Qualitative Assessment of Vaccination Hesitancy Among Members of the Apostolic Church of Zimbabwe: A Case Study
Qualitative Assessment of Vaccination Hesitancy Among Members of the Apostolic Church of Zimbabwe: A Case Study
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DOI：
10.1007/s10943-017-0428-7
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发表时间：
2017-10-01
影响因子：
2.8
通讯作者：
Kaiser, R.
中科院分区：
文献类型：
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作者：
Machekanyanga, Z.;Ndiaye, S.;Kaiser, R.
对疫苗犹豫不决或缺乏信心被认为是对疫苗接种计划成功的威胁。2009-2010年南部非洲麻疹疫情的上升和蔓延与使徒教会成员的反对有关，截至2014年，津巴布韦估计约有350万人。为告知麻疹-风疹疫苗接种运动干预措施的规划，我们使用来自不同利益相关者的数据对导致疫苗犹豫的因素进行了评估。在津巴布韦三个地区的九个地区中，我们通过与为使徒社区服务的卫生工作者和国家扩大免疫计划成员的焦点小组讨论收集了关于宗教态度和对疫苗的看法的数据;与宗教领袖的半结构化访谈;以及与使徒父母/照顾者的结构化访谈中的开放式问题。疫苗知识贫乏，缺乏对疫苗接种有效性的理解和欣赏，强调祈祷而不是使用药物的宗教教义，在宗教控制的社区中缺乏隐私，以及教育水平低被认为是导致关键社区成员和领导人对疫苗犹豫不决的主要因素。在公共场合接受疫苗接种有被制裁的风险。对疫苗缺乏了解是犹豫不决的一个主要因素，而宗教教义认为祈祷是一种替代办法，这又加剧了这种犹豫不决。由于父母/照顾者认为疫苗对他们的孩子是危险的，并认为它们可能导致死亡或疾病，使徒教会的成员对替代方法更有信心，例如使用圣水和祈祷来治疗疾病。在这种情况下，一方面必须揭穿关于圣水力量的神话，另一方面必须传播关于疫苗效力的积极信息，以减少犹豫。关于疫苗和疫苗接种的教育与政府干预相结合，例如通过使用社会距离政策，可以提供一个框架，减少犹豫和增加对疫苗接种的需求。
Vaccine hesitancy or lack of confidence in vaccines is considered a threat to the success of vaccination programs. The rise and spread of measles outbreaks in southern Africa in 2009-2010 were linked to objections among Apostolic Church members, estimated at about 3.5 million in Zimbabwe as of 2014. To inform planning of interventions for a measles-rubella vaccination campaign, we conducted an assessment of the factors contributing to vaccine hesitancy using data from various stakeholders. Among nine districts in three regions of Zimbabwe, we collected data on religious attitudes toward, and perceptions of, vaccines through focus group discussions with health workers serving Apostolic communities and members of the National Expanded Programme on Immunization; semi-structured interviews with religious leaders; and open-ended questions in structured interviews with Apostolic parents/caregivers. Poor knowledge of vaccines, lack of understanding and appreciation of the effectiveness of vaccinations, religious teachings that emphasize prayers over the use of medicine, lack of privacy in a religiously controlled community, and low levels of education were found to be the main factors contributing to vaccine hesitancy among key community members and leaders. Accepting vaccination in public is a risk of sanctions. Poor knowledge of vaccines is a major factor of hesitancy which is reinforced by religious teachings on the power of prayers as alternatives. Because parents/caregivers perceive vaccines as dangerous for their children and believe they can cause death or disease, members of the Apostolic Church have more confidence in alternative methods such as use of holy water and prayers to treat diseases. Under these circumstances, it is important to debunk the myths about the power of holy water on the one hand and disseminate positive information of the efficacy of vaccines on the other hand in order to reduce hesitancy. Education about vaccines and vaccination in conjunction with government intervention, for example, through the use of social distancing policies can provide a framework for reducing hesitancy and increasing demand for vaccination.