Department of Immunization Program, Shanghai Municipal Centers for Disease Control & Prevention, Shanghai, China.
Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan, United States of America.
PLoS One. 2018 Dec 13;13(12):e0209117. doi: 10.1371/journal.pone.0209117. eCollection 2018.
Vaccine hesitancy has been little studied in low- and middle-income countries but is a potential concern because vaccine refusal may increase the burden of infectious diseases and impede control efforts. The aim of this study was to compare vaccine hesitancy between locals, long-time city residents, and non-locals, who have more recently moved to the city from either other urban or rural areas, in Shanghai, China.
Parents of infants ≤3 months of age were surveyed at immunization clinics in Shanghai, China. Participants completed a paper questionnaire utilizing the 10-item Vaccine Hesitancy Scale, which was developed by the World Health Organization Strategic Advisory Group of Experts on Immunization. Items were grouped based on internal consistency, and regressed onto demographic variables using a negative binomial model.
In total, 1,188 (92.5%) individuals participated. For most items on the scale, parents expressed positive beliefs about vaccines. However, about half of parents somewhat or strongly agreed that new vaccines carried more risks than older vaccines, and 71.6% somewhat or strongly agreed that they were concerned about serious adverse effects. Seven items from the Vaccine Hesitancy Scale were highly correlated and mapped onto "lack of confidence"; the other three items were analysed separately. Compared to mothers, fathers had less lack of confidence (β: -0.06, 95% CI: -0.12, -0.01), and individuals living in the outer suburbs (β: 0.13, 95% CI: 0.01, 0.25) and rural non-locals (β: 0.10, 95% CI: 0.02, 0.18) had greater lack of confidence in vaccines compared to their urban or local counterparts, respectively.
Shanghai parents professed confidence in certain vaccine benefits, but vaccine messaging could focus on addressing misconceptions about vaccines for diseases no longer common, newer vaccines, and adverse effects associated with vaccination. These messages may need to be separately tailored to locals and non-locals, who have differing concerns.
疫苗犹豫在中低收入国家研究较少，但这是一个潜在的关注点，因为疫苗拒绝可能会增加传染病的负担，并阻碍控制工作。本研究旨在比较中国上海的本地人、长期城市居民和非本地人（最近从城市以外的城市或农村地区搬到城市的人）之间的疫苗犹豫程度。
在中国上海的免疫接种诊所，对婴儿≤3 个月大的父母进行了调查。参与者使用世界卫生组织免疫战略咨询专家组开发的 10 项疫苗犹豫量表完成了纸质问卷。根据内部一致性，将项目分组，并使用负二项回归模型将其回归到人口统计学变量上。
共有 1188 名（92.5%）参与者参与了研究。对于该量表的大多数项目，父母对疫苗表示出积极的信念。然而，大约一半的父母或多或少地同意新疫苗比旧疫苗风险更大，71.6%或多或少地同意他们担心严重的副作用。疫苗犹豫量表的七个项目高度相关，并映射到“缺乏信心”上；另外三个项目单独进行分析。与母亲相比，父亲的信心不足程度较低（β：-0.06，95%置信区间：-0.12，-0.01），而居住在外郊区（β：0.13，95%置信区间：0.01，0.25）和农村非本地居民（β：0.10，95%置信区间：0.02，0.18）与城市或本地居民相比，对疫苗的信心较低。
上海的父母对某些疫苗的益处表示信任，但疫苗信息传递可以集中在解决对不再常见疾病、新型疫苗和与接种相关的不良影响的误解上。这些信息可能需要分别针对本地人和非本地人进行调整，因为他们有不同的关注点。
