Practice Advancement and Clinical Education, UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Department of Maternal Child Health, UNC Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Vaccine. 2023 Oct 26;41(45):6710-6718. doi: 10.1016/j.vaccine.2023.09.027. Epub 2023 Oct 3.
Resilience in vaccination demand is ever more critical as the COVID-19 pandemic has increased our understanding of the importance of vaccines on health and well-being. Yet timid demand for COVID-19 vaccines where available and reduced uptake of routine immunizations globally further raise the urgent need to build vaccination resilience. We demonstrate the complexity of vaccination demand and resilience in a framework where relevant dimensions are intertwined, fluid, and contextual.
We developed the Vaccination Demand Resilience (VDR) framework based on a literature review on vaccination demand and expert consultation. The matrix framework builds on three main axes: 1) vaccination attitudes and beliefs; 2) vaccination seeking behavior; and 3) vaccination status. The matrix generated eight quadrants, which can help explain people's levels of vaccination demand and resilience. We selected four scenarios as examples to demonstrate different interventions that could move people across quadrants and build vaccination resilience.
Incongruence between individuals' attitudes and beliefs, vaccination behavior, and vaccination status can arise. For example, an individual can be vaccinated due to mandates but reject vaccination benefits and otherwise avoid seeking vaccination. Such incongruence could be altered by interventions to build resilience in vaccination demand. These interventions include information, education and communication to change individuals' vaccination attitudes and beliefs, incentive programs and reminder-recalls to facilitate vaccination seeking, or by strengthening healthcare provider communications to reduce missed opportunities.
Vaccination decision-making is complex. Individuals can be vaccinated without necessarily accepting the benefits of vaccination or seeking vaccination, threatening resilience in vaccination demand. The VDR framework can provide a useful lens for program managers and policy makers considering interventions and policies to improve vaccination resilience. This would help build and sustain confidence and demand for vaccinations, and help to continue to prevent disease, disability, and death from vaccine-preventable diseases.
随着 COVID-19 大流行增加了我们对疫苗在健康和福祉方面重要性的认识，疫苗需求的弹性变得更加重要。然而，在有疫苗可用的地方，人们对 COVID-19 疫苗的需求疲软，以及全球常规免疫接种率的下降，进一步凸显了建立疫苗接种弹性的迫切需要。我们在一个相关维度相互交织、流动和具有背景的框架中展示了疫苗接种需求和弹性的复杂性。
我们基于对疫苗接种需求的文献综述和专家咨询，制定了疫苗接种需求弹性（VDR）框架。矩阵框架建立在三个主要轴上：1）疫苗接种态度和信念；2）疫苗接种寻求行为；3）疫苗接种状况。矩阵生成了八个象限，可以帮助解释人们的疫苗接种需求和弹性水平。我们选择了四个场景作为示例，展示了可以使人们在象限之间移动并建立疫苗接种弹性的不同干预措施。
个人的态度和信念、疫苗接种行为和疫苗接种状况之间可能会出现不一致。例如，一个人可能因强制要求而接种疫苗，但拒绝接种疫苗的好处，并且避免寻求接种疫苗。这种不一致可以通过建立疫苗接种需求弹性的干预措施来改变。这些干预措施包括信息、教育和沟通，以改变个人的疫苗接种态度和信念；激励计划和提醒召回，以促进疫苗接种寻求；或通过加强医疗保健提供者的沟通，减少错失机会。
疫苗接种决策是复杂的。个人可以接种疫苗，但不一定接受疫苗的好处或寻求接种疫苗，这会威胁到疫苗接种需求的弹性。VDR 框架可以为考虑干预措施和政策以提高疫苗接种弹性的计划管理者和政策制定者提供有用的视角。这将有助于建立和维持对疫苗接种的信心和需求，并有助于继续预防疫苗可预防疾病造成的疾病、残疾和死亡。
