Saada Adrianna, Lieu Tracy A, Morain Stephanie R, Zikmund-Fisher Brian J, Wittenberg Eve
Center for Health Decision Science, Harvard School of Public Health, Boston, MA, USA.
Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA.
Clin Pediatr (Phila). 2015 Mar;54(3):236-43. doi: 10.1177/0009922814548838. Epub 2014 Sep 7.
A growing number of parents adopt alternative vaccination schedules for their children. A better understanding of parents' rationales for these choices is needed to guide vaccine decision making.
We conducted 24 semistructured telephone interviews with parents of 12- to 36-month-olds and analyzed data using an inductive approach.
We identified 5 alternative vaccination approaches: "Dr Sears" schedule, shot-limiting approach, selective delay or decline, visit-by-visit decisions, and refusal of all vaccines. Parents who adopted alternative approaches expressed a desire for more control of exposure to vaccine ingredients; vaccine safety, immune system burden, and perceived disease risk were articulated as concerns.
Parents who adopt alternative vaccination schedules can be classified in defined subgroups based on their decision-making approaches, and many describe considered reasons to support their actions. Communications that acknowledge and address those reasons may be better able to engage parents and ultimately enhance the process of decision making about vaccines.
越来越多的父母为孩子采用非传统的疫苗接种时间表。需要更好地理解父母做出这些选择的理由，以指导疫苗决策。
我们对12至36个月大孩子的父母进行了24次半结构化电话访谈，并采用归纳法分析数据。
我们确定了5种非传统的疫苗接种方法：“西尔斯医生”时间表、限制接种次数方法、选择性延迟或拒绝、逐次就诊决策以及拒绝所有疫苗。采用非传统方法的父母表示希望更多地控制对疫苗成分的接触；疫苗安全性、免疫系统负担和感知到的疾病风险被提及为关注点。
采用非传统疫苗接种时间表的父母可以根据其决策方法分类到特定亚组中，许多父母描述了支持其行为的深思熟虑的理由。承认并解决这些理由的沟通可能更能让父母参与进来，并最终加强疫苗决策过程。
