University of Toronto, Toronto, Ontario, Canada.
University Health Network, Toronto, Ontario, Canada.
Qual Health Res. 2020 Sep;30(11):1762-1776. doi: 10.1177/1049732320933863. Epub 2020 Jun 29.
Vaccines are some of the most cost-effective public health interventions for reducing disease burden and mortality. However, in recent years, health systems have faced a growing challenge with increasing number of parents who choose not to vaccinate their children. This decision has important implications for the health of communities worldwide, and despite a considerable amount of research that reinforces vaccine effectiveness and safety, there is uncertainty surrounding the factors that may encourage vaccine hesitancy in parents. In this interpretive review of 34 qualitative studies, we examine the factors that bolster vaccine hesitancy, rejection, and delay, and identify the overlaps and relationships between these factors. We depict our findings using the metaphor of a gear train where each gear represents one of seven factors: previous experiences; "natural" and "organic" living; perceptions of other parents; experiences interacting with health care providers; information sources, challenges, and preferences; distrust in health system players; and mandatory vaccine policies.
疫苗是减轻疾病负担和死亡率的最具成本效益的公共卫生干预措施之一。然而，近年来，卫生系统面临着越来越多的父母选择不为孩子接种疫苗的挑战。这一决定对全球社区的健康具有重要影响，尽管有大量研究证实了疫苗的有效性和安全性，但对于可能导致父母对疫苗犹豫不决的因素仍存在不确定性。在对 34 项定性研究的解释性综述中，我们研究了增强疫苗犹豫、拒绝和延迟的因素，并确定了这些因素之间的重叠和关系。我们使用齿轮传动的隐喻来描述我们的发现，其中每个齿轮代表七个因素之一：以往的经验；“自然”和“有机”生活；对其他父母的看法；与医疗保健提供者互动的经验；信息来源、挑战和偏好；对卫生系统参与者的不信任；以及强制性疫苗政策。
