University of the Witwatersrand, Johannesburg, South Africa.
School of Public Health, University of Ghana, P. O. Box 65 LG, Legon, Ghana.
Malar J. 2024 Nov 29;23(1):365. doi: 10.1186/s12936-024-05180-x.
Vaccines have increasingly become some of the most effective public health tools for promoting health and reducing the burden of infectious diseases. The availability of a malaria vaccine for routine use will be a major milestone, nonetheless, trust by the public for the vaccine could pose a major challenge for its acceptance. Documented evidence such as the boycott of the oral polio vaccine in northern Nigeria and the failure of the Ebola vaccine trial in Ghana among others highlight the impact of public trust on vaccine acceptance.
This is an explorative cross-sectional mixed-method study conducted in the Kassena Nankana districts. The study was conducted in the Kassena Nankana Districts between May and December 2020. A total of 390 structured questionnaires were administrated to mothers and caregivers of children under five years of age while 15 in-depth interviews were conducted with mothers and health workers. STATA software Version 16.0 was used to interpret the quantitative data, where bivariate and multivariate regression analysis was performed to determine the influence of trust on vaccine acceptance while QSR NVivo 12 software was used to code the qualitative data to aid the thematic analysis.
The results revealed that the level of knowledge of the RTS,S vaccine among participants was high. About 95.4% of the mothers had good knowledge of the malaria vaccine and more than half 61.2% of them got information about the vaccine from the health facility. The level of trust for the malaria vaccine was equally high with 91.4% of the mothers reporting that the vaccine treats childhood malaria. In a bivariate analysis, educational status (P = 0.013), ethnicity (P = 0.008), marital status (P = 0.041), education on the vaccine and perceived ineffectiveness P < 0.05, and trust for the malaria vaccine (P < 0.05) were found to be statistically associated with vaccine acceptance. Compared with participants who agree that vaccines are harmless to children, those who disagree were significantly less likely to accept vaccines (OR = 0.25, 95%CI [0.08, 0.83], p = 0.017). The qualitative data correspondingly revealed that mothers trusted vaccines which thus accounted for the high uptake of the malaria vaccine in the districts.
The results of this study suggest that trust in the malaria vaccine is critical for its uptake. Therefore, efforts towards improving acceptance of the vaccine should be focused on building and sustaining trust for the vaccine among mothers and community members.
疫苗已成为促进健康和减轻传染病负担的最有效公共卫生工具之一。疟疾疫苗的常规使用将是一个重要的里程碑，但公众对疫苗的信任可能是其接受的主要挑战。有记录的证据表明，例如尼日利亚北部的口服脊髓灰质炎疫苗抵制事件，以及加纳的埃博拉疫苗试验失败等事件，都突出了公众信任对疫苗接受度的影响。
这是一项在卡塞纳-南卡纳区进行的探索性横断面混合方法研究。该研究于 2020 年 5 月至 12 月在卡塞纳-南卡纳区进行。共向 390 名 5 岁以下儿童的母亲和照顾者发放了 390 份结构式问卷，同时对 15 名母亲和卫生工作者进行了 15 次深入访谈。使用 STATA 软件版本 16.0 解释定量数据，进行单变量和多变量回归分析，以确定信任对疫苗接受度的影响，同时使用 QSR NVivo 12 软件对定性数据进行编码，以辅助主题分析。
结果表明，参与者对 RTS,S 疫苗的知识水平较高。大约 95.4%的母亲对疟疾疫苗有很好的了解，超过一半（61.2%）的母亲从医疗机构获得了疫苗信息。对疟疾疫苗的信任程度同样很高，91.4%的母亲表示疫苗可治疗儿童疟疾。在单变量分析中，教育程度（P=0.013）、族裔（P=0.008）、婚姻状况（P=0.041）、疫苗教育（P<0.05）和对疟疾疫苗的信任（P<0.05）与疫苗接种率呈统计学相关。与同意疫苗对儿童无害的参与者相比，不同意疫苗对儿童无害的参与者明显不太可能接受疫苗（OR=0.25，95%CI [0.08，0.83]，p=0.017）。相应的定性数据表明，母亲信任疫苗，这也是该地区疟疾疫苗高接种率的原因。
本研究结果表明，对疟疾疫苗的信任是其获得认可的关键。因此，提高疫苗接受度的努力应集中在增强母亲和社区成员对疫苗的信任。
