Sundaram Shanthosh P, Devi Ningombam J, Lyngdoh Markordor, Medhi Gajendra K, Lynrah Wallambok
Department of Community Medicine, NEIGRIHMS, Shillong, Meghalaya, India.
J Patient Exp. 2023 Jul 12;10:23743735231183673. doi: 10.1177/23743735231183673. eCollection 2023.
Vaccine hesitancy should be dealt as an important issue as it carries both individual- and community-level risks; however, it lacks proper assessment in particular among the indigenous tribal population. A community-based sequential explanatory mixed methods study was conducted among 238 eligible individuals in Ri-Bhoi district, Meghalaya. The quantitative part involved a cross-sectional study to determine the proportion of vaccine hesitancy and the qualitative part comprised in-depth interviews among the eligible residents and key informant interviews among the health workers providing the vaccination services, to explore the facilitators and barriers of vaccine uptake. A total of 113 [47.5% (95% confidence interval [CI]: 41.0%-54.0%)] participants were found to be hesitant to vaccination, among which 16.8% (95% CI: 12.4%-22.3%) were initially hesitant and 30.7% (95% CI: 24.9%-37.0%) had vaccine refusal. The themes generated through qualitative interviews were individual-related, disease-related, vaccine-related, healthcare system and provider related and socio-cultural and religious. The main barriers for the likelihood of action were perceived susceptibility and perceived severity under the individual perception along with ambiguity aversion, scepticism about the efficacy, mistrust, concerns on side effects, rumors, and socio-cultural and religious misbeliefs. Vaccine hesitancy is found to be considerably higher and it depends on complacency toward the vaccine, confidence in its safety, perceived susceptibility to the disease and perceived severity to the disease coupled with modifying factors for cues for action. Healthcare workers should better communicate to improve the uptake of vaccines by reducing the barriers to the vaccine acceptance.
疫苗犹豫应作为一个重要问题来对待，因为它会带来个人和社区层面的风险；然而，它缺乏适当的评估，尤其是在本土部落人口中。在梅加拉亚邦里博伊区的238名符合条件的个体中开展了一项基于社区的序列解释性混合方法研究。定量部分涉及一项横断面研究，以确定疫苗犹豫的比例，定性部分包括对符合条件的居民进行深入访谈以及对提供疫苗接种服务的卫生工作者进行关键 informant 访谈，以探讨疫苗接种的促进因素和障碍。共有113名[47.5%（95%置信区间[CI]：41.0%-54.0%）]参与者被发现对疫苗接种犹豫不决，其中16.8%（95%CI：12.4%-22.3%）最初犹豫不决，30.7%（95%CI：24.9%-37.0%）拒绝接种疫苗。通过定性访谈产生的主题包括与个人相关、与疾病相关、与疫苗相关、与医疗保健系统和提供者相关以及社会文化和宗教方面。行动可能性的主要障碍包括个人认知中的感知易感性和感知严重性，以及模糊厌恶、对疗效的怀疑、不信任、对副作用的担忧、谣言以及社会文化和宗教错误观念。发现疫苗犹豫程度相当高，它取决于对疫苗的自满、对其安全性的信心、对疾病的感知易感性和对疾病的感知严重性以及行动线索的调节因素。医护人员应更好地进行沟通，通过减少疫苗接受的障碍来提高疫苗接种率。
