Kömürlüoğlu Ayça, Çelik Nurullah, Çiçek Ayla Uzun, Yalçın Siddika Songül
Institude of Child Health, Department of Social Pediatrics, Hacettepe University, Ankara, Türkiye.
Faculty of Medicine, Department of Pediatrics, Sivas Cumhuriyet University, Sivas, Türkiye.
BMC Public Health. 2025 May 7;25(1):1683. doi: 10.1186/s12889-025-22797-y.
Vaccine hesitancy (VH) and vaccine refusal are increasing globally, posing a significant challenge to public health. This study aimed to evaluate VH and associated factors in parents of children with different chronic conditions, comparing them to a control group of healthy children.
This cross-sectional study included mothers of children aged 6 to 12 years, diagnosed with Autism Spectrum Disorder (ASD), attention deficit hyperactivity disorder (ADHD), type 1 diabetes mellitus (T1DM), congenital heart disease (CHD), congenital hypothyroidism (CH) and Familial Mediterranean Fever (FMF) and healthy children without chronic diseases. The study collected sociodemographic data, and parents completed the Parent Attitudes about Childhood Vaccines (PACV) survey and the Parental Attitude Research Instrument (PARI). Vaccine hesitancy was defined as a PACV score ≥ 50.
A total of 1163 participants were included, consisting of 546 children with chronic conditions. The overall VH rate was %14.7. Compared to control group, parents of children with T1DM had 3.3 times higher odds of VH, and parents of children with ASD had 1.8 times higher odds of VH. However, parents of children with CHD had lower odds of VH [OR: 0.38 (95% CI: 0.15-0.97)]. The most common reasons for VH were concerns about vaccine ingredients (40.2%) and fear of adverse events (22.5%). The primary suggested solution was receiving more information from healthcare professionals (33.3%). Factors such as having a child with a chronic condition, personal experience with vaccine adverse events, and reliance on the internet for vaccine information were associated with increased VH, whereas obtaining information from healthcare professionals was linked to lower VH. Higher parental democratic attitudes were associated with lower VH, while increased marital conflict was linked to higher VH.
Addressing both informational gaps and psychosocial factors, such as marital conflict and democratic parenting attitudes, can enhance vaccine acceptance. Healthcare professionals should provide personalized guidance and resources to empower parents, enabling them to make informed vaccination decisions for high-risk groups such as children with chronic conditions.
疫苗犹豫和拒绝接种疫苗的现象在全球范围内日益增加，对公共卫生构成重大挑战。本研究旨在评估患有不同慢性病儿童的父母中的疫苗犹豫情况及相关因素，并将他们与健康儿童的对照组进行比较。
这项横断面研究纳入了6至12岁儿童的母亲，这些儿童被诊断患有自闭症谱系障碍（ASD）、注意力缺陷多动障碍（ADHD）、1型糖尿病（T1DM）、先天性心脏病（CHD）、先天性甲状腺功能减退症（CH）和家族性地中海热（FMF），以及无慢性病的健康儿童。研究收集了社会人口学数据，父母完成了《儿童疫苗家长态度》（PACV）调查和《家长态度研究工具》（PARI）。疫苗犹豫被定义为PACV得分≥50。
共纳入1163名参与者，其中包括546名患有慢性病的儿童。总体疫苗犹豫率为14.7%。与对照组相比，T1DM儿童的父母出现疫苗犹豫的几率高3.3倍，ASD儿童的父母出现疫苗犹豫的几率高1.8倍。然而，CHD儿童的父母出现疫苗犹豫的几率较低[比值比：0.38（95%置信区间：0.15 - 0.97）]。疫苗犹豫最常见的原因是对疫苗成分的担忧（40.2%）和对不良事件的恐惧（22.5%）。最主要的建议解决方案是从医疗保健专业人员那里获取更多信息（33.3%）。诸如孩子患有慢性病、个人有疫苗不良事件经历以及依赖互联网获取疫苗信息等因素与疫苗犹豫增加有关，而从医疗保健专业人员那里获取信息则与较低的疫苗犹豫相关。较高的父母民主态度与较低的疫苗犹豫相关，而婚姻冲突增加则与较高的疫苗犹豫相关。
解决信息差距以及婚姻冲突和民主育儿态度等心理社会因素，可以提高疫苗接种率。医疗保健专业人员应提供个性化指导和资源，以增强父母的能力，使他们能够为患有慢性病的儿童等高风险群体做出明智的疫苗接种决策。
