Dow Medical College, Dow University of Health Sciences, Baba-e-Urdu Road, Karachi 74200, Pakistan.
Arch Public Health. 2013 Jul 13;71(1):19. doi: 10.1186/0778-7367-71-19.
The Expanded Program on Immunization (EPI) was initiated by World Health Organization (WHO) in 1974 in order to save children from life threatening, disabling vaccine-preventable diseases (VPDs). In Pakistan, this program was launched in 1978 with the main objectives of eradicating polio by 2012, eliminating measles and neonatal tetanus by 2015, and minimizing the incidence of other VPDs. However, despite the efforts of government and WHO, this program has not received the amount of success that was desired. Hence, the objectives of this study were to elucidate the main reasons behind not achieving the full immunization coverage in Pakistan, the awareness of children's attendant about the importance of vaccination, their attitudes, thoughts and fears regarding childhood immunization, and the major hurdles faced in pursuit of getting their children vaccinated.
This was an observational, cross-sectional, questionnaire-based study conducted during a one year period from 4th January, 2012 to 6th January, 2013 at the pediatric outpatient clinics of Civil Hospital (CHK) and National Institute of Child Health (NICH). We attempted to interview all the parents who could be approached during the period of the study. Thus, convenience sampling was employed. The parents were approached in the clinics and interviewed after seeking informed, written consent. Those patients who were not accompanied by either of their parents were excluded from the study. The study instrument comprised of three sections. The first section consisted was concerned with the demographics of the patient and the parents. The second section dealt with the reasons for complete vaccination or under-vaccination. The last section aimed to assess the knowledge, attitudes and beliefs of the respondents.
Out of 1044 patients, only 713(68.3%) were fully vaccinated, 239(22.9%) were partially vaccinated while 92(8.8%) had never been vaccinated. The vaccination status showed statistically significant association with ethnicity, income, residence, number of children and paternal occupation (p < 0.05 for all). The most common provocative factor for vaccination compliance was mass media (61.9%). The most common primary reason for non-vaccination was lack of knowledge (18.1%), whereas the most common secondary reason for non-vaccination was religious taboos (31.4%). Majority of the respondents demonstrated poor knowledge of EPI schedules or VPDs. However, most believed that there was a need for more active government/NGO involvement in this area.
The most common primary reason for non-vaccination, i.e. lack of knowledge, and the most common secondary reason, i.e. religious taboos, imply that there is dire need to promote awareness among the masses in collaboration with NGOs, and major religious and social organizations.
世界卫生组织（WHO）于 1974 年发起了扩大免疫规划（EPI），旨在使儿童免受危及生命的、致残的疫苗可预防疾病（VPD）的侵害。在巴基斯坦，该规划于 1978 年启动，主要目标是到 2012 年根除小儿麻痹症，到 2015 年消除麻疹和新生儿破伤风，并尽量减少其他 VPD 的发病率。然而，尽管政府和世卫组织做出了努力，该规划仍未取得预期的成功。因此，本研究的目的是阐明巴基斯坦未能实现全面免疫接种覆盖的主要原因、儿童照顾者对疫苗接种重要性的认识、他们对儿童免疫接种的态度、想法和担忧，以及在为孩子接种疫苗方面面临的主要障碍。
这是一项观察性、横断面、基于问卷的研究，于 2012 年 1 月 4 日至 2013 年 1 月 6 日在公立医院（CHK）和国家儿童健康研究所（NICH）的儿科门诊进行。我们试图在研究期间采访所有能接触到的家长。因此，采用了便利抽样法。在征得知情、书面同意后，在诊所中与家长进行面谈。那些没有父母陪伴的患者被排除在研究之外。研究工具包括三个部分。第一部分涉及患者和家长的人口统计学特征。第二部分涉及完全接种或部分接种的原因。第三部分旨在评估受访者的知识、态度和信念。
在 1044 名患者中，只有 713 名（68.3%）完全接种了疫苗，239 名（22.9%）部分接种了疫苗，92 名（8.8%）从未接种过疫苗。接种状况与种族、收入、居住地、儿童数量和父亲职业呈统计学显著关联（p<0.05）。促进疫苗接种依从性的最常见刺激因素是大众媒体（61.9%）。不接种疫苗的最常见主要原因是缺乏知识（18.1%），而不接种疫苗的最常见次要原因是宗教禁忌（31.4%）。大多数受访者对 EPI 计划或 VPD 的知识了解甚少。然而，大多数人认为需要政府/非政府组织在这方面更积极地参与。
不接种疫苗的最常见主要原因，即缺乏知识，以及最常见的次要原因，即宗教禁忌，这意味着迫切需要与非政府组织以及主要的宗教和社会组织合作，在大众中宣传提高认识。
