Hacettepe University, School of Medicine, Pediatric Allergy and Asthma Unit, Ankara, Turkey.
Ministry of Health, Ankara Education and Research Hospital, Ankara, Turkey.
Vaccine. 2014 Apr 25;32(20):2275-80. doi: 10.1016/j.vaccine.2014.02.076. Epub 2014 Mar 12.
During the recent pandemic, Influenza A/H1N1 vaccine uptake remained far below the targeted rates. Associated factors regarding vaccine refusal in the general population have been reported in many studies, however the reasons behind refusals for asthmatic children have not yet been identified. We aimed to investigate Influenza A/H1N1 virus vaccine acceptance for children with asthma, to determine the attitudes and beliefs of parents concerning Influenza A/H1N1 disease and vaccine and to identify the association of asthma control parameters with vaccination.
The parents of asthmatic children aged 6-18 years participated in a cross-sectional survey study in three pediatric allergy outpatient clinics. The survey measured demographic factors, asthma control parameters, vaccination rates, and beliefs and attitudes regarding Influenza A/H1N1 vaccine.
Of the 625 asthmatic children, 16.8% (n=105) were immunized with Influenza A/H1N1 and 45.7% (n=286) with seasonal influenza vaccine. Educational background of parents (p<0.001 and p=0.002, for father's and mother's educational level, respectively), previous vaccination with seasonal influenza (p<0.001), and having a family member vaccinated against Influenza A/H1N1 (p<0.001) had a significant influence on vaccine acceptance, while fear of side effects (88.6%) was the major parental reason for refusing the vaccine. Asthma control parameters had no influence on uptake of the vaccine. Physician recommendation (84.8%) was important in the decision-making process for immunization. The statement "Children with asthma should receive swine flu vaccine" increased the likelihood of being vaccinated [OR: 2.160, (95%CI 1.135-4.111), p=0.019].
Although asthmatic children are considered to be a high-priority group for Influenza A/H1N1 vaccination, we found low uptake of vaccine among our patients. Beliefs and attitudes rather than asthma control parameters influenced parental decisions for immunization. Understanding the underlying determinants for refusing the vaccine will help to improve vaccine campaigns in advance of a future outbreak.
在最近的大流行期间，甲型 H1N1 流感疫苗的接种率仍然远低于目标接种率。许多研究报告了与普通人群疫苗接种率低相关的因素，但尚未确定哮喘儿童拒绝接种疫苗的原因。我们旨在调查哮喘儿童对甲型 H1N1 病毒疫苗的接受程度，确定父母对甲型 H1N1 疾病和疫苗的态度和信念，并确定哮喘控制参数与疫苗接种的相关性。
在三家儿科过敏门诊，6-18 岁哮喘儿童的父母参加了一项横断面调查研究。该调查测量了人口统计学因素、哮喘控制参数、疫苗接种率以及对甲型 H1N1 疫苗的信念和态度。
在 625 名哮喘儿童中，有 16.8%（n=105）接种了甲型 H1N1 疫苗，45.7%（n=286）接种了季节性流感疫苗。父母的教育背景（父亲和母亲的教育水平分别为 p<0.001 和 p=0.002）、以前接种过季节性流感（p<0.001）以及有家庭成员接种过甲型 H1N1 疫苗（p<0.001）对疫苗接种有显著影响，而对副作用的恐惧（88.6%）是父母拒绝接种疫苗的主要原因。哮喘控制参数对疫苗接种率没有影响。医生的建议（84.8%）是免疫决策过程中的重要因素。“哮喘儿童应接种猪流感疫苗”的说法增加了接种疫苗的可能性[OR：2.160，（95%CI 1.135-4.111），p=0.019]。
尽管哮喘儿童被认为是甲型 H1N1 疫苗接种的高优先级人群，但我们发现我们的患者疫苗接种率较低。父母的决定取决于信念和态度，而不是哮喘控制参数。了解拒绝接种疫苗的根本原因将有助于在未来爆发之前改进疫苗接种活动。
