Unit Medical Anthropology and Global Health, Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Vienna, Austria.
Department of Tropical Medicine, Bernhard Nocht Institute for Tropical Medicine & I Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
PLoS Negl Trop Dis. 2024 May 13;18(5):e0012173. doi: 10.1371/journal.pntd.0012173. eCollection 2024 May.
Yellow fever (YF), a mosquito-borne viral hemorrhagic fever, is endemic in Uganda and causes frequent outbreaks. A total of 1.6 million people were vaccinated during emergency mass immunization campaigns in 2011 and 2016. This study explored local perceptions of YF emergency mass immunization among vulnerable groups to inform future vaccination campaigns.
In this qualitative study, we conducted 43 semi-structured interviews, 4 focus group discussions, and 10 expert interviews with 76 participants. Data were collected in six affected districts with emergency mass vaccination. We included vulnerable groups (people ≥ 65 years and pregnant women) who are typically excluded from YF vaccination except during mass immunization. Data analysis was conducted using grounded theory. Inductive coding was utilized, progressing through open, axial, and selective coding.
Participants relied on community sources for information about the YF mass vaccination. Information was disseminated door-to-door, in community spaces, during religious gatherings, and on the radio. However, most respondents had no knowledge of the vaccine, and it was unclear to them whether a booster dose was required. In addition, the simultaneous presidential election during the mass vaccination campaign led to suspicion and resistance to vaccination. The lack of reliable and trustworthy information and the politicization of vaccination campaigns reinforced mistrust of YF vaccines.
CONCLUSIONS/SIGNIFICANCE: People in remote areas affected by YF outbreaks rely on community sources of information. We therefore recommend improving health education, communication, and engagement through respected and trusted community members. Vaccination campaigns can never be seen as detached from political systems and power relations.
黄热病（YF）是一种蚊媒病毒性出血热，在乌干达流行，并经常暴发。2011 年和 2016 年的紧急大规模免疫接种活动中，共有 160 万人接种了疫苗。本研究旨在探讨弱势群体对 YF 紧急大规模免疫接种的当地看法，以为未来的疫苗接种活动提供信息。
在这项定性研究中，我们在六个受影响的地区进行了 43 次半结构式访谈、4 次焦点小组讨论和 10 次专家访谈，共涉及 76 名参与者。我们包括弱势群体（年龄≥65 岁的人和孕妇），他们通常不被包括在 YF 疫苗接种范围内，除非在大规模免疫接种期间。使用扎根理论进行数据分析。采用归纳编码，经过开放式、轴向式和选择性编码逐步进行。
参与者依靠社区来源获取 YF 大规模接种的信息。信息通过挨家挨户、社区空间、宗教集会和广播传播。然而，大多数受访者对疫苗一无所知，也不清楚是否需要加强剂量。此外，在大规模接种期间同时进行总统选举，导致了对疫苗接种的怀疑和抵制。缺乏可靠和值得信赖的信息以及疫苗接种活动的政治化加剧了对 YF 疫苗的不信任。
结论/意义：受 YF 暴发影响的偏远地区的人们依赖社区来源获取信息。因此，我们建议通过受尊重和信任的社区成员来改善健康教育、沟通和参与。疫苗接种活动绝不能与政治制度和权力关系脱节。
