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婴儿期及时接种麻疹、腮腺炎和风疹疫苗:态度和医学建议对疫苗接种意愿的影响。

Timely MMR vaccination in infancy: influence of attitudes and medical advice on the willingness to vaccinate.

作者信息

Schönberger K, Ludwig M-S, Wildner M, Kalies H

机构信息

Division of Epidemiology, Institute of Social Paediatrics and Adolescent Medicine, Ludwig-Maximilians-University of Munich, Germany.

出版信息

Klin Padiatr. 2012 Nov;224(7):437-42. doi: 10.1055/s-0032-1321731. Epub 2012 Jul 20.

Abstract

In light of the failure to eliminate measles by 2010, the closure of any gaps in immunisation coverage is of paramount importance to interrupt transmission and to protect vulnerable individuals. Not only vaccination-critical attitudes of parents but furthermore the medical advice by physician in charge influence the vaccine uptake. 3 groups of factors which potentially influence parental decisions on child vaccination were analysed by univariable and multivariable logistic regression for the timely uptake of the first and the second dose of measles vaccination: parents' attitudes towards immunization, the influence of medical and laypersons and the influence of the advice of a medical doctor. A total of 3 041 children were eligible for the analysis. 53.0% of these received the first and 42.9% the second MMR dose in time. If parents considered that vaccinations are important and protective as well as the consulted physician advices towards vaccinations, children had significantly higher chances of a timely vaccination. Whereas, if parents were afraid of vaccinations or get advised by an alternative practitioner, the children had lower chances of being vaccinated in time. If medical providers help parents to reduce uncertainties about vaccination the chance for children to be vaccinated in time increased. It appeared that there still are unmet information needs after the medical consultation. By and large the medical advice plays an important role for vaccination uptake and its timing. In order to raise the vaccination rates further target-population specific approaches are needed.

摘要

鉴于2010年未能消除麻疹,填补免疫接种覆盖率方面的任何差距对于阻断传播和保护弱势群体至关重要。不仅家长对疫苗接种的关键态度,而且负责医生的医疗建议都会影响疫苗接种率。通过单变量和多变量逻辑回归分析了可能影响家长对儿童疫苗接种决策的3组因素,以确定及时接种第一剂和第二剂麻疹疫苗的情况:家长对免疫接种的态度、医疗人员和非专业人员的影响以及医生建议的影响。共有3041名儿童符合分析条件。其中53.0%的儿童及时接种了第一剂麻疹、腮腺炎和风疹(MMR)疫苗,42.9%的儿童及时接种了第二剂。如果家长认为疫苗接种很重要且具有保护作用,并且咨询的医生也建议接种疫苗,那么儿童及时接种疫苗的可能性会显著更高。然而,如果家长害怕接种疫苗或听从替代疗法从业者的建议,儿童及时接种疫苗的可能性就会降低。如果医疗服务提供者帮助家长减少对疫苗接种的疑虑,儿童及时接种疫苗的机会就会增加。看来在医疗咨询后仍存在未满足的信息需求。总体而言,医疗建议对疫苗接种率及其接种时间起着重要作用。为了进一步提高疫苗接种率,需要针对特定目标人群采取相应方法。

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