Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
Global Health and Chronic Conditions Research Group, Chiang Mai University, Chiang Mai, Thailand.
J Prim Care Community Health. 2024 Jan-Dec;15:21501319241303568. doi: 10.1177/21501319241303568.
Pneumonia is a leading cause of mortality worldwide, with Streptococcus pneumoniae being the most common cause. Older adults are particularly at risk. However, vaccination rates in Thailand remain low.
This study aims to examine the prevalence of vaccine refusal and its association with factors outlined in the 5C model (Confidence, Complacency, Constraints, Calculation, and Collective Responsibility) among older patients with morbidities.
Study was conducted at outpatient clinic of the Department of Family Medicine, Chiang Mai University.
An observational cross-sectional study. The data was collected via a self-administered questionnaire including demographic data, questionnaire in 5C model, and intention to received pneumococcal vaccine. Comparison of characteristic between vaccine refuser and non-refuser was performed by using Chi-square or a -test. To explore the association between factors in 5C model and vaccine refusal, multiple logistic regression was performed with an adjustment for confounders.
From a total of 150 participants, the mean age was 69.8 ± 5.6 years old. Most of the patients were female (60.7%). The study found that 18% of the participants refused the pneumococcal vaccine. After adjusted for the confounders, the lower collective responsibility and confidence were significantly associated with vaccine refusal (Odds ratio 0.22 (95% confidence interval [CI] 0.06-0.74, = .015) and Odds ratio 0.43 (95% CI 0.20-0.89, = .024), respectively.
Strategies to enhance confidence and address complacency about vaccines are essential for improving pneumococcal vaccination coverage. This insight can be used as a guideline and policies can be formulated which are aimed at reducing pneumococcal vaccine refusal in the older adults by enhancing communication about the benefits, efficacy, and risks of vaccines.
肺炎是全球范围内导致死亡的主要原因，其中肺炎链球菌是最常见的病因。老年人的风险尤其高。然而，泰国的疫苗接种率仍然很低。
本研究旨在检查患有慢性病的老年患者中疫苗拒绝接种及其与 5C 模型（信心、自满、约束、计算和集体责任）中列出的因素的相关性。
研究在清迈大学家庭医学系的门诊进行。
采用观察性横断面研究。通过自填式问卷收集数据，包括人口统计学数据、5C 模型问卷和接种肺炎球菌疫苗的意愿。使用卡方检验或 t 检验比较疫苗拒绝者和非拒绝者的特征。为了探索 5C 模型中的因素与疫苗拒绝之间的关联，采用多元逻辑回归分析，并对混杂因素进行调整。
在总共 150 名参与者中，平均年龄为 69.8±5.6 岁。大多数患者为女性（60.7%）。研究发现，18%的参与者拒绝接种肺炎球菌疫苗。在调整混杂因素后，较低的集体责任感和信心与疫苗拒绝显著相关（优势比 0.22（95%置信区间 [CI] 0.06-0.74，P=0.015）和优势比 0.43（95% CI 0.20-0.89，P=0.024））。
增强对疫苗的信心和解决对疫苗的自满情绪的策略对于提高肺炎球菌疫苗接种覆盖率至关重要。这一发现可以作为一个指导方针，并制定政策，旨在通过加强关于疫苗的益处、疗效和风险的沟通，减少老年人对肺炎球菌疫苗的拒绝。
