Department of International Health, Johns Hopkins University Bloomberg School of Public Health, United States; Institute for Vaccine Safety, Johns Hopkins University Bloomberg School of Public Health, United States.
Department of International Health, Johns Hopkins University Bloomberg School of Public Health, United States; Department of Health, Behavior and Society, Johns Hopkins University Bloomberg School of Public Health, United States; Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, United States; Institute for Vaccine Safety, Johns Hopkins University Bloomberg School of Public Health, United States.
Vaccine. 2020 Mar 17;38(13):2827-2832. doi: 10.1016/j.vaccine.2020.02.019. Epub 2020 Feb 22.
Infants too young to be fully vaccinated are vulnerable to potentially deadly influenza and pertussis infections. The cocooning strategy limits this risk by vaccinating those likely to interact with the infant and mother during this vulnerable time, such as close friends and family members. Distribution of accurate and accessible vaccine information through existing social networks could be an important tool in increasing vaccine confidence and coverage.
We surveyed 1095 pregnant women from diverse prenatal care practices in Georgia and Colorado. These women were surveyed through a mobile app to assess vaccine intentions, attitudes, beliefs, norms, and levels of trust, and then presented brief individually-tailored educational videos about maternal and infant vaccines and the cocooning strategy. They were then given the opportunity to refer up to six contacts to enroll in the app and receive similar vaccine education.
Twenty-eight percent of these women referred at least one contact, with an average of 2.67 contacts per referring woman. Most referrals (93%) were partners, parents, siblings, relatives, or close friends. Attitudinal constructs significantly associated with increased likelihood of referring contacts included: intention to receive maternal influenza vaccine, perceived safety of maternal Tdap vaccine, perceived efficacy of maternal influenza vaccine, perceived susceptibility to and severity of influenza during pregnancy, and trust in vaccine information from the Centers for Disease Control and Prevention (CDC) and academic institutions. Uncertainty about infant vaccine intentions was associated with decreased likelihood of referring contacts.
Pregnant women who valued vaccination and trusted vaccine information from academic institutions were more likely to refer an educational app about vaccines than those who did not. Further research is needed to determine the potential impact of this strategy on vaccine coverage when implemented on a large scale.
The survey informing this article was part of a randomized controlled trial funded by the National Institutes of Health [clinicaltrials.gov registration number NCT02898688].
由于婴儿年龄太小，无法完全接种疫苗，因此他们容易受到潜在致命流感和百日咳感染。通过对那些在婴儿和母亲脆弱时期与之互动的人进行疫苗接种，如亲密朋友和家庭成员，可采用“围堵”策略来限制这种风险。通过现有的社交网络传播准确且易获取的疫苗信息，可能是增强疫苗信心和覆盖率的重要手段。
我们对佐治亚州和科罗拉多州的 1095 名来自不同产前护理机构的孕妇进行了调查。通过移动应用程序对这些女性进行调查，以评估疫苗接种意向、态度、信念、规范和信任程度，然后为她们提供有关孕产妇和婴儿疫苗接种以及“围堵”策略的简短个性化教育视频。之后，她们有机会向最多六位联系人推荐该应用程序，以使其接受类似的疫苗教育。
这些女性中有 28%至少推荐了一位联系人，每位推荐者平均推荐 2.67 位联系人。大多数推荐对象（93%）为伴侣、父母、兄弟姐妹、亲戚或亲密朋友。与增加推荐联系人的可能性显著相关的态度构念包括：接受母亲流感疫苗的意向、对母亲 Tdap 疫苗安全性的看法、对母亲流感疫苗有效性的看法、对怀孕期间流感易感性和严重性的看法，以及对疾病预防控制中心（CDC）和学术机构的疫苗信息的信任。对婴儿疫苗接种意向的不确定性与降低推荐联系人的可能性有关。
重视疫苗接种且信任学术机构疫苗信息的孕妇比不重视疫苗接种和不信任疫苗信息的孕妇更有可能推荐有关疫苗的教育应用程序。当在大规模实施时，需要进一步研究该策略对疫苗覆盖率的潜在影响。
本文所报道的调查是由美国国立卫生研究院资助的一项随机对照试验的一部分[临床试验.gov 注册号 NCT02898688]。
