Faculty of Medicine, Departamento de Epidemiología y Estudios en Salud, Universidad de los Andes, Santiago, Chile.
Research Center for Students Mental Health (ISME), Faculty of Education, Universidad de los Andes, Santiago, Chile.
BMC Public Health. 2023 Sep 28;23(1):1882. doi: 10.1186/s12889-023-16769-3.
Infant vaccination has significantly reduced the morbidity and mortality of transmittable diseases worldwide. Its coverage is high (85%); however, partial or suboptimal vaccination has been an important public health problem. This study aimed (1) to design and explore the psychometric features of a questionnaire to determine the reasons for this partial or suboptimal vaccination; and 2) to determine the factors associated with delaying Diphtheria, Tetanus, Poliomyelitis (DTaP) vaccination.
This study contained two parts. In Part One, a questionnaire was created by the research team and then validated by a committee of experts in the field and a group of parents. It included the following contents: sociodemographic variables, features of the vaccination services, history of vaccination, and attitudes and perceptions about vaccination. Part Two was a cross-sectional study, recruiting private and public healthcare centers to explore the psychometrics features of the instrument, performing exploratory factor analysis, and determining the associated factors with DTaP vaccination delay throughout multivariable regression models.
Initially, six experts validated the questionnaire. For instance, on a scale of 1 to 5, the general evaluation of the questionnaire was ≥ 4 for all the experts. Additionally, five experts considered that most of the questions were easy to understand, and all thought the questionnaire had a clear and logical organization. The resulting questionnaire included the "Trust and positive attitude towards vaccination" scale, which had a good structure of items and internal consistency (α = 0.7918). Six healthcare centers were recruited in the second part of the study, and 715 people answered the questionnaire. Not being the mother who brings the child to the health center, having more than one child, and having a history of previous vaccination delays increased the risk of delaying vaccination. Attending the healthcare center for a reason other than only vaccination, obtaining information about vaccines from the Internet, and having higher trust and positive attitudes to vaccination reduced the risk of delay.
First study during the pandemic to explore the role of different factors on the risk of DTaP vaccination delay in Latin America. The findings highlighted the importance of trust in the vaccination system. The instrument presented in this article may help the scientific community evaluate future interventions to increase trust and positive attitudes toward the vaccination process.
婴儿疫苗接种大大降低了全球传染病的发病率和死亡率。其接种覆盖率很高（85%）；然而，部分或不完全接种疫苗一直是一个重要的公共卫生问题。本研究旨在：（1）设计并探索一种问卷的心理计量学特征，以确定这种部分或不完全接种疫苗的原因；（2）确定与延迟接种白喉、破伤风、脊髓灰质炎（DTaP）疫苗相关的因素。
本研究包括两部分。在第一部分中，研究团队创建了一份问卷，然后由该领域的专家委员会和一组家长进行验证。它包括以下内容：社会人口统计学变量、疫苗接种服务特征、疫苗接种史以及对疫苗接种的态度和看法。第二部分是一项横断面研究，招募私立和公立医院，以探索该工具的心理计量学特征，进行探索性因素分析，并通过多变量回归模型确定与 DTaP 疫苗接种延迟相关的因素。
最初，有六位专家对问卷进行了验证。例如，在 1 到 5 的量表上，所有专家对问卷的总体评价都≥4。此外，五位专家认为大多数问题都易于理解，并且所有专家都认为问卷的组织清晰合理。最终的问卷包括“对疫苗接种的信任和积极态度”量表，该量表具有良好的项目结构和内部一致性（α=0.7918）。在研究的第二部分，有六家医疗中心参与了研究，共有 715 人回答了问卷。不是带孩子去保健中心的母亲、有多个孩子、有既往疫苗接种延迟史会增加疫苗接种延迟的风险。因其他原因而非仅为接种疫苗而到医疗中心、从互联网获取疫苗信息、对疫苗接种有更高的信任和积极态度会降低延迟的风险。
这是大流行期间首次在拉丁美洲探索不同因素对 DTaP 疫苗接种延迟风险的作用的研究。研究结果强调了对疫苗接种系统的信任的重要性。本文介绍的工具可能有助于科学界评估未来增加对疫苗接种过程的信任和积极态度的干预措施。
