Ellingson Mallory K, Omer Saad B, Sevdalis Nick, Thomson Angus
Department of Epidemiology of Microbial Diseases, Yale School of Public Health, Yale University, New Haven, CT, United States of America.
Department of Internal Medicine, Infectious Disease, Yale School of Medicine, Yale University, New Haven, CT, United States of America.
PLOS Glob Public Health. 2023 Apr 12;3(4):e0001820. doi: 10.1371/journal.pgph.0001820. eCollection 2023.
Improved uptake of adult vaccinations could substantially reduce the burden of infectious disease worldwide, however very few countries achieve high coverage of recommended adult vaccinations. Vaccine hesitancy is an important driver of low vaccine uptake among adults but no measure currently exists to capture general vaccination attitudes in this population accurately and efficiently. We utilize data from two surveys of adult vaccine attitudes and uptake conducted in fifteen countries to evaluate the Vaccination Trust Indicator (VTI). The VTI is a six-item measure intended to capture general vaccine attitudes. We utilized multivariable logistic regression to examine the association between VTI scores and self-reported receipt of the seasonal influenza vaccine, receipt of a tetanus toxoid-containing vaccine and intent to receive the flu vaccine in the next season. In the five countries with self-reported vaccine receipt data, we found that a ten-point increase in VTI score was associated with a 50% increase in odds of influenza vaccine receipt (OR = 1.55, 95% CI = 1.48, 1.62) and 25% increase in the odds of tetanus vaccine receipt (OR = 1.26, 95% CI = 1.21, 1.30). Strong associations between VTI score and vaccine receipt were found in each country except China. A strong association between VTI score and intent to receive the influenza vaccine was found in all fifteen countries. The VTI is a promising tool for assessing adult immunization attitudes with clear and immediate uses for immunization programs globally.
提高成人疫苗接种率可大幅减轻全球传染病负担，然而很少有国家能实现推荐成人疫苗的高接种覆盖率。疫苗犹豫是成人疫苗接种率低的一个重要驱动因素，但目前尚无措施能准确有效地了解这一人群的总体疫苗接种态度。我们利用在15个国家进行的两项成人疫苗态度和接种情况调查的数据来评估疫苗接种信任指标（VTI）。VTI是一项包含六个项目的指标，旨在了解总体疫苗态度。我们使用多变量逻辑回归来研究VTI得分与自我报告的季节性流感疫苗接种情况、含破伤风类毒素疫苗的接种情况以及下一季接种流感疫苗的意愿之间的关联。在有自我报告疫苗接种数据的五个国家中，我们发现VTI得分每提高10分，流感疫苗接种几率增加50%（比值比=1.55，95%置信区间=1.48，1.62），破伤风疫苗接种几率增加25%（比值比=1.26，95%置信区间=1.21，1.30）。除中国外，每个国家的VTI得分与疫苗接种之间均存在强关联。在所有15个国家中，VTI得分与接种流感疫苗的意愿之间均存在强关联。VTI是评估成人免疫态度的一个很有前景的工具，对全球免疫规划具有明确且即时的用途。
