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旨在提高流感疫苗接种率的关注群体免疫的利他主义干预效果的初步研究。

Pilot study to determine effect of an altruism intervention focusing on herd immunity to enhance influenza vaccination rates.

机构信息

Department of Pediatrics, Wake Forest School of Medicine, 1 Medical Center Blvd, Winston-Salem, NC 27157, USA.

Department of Pediatrics, Northwestern Feinberg School of Medicine, 225 E Chicago Ave, Chicago, IL 60611, USA.

出版信息

Vaccine. 2022 Nov 2;40(46):6625-6630. doi: 10.1016/j.vaccine.2022.09.074. Epub 2022 Oct 6.

Abstract

OBJECTIVE

A prospective, single-arm clinical trial was conducted to evaluate an altruism-tailored educational intervention to improve parental attitudes and vaccine uptake in vaccine-hesitant parents.

METHODS

Vaccine-hesitant parents at two primary care sites, spanning two influenza seasons from 2020 to 2021 were provided an intervention (spoken and written communication) which highlighted altruistic benefits of accepting the seasonal influenza vaccine to optimize herd immunity to help protect pediatric cancer patients. Eligible parents included those with children eligible for the seasonal influenza vaccine, those who were proficient in English, and those with scores on the adjusted Vaccine Hesitancy Scale (aVHS) suggesting vaccine hesitancy (score ≥ 3). Enrollees completed a demographic questionnaire, underwent the educational intervention, and repeated the aVHS. Vaccination status at that visit was assessed. The primary outcome was change in aVHS scores obtained pre- and post-intervention. Influenza vaccine acceptance, along with demographic information, were also analyzed.

RESULTS

We enrolled 510 parents of influenza vaccine eligible children and identified 73 vaccine-hesitant parents. There was an overall trend toward lower aVHS score, with a mean change in hesitancy score of -0.4 (P < 0.01). 43/73 (58.9 %) of the cohort experienced a positive effect toward a lower aVHS score, and 27/73 (37.0 %) of vaccine hesitant subjects became non-hesitant on the aVHS. Several demographic characteristics were associated with vaccine hesitancy in the screening population: educational level lower than bachelor's degree (p = 0.03), household income < 400 % of federal poverty level (p < 0.01), unmarried (p = 0.02), and identifying with a political affiliation other than Democrat (p < 0.01). However, no demographic characteristics were significantly associated with an individual becoming non-hesitant. Our altruism-tailored communication approach carried the largest positive impact on the altruism-specific question on the aVHS, decreasing the post-intervention response value by nearly 25 % (P < 0.01).

CONCLUSIONS

Our altruism-tailored communication approach significantly improved attitudes regarding childhood influenza vaccine among vaccine-hesitant parents.

CLINICALTRIALS

gov Identifier: NCT04568590.

摘要

目的

进行了一项前瞻性、单臂临床试验,以评估一项利他主义为导向的教育干预措施,以改善对疫苗持犹豫态度的父母的态度和疫苗接种率。

方法

在两个初级保健点,跨越 2020 年至 2021 年两个流感季节,为对疫苗持犹豫态度的父母提供了一种干预措施(口头和书面交流),强调了接受季节性流感疫苗的利他主义益处,以优化群体免疫力,帮助保护儿科癌症患者。合格的父母包括有资格接种季节性流感疫苗的儿童的父母、精通英语的父母以及疫苗犹豫量表(aVHS)得分表明疫苗犹豫(得分≥3)的父母。参与者完成了一份人口统计问卷,接受了教育干预,并重复了 aVHS。在那次就诊时评估了疫苗接种情况。主要结果是干预前后 aVHS 评分的变化。还分析了流感疫苗的接受情况以及人口统计学信息。

结果

我们招募了 510 名有资格接种流感疫苗的儿童的父母,确定了 73 名对疫苗持犹豫态度的父母。总体而言,aVHS 评分呈下降趋势,犹豫评分的平均变化为-0.4(P<0.01)。73 名队列中的 43 名(58.9%)经历了较低 aVHS 评分的积极影响,73 名疫苗犹豫者中有 27 名(37.0%)在 aVHS 上不再犹豫。在筛查人群中,一些人口统计学特征与疫苗犹豫有关:学历低于学士学位(p=0.03),家庭收入低于联邦贫困水平的 400%(p<0.01),未婚(p=0.02),认同除民主党以外的政治派别(p<0.01)。然而,没有人口统计学特征与个体不再犹豫显著相关。我们的利他主义导向的沟通方法对 aVHS 上的利他主义特定问题产生了最大的积极影响,使干预后的反应值降低了近 25%(P<0.01)。

结论

我们的利他主义导向的沟通方法显著改善了对疫苗持犹豫态度的父母对儿童流感疫苗的态度。

临床试验

gov 标识符:NCT04568590。

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