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COVID-19大流行期间加拿大不同种族文化群体的儿童常规疫苗接种:一项全国性横断面研究。

Routine childhood vaccination among ethnocultural groups in Canada during the COVID-19 pandemic: A national cross-sectional study.

作者信息

Humble Robin M, Dubé Eve, Olson Joanne, Scott Shannon D, MacDonald Shannon E

机构信息

Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada.

Department of Anthropology, Laval University, Quebec City, Quebec, Canada.

出版信息

Prev Med Rep. 2023 Sep 25;36:102435. doi: 10.1016/j.pmedr.2023.102435. eCollection 2023 Dec.

Abstract

Some ethnocultural groups in Canada experience low routine childhood vaccination, with social locations and discriminations contributing to inequities. This study aimed to characterize routine childhood vaccination in the context of the COVID-19 pandemic, including the influence of discriminatory experiences when accessing health services. We conducted a cross-sectional national survey to assess parents' acceptance of routine vaccines for their children ≤ 17 years in Oct/Nov 2021. Descriptive statistics were used to explore differences among ethnocultural groups and logistic regression to assess associations with parents' low acceptance. Of 2531 parents, 21.8 % self-identified as Racialized minorities, 7.7 % Indigenous, 23.3 % newcomers, 10.0 % spoke minority languages most often, and 69.6 % belonged to a reference group who did not report these characteristics. Statistically significant findings included 36.6 % of Indigenous parents reporting that the pandemic made them realize that routine vaccines were more important compared to 16.7 % of newcomers. Discrimination/racism when accessing health services was most often experienced by Indigenous (27.8 %) and Racialized minorities (20.2 %), compared to the reference group (4.8 %). Racialized minorities were more likely to report low acceptance of routine vaccination (aOR = 2.19, 95 % CI: 1.18-4.05), and younger parents and those with only preschool-aged children were less likely to have low acceptance (aOR = 0.59, 95 % CI: 0.37-0.94; aOR = 0.53, 95 % CI: 0.36, 0.79). Low acceptance was associated with everyday stress preventing vaccination (aOR = 2.18, 95 % CI: 1.41-3.38). Public health decision-makers should ensure equitable access to routine childhood vaccination that targets the inclusion of ethnocultural groups, who may experience disproportionate barriers and low acceptance.

摘要

加拿大的一些种族文化群体儿童常规疫苗接种率较低,社会地位和歧视导致了不平等现象。本研究旨在描述新冠疫情背景下的儿童常规疫苗接种情况,包括获取医疗服务时歧视经历的影响。我们在2021年10月/11月进行了一项全国性横断面调查,以评估父母对其17岁及以下子女常规疫苗的接受情况。描述性统计用于探索种族文化群体之间的差异,逻辑回归用于评估与父母低接受度的关联。在2531名父母中,21.8%自我认定为少数族裔,7.7%为原住民,23.3%为新移民,10.0%最常说少数族裔语言,69.6%属于未报告这些特征的参照组。具有统计学意义的发现包括,36.6%的原住民父母表示疫情让他们意识到常规疫苗更重要,而新移民中这一比例为亦为16.7%。与参照组(4.8%)相比,原住民(27.8%)和少数族裔(20.2%)在获取医疗服务时最常经历歧视/种族主义。少数族裔更有可能报告对常规疫苗接种接受度低(调整后比值比=2.19,95%置信区间:1.18-4.05),而年轻父母和只有学龄前儿童的父母接受度低的可能性较小(调整后比值比=0.59,95%置信区间:0.37-0.94;调整后比值比=0.53,95%置信区间:0.36,0.79)。接受度低与日常压力导致无法接种疫苗有关(调整后比值比=2.18,95%置信区间:1.41-3.38)。公共卫生决策者应确保公平获取儿童常规疫苗接种服务,目标是纳入可能面临不成比例障碍和接受度低的种族文化群体。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c846/10562748/00e7a90e1651/gr1.jpg

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