Frew Paula M, Fisher Allison Kennedy, Basket Michelle M, Chung Yunmi, Schamel Jay, Weiner Judith L, Mullen Jennifer, Omer Saad B, Orenstein Walter A
Emory University, School of Medicine, 1760 Haygood Road, Atlanta, GA 30322, United States; Emory University, Rollins School of Public Health, 1518 Clifton Rd, Atlanta, GA 30322, United States; U.S. Centers for Disease Control and Prevention, National Center for Immunization and Respiratory Diseases, 1600 Clifton Rd. Atlanta, GA 30333, United States.
U.S. Centers for Disease Control and Prevention, National Center for Immunization and Respiratory Diseases, 1600 Clifton Rd. Atlanta, GA 30333, United States.
Vaccine. 2016 Nov 4;34(46):5689-5696. doi: 10.1016/j.vaccine.2016.08.001. Epub 2016 Oct 6.
Understanding the current status of parents' vaccine decision making is crucial to inform public policy. We sought to assess changes in vaccine decisions among parents of young children.
We conducted a web-based national poll of parents of children <7years in 2012 and 2014. Participants reported vaccine decisions for their youngest child. We calculated survey-weighted population estimates of overall immunizations decisions, and delay/refusal rates for specific vaccines.
In 2012, 89.2% (95% CI, 87.3-90.8%) reported accepting or planning to accept all recommended non-influenza childhood vaccines, 5.5% (4.5-6.6%) reported intentionally delaying one or more, and 5.4% (4.1-6.9%) reported refusing one or more vaccines. In 2014, the acceptance, delay, and refusal rates were 90.8% (89.3-92.1%), 5.6% (4.6-6.9%), and 3.6% (2.8-4.5%), respectively. Between 2012 and 2014, intentional vaccine refusal decreased slightly among parents of older children (2-6years) but not younger children (0-1years). The proportion of parents working to catch up on all vaccines increased while those refusing some but not all vaccines decreased. The South experienced a significant increase in estimated acceptance (90.1-94.1%) and a significant decrease in intentional ongoing refusal (5.0-2.1%). Vaccine delay increased in the Northeast (3.2-8.8%).
Nationally, acceptance and ongoing intentional delay of recommended non-influenza childhood vaccines were stable. These findings suggest that more effort is warranted to counter persistent vaccine hesitancy, particularly at the local level. Longitudinal monitoring of immunization attitudes is also warranted to evaluate temporal shifts over time and geographically.
了解父母疫苗决策的现状对于为公共政策提供信息至关重要。我们试图评估幼儿父母疫苗决策的变化情况。
我们在2012年和2014年对7岁以下儿童的父母进行了一项基于网络的全国性民意调查。参与者报告了他们最小孩子的疫苗决策情况。我们计算了调查加权后的总体免疫决策人口估计数以及特定疫苗的延迟/拒绝率。
2012年，89.2%（95%可信区间，87.3 - 90.8%）的父母报告接受或计划接受所有推荐的非流感儿童疫苗，5.5%（4.5 - 6.6%）的父母报告有意延迟一种或多种疫苗接种，5.4%（4.1 - 6.9%）的父母报告拒绝一种或多种疫苗。2014年，接受、延迟和拒绝率分别为90.8%（89.3 - 92.1%）、5.6%（4.6 - 6.9%）和3.6%（2.8 - 4.5%）。2012年至2014年期间，年龄较大儿童（2 - 6岁）的父母中有意拒绝疫苗的情况略有下降，但年龄较小儿童（0 - 1岁）的父母中没有下降。努力补种所有疫苗的父母比例增加，而拒绝部分但非全部疫苗的父母比例下降。南部地区估计的接受率显著上升（90.1 - 94.1%），有意持续拒绝率显著下降（5.0 - 2.1%）。东北地区疫苗延迟情况增加（3.2 - 8.8%）。
在全国范围内，推荐的非流感儿童疫苗的接受情况和持续的有意延迟情况较为稳定。这些发现表明，有必要做出更多努力来应对持续存在的疫苗犹豫问题，特别是在地方层面。还需要对免疫态度进行纵向监测，以评估随时间和地理区域的变化趋势。
