Andrade-Guerrero Felipe, Tapia Adriana, Andrade Vinicio, Vásconez-González Jorge, Andrade-Guerrero José, Noroña-Calvachi Carlos, Izquierdo-Condoy Juan S, Yeager Justin, Ortiz-Prado Esteban
One Health Research Group, Faculty of Medicine, Universidad de las Américas, Quito 170137, Ecuador.
Department of Pediatrics, Metropolitano Hospital, Quito 170137, Ecuador.
Vaccines (Basel). 2022 Dec 27;11(1):60. doi: 10.3390/vaccines11010060.
Vaccination coverage in Ecuador has decreased since 2013, falling short of the World Health Organization's vaccination goal. There are several causes for this deficiency in coverage, one of these are lost vaccination opportunities, which are caused when a patient without contraindications postpones, or for other reasons fails to receive a recommended immunization. The objective of this study was to determine the state of knowledge regarding vaccination contraindications among the Metropolitan District of Quito health personnel to assess missed vaccination opportunities. Through this cross-sectional descriptive study, health personnel were surveyed online and asked 18 clinical scenarios which were created to evaluate their knowledge of the true contraindications of vaccination, and measure missed opportunities. A total of 273 surveys were collected; 74% belonged to the public health system, and the rest represented by private practitioners. Of those surveyed, 98.2% of health personnel had improperly denied vaccination at least once. We specifically found vaccinations were incorrectly denied more frequently in cases where the hypothetical patient presented mild or moderate fever cases. The use of corticosteroids, autoimmune diseases, and egg allergy were also incorrectly denied (89%, 71.4%, 72.9%, and 58.6%, respectively). Among the health personnel surveyed, there is an apparent lack of knowledge of the true contraindications of vaccination and differences in knowledge about contraindications according to personnel in charge of administering immunization to children. Our preliminary results suggest that lack of education related to side effects could be biasing medical professionals' decisions, causing them to unnecessarily delay or deny vaccinations, which likely contributes to explaining low overall vaccination coverage in Quito, the capital city of Ecuador.
自2013年以来，厄瓜多尔的疫苗接种覆盖率有所下降，未达到世界卫生组织的疫苗接种目标。造成这种覆盖率不足的原因有几个，其中之一是疫苗接种机会的丧失，这是指没有禁忌证的患者推迟接种，或因其他原因未接受推荐的免疫接种。本研究的目的是确定基多市辖区卫生人员对疫苗接种禁忌证的了解情况，以评估错过的疫苗接种机会。通过这项横断面描述性研究，对卫生人员进行了在线调查，并向他们提出了18个临床情景，这些情景旨在评估他们对疫苗接种真正禁忌证的了解情况，并衡量错过的机会。共收集了273份调查问卷；74%属于公共卫生系统，其余由私人执业者代表。在接受调查的人员中，98.2%的卫生人员至少有一次不恰当地拒绝接种疫苗。我们特别发现，在假设患者出现轻度或中度发热的情况下，疫苗接种被错误拒绝的频率更高。使用皮质类固醇、自身免疫性疾病和鸡蛋过敏也被错误拒绝（分别为89%、71.4%、72.9%和58.6%）。在接受调查的卫生人员中，明显缺乏对疫苗接种真正禁忌证的了解，并且根据负责儿童免疫接种的人员不同，对禁忌证的了解也存在差异。我们的初步结果表明，与副作用相关的教育不足可能会影响医学专业人员的决策，导致他们不必要地推迟或拒绝接种疫苗，这可能有助于解释厄瓜多尔首都基多市总体疫苗接种覆盖率较低的原因。
