Mathebula Lindi, Cooper Sara, Zunza Moleen, Wiysonge Charles Shey
Cochrane South Africa, South African Medical Research Council, Cape Town, Western Cape, South Africa
Cochrane South Africa, South African Medical Research Council, Cape Town, Western Cape, South Africa.
BMJ Open. 2025 Feb 7;15(2):e093451. doi: 10.1136/bmjopen-2024-093451.
Vaccines have proven to be one of the most effective ways to prevent infections. Since the introduction of the Expanded Programme on Immunisation worldwide by WHO in 1974, vaccines have saved more than 150 million lives and prevented countless illnesses and disabilities. In South Africa, vaccination has contributed substantially to the decline in under-five childhood deaths from 89 418 in 2005 to 47 409 in 2013. However, the country still has limitations in achieving optimal uptake of vaccines.
This study will use a mixed-methods design to identify the factors associated with acceptance, hesitancy and refusal of childhood vaccines in three subdistricts of the Cape Town Metropolitan Health District in South Africa. In phase I of the study, we aim to estimate the uptake of childhood vaccines and assess the factors associated with uptake among a representative sample of at least 236 caregivers of children aged 0-2 years in a cross-sectional study. For phase II of the study, we will explore the behavioural and social drivers of childhood vaccination from the perspective of caregivers of children aged 0-2 years using a purposively selected sample of 20-25 participants from phase I. Finally, for phase III of the study, we will explore the behavioural and social drivers of childhood vaccination from the perspective of 20-25 healthcare workers providing vaccinations to children aged 0-2 years purposively sampled from primary healthcare facilities.
Ethical approval was obtained from Stellenbosch University (S23/10/232). Various steps will be taken to ensure the anonymity and confidentiality of participants. Findings of the study will be shared with various healthcare stakeholders through conferences and presentations at relevant meetings.
Evidence from several studies conducted in South Africa shows a significant increase in vaccine hesitancy within the country. The findings of this study will provide insight into the characteristics associated with vaccine acceptance, hesitancy and refusal in Cape Town. The results will help inform the development of evidence-based interventions that can be implemented to improve vaccination coverage.
疫苗已被证明是预防感染最有效的方法之一。自1974年世界卫生组织在全球推行扩大免疫规划以来，疫苗已挽救了超过1.5亿人的生命，并预防了无数疾病和残疾。在南非，疫苗接种对五岁以下儿童死亡人数的下降做出了重大贡献，从2005年的89418例降至2013年的47409例。然而，该国在实现疫苗的最佳接种率方面仍存在局限性。
本研究将采用混合方法设计，以确定南非开普敦都市卫生区三个分区中与儿童疫苗接受、犹豫和拒绝相关的因素。在研究的第一阶段，我们旨在通过一项横断面研究，估计至少236名0至2岁儿童的看护者的代表性样本中儿童疫苗的接种率，并评估与接种率相关的因素。在研究的第二阶段，我们将从第一阶段有目的地选取20至25名参与者，从0至2岁儿童看护者的角度探索儿童疫苗接种的行为和社会驱动因素。最后，在研究的第三阶段，我们将从20至25名在初级卫生保健机构有目的地抽取的为0至2岁儿童接种疫苗的医护人员的角度，探索儿童疫苗接种的行为和社会驱动因素。
已获得斯泰伦博斯大学的伦理批准（S23/10/232）。将采取各种措施确保参与者的匿名性和保密性。研究结果将通过会议以及在相关会议上的报告与各医疗利益相关者分享。
在南非进行的多项研究的证据表明，该国疫苗犹豫现象显著增加。本研究结果将深入了解开普敦与疫苗接受、犹豫和拒绝相关的特征。这些结果将有助于为制定可实施的循证干预措施提供信息，以提高疫苗接种覆盖率。
