Lohiniva Anna-Leena, Barakat Amal, Dueger Erica, Restrepo Suzanne, El Aouad Rajae
Global Disease Detection Center-Egypt, US Naval Medical Research Unit no. 3, Cairo, Egypt.
Centre National de réfèrence Grippe-Institut National d'Hygiène-Ministry of Health, Rabat, Morocco.
PLoS One. 2014 Oct 14;9(10):e96244. doi: 10.1371/journal.pone.0096244. eCollection 2014.
Vaccination uptake of pregnant women in Morocco during the A (H1N1) pdm09 pandemic was lower than expected. A qualitative study using open-ended questions was developed to explore the main determinants of acceptance and non-acceptance of the monovalent A (H1N1) pdm09 vaccine among pregnant women in Morocco and to identify information sources that influenced their decision-making process. The study sample included 123 vaccinated and unvaccinated pregnant women who were in their second or third trimester between December 2009 and March 2010. They took part in 14 focus group discussions and eight in-depth interviews in the districts of Casablanca and Kenitra. Thematic qualitative analysis identified reasons for vaccine non-acceptance: (1) fear of the monovalent A (H1N1) pdm09 vaccine, (2) belief in an A (H1N1) pdm09 pandemic conspiracy, (3) belief in the inapplicability of the monovalent A (H1N1) pdm09 vaccine to Moroccans, (4) lack of knowledge of the monovalent A (H1N1) pdm09 vaccine, and (5) challenges of vaccination services/logistics. Reasons for vaccine acceptance included: (1) perceived benefits and (2) modeling. Decision-making was strongly influenced by family, community, mass media, religious leaders and health providers suggesting that broad communication efforts should also be used to advocate for vaccination. Meaningful communication for future vaccine campaigns must consider these context-specific findings. As cultural and religious values are shared across many Arab countries, these findings may also provide valuable insights for seasonal influenza vaccine planning in the Middle East and North Africa region at large.
在甲型（H1N1）pdm09流感大流行期间，摩洛哥孕妇的疫苗接种率低于预期。开展了一项使用开放式问题的定性研究，以探究摩洛哥孕妇接受和不接受单价甲型（H1N1）pdm09疫苗的主要决定因素，并确定影响其决策过程的信息来源。研究样本包括123名接种和未接种疫苗的孕妇，她们在2009年12月至2010年3月期间处于妊娠中期或晚期。她们在卡萨布兰卡和凯尼特拉地区参加了14次焦点小组讨论和8次深入访谈。主题定性分析确定了不接受疫苗的原因：（1）对单价甲型（H1N1）pdm09疫苗的恐惧，（2）相信甲型（H1N1）pdm09流感大流行阴谋，（3）认为单价甲型（H1N1）pdm09疫苗不适用于摩洛哥人，（4）对单价甲型（H1N1）pdm09疫苗缺乏了解，以及（5）疫苗接种服务/后勤方面的挑战。接受疫苗的原因包括：（1）感知到的益处和（2）榜样作用。决策受到家庭、社区、大众媒体、宗教领袖和医疗服务提供者的强烈影响，这表明还应开展广泛的宣传工作来倡导疫苗接种。未来疫苗接种运动的有效沟通必须考虑这些针对具体情况的研究结果。由于许多阿拉伯国家都有共同的文化和宗教价值观，这些研究结果也可能为整个中东和北非地区的季节性流感疫苗规划提供有价值的见解。
