Salloum Maha, Paviotti Antea, Matuvanga Trésor Zola, Lemey Gwen, Bolombo Freddy Bikioli, Maketa Vivi, Muhindo-Mavoko Hypolite, Van Damme Pierre, Mitashi Patrick, Van Geertruyden Jean-Pierre, Bastiaens Hilde
Centre for the Evaluation of Vaccination, Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, Belgium.
Global Health Institute, Department of Family Medicine and Population Health, University of Antwerp, Antwerp, Belgium.
Vaccine X. 2024 Dec 4;22:100592. doi: 10.1016/j.jvacx.2024.100592. eCollection 2025 Jan.
The Democratic Republic of the Congo (DRC) struggles with low full childhood vaccination coverage (around 50 %) and a high children-under-five mortality rate (79 deaths per 1000 live births). This situation is potentially exacerbated by vaccine hesitancy, which was identified by the World Health Organization (WHO) as one of the top 10 global health threats in 2019. To gain deeper insights into levels of vaccine confidence possibly influencing vaccination coverage, we explored perceptions and attitudes towards childhood and adult vaccines in Boende (Tshuapa province, western DRC), which experienced an Ebola outbreak in 2014 and hosted the EBL2007 Ebola vaccine trial (2019-2022). Using purposeful sampling, we conducted 29 individual interviews and 14 focus group discussions with diverse community members between July 2022 and March 2023. Our findings suggest the prevalence of a relatively low level of trust in COVID-19 vaccines compared to other vaccines. Additionally, the fear of Ebola disease seemed to lead to general acceptance of the EBL2007 trial vaccine, although some concerns were voiced about pre-testing and the decision to conduct the trial in the DRC. While trust in childhood vaccines and reported uptake appeared to be high, concerns existed regarding potential adverse effects and the possibility that vaccines targeted African children specifically. Our analysis further identified four recommendations to possibly enhance vaccine confidence in the region. This study highlights the multifaceted nature of vaccine confidence, influenced by the perceived risk of the targeted diseases, past experiences with medical interventions and staff, and sociopolitical contexts. However, we emphasise that increasing vaccine uptake requires a comprehensive approach, addressing not only vaccine confidence, but also crucial aspects like access to vaccines and robust disease surveillance activities. This would ultimately reduce the burden of vaccine-preventable diseases and lead to better public health outcomes in the region.
刚果民主共和国面临儿童全程疫苗接种覆盖率较低（约50%）以及五岁以下儿童死亡率较高（每1000例活产中有79例死亡）的问题。疫苗犹豫情绪可能使这种情况进一步恶化，世界卫生组织（WHO）将其确定为2019年全球十大健康威胁之一。为了更深入了解可能影响疫苗接种覆盖率的疫苗信心水平，我们在博恩德（刚果民主共和国西部楚阿帕省）探索了对儿童和成人疫苗的看法与态度，该地在2014年经历了埃博拉疫情，并于2019年至2022年开展了EBL2007埃博拉疫苗试验。我们采用目的抽样法，在2022年7月至2023年3月期间与不同社区成员进行了29次个人访谈和14次焦点小组讨论。我们的研究结果表明，与其他疫苗相比，对新冠疫苗的信任程度相对较低。此外，对埃博拉疾病的恐惧似乎导致人们普遍接受EBL2007试验疫苗，尽管有人对预测试以及在刚果民主共和国进行试验的决定表示担忧。虽然对儿童疫苗的信任度和报告的接种率似乎较高，但人们对潜在的不良反应以及疫苗专门针对非洲儿童的可能性存在担忧。我们的分析还确定了四条可能提高该地区疫苗信心的建议。这项研究突出了疫苗信心的多面性，它受到目标疾病的感知风险、过去的医疗干预和医护人员经历以及社会政治背景的影响。然而，我们强调，提高疫苗接种率需要采取综合方法，不仅要解决疫苗信心问题，还要解决诸如疫苗可及性和强有力的疾病监测活动等关键问题。这最终将减轻疫苗可预防疾病的负担，并在该地区带来更好的公共卫生成果。
