Department of Pediatrics and Child Health, Aga Khan University Hospital, Stadium Rd, PO Box 3500 Karachi 74800, Pakistan; Centre for Child, Adolescent, and Maternal Health Research, Faculty of Medicine and Health Technology, Tampere University, Arvo Ylpön katu 34, Tampere 33520, Finland.
Department of Pediatrics and Child Health, Aga Khan University Hospital, Stadium Rd, PO Box 3500 Karachi 74800, Pakistan; The Kirby Institute, UNSW Sydney, Wallace Wurth Building High Street, UNSW Sydney, Kensington, NSW 2052, Australia.
Vaccine. 2023 Aug 23;41(37):5376-5382. doi: 10.1016/j.vaccine.2023.07.003. Epub 2023 Jul 17.
This study aimed to evaluate the parental acceptance of Typhoid Conjugate Vaccine (TCV) and to determine the predictors of TCV vaccination status among children in an outbreak setting of extensively drug resistant (XDR) typhoid fever in Karachi, Pakistan.
A cross-sectional survey using the WHO recommended rapid vaccine coverage assessment technique was conducted. Out of 11, four union councils (UCs) in Lyari Town were randomly selected. A parent or primary caretaker from the eligible household was interviewed. Data were collected using a locally validated vaccine attitudes scale (VAS). Sum of scores was calculated for VAS. A higher score denoted negative attitudes and perceptions regarding TCV and vice versa. Multivariable logistic regression was performed to determine the predictors of TCV vaccination status.
Based on the 14-item parental VAS, 78.0 % of the parents had a score between 0 to <40 and 22 % had a score ≥40. VAS score of <40 was significantly associated with higher odds of receiving TCV during the campaign setting (adjusted Odds Ratio (aOR): 1.30; 95 % Confidence Interval (CI): 1.02, 1.66). The odds of receiving TCV vaccination were higher among children whose parents were aware of the ongoing vaccination campaign in the area (aOR: 4.57; 95 % CI: 2.93, 7.12) and expressed willingness to get their child vaccinated against typhoid fever (aOR: 2.54; 95 % CI: 1.82, 3.55).
Parental awareness of the ongoing vaccination campaign, positive perception and attitudes towards vaccine were found to be significantly associated with TCV vaccination among children. Appropriately structured pre-vaccination awareness campaigns focused on childhood vaccination targeted towards parents are necessary to improve parental awareness, attitude and behavior towards vaccination.
本研究旨在评估父母对伤寒结合疫苗（TCV）的接受程度，并确定在巴基斯坦卡拉奇广泛耐药（XDR）伤寒爆发环境中儿童 TCV 疫苗接种状况的预测因素。
采用世界卫生组织（WHO）推荐的快速疫苗覆盖率评估技术进行横断面调查。从 Lyari 镇的 11 个联盟理事会（UC）中随机选择了 4 个 UC。对符合条件的家庭中的父母或主要照顾者进行了访谈。使用经过本地验证的疫苗态度量表（VAS）收集数据。为 VAS 计算了总分。较高的分数表示对 TCV 的负面态度和看法，反之亦然。采用多变量逻辑回归来确定 TCV 疫苗接种状况的预测因素。
根据 14 项父母 VAS，78.0%的父母得分在 0 至<40 之间，22%的父母得分≥40。VAS 得分<40 与在疫苗接种运动期间接种 TCV 的几率较高显著相关（调整后的优势比（aOR）：1.30；95%置信区间（CI）：1.02，1.66）。如果父母了解该地区正在进行的疫苗接种运动（aOR：4.57；95%CI：2.93，7.12）并表示愿意让孩子接种伤寒疫苗（aOR：2.54；95%CI：1.82，3.55），则儿童接种 TCV 疫苗的几率更高。
发现父母对正在进行的疫苗接种运动的认识、对疫苗的积极看法和态度与儿童 TCV 疫苗接种显著相关。需要有针对性地开展以父母为目标的儿童疫苗接种前宣传活动，以提高父母对疫苗接种的认识、态度和行为。
