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探讨加利福尼亚州新法律对儿童疫苗的个人信仰豁免的影响,以及加利福尼亚州 homeschooling 母亲在疫苗决策方面的情况。

Exploring California's new law eliminating personal belief exemptions to childhood vaccines and vaccine decision-making among homeschooling mothers in California.

机构信息

Johns Hopkins Bloomberg School of Public Health, Baltimore, MD USA.

Johns Hopkins Bloomberg School of Public Health, Department of International Health, 615 N. Wolfe E6608, Baltimore, MD USA.

出版信息

Vaccine. 2019 Jan 29;37(5):742-750. doi: 10.1016/j.vaccine.2018.12.018. Epub 2019 Jan 6.

Abstract

BACKGROUND

California's Senate Bill 277 (SB-277) law eliminated the personal belief exemption to school immunization requirements. A potential consequence may be that parents choose homeschooling to avoid immunization. Vaccine attitudes and behaviors have not been well studied among the home-schooling population. This study explored the effect of SB-277 and vaccine decision-making among California home schoolers.

METHODS

Purposive and snowball sampling were used recruit home-schooling parents through home-schooling Facebook groups based on home school type in high-exemption regions in California for in-depth interviews. Participants had to have a child in a legalized form of homeschooling in California in grades kindergarten-twelfth grade.

RESULTS

Twenty-four mothers were interviewed. Participants were categorized based on self-reported vaccine attitudes and behavior into three groups: Confident and Accepting, Hesitant and Accepting, and Skeptical and Refusing. All reported the belief that SB-277 is an infringement on parental rights but was not currently impacting them. Confident and Accepting mothers (n = 10) generally believed vaccinations were safe, effective, and posed a lower risk than vaccine preventable disease (VPD). Hesitant and Accepting mothers (n = 5) expressed varying confidence levels in the belief that vaccinations were safe and effective, were not confident in the belief that vaccination posed lower risks than VPD risk, and risk perception affected vaccine decision-making. Skeptical and Refusing mothers (n = 9) generally believed that vaccinations were unsafe and ineffective, refused select vaccines, believed that vaccination posed a more serious risk than VPD risks, and belief of vaccine harm was a salient factor in vaccine decision-making.

CONCLUSION

Home-schooling mothers were concerned about SB-277 but did not report that it was directly impacting their children, their vaccine decisions, or reason to home school. Vaccine attitudes and beliefs among homeschooling mothers broadly fell into categories similar to parents of non-home-schooled children. Future quantitative studies should measure vaccine hesitancy and refusal prevalence and potential confounders.

摘要

背景

加州参议院法案 277(SB-277)法案取消了学校免疫接种要求的个人信仰豁免。一个潜在的后果可能是,家长选择在家教育以避免接种疫苗。在家教育人群中的疫苗态度和行为尚未得到充分研究。本研究探讨了 SB-277 对加州在家上学者的影响以及疫苗决策。

方法

采用目的抽样和滚雪球抽样,通过加州高豁免地区的在家上学 Facebook 群组,根据在家上学类型招募在家上学的家长,进行深入访谈。参与者必须在加利福尼亚州有一个在法定形式下在家上学的孩子,从幼儿园到十二年级。

结果

共采访了 24 位母亲。根据自我报告的疫苗态度和行为,参与者分为三类:自信且接受、犹豫不决且接受、怀疑且拒绝。所有人都报告说,他们认为 SB-277 侵犯了父母的权利,但目前并未对他们造成影响。自信且接受的母亲(n=10)普遍认为疫苗是安全有效的,并且比疫苗可预防的疾病(VPD)风险低。犹豫不决且接受的母亲(n=5)对疫苗安全有效的信念存在不同程度的信心,对疫苗比 VPD 风险低的信念缺乏信心,风险感知影响疫苗决策。怀疑且拒绝的母亲(n=9)普遍认为疫苗不安全且无效,拒绝接种某些疫苗,认为疫苗接种比 VPD 风险更严重,对疫苗危害的信念是疫苗决策的重要因素。

结论

在家上学的母亲对 SB-277 感到担忧,但并未报告称其直接影响他们的孩子、他们的疫苗接种决定或选择在家上学的原因。在家上学的母亲的疫苗态度和信念大致分为与非在家上学儿童的父母相似的类别。未来的定量研究应衡量疫苗犹豫和拒绝的流行率以及潜在的混杂因素。

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