Byström Emma, Lindstrand Ann, Bergström Jakob, Riesbeck Kristian, Roth Adam
Unit for Vaccination Programs, Department of Communicable Disease Control and Health Protection, Public Health Agency of Sweden, Folkhälsomyndigheten, 171 82 Solna, Sweden; Clinical Microbiology, Department of Translational Medicine, Faculty of Medicine, Lund University, Jan Waldenströms gata 59, 205 02 Malmö, Sweden.
Expanded Programme on Immunization, Department of Immunization, Vaccines and Biologicals, World Health Organization, WHO, 20 Avenue Appia 1202, Geneva, Switzerland.
Vaccine. 2020 May 8;38(22):3909-3917. doi: 10.1016/j.vaccine.2020.01.078. Epub 2020 Feb 11.
Vaccination coverage for infant vaccinations in the Swedish National Immunization Program (NIP) has been high for more than a decade, with approximately 97% of 2-year-old children fully immunized. Vaccination coverage against Human Papilloma Virus (HPV) has been around 80% since introduction for girls in 2012. This indicates high parental confidence in the NIP, but as seen in other European countries rapid shifts in confidence may occur. This study examined vaccine confidence and attitudes towards vaccinations among parents in the Swedish population.
A web-based survey was sent to 1046 parents with children aged 0-15 years, in a panel administrated by The Public Health Agency of Sweden. The survey included questions on vaccination awareness, safety and information channels. The response rate was 87%. Data were weighted to adjust for non-responders and for representativeness of the Swedish population.
Parents were categorized as acceptors (79%), questioning acceptors (19%) or selective refusers (2%). When excluding responses for HPV vaccination, the proportion of acceptors increased to 91%. The main reasons for questioning or refusing a vaccine were worry over adverse events, negative or lack of information. Along a spectrum of beliefs, acceptors and questioning acceptors were more similar compared to selective refusers. Nurses at child health clinics constituted the most used vaccination information source for acceptors, whereas selective refusers to a greater extent searched information online and in social media.
The study demonstrates that parents in Sweden have confidence in and are positive towards vaccinations given within the NIP. One in five parents question vaccines, particularly regarding the HPV vaccine, but still concur to the NIP. Information on vaccines online and at vaccination appointments, including vaccine safety, is important for maintaining confidence in vaccination. Conducting recurring studies is valuable for monitoring vaccine confidence and changes in attitudes towards vaccination.
在瑞典国家免疫规划（NIP）中，婴儿疫苗接种覆盖率十多年来一直很高，约97%的2岁儿童完成了全程免疫。自2012年面向女孩引入人乳头瘤病毒（HPV）疫苗接种以来，接种覆盖率一直约为80%。这表明家长对国家免疫规划高度信任，但正如在其他欧洲国家所看到的那样，信任可能会迅速转变。本研究调查了瑞典人群中家长对疫苗的信任以及对疫苗接种的态度。
通过瑞典公共卫生机构管理的一个小组，向1046名有0至15岁孩子的家长发送了一项基于网络的调查。该调查包括有关疫苗接种意识、安全性和信息渠道的问题。回复率为87%。对数据进行加权处理，以调整未回复者的情况以及瑞典人口的代表性。
家长被分为接受者（79%）、有疑问的接受者（19%）或选择性拒绝者（2%）。在排除HPV疫苗接种的回复后，接受者的比例增至91%。质疑或拒绝接种疫苗的主要原因是担心不良事件、负面信息或缺乏信息。在一系列信念方面，与选择性拒绝者相比，接受者和有疑问的接受者更为相似。儿童健康诊所的护士是接受者最常使用的疫苗接种信息来源，而选择性拒绝者在更大程度上通过在线和社交媒体搜索信息。
该研究表明，瑞典的家长对国家免疫规划内的疫苗接种有信心且持积极态度。五分之一的家长对疫苗有疑问，特别是关于HPV疫苗，但仍认同国家免疫规划。在线以及在疫苗接种预约时提供的有关疫苗的信息，包括疫苗安全性，对于维持对疫苗接种的信心很重要。定期开展研究对于监测疫苗信心以及对疫苗接种态度的变化很有价值。
