Sydney School of Public Health, Faculty of Medicine & Health, University of Sydney, Edward Ford Building, Sydney, NSW, Australia.
Australian Centre for Health Engagement, Evidence & Values (ACHEEV), School of Health and Society, Faculty of the Arts, Social Sciences & Humanities, University of Wollongong, Northfields Ave, Wollongong, NSW, Australia.
BMC Public Health. 2021 Apr 9;21(1):578. doi: 10.1186/s12889-021-10604-3.
Communities with low vaccination rates are at greater risk during outbreaks of vaccine preventable diseases. Most Australian parents support vaccines, but some refuse and are often judged harshly by their community, especially during an outbreak. We sought the perspectives of Australian public health experts on the key issues faced when managing a measles outbreak in an area with high anti-vaccination sentiment.
A measles outbreak scenario formed the basis of a 3-round modified Delphi process to identify key practitioner concerns in relation to parents/carers who don't follow the recommended vaccination schedule. We surveyed a range of professionals in the field: policymakers, infectious disease experts, immunisation program staff, and others involved in delivering childhood vaccinations, to identify key priorities when responding to an outbreak in a community with low vaccination coverage.
Findings indicate that responses to measles outbreaks in communities with high anti-vaccination sentiment are motivated by concerns about the potential for a much larger outbreak event. The highest operational priority is to isolate infected children. The two most highly ranked practical issues are mistrust from non-vaccinating members of the local region and combatting misinformation about vaccines. Trying to change minds of such individuals is not a priority during an outbreak, nor is vaccinating their children. Using media and social media to provide information about the outbreak and measures the public can take to limit the spread of the disease was a focus.
Our findings provide a deeper understanding of the challenges faced during an outbreak and priorities for communicating with communities where there is a high level of anti-vaccination sentiment. In the context of a global pandemic, the results of this study also have implications for managing public health responses to community transmission of SARS-CoV-2, as COVID-19 vaccines becomes widely available.
疫苗可预防疾病爆发时，疫苗接种率低的社区面临更大的风险。大多数澳大利亚父母支持疫苗接种，但也有一些人拒绝接种，他们经常受到社区的严厉评判，尤其是在疫情爆发期间。我们想了解澳大利亚公共卫生专家对在高反疫苗接种情绪地区管理麻疹疫情时所面临的关键问题的看法。
麻疹疫情情景是三轮改良德尔菲法的基础，旨在确定与不遵守推荐疫苗接种时间表的父母/照顾者相关的关键从业人员关注问题。我们调查了该领域的一系列专业人员：政策制定者、传染病专家、免疫计划工作人员以及其他参与儿童疫苗接种的人员，以确定在疫苗接种率低的社区应对疫情时的关键优先事项。
研究结果表明，对高反疫苗接种情绪社区麻疹疫情的反应是由对更大规模疫情爆发的潜在可能性的担忧所驱动的。最高的运营优先级是隔离受感染的儿童。两个排名最高的实际问题是来自当地不信任非接种者和对抗疫苗错误信息。在疫情爆发期间，试图改变这些人的想法不是优先事项，也不是为他们的孩子接种疫苗。利用媒体和社交媒体提供有关疫情和公众可以采取的措施来限制疾病传播的信息是重点。
我们的研究结果提供了对在疫情爆发期间面临的挑战以及与具有高反疫苗接种情绪的社区进行沟通的优先事项的更深入理解。在全球大流行的背景下，这项研究的结果也对管理 SARS-CoV-2 社区传播的公共卫生应对措施有影响，因为 COVID-19 疫苗已广泛使用。
