Schmid Philipp, Rauber Dorothee, Betsch Cornelia, Lidolt Gianni, Denker Marie-Luisa
Center for Empirical Research in Economics and Behavioral Sciences, University of Erfurt, Erfurt, Germany.
Department of Media and Communication Sciences, University of Erfurt, Erfurt, Germany.
PLoS One. 2017 Jan 26;12(1):e0170550. doi: 10.1371/journal.pone.0170550. eCollection 2017.
Influenza vaccine hesitancy is a significant threat to global efforts to reduce the burden of seasonal and pandemic influenza. Potential barriers of influenza vaccination need to be identified to inform interventions to raise awareness, influenza vaccine acceptance and uptake.
This review aims to (1) identify relevant studies and extract individual barriers of seasonal and pandemic influenza vaccination for risk groups and the general public; and (2) map knowledge gaps in understanding influenza vaccine hesitancy to derive directions for further research and inform interventions in this area.
Thirteen databases covering the areas of Medicine, Bioscience, Psychology, Sociology and Public Health were searched for peer-reviewed articles published between the years 2005 and 2016. Following the PRISMA approach, 470 articles were selected and analyzed for significant barriers to influenza vaccine uptake or intention. The barriers for different risk groups and flu types were clustered according to a conceptual framework based on the Theory of Planned Behavior and discussed using the 4C model of reasons for non-vaccination.
Most studies were conducted in the American and European region. Health care personnel (HCP) and the general public were the most studied populations, while parental decisions for children at high risk were under-represented. This study also identifies understudied concepts. A lack of confidence, inconvenience, calculation and complacency were identified to different extents as barriers to influenza vaccine uptake in risk groups.
Many different psychological, contextual, sociodemographic and physical barriers that are specific to certain risk groups were identified. While most sociodemographic and physical variables may be significantly related to influenza vaccine hesitancy, they cannot be used to explain its emergence or intensity. Psychological determinants were meaningfully related to uptake and should therefore be measured in a valid and comparable way. A compendium of measurements for future use is suggested as supporting information.
流感疫苗犹豫是全球减轻季节性流感和大流行性流感负担努力的重大威胁。需要确定流感疫苗接种的潜在障碍，以便为提高认识、流感疫苗接受度和接种率的干预措施提供依据。
本综述旨在（1）识别相关研究，并提取针对高危人群和普通公众的季节性和大流行性流感疫苗接种的个体障碍；（2）梳理在理解流感疫苗犹豫方面的知识空白，以得出进一步研究的方向，并为该领域的干预措施提供信息。
检索了涵盖医学、生物科学、心理学、社会学和公共卫生领域的13个数据库，查找2005年至2016年间发表的同行评审文章。按照PRISMA方法，选择了470篇文章并分析了流感疫苗接种或接种意愿的重大障碍。根据基于计划行为理论的概念框架，对不同风险群体和流感类型的障碍进行了聚类，并使用未接种疫苗原因的4C模型进行了讨论。
大多数研究在美国和欧洲地区进行。医护人员（HCP）和普通公众是研究最多的人群，而针对高危儿童的家长决策研究较少。本研究还识别了研究不足的概念。在不同程度上，缺乏信心、不便、算计和自满被确定为高危人群接种流感疫苗的障碍。
确定了许多特定于某些风险群体的不同心理、背景、社会人口统计学和身体障碍。虽然大多数社会人口统计学和身体变量可能与流感疫苗犹豫显著相关，但它们不能用来解释其出现或强度。心理决定因素与接种情况有意义地相关，因此应以有效且可比的方式进行测量。建议编制一份未来使用的测量简编作为支持信息。
