Miller Jonathan M, Carroll Ricki S
Chief, Primary Care; Medical Director, Value Based Care, Nemours Children's Health; Clinical Associate Professor, Pediatrics; Sidney Kimmel Medical College, Thomas Jefferson University.
Attending Physician, Divisions of Orthogenetics & Palliative Medicine, Nemours Children's Health; Clinical Associate Professor, Pediatrics, Sidney Kimmel Medical College, Thomas Jefferson University.
Dela J Public Health. 2022 Mar 29;8(1):60-64. doi: 10.32481/djph.2022.03.009. eCollection 2022 Mar.
The tremendous success of vaccination programs worldwide over the past two centuries has produced a paradoxical effect whereby a lack of exposure to the devastating consequences of vaccine-preventable diseases has created an environment in which fear of the side effects of vaccines can overshadow concerns about the impact of the diseases they are meant to prevent. As vaccine hesitancy grew over the past twenty years, states passed legislation, such as non-medical exemptions from vaccination, that have cultivated pockets of poor vaccine uptake allowing for the return of vaccine-preventable diseases such as measles and pertussis. The COVID-19 pandemic has further intensified mistrust of vaccines, impacting both the reasons for vaccine hesitancy and the attributes of vaccine hesitant parents. Because unimmunized children are at increased risk for vaccine-preventable diseases and associated cancers, as well as reduced access to adequate healthcare, they are a particularly vulnerable population warranting special protections and support. A comprehensive approach to combat vaccine hesitancy and promote uptake should include a focus on evidence-based initiatives at the legislative, practice, and provider levels. These strategies can substantively inform health policy, from upstream legislation strengthening school mandates and eliminating non-medical exemptions to downstream policies that impact provider conversations about immunization.
在过去两个世纪里，全球疫苗接种计划取得了巨大成功，但却产生了一种自相矛盾的效果：由于人们没有接触到疫苗可预防疾病的毁灭性后果，从而营造了一种环境，在这种环境中，对疫苗副作用的恐惧可能会掩盖对这些疫苗旨在预防的疾病影响的担忧。在过去二十年里，随着疫苗犹豫情绪的加剧，各国通过了一些立法，比如允许非医学原因的疫苗豁免，这些立法导致了疫苗接种率低的地区出现，使得麻疹和百日咳等疫苗可预防疾病得以卷土重来。新冠疫情进一步加剧了人们对疫苗的不信任，影响了疫苗犹豫的原因以及有疫苗犹豫情绪的父母的特征。由于未接种疫苗的儿童患疫苗可预防疾病和相关癌症的风险增加，以及获得充分医疗保健的机会减少，他们是一个特别脆弱的群体，需要特别的保护和支持。应对疫苗犹豫情绪并促进疫苗接种的综合方法应包括关注立法、实践和医疗服务提供者层面基于证据的举措。这些策略可以切实为卫生政策提供信息，从加强学校强制接种规定和取消非医学豁免的上游立法，到影响医疗服务提供者关于免疫接种谈话的下游政策。
