Department of General Pediatrics, CHI at Temple Street, Dublin, Ireland.
Department of Pediatrics, Cork University Hospital, Cork, Ireland.
Eur J Pediatr. 2021 Sep;180(9):2839-2847. doi: 10.1007/s00431-021-04039-6. Epub 2021 Mar 27.
Vaccine hesitancy is defined as a delay in acceptance, or refusal, of vaccines, despite availability. It is a complex and context specific phenomenon and identified as a global health priority. The "Parent Attitudes about Childhood Vaccines" (PACV) questionnaire is a validated tool for identifying vaccine hesitancy. Our aim was to use the PACV to assess vaccine hesitancy and its relationship with reported non-vaccination in an Irish population, for the first time. Our participants were parents or caregivers of children attending general pediatric clinics in a tertiary pediatric hospital in Dublin, Ireland, between September and December 2018. In total, 436 participants completed the questionnaire. 5.5% of our population reported non-vaccination. Human papilloma virus and measles, mumps, rubella vaccines were the most commonly cited vaccines of concern (11.5% and 6.7%, respectively), and autism spectrum disorder was the most commonly side effect of concern (4.3%). Mean PACV score was 26.9 (SD 19.1), with a significant difference between non-vaccinators and vaccinators (53.2 vs 25.3, p<0.001). Safety and efficacy concerns were the major contributor to non-vaccination. 14.4% of our population were vaccine-hesitant using the conventional cut-off score, which increased to 22% when using an optimal cut-off which maximized sensitivity and specificity. The accuracy of the PACV score to identify non-vaccination was good (area under the ROC curve = 0.827), and the optimal cut-off had a high negative predictive value (98.5%).Conclusion: PACV identified reported non-vaccination with high accuracy in our population. It may be useful to screen vaccine-hesitant parents who could benefit from interventions to improve uptake. What is Known: • Vaccine hesitancy is a leading threat to global health, with falls in vaccine uptake associated with disease outbreaks worldwide. • The Parent Attitudes about Childhood Vaccines (PACV) questionnaire is a validated measure of vaccine hesitancy and correlates with non-vaccination in many populations. What is New: • This large study in a pediatric outpatient clinic setting represents the first use of the PACV in a Western European population to assess vaccination hesitancy. • The PACV may be an effective way of screening a pediatric clinic population to identify vaccine-hesitant parents or caregivers for targeted vaccine promotion.
疫苗犹豫是指尽管疫苗可及，但仍延迟或拒绝接种疫苗。它是一种复杂且特定于具体情况的现象，被确定为全球卫生的重点问题。“儿童疫苗家长态度”（PACV）问卷是一种用于识别疫苗犹豫的经过验证的工具。我们的目的是首次使用 PACV 来评估爱尔兰人群中的疫苗犹豫及其与报告的未接种疫苗之间的关系。我们的参与者是 2018 年 9 月至 12 月期间在都柏林一家儿科三级医院普通儿科诊所就诊的儿童的父母或照顾者。共有 436 名参与者完成了问卷调查。我们人群中有 5.5%的人未接种疫苗。人乳头瘤病毒和麻疹、腮腺炎、风疹疫苗是最常被提及的关注疫苗（分别为 11.5%和 6.7%），最常被提及的关注副作用是自闭症谱系障碍（4.3%）。PACV 平均得分为 26.9（SD 19.1），未接种疫苗者和接种疫苗者之间存在显著差异（53.2 与 25.3，p<0.001）。安全性和有效性问题是未接种疫苗的主要原因。使用常规截止值，我们人群中有 14.4%的人存在疫苗犹豫，当使用最大程度提高敏感性和特异性的最佳截止值时，该比例增加到 22%。PACV 评分识别未接种疫苗的准确性较高（ROC 曲线下面积=0.827），最佳截止值具有较高的阴性预测值（98.5%）。结论：在我们的人群中，PACV 以较高的准确性识别报告的未接种疫苗。它可能有助于筛选需要干预以提高接种率的疫苗犹豫父母。已知：•疫苗犹豫是对全球健康的主要威胁，疫苗接种率下降与世界各地的疾病爆发有关。•“儿童疫苗家长态度”（PACV）问卷是衡量疫苗犹豫的一种经过验证的衡量标准，并且与许多人群的未接种疫苗有关。新内容：•这项在儿科门诊诊所环境中的大型研究代表了首次在西欧人群中使用 PACV 来评估疫苗接种犹豫。•PACV 可能是一种有效的方法，可以对儿科诊所人群进行筛查，以确定疫苗犹豫的父母或照顾者，以便进行有针对性的疫苗推广。
