The Manoff Group, 4301 Connecticut Avenue, N.W., Suite 454, Washington, D.C. 20008, USA.
Int Health. 2012 Dec;4(4):229-38. doi: 10.1016/j.inhe.2012.07.004.
In collaboration with WHO, IMMUNIZATION basics analyzed 126 documents from the global grey literature to identify reasons why eligible children had incomplete or no vaccinations. The main reasons for under-vaccination were related to immunization services and to parental knowledge and attitudes. The most frequently cited factors were: access to services, health staff attitudes and practices, reliability of services, false contraindications, parents' practical knowledge of vaccination, fear of side effects, conflicting priorities and parental beliefs. Some family demographic characteristics were strong, but underlying, risk factors for under-vaccination. Studies must be well designed to capture a complete picture of the simultaneous causes of under-vaccination and to avoid biased results. Although the grey literature contains studies of varying quality, it includes many well-designed studies. Every immunization program should strive to provide quality services that are accessible, convenient, reliable, friendly, affordable and acceptable, and should solicit feedback from families and community leaders. Every program should monitor missed and under-vaccinated children and assess and address the causes. Although global reviews, such as this one, can play a useful role in identifying key questions for local study, local enquiry and follow-up remain essential.
与世界卫生组织合作，免疫基础知识分析了全球灰色文献中的 126 份文件，以确定合格儿童未完成或未接种疫苗的原因。疫苗接种不足的主要原因与免疫服务以及父母的知识和态度有关。最常提到的因素有：获得服务的机会、卫生工作人员的态度和做法、服务的可靠性、虚假禁忌症、父母对疫苗接种的实际了解、对副作用的恐惧、优先事项冲突以及父母的信念。一些家庭人口统计学特征是疫苗接种不足的强烈但潜在的危险因素。研究必须精心设计，以全面了解疫苗接种不足的同时发生的原因，并避免产生有偏差的结果。尽管灰色文献包含了不同质量的研究，但其中包含了许多精心设计的研究。每个免疫规划都应努力提供可及、方便、可靠、友好、负担得起和可接受的优质服务，并应征求家庭和社区领导人的反馈意见。每个规划都应监测错过和未接种疫苗的儿童，并评估和解决原因。虽然全球审查，如本审查，可以在确定当地研究的关键问题方面发挥有用的作用，但当地的探究和后续行动仍然是必要的。
