Socioeconomic Determinants in Vaccine Hesitancy and Vaccine Refusal in Italy
Socioeconomic Determinants in Vaccine Hesitancy and Vaccine Refusal in Italy
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DOI：
10.3390/vaccines8020276
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发表时间：
2020-06-01
期刊：
影响因子：
7.8
通讯作者：
Cocchio, Silvia
中科院分区：
文献类型：
--
作者：
Bertoncello, Chiara;Ferro, Antonio;Cocchio, Silvia
儿童疫苗接种一直是控制传染病的一个里程碑。然而，即使在提供平等接种机会的国家，一些可通过疫苗预防的疾病也再次出现。不理想的疫苗接种覆盖率受到了质疑。目的是探究在疫苗犹豫和完全拒绝接种方面的社会经济不平等情况。通过一项在线调查，纳入了至少有一个3个月至7岁儿童的家庭。这些家庭被分为支持疫苗接种、犹豫接种和反对疫苗接种三类。利用逻辑回归模型研究了社会经济决定因素与犹豫/拒绝接种之间的关联。共收集了3865份问卷：64.0%的家庭支持疫苗接种，32.4%的家庭犹豫接种，3.6%的家庭反对疫苗接种。感知到的经济困难程度增加与犹豫接种相关（调整后的优势比（AOR）从1.34到1.59），父母教育程度较低与拒绝接种显著相关（AOR从1.89到3.39）。家庭经济困难和父母教育程度并非同步变化。经济困难是犹豫接种的一个决定因素。教育程度较低是完全拒绝接种的一个预测因素，且不影响犹豫接种情况。这些发现可作为警示，即使在全民医疗保健系统中，也需要对社会经济不平等情况作出进一步解释。深入了解这些因素对于提高便利性和消除潜在的接种机会问题是必要的。
Childhood vaccination has been a milestone in the control of infectious diseases. However, even in countries offering equal access to vaccination, a number of vaccine-preventable diseases have re-emerged. Suboptimal vaccination coverage has been called into question. The aim was to explore socioeconomic inequalities in vaccine hesitancy and outright refusal. Families with at least one child aged between 3 months and 7 years were involved through an online survey. Families were classified as provaccine, hesitant, or antivaccine. The association between socioeconomic determinants and hesitancy/refusal was investigated with a logistic-regression model. A total of 3865 questionnaires were collected: 64.0% of families were provaccine, 32.4% hesitant, and 3.6% antivaccine. Rising levels of perceived economic hardship were associated with hesitancy (adjusted odds ratio (AOR) from 1.34 to 1.59), and lower parental education was significantly associated with refusal (AOR from 1.89 to 3.39). Family economic hardship and parental education did not move in parallel. Economic hardship was a determinant of hesitancy. Lower education was a predictor of outright refusal without affecting hesitancy. These findings may serve as warnings, and further explanations of socioeconomic inequities are needed even in universal healthcare systems. Insight into these factors is necessary to improve convenience and remove potential access issues.