Department of Family Medicine and Community Health, Duke University School of Medicine, Durham, North Carolina, USA.
Center for Health Policy and Inequalities Research, Duke University, Durham, North Carolina, USA.
BMC Public Health. 2020 Oct 20;20(1):1573. doi: 10.1186/s12889-020-09598-1.
Vaccine hesitancy has been recognized as an important barrier to timely vaccinations around the world, including in sub-Saharan Africa. In Tanzania, 1 in 4 children is not fully vaccinated. The objective of this mixed methods study was to describe and contextualize parental concerns towards vaccines in Tanzania.
Between 2016 and 2017, we conducted a cross-sectional survey (n = 134) and four focus group discussions (FGDs, n = 38) with mothers of children under 2 years of age residing in Mtwara region in Southern Tanzania. The survey and FGDs assessed vaccination knowledge and concerns and barriers to timely vaccinations. Vaccination information was obtained from government-issued vaccination cards.
In the cross-sectional survey, 72% of mothers reported missed or delayed receipt of vaccines for their child. Although vaccine coverage was high, timeliness of vaccinations was lower and varied by vaccine. Rural mothers reported more vaccine-related concerns compared to urban mothers; literacy and access to information were identified as key drivers of the difference. Mothers participating in FGDs indicated high perceived risk of vaccine-preventable illnesses, but expressed concerns related to poor geographic accessibility, unreliability of services, and missed opportunities for vaccinations resulting from provider efforts to minimize vaccine wastage.
Findings from our cross-sectional survey indicate the presence of vaccination delays and maternal concerns related to childhood vaccines in Tanzania. In FGDs, mothers raised issues related to convenience more often than issues related to vaccine confidence or complacency. Further research is necessary to understand how these issues may contribute to the emergence and persistence of vaccine hesitancy and to identify effective mitigation strategies.
疫苗犹豫已被认为是全球范围内及时接种疫苗的一个重要障碍，包括撒哈拉以南非洲地区。在坦桑尼亚，1/4 的儿童没有完全接种疫苗。本混合方法研究的目的是描述和背景化坦桑尼亚父母对疫苗的担忧。
2016 年至 2017 年期间，我们在坦桑尼亚南部姆特瓦拉地区对 134 名 2 岁以下儿童的母亲进行了横断面调查（n=134）和 4 次焦点小组讨论（FGD，n=38）。调查和 FGD 评估了接种疫苗的知识、担忧以及及时接种疫苗的障碍。接种疫苗的信息来自政府颁发的接种卡。
在横断面调查中，72%的母亲报告说她们的孩子错过了或延迟接种疫苗。尽管疫苗接种覆盖率很高，但疫苗接种的及时性较低，且因疫苗而异。农村母亲比城市母亲报告了更多的疫苗相关担忧；文化程度和获取信息的能力被认为是造成这种差异的关键因素。参加 FGD 的母亲表示，她们高度认识到可通过疫苗预防的疾病的风险，但对地理上的不便、服务的不可靠性以及提供者为尽量减少疫苗浪费而错失接种机会表示担忧。
我们的横断面调查结果表明，坦桑尼亚存在疫苗接种延迟和与儿童疫苗相关的母亲担忧。在 FGD 中，母亲更多地提出了与便利性相关的问题，而不是与疫苗信心或自满相关的问题。需要进一步研究以了解这些问题如何促成疫苗犹豫的出现和持续存在，并确定有效的缓解策略。
