Čeponytė Kamilė, Narkevičiūtė Eglė, Beržanskytė Aušra, Burokienė Sigita
Faculty of Medicine, Vilnius University, Vilnius, Lithuania.
Department of Public Health, Institute of Health Sciences, Faculty of Medicine, Vilnius University, Lithuania.
Acta Med Litu. 2024;31(1):42-53. doi: 10.15388/Amed.2024.31.1.7. Epub 2024 Feb 27.
Data from recent years show that the COVID-19 pandemic has significantly reduced the scope of child immunisation worldwide. If the numbers continue to fall, we may have a vaccination crisis. In order to understand the local factors of this phenomenon, we studied parents' viewpoint towards childhood vaccination in Lithuania. Therefore, the aim of our study was to determine the impact of parental attitudes on children's vaccination.
A web-based cross-sectional study was made in Lithuania from October 20th to November 3rd, 2020, using Google Forms. An anonymous questionnaire included both quantitative and qualitative questions. The questionnaire was distributed to the general population in Lithuania via social media and a snowball sampling. Only parents who have at least one child under 18 years old were involved in the study. We analysed the parents' attitudes towards vaccination by their socioeconomic and demographic determinants using MS Excel and OpenEpi tools. The respondents were considered vaccine supporters if they vaccinated all their children with state-reimbursed vaccines or only vaccinated some of their children, and vaccine sceptics if they did not vaccinate their children with state-reimbursed vaccines.
The population of our research consisted of 775 parents. There were more males against vaccination than females, respectively, 59.6% and 33.2%. 65.0% of all respondents stated that they vaccinated their children with the full course of vaccines, while the remaining 35.0% did not vaccinate. University-level education dominated in both pro-vaccine and anti-vaccine groups. We found that 16.9% of parents who were unvaccinated as children themselves tend not to vaccinate their children. However, in the pro-vaxx group, only 0.7% of parents were unvaccinated during childhood. 50.8% of vaccine sceptics were not fully informed by healthcare professionals about the benefits and risks of vaccination, while only 31.6% of vaccine supporters were not informed. Social environment did not have an impact on the decision whether to vaccinate or not to vaccinate a child among both vaccine advocates and vaccine deniers (accordingly, 51.2% and 42.9%). 29.3% of respondents stated that the cost of paid vaccinations was too high. Open-text survey responses gave us more in-depth insight about the parental decision-making process. Protection of children and society from infectious diseases (31.7%) was mentioned as the main reason for vaccination. Whereas vaccine-hesitant parents were mostly concerned about already-occurring side effects or their risk (43.4%).
Our findings confirmed that vaccine hesitancy was associated with not being vaccinated in childhood themselves, lack of information from medical practitioners and male gender. The price of vaccines also had an impact on immunisation rates - more than one-third of the vaccine supporting parents indicated that the cost of paid vaccinations was too high. The main incentive for vaccine compliance was parents' desire to protect their children and society from infectious diseases. Whereas vaccine-hesitant parents were mostly concerned about already occurring side effects or their risk. There was no consensus, whether vaccination of children should be mandatory in Lithuania, as the answers to the question were almost evenly distributed. The formation of parents' attitudes towards children's vaccination is a complex process that is determined by parents' attitudes towards the health care system, lack of trust in doctors, and gaps in communication about the benefits and risks of vaccination. All of this information should be taken into account in health policy-making.
近年来的数据显示，新冠疫情显著缩小了全球儿童免疫接种的范围。如果接种人数持续下降，我们可能会面临疫苗接种危机。为了解这一现象的当地因素，我们研究了立陶宛父母对儿童疫苗接种的看法。因此，我们研究的目的是确定父母态度对儿童疫苗接种的影响。
2020年10月20日至11月3日在立陶宛进行了一项基于网络的横断面研究，使用谷歌表单。一份匿名问卷包括定量和定性问题。问卷通过社交媒体和滚雪球抽样分发给立陶宛的普通人群。只有至少有一个18岁以下孩子的父母参与了这项研究。我们使用MS Excel和OpenEpi工具，通过社会经济和人口统计学决定因素分析了父母对疫苗接种的态度。如果受访者用国家报销的疫苗为所有孩子接种或只给部分孩子接种疫苗，则被视为疫苗支持者；如果他们没有用国家报销的疫苗为孩子接种疫苗，则被视为疫苗怀疑者。
我们的研究对象包括775名父母。反对接种疫苗的男性比女性多，分别为59.6%和33.2%。65.0%的受访者表示他们已为孩子接种了全程疫苗，而其余35.0%的人没有接种。在支持疫苗接种和反对疫苗接种的群体中，大学学历的人占主导。我们发现，16.9%自己小时候未接种疫苗的父母往往不给自己的孩子接种疫苗。然而，在支持接种疫苗的群体中，只有0.7%的父母小时候未接种疫苗。50.8%的疫苗怀疑者未从医疗保健专业人员那里充分了解疫苗接种的益处和风险，而只有31.6%的疫苗支持者未得到相关信息。社会环境对疫苗倡导者和疫苗反对者中是否给孩子接种疫苗的决定没有影响（相应地，分别为51.2%和42.9%）。29.3%的受访者表示自费疫苗接种费用过高。开放式调查回复让我们对父母的决策过程有了更深入的了解。保护儿童和社会免受传染病侵害（31.7%）被提及为接种疫苗的主要原因。而对接种疫苗犹豫不决的父母主要担心已经出现的副作用或其风险（43.4%）。
我们的研究结果证实，对接种疫苗犹豫不决与自己小时候未接种疫苗、缺乏医生提供的信息以及男性性别有关。疫苗价格也对免疫接种率有影响——超过三分之一支持接种疫苗的父母表示自费疫苗接种费用过高。遵守疫苗接种规定的主要动机是父母希望保护自己的孩子和社会免受传染病侵害。而对接种疫苗犹豫不决的父母主要担心已经出现的副作用或其风险。在立陶宛，对于儿童疫苗接种是否应强制进行没有达成共识，因为对该问题的回答几乎是平均分布的。父母对儿童疫苗接种态度的形成是一个复杂的过程，这取决于父母对医疗保健系统的态度、对医生缺乏信任以及在疫苗接种益处和风险沟通方面的差距。在卫生政策制定中应考虑所有这些信息。
