新加坡父母对肺炎球菌疾病和肺炎球菌结合疫苗的认知、态度及看法：一项基于问卷调查的评估
Parental knowledge, attitudes and perception of pneumococcal disease and pneumococcal conjugate vaccines in Singapore: a questionnaire-based assessment.
作者信息
How Choon How, Phua See Chun Priscilla, Shafi Fakrudeen, Jakes Rupert W
机构信息
Changi General Hospital, Singapore, Singapore.
Singhealth Polyclinics, Singapore, Singapore.
出版信息
BMC Public Health. 2016 Sep 2;16(1):923. doi: 10.1186/s12889-016-3597-5.
BACKGROUND
Under the National Childhood Immunisation Schedule (NCIS) in Singapore most vaccines are provided free while some, including pneumococcal conjugate vaccines (PCV), added to the NCIS in October 2009, are not free. In contrast to ≥95 % coverage achieved for recommended childhood vaccines that are free, 2013 coverage of the PCV booster dose was 58.9 % (for unclear reasons). To date, no population impact on pneumococcal disease (PD) has been observed. We conducted a questionnaire-based study of parents of young children to assess the value of PCV to parents, and to quantify the extent to which vaccine cost is a barrier to PCV uptake in Singapore.
METHODS
A single, trained interviewer administered a questionnaire to 200 parents ≥21 years of age with young children attending the Singapore Sengkang Polyclinic. The questionnaire asked closed-ended questions on parents' knowledge about PD and PCV. A 5-point Likert scale measured perceived benefits and barriers to PCV vaccination.
RESULTS
There were 162 parents whose children were either PCV-vaccinated or who intended to vaccinate their child with PCV (Vaccinated group), and 38 whose children were non-PCV vaccinated or who did not intend to vaccinate (Unvaccinated group). The odds ratio for PCV vaccination among parents who perceived cost as a barrier was 0.16 (95%CI 0.02-1.23). Compared to the Vaccinated group, parents in the Unvaccinated group were less willing to pay for PCV (50.0 %/94.4 %). Compared to the Vaccinated group, fewer parents in the Unvaccinated group had heard about PD (34.2 %/82.1 %) or PCV (36.8 %/69.1 %), or perceived that PD was a threat to their child. Fewer parents in the Unvaccinated group knew that vaccination could prevent PD (28.9 %/77.8 %), or reported that PCV vaccination was recommended to them by any source (63.2 % had no PCV recommendation, versus 20.4 %). When informed that PCV is included in the NCIS only 65.8 % of parents in the Unvaccinated group, versus 98.8 % in the Vaccinated group, indicated that they would be willing to vaccinate their child.
CONCLUSIONS
Cost considerations, not having vaccination recommended to parents and a lack of knowledge among parents of the benefits of PCV to the child may adversely impact PCV uptake in Singapore.
背景
在新加坡的国家儿童免疫计划（NCIS）下，大多数疫苗是免费提供的，而一些疫苗，包括2009年10月添加到NCIS中的肺炎球菌结合疫苗（PCV），则不是免费的。与免费的推荐儿童疫苗所达到的≥95%的覆盖率形成对比的是，2013年PCV加强剂的覆盖率为58.9%（原因不明）。迄今为止，尚未观察到对肺炎球菌疾病（PD）的人群影响。我们对幼儿家长进行了一项基于问卷的研究，以评估PCV对家长的价值，并量化疫苗成本在多大程度上成为新加坡PCV接种的障碍。
方法
一名经过培训的单一访员向200名年龄≥21岁、孩子在新加坡盛港综合诊所就诊的家长发放了问卷。问卷询问了家长关于PD和PCV的封闭式问题。采用5点李克特量表衡量对PCV接种的感知益处和障碍。
结果
有162名家长的孩子已接种PCV或打算为孩子接种PCV（接种组），38名家长的孩子未接种PCV或不打算接种（未接种组）。将成本视为障碍的家长中PCV接种的优势比为0.16（95%置信区间0.02 - 1.23）。与接种组相比，未接种组的家长为PCV付费的意愿较低（50.0%/94.4%）。与接种组相比，未接种组中听说过PD（34.2%/82.1%）或PCV（36.8%/69.1%），或认为PD对其孩子构成威胁的家长较少。未接种组中知道接种可预防PD（28.9%/77.8%），或报告有任何来源向他们推荐PCV接种的家长较少（63.2%没有PCV推荐，而接种组为20.4%）。当得知PCV已纳入NCIS时，未接种组中只有65.8%的家长表示愿意为孩子接种，而接种组为98.8%。
结论
成本考量、未被家长推荐接种以及家长对PCV对孩子益处的知识缺乏可能会对新加坡的PCV接种产生不利影响。
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