Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
CDC Foundation, Atlanta, GA, USA.
Vaccine. 2022 Sep 16;40(39):5664-5669. doi: 10.1016/j.vaccine.2022.08.002. Epub 2022 Aug 5.
Many families express hesitancy around immunizing their children against COVID-19. We sought to better understand the perspectives of vaccine hesitant caregivers, and develop targeted recommendations for health care workers and policymakers to engage in more effective vaccine discussions.
We conducted semi-structured telephone interviews with 23 caregivers recruited from a pediatric infectious diseases clinic, including a subset of patients referred to discuss vaccine hesitancy. Thematic analysis of the interviews identified themes that were mapped using behavior change models to identify perceived barriers and facilitators towards COVID-19 immunization.
Barriers and facilitators were mapped to the WHO (World Health Organization) 3C's (confidence, complacency, convenience) model of vaccine hesitancy as well as the COM-B (capability, opportunity, motivation) behavior change model. Barriers included mistrust in authorities, misperception of the risk of COVID-19 in children, and perceived health contraindications and negative previous vaccine experiences. Facilitators included positive relationships with healthcare workers, the promise of a "return to normal", and societal pressures to immunize.
Efforts to increase vaccine uptake in the pediatric population must target specific barriers and facilitators to immunization expressed by caregivers. To address these concerns, we suggest: 1. Educating hesitant caregivers by highlighting the long-term pandemic effects on children and the threat of COVID-19 to children's health, 2. Building on the trust caregivers have in healthcare workers by involving frontline workers in public health policy, and 3. Harnessing the power of peer pressure by mobilization of societal pressures and establishing COVID-19 vaccination as the norm in children.
许多家庭对接种新冠疫苗犹豫不决。我们试图更好地了解疫苗犹豫的看护者的观点，并为医疗保健工作者和政策制定者制定有针对性的建议，以进行更有效的疫苗讨论。
我们对 23 名从儿科传染病诊所招募的看护者进行了半结构化电话访谈，其中包括一些被转介来讨论疫苗犹豫的患者。对访谈的主题分析确定了主题，并使用行为改变模型对其进行映射，以确定对 COVID-19 免疫接种的感知障碍和促进因素。
障碍和促进因素被映射到世卫组织（世界卫生组织）的 3C（信心、自满、方便）疫苗犹豫模型以及 COM-B（能力、机会、动机）行为改变模型。障碍包括对权威机构的不信任、对儿童感染 COVID-19 的风险的误解，以及对健康禁忌症和以前疫苗接种经历的负面看法。促进因素包括与医疗保健工作者的良好关系、“恢复正常”的承诺，以及社会对免疫接种的压力。
必须针对看护者对免疫接种表达的具体障碍和促进因素，努力提高儿科人群的疫苗接种率。为了解决这些问题，我们建议：1. 通过强调长期大流行对儿童的影响以及 COVID-19 对儿童健康的威胁，教育犹豫不决的看护者；2. 通过让一线工作人员参与公共卫生政策，利用看护者对医疗保健工作者的信任；3. 通过动员社会压力并将 COVID-19 疫苗接种确立为儿童的规范，利用同伴压力的力量。
