Costa-Pinto Jessica C, Willaby Harold W, Leask Julie, Hoq Monsurul, Schuster Tibor, Ghazarian Alice, O'Keefe Jacinta, Danchin Margie H
Department of General Medicine, Royal Children's Hospital, Melbourne, Victoria, Australia.
School of Public Health, University of Sydney, Sydney Medical School, Sydney, New South Wales, Australia.
J Paediatr Child Health. 2018 May;54(5):522-529. doi: 10.1111/jpc.13790. Epub 2017 Nov 23.
Despite Australia's high vaccination rates, an estimated 3.3% of children are under-vaccinated due to vaccine refusal and the proportion of parents with concerns is unclear. Amongst Australian parents, we aimed to determine the prevalence of vaccine concerns, resources and health-care providers (HCPs) accessed and satisfaction with these resources in two different settings. We also aimed to identify relationships between the level of vaccine concern, socio-economic status and vaccine uptake.
Parents of children under 5 years attending general paediatric clinics in a tertiary paediatric hospital (n = 301/398, 76%) and children under 19 months attending community maternal child health centres (n = 311/391, 81%) completed the survey. Vaccination status was obtained from the Australian Childhood Immunisation Register.
Despite high support for vaccination (98%, confidence interval (CI) 97-99), 43% of parents reported vaccine concerns (CI 40-47) including the number of vaccines given in the first 2 years (25%, CI 22 to 29), vaccine ingredients (22%, CI 19-25), allergies (18%, CI 15-21), weakening of the immune system (17%, CI 14-20) and autism (11%, CI 8-13). HCPs were the most commonly accessed and trusted information source. In all, 23% of parents reported insufficient knowledge to make good vaccination decisions (CI 20-26). There was little evidence of an association between parental vaccine acceptance or socio-economic status and vaccination status.
Despite high support for vaccines, nearly half of Australian parents have some concerns and a quarter lack vaccine decision-making confidence regarding childhood vaccines. Parents frequently access and report high trust in HCPs, who are best placed to address parental vaccine concerns through provision of clear information, using effective communication strategies. Further research in more highly hesitant populations is required to determine the relationship between the level and nature of vaccination concerns and vaccine uptake.
尽管澳大利亚的疫苗接种率很高，但估计有3.3%的儿童因拒绝接种疫苗而未得到充分接种，而家长们的担忧比例尚不清楚。在澳大利亚的家长中，我们旨在确定在两种不同环境下对疫苗的担忧程度、获取的资源和医疗保健提供者（HCP）以及对这些资源的满意度。我们还旨在确定疫苗担忧程度、社会经济地位和疫苗接种率之间的关系。
在一家三级儿科医院的普通儿科诊所就诊的5岁以下儿童的家长（n = 301/398，76%）和在社区母婴健康中心就诊的19个月以下儿童的家长（n = 311/391，81%）完成了调查。疫苗接种状况从澳大利亚儿童免疫登记处获取。
尽管对疫苗接种的支持率很高（98%，置信区间（CI）97 - 99），但43%的家长表示对疫苗存在担忧（CI 40 - 47），包括前两年接种的疫苗数量（25%，CI 22至29）、疫苗成分（22%，CI 19 - 25）、过敏（18%，CI 15 - 21）、免疫系统减弱（17%，CI 14 - 20）和自闭症（11%，CI 8 - 13）。医疗保健提供者是最常被咨询且最受信任的信息来源。总体而言，23%的家长表示缺乏做出良好疫苗接种决策的知识（CI 20 - 26）。几乎没有证据表明家长对疫苗的接受程度或社会经济地位与疫苗接种状况之间存在关联。
尽管对疫苗的支持率很高，但近一半的澳大利亚家长存在一些担忧，四分之一的家长对儿童疫苗的决策缺乏信心。家长经常咨询医疗保健提供者并对其高度信任，医疗保健提供者最适合通过提供清晰信息并采用有效的沟通策略来解决家长对疫苗的担忧。需要对更高度犹豫的人群进行进一步研究，以确定疫苗担忧的程度和性质与疫苗接种率之间的关系。
