越南疫苗副作用的媒体呈现及其对疫苗接种服务利用情况的影响。
Media representation of vaccine side effects and its impact on utilization of vaccination services in Vietnam.
作者信息
Tran Bach Xuan, Boggiano Victoria L, Nguyen Long Hoang, Latkin Carl A, Nguyen Huong Lan Thi, Tran Tung Thanh, Le Huong Thi, Vu Thuc Thi Minh, Ho Cyrus Sh, Ho Roger Cm
机构信息
Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam,
Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA,
出版信息
Patient Prefer Adherence. 2018 Sep 6;12:1717-1728. doi: 10.2147/PPA.S171362. eCollection 2018.
BACKGROUND
Media representation of vaccine side effects impacts the success of immunization programs globally. Exposure to the media can cause individuals to feel hesitant toward, or even refuse, vaccines. This study aimed to explore the impact of the media on beliefs and behaviors regarding vaccines and vaccine side effects in an urban clinic in Vietnam.
METHODS
A cross-sectional study was conducted in an urban vaccination clinic in Hanoi, Vietnam from November 2015 to March 2016. The primary outcomes of this study were the decisions of Vietnamese subjects after hearing about adverse effects of immunizations (AEFIs) in the media. Socio-demographic characteristics as well as beliefs regarding vaccination were also investigated. Multivariate logistic regression was used to identify factors associated with subjects' behaviors regarding vaccines.
RESULTS
Among 429 subjects, 68.2% of them said they would be hesitant about receiving vaccines after hearing about AEFIs, while 12.4% of subjects said they would refuse vaccines altogether after hearing about AEFIs. Wealthy individuals (OR=0.41; 95% CI=0.19-0.88), and those who displayed trust in government-distributed vaccines (OR=0.20; 95% CI=0.06-0.72) were less likely to display hesitancy regarding vaccination. Receiving information from community health workers (OR=0.44; 95% CI=0.20-0.99) and their relatives, colleagues, and friends (OR=0.47; 95% CI=0.25-0.88) was negatively associated with vaccine hesitancy, but facilitated vaccine refusal after reading about AEFIs in the media (OR=3.12; 95% CI=1.10-8.90 and OR=3.75; 95% CI=1.56-9.02, respectively).
CONCLUSION
Our results reveal a significantly high rate of vaccine hesitancy and refusal among subjects living in an urban setting in Vietnam, after hearing about AEFIs in the media. Vietnam needs to develop accurate information systems in the media about immunizations, to foster increased trust between individuals, health care professionals, and the Vietnamese government.
背景
媒体对疫苗副作用的报道影响着全球免疫规划的成效。接触媒体会使个体对疫苗产生犹豫甚至拒绝接种。本研究旨在探讨媒体对越南一家城市诊所中人们关于疫苗及疫苗副作用的信念和行为的影响。
方法
2015年11月至2016年3月在越南河内的一家城市疫苗接种诊所开展了一项横断面研究。本研究的主要结局是越南受试者在听闻媒体报道的免疫接种不良反应（AEFI）后的决策。还调查了社会人口学特征以及对疫苗接种的信念。采用多因素逻辑回归来确定与受试者疫苗相关行为有关的因素。
结果
在429名受试者中，68.2%的人表示在听闻AEFI后会对接种疫苗犹豫不决，而12.4%的受试者表示在听闻AEFI后会完全拒绝接种疫苗。富裕人群（比值比[OR]=0.41；95%置信区间[CI]=0.19 - 0.88）以及那些对政府分发的疫苗表示信任的人（OR=0.20；95% CI=0.06 - 0.72）对接种疫苗表现出犹豫的可能性较小。从社区卫生工作者（OR=0.44；95% CI=0.20 - 0.99）及其亲属、同事和朋友处获取信息（OR=0.47；95% CI=0.25 - 0.88）与疫苗犹豫呈负相关，但在媒体上读到AEFI后会促使疫苗被拒绝（分别为OR=3.12；95% CI=1.10 - 8.90和OR=3.75；95% CI=1.56 - 9.02）。
结论
我们的结果显示，在听闻媒体报道的AEFI后，越南城市地区的受试者中疫苗犹豫和拒绝率显著较高。越南需要在媒体上建立关于免疫接种的准确信息系统，以增进个体、医疗保健专业人员和越南政府之间的信任。
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