Behavioural Science Office, Centre for Surveillance, Integrated Insights, and Risk Assessment, Data, Surveillance and Foresight Branch, Public Health Agency of Canada, Canada; Impact Canada, Impact & Innovation Unit, Privy Council Office, Canada.
Behavioural Science Office, Centre for Surveillance, Integrated Insights, and Risk Assessment, Data, Surveillance and Foresight Branch, Public Health Agency of Canada, Canada.
Vaccine. 2024 Oct 24;42(24):126236. doi: 10.1016/j.vaccine.2024.126236. Epub 2024 Aug 31.
Routine childhood vaccination is a crucial component of public health in Canada and worldwide. To facilitate catch-up from the global decline in routine vaccination caused by the COVID-19 pandemic, and toward the ongoing pursuit of coverage goals, vaccination programs must understand barriers to vaccine access imposed or exacerbated by the pandemic. We conducted a regionally representative online survey in January 2023 including 2036 Canadian parents with children under the age of 18. We used the COM-B model of behaviour to examine factors influencing vaccination timeliness during the pandemic. We assessed Capability with measures of vaccine understanding and decision difficulty, and Motivation with a measure of vaccine confidence. Opportunity was assessed through parents' self-reported experience with barriers to vaccination. Twenty-four percent of surveyed parents reported having missed or delayed one of their children's scheduled routine vaccinations since the beginning of the pandemic, though most parents reported having either caught up or the intention to catch up soon. In the absence of opportunity barriers, motivation was associated with timely vaccination for children aged 0-4 years (aOR = 1.81, 95 % CI: 1.14-2.84). However, experience with one or more opportunity barriers, particularly clinic closures and difficulties getting an appointment, eliminated this relationship, suggesting perennial and new pandemic-associated barriers are a critical challenge to vaccine coverage goals in Canada.
常规儿童疫苗接种是加拿大和全球公共卫生的重要组成部分。为了从 COVID-19 大流行导致的全球常规疫苗接种下降中加快追赶进度，并持续追求覆盖目标，疫苗接种计划必须了解大流行造成或加剧的疫苗获取障碍。我们于 2023 年 1 月进行了一项具有地区代表性的在线调查，其中包括 2036 名有 18 岁以下子女的加拿大父母。我们使用行为的 COM-B 模型来研究大流行期间疫苗接种及时性的影响因素。我们通过疫苗理解和决策难度的衡量来评估能力，通过疫苗信心的衡量来评估动机。机会是通过父母自我报告的疫苗接种障碍体验来评估的。24%的被调查父母报告自大流行开始以来，他们的孩子错过了或推迟了一次预定的常规疫苗接种，但大多数父母报告已经赶上或打算尽快赶上。在没有机会障碍的情况下，对于 0-4 岁的儿童，动机与及时接种疫苗有关（aOR=1.81，95%CI：1.14-2.84）。然而，经历过一个或多个机会障碍，特别是诊所关闭和预约困难，消除了这种关系，这表明长期存在和新出现的与大流行相关的障碍是加拿大疫苗覆盖目标的一个重大挑战。
