterized by wide access to safe and effective vaccines. To achieve this, we conducted field testing of the Vaccine Hesitancy Scale (VHS), as it was developed by the Strategic Advisory Group of Experts Working Group (SAGE WG), in Cluj-Napoca city, Cluj County, Romania. The scale is designed to quantify VH prevalence in a population, establish which vaccines generate the highest percentage of hesitancy, and allow a qualitative assessment of the individual's reasons for hesitance. Materials and Methods: We conducted an observational cross-sectional survey, which was comprised of descriptive, analytical, and qualitative elements regarding VH. The necessary sample size was 452 individuals. The VHS and Matrix of Determinants (recommended by SAGE WG) for reasons people gave to justify their hesitance, was interpreted by qualitative thematic analysis (QTA) to ensure the validity and reliability in detecting hesitancy across various cultural settings and permit global comparisons. Results: We found a VH of 30.3% and 11.7% of parents reported refusing to vaccinate their child. Among the VH responders, the varicella vaccine generated 35% hesitancy, measles vaccine 27.7%, Human Papillomavirus (HPV) 24.1%, and mumps vaccine 23.4%, respectively. The QTA values for percent agreement ranged from 91% to 100%. Cohen's Kappa values ranged from 0.45 to 0.95. Contextual influences identified for VH were media, leaders and lobbies, and perception of the pharmaceutical industry. Individual and group influences for VH were beliefs, knowledge, and risk/benefits (perceived). Vaccine and vaccination specific issues for VH were risk/benefit (rational) and health care practitioners (trustworthiness, competence). Conclusions: One-third of the investigated population had expressed VH, and a further one-third of these had refused a vaccine for their child. Chicken Pox, Measles, Mumps, Rubella (MMR), and HPV vaccines generated the most hesitation. Negative information from the media was the most frequently evoked reason for VH.