Navin Mark C, Kozak Andrea T, Attwell Katie
Department of Philosophy, Oakland University, Mathematics and Science Center, Room 746, 146 Library Drive, Rochester, MI 48309-4479, USA.
Department of Psychology, Oakland University, Pryale Hall, Room 210, 654 Pioneer Drive, Rochester, MI 48309-4482, USA.
Vaccine. 2022 Dec 5;40(51):7433-7439. doi: 10.1016/j.vaccine.2021.07.061. Epub 2021 Sep 25.
In US states, childhood immunization mandates are enforced for school registration by front-line school staff, usually secretaries. Despite substantial changes to mandate policies in several states and many countries, little attention has been paid to the people who enforce them. This qualitative pilot study aimed to uncover beliefs, attitudes, and practices regarding immunization governance of Michigan school staff.
Front-line administrative workers from Michigan schools and district offices were solicited by email. Sixteen were interviewed remotely.
Front-line school staff believed in vaccines, but did not advocate for vaccination while registering children. Instead, they sought low-friction bureaucratic transactions, privileging the collection of data over the promotion of public health goals. This revealed a mismatch between the goals of the front-line staff who enforce vaccine mandates in schools and the goals of the policymakers who created school vaccine mandates.
This study found low mobilization of front-line enforcers of mandates in public-facing school administration roles, a problem likely to afflict the majority of American states with the 'mandates + exemptions' model of immunization governance. Schools would have stronger incentives to promote vaccination if state funding were better tied to immunization compliance. Front-line staff could better enforce vaccine mandates if they were provided with resources and training about vaccine promotion.
在美国各州，儿童免疫接种要求由一线学校工作人员（通常是秘书）在办理入学登记时执行。尽管几个州和许多国家的免疫接种要求政策发生了重大变化，但对执行这些政策的人员却很少关注。这项定性试点研究旨在揭示密歇根州学校工作人员在免疫接种管理方面的信念、态度和做法。
通过电子邮件邀请密歇根州学校和学区办公室的一线行政人员参与。16人接受了远程访谈。
一线学校工作人员相信疫苗，但在为儿童办理入学登记时并不倡导接种疫苗。相反，他们寻求低摩擦的官僚程序，将数据收集置于促进公共卫生目标之上。这揭示了在学校执行疫苗要求的一线工作人员的目标与制定学校疫苗要求的政策制定者的目标之间存在不匹配。
本研究发现，在面向公众的学校管理岗位上，一线执行人员的动员程度较低，这一问题可能困扰大多数采用“要求+豁免”免疫接种管理模式的美国州。如果州资金能更好地与免疫接种合规情况挂钩，学校将更有动力推广疫苗接种。如果为一线工作人员提供有关疫苗推广的资源和培训，他们就能更好地执行疫苗要求。
