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应对疫苗犹豫:为与家长合作的初级保健医生提供的临床指导。

Addressing vaccine hesitancy: Clinical guidance for primary care physicians working with parents.

机构信息

Resident in the Public Health and Preventive Medicine program at the University of Toronto in Ontario.

Associate Medical Officer of Health with Toronto Public Health and Adjunct Professor in the Dalla Lana School of Public Health at the University of Toronto.

出版信息

Can Fam Physician. 2019 Mar;65(3):175-181.

Abstract

OBJECTIVE

To provide primary care physicians with clinical guidance for addressing parental vaccine hesitancy.

SOURCES OF INFORMATION

The PubMed database was searched for English-language articles published in the 10 years before January 1, 2018. Search terms included or or or and or . References of identified articles were assessed for additional relevant articles. A separate gray literature search was conducted using Google to find best-practice guidelines from public health and health care organizations, knowledge translation materials for health care providers, and resources that could be used in discussions with parents about vaccines.

MAIN MESSAGE

Practical tips for addressing parental vaccine hesitancy in primary care include starting early, presenting vaccination as the default approach, building trust, being honest about side effects, providing reassurance on a robust vaccine safety system, focusing on protection of the child and community, telling stories, and addressing pain. Also provided are statements that providers could use in vaccination-related conversations; answers to commonly asked questions on benefits, safety, and immunologic aspects of vaccines; and links to a number of online resources for physicians and parents.

CONCLUSION

Vaccine-hesitant parents who are on the fence far outnumber vaccine refusers; therefore, counseling this group might be more effective. Reasons behind vaccine hesitancy are complex and encompass more than just a knowledge deficit. As a trusted source of information on vaccines, family physicians play a key role in driving vaccine acceptance.

摘要

目的

为初级保健医生提供解决家长疫苗犹豫的临床指导。

信息来源

在 2018 年 1 月 1 日之前的 10 年内,检索了英文文献数据库 PubMed 中发表的文章。检索词包括 或 或 或 或 或 。对确定文章的参考文献进行了评估,以查找公共卫生和医疗保健组织的最佳实践指南、医疗保健提供者的知识转化材料,以及可用于与家长讨论疫苗的资源。

主要信息

在初级保健中解决家长疫苗犹豫的实用技巧包括:尽早开始,将疫苗接种作为默认方法,建立信任,诚实地对待副作用,对强大的疫苗安全系统提供保证,关注对儿童和社区的保护,讲述故事,并解决疼痛问题。还提供了提供者可以在疫苗接种相关对话中使用的陈述;关于疫苗的益处、安全性和免疫学方面的常见问题的答案;以及为医生和家长提供的许多在线资源的链接。

结论

处于犹豫不决的疫苗接种家长比疫苗拒绝者多得多;因此,对这一群体进行咨询可能更有效。疫苗犹豫的背后原因复杂,不仅仅是知识缺乏。作为疫苗信息的可靠来源,家庭医生在推动疫苗接种接受方面发挥着关键作用。

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本文引用的文献

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Working with vaccine-hesitant parents: An update.与对疫苗持犹豫态度的家长合作:最新情况
Paediatr Child Health. 2018 Dec;23(8):561-562. doi: 10.1093/pch/pxy144. Epub 2018 Nov 19.
4
Interventions to increase pediatric vaccine uptake: An overview of recent findings.增加儿科疫苗接种率的干预措施:近期研究结果概述。
Hum Vaccin Immunother. 2017 Nov 2;13(11):2503-2511. doi: 10.1080/21645515.2017.1367069. Epub 2017 Sep 26.
6
Vaccine Hesitancy: In Search of the Risk Communication Comfort Zone.疫苗犹豫:探寻风险沟通的舒适区
PLoS Curr. 2017 Mar 3;9:ecurrents.outbreaks.0561a011117a1d1f9596e24949e8690b. doi: 10.1371/currents.outbreaks.0561a011117a1d1f9596e24949e8690b.
10
Countering Vaccine Hesitancy.应对疫苗犹豫
Pediatrics. 2016 Sep;138(3). doi: 10.1542/peds.2016-2146.

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