Department of Infectious Disease Epidemiology; London School of Hygiene & Tropical Medicine; London, UK.
Hum Vaccin Immunother. 2013 Aug;9(8):1779-81. doi: 10.4161/hv.25932. Epub 2013 Jul 29.
Studies to better understand the determinants of vaccine acceptance have expanded to include more investigation into dynamics of individual decision-making as well as the influences of peers and social networks. Vaccine acceptance is determined by a range of factors, from structural issues of supply, costs and access to services, as well as the more demand-side determinants. The term vaccine hesitancy is increasingly used in the investigation of demand-side determinants, moving away from the more polarized framing of pro- and anti-vaccine groups to recognizing the importance of understanding and engaging those who are delaying vaccination, accepting only some vaccines, or who are yet undecided, but reluctant. As hesitancy is a state of indecision, it is difficult to measure, but the stage of indecision is a critical time to engage and support the decision-making process. This article suggests modes of investigating the determinants of vaccine confidence and levers of vaccine acceptance toward better engagement and dialogue early in the process of decision-making. Pressure to vaccinate can be counter-productive. Listening and dialog can support individual decision-making and more effectively inform the public health community of the issues and concerns influencing vaccine hesitancy.
为了更好地了解疫苗接种接受度的决定因素，研究已经扩展到更深入地研究个人决策的动态以及同伴和社交网络的影响。疫苗接种接受度由一系列因素决定，包括供应、成本和服务获取等结构性问题，以及更多的需求方决定因素。在需求方决定因素的研究中，越来越多地使用“疫苗犹豫”一词，这一概念摒弃了对支持和反对疫苗接种群体更为两极化的描述，转而认识到理解和接触那些推迟接种、只接受某些疫苗或尚未做出决定但犹豫不决的人的重要性。由于犹豫是一种犹豫不决的状态，因此很难衡量，但犹豫不决的阶段是参与和支持决策过程的关键时期。本文提出了一些调查疫苗信心决定因素和接受疫苗的杠杆的模式，以便在决策过程的早期更好地参与和对话。强制接种可能会适得其反。倾听和对话可以支持个人决策，并更有效地让公共卫生界了解影响疫苗犹豫的问题和关注点。
