Sanders Chris, Burnett Kristin, Ray Lana, Ulanova Marina, Halperin Donna M, Halperin Scott A
Department of Sociology, Lakehead University, Thunder Bay, Ontario, Canada.
Department of Indigenous Learning, Lakehead University, Thunder Bay, Ontario, Canada.
PLoS One. 2024 Dec 5;19(12):e0308876. doi: 10.1371/journal.pone.0308876. eCollection 2024.
This article examines the complicated terrain of immunization acceptance and access among Indigenous peoples in northern Ontario by drawing on conversations held prior to 2019 that explored knowledge about Haemophilus influenzae type a (Hia) infection specifically and attitudes toward vaccines more broadly. In the decade preceding COVID-19, Hia emerged as a leading cause of morbidity and mortality in Indigenous communities in northern Canada. Before developing new vaccines, it is imperative to hold conversations with the communities most affected and to learn more about Indigenous peoples' perceptions of and knowledge about vaccines, both generally and Hia specifically. We conducted focus groups and one-on-one conversations with Anishinaabe Peoples in northwestern Ontario. Our findings illustrate that decisions to vaccinate are informed by a host of social, institutional, and ideological factors and historical and contemporary relationships with government institutions and health practitioners. In particular, Indigenous community members perceived their relationships with social and health services and education institutions as coercive. Thus, public health approaches cannot continue to operate in ways that prioritize interventions for Indigenous peoples and communities so that they "do the right thing." More emphasis is needed on health service and social service provider knowledge, skills, attitudes and practices-redirecting the onus onto those within the health care system. Solutions must respect Indigenous nationhood and the right of self-determination. Finally, we suggest the term vaccine hesitancy may not entirely capture the breadth of experiences that many Indigenous Peoples and communities have and continue to have within the health care system in Canada.
本文通过借鉴2019年之前进行的对话来审视安大略省北部原住民群体中疫苗接种接受度和可及性这一复杂领域，这些对话专门探讨了关于a型流感嗜血杆菌（Hia）感染的知识以及更广泛的疫苗态度。在新冠疫情之前的十年里，Hia成为加拿大北部原住民社区发病和死亡的主要原因。在研发新疫苗之前，必须与受影响最严重的社区进行对话，并更多地了解原住民对疫苗的总体看法和知识，特别是对Hia疫苗的看法和知识。我们在安大略省西北部与阿尼什纳比人进行了焦点小组讨论和一对一访谈。我们的研究结果表明，接种疫苗的决定受到一系列社会、机构和意识形态因素以及与政府机构和医疗从业者的历史和当代关系的影响。特别是，原住民社区成员认为他们与社会、卫生服务和教育机构的关系具有强制性。因此，公共卫生方法不能继续以优先考虑对原住民群体和社区进行干预，以便他们“做正确的事”的方式运作。需要更加重视卫生服务和社会服务提供者的知识、技能、态度和做法，将责任重新转移到医疗保健系统内部的人员身上。解决方案必须尊重原住民的国家地位和自决权。最后，我们认为“疫苗犹豫”这个术语可能无法完全涵盖许多原住民群体和社区在加拿大医疗保健系统中已经经历并仍在经历的广泛经历。
