Bradshaw Jennifer, Brzozowski Amanda, Katti Priya, Chapman Olivia, Pham Audrey, Torgerson Andrew, Wankum Ethan, Snavely Aimee, Baskin Carole R
Saint Louis County Department of Public Health, Berkeley, MO, USA.
College for Public Health and Social Justice, Saint Louis University, St Louis, MO, USA.
Public Health Rep. 2024 Nov 28:333549241297685. doi: 10.1177/00333549241297685.
To gather perspectives on childhood vaccination and vaccine hesitancy, the Saint Louis County Department of Public Health (DPH) surveyed parents seeking nonmedical exemptions, conducted focus groups of school nurses, and interviewed pediatricians.
We distributed exemption forms and voluntary questionnaires to parents in St Louis County who were seeking nonmedical exemptions for their school-aged children at any DPH clinic from August 2019 through December 2022. We conducted and recorded four 75- to 90-minute focus groups of 11 school nurses in groups of 2 or 3 nurses in September 2022. We conducted and recorded interviews of 8 pediatricians in March 2023. We calculated descriptive statistics, transcribed focus group discussions and interviews, and performed qualitative coding.
We collected 1871 exemption forms. The median age of children (n = 1854) was 6 years. Of the 10 vaccines included in the exemption list, the percentage of exclusions ranged from 91.2% for meningococcal conjugate to 88.7% for hepatitis A. We identified 4 themes in the focus groups: recent changes in vaccine compliance, hesitancy and barriers, services addressing hesitancy and barriers, and future requests for DPH. Analysis of pediatrician interviews revealed themes relating to vaccine information, community efforts, and physician decision-making.
This study highlights the need for a multidisciplinary approach to vaccine hesitancy in St Louis County. Future interventions need to focus on beliefs and behavioral change related to vaccines and not just the economics and accessibility of vaccines.
为了收集关于儿童疫苗接种和疫苗犹豫的观点，圣路易斯县公共卫生部（DPH）对寻求非医学豁免的家长进行了调查，组织了学校护士焦点小组，并采访了儿科医生。
2019年8月至2022年12月期间，我们在圣路易斯县向在任何DPH诊所为其学龄儿童寻求非医学豁免的家长分发了豁免表格和自愿问卷。2022年9月，我们组织并记录了4个由11名学校护士参加的75至90分钟的焦点小组，每组2至3名护士。2023年3月，我们对8名儿科医生进行了采访并记录。我们计算了描述性统计数据，转录了焦点小组讨论和采访内容，并进行了定性编码。
我们收集了1871份豁免表格。儿童（n = 1854）的中位年龄为6岁。在豁免清单中的10种疫苗中，排除率从脑膜炎球菌结合疫苗的91.2%到甲型肝炎疫苗的88.7%不等。我们在焦点小组中确定了4个主题：疫苗依从性的近期变化、犹豫和障碍、解决犹豫和障碍的服务以及对DPH的未来要求。对儿科医生采访的分析揭示了与疫苗信息、社区努力和医生决策相关的主题。
本研究强调了在圣路易斯县采取多学科方法应对疫苗犹豫的必要性。未来的干预措施需要关注与疫苗相关的信念和行为改变，而不仅仅是疫苗的经济性和可及性。
