儿童父母肠道病毒71型灭活疫苗犹豫及其影响因素分析  

Parental hesitancy to use inactivated enterovirus 71 vaccine and factors influencing hesitancy

作　　者：唐智敏 余文周[1] 刘燕敏[1] 冯子健[1] Tang Zhimin;Yu Wenzhou;Liu Yanmin;Feng Zijian(Department of National Immunization Pro- gram, Chinese Center for Disease Control and Prevention, Beijing 100050, China;Chinese Center for Disease Control and Prevention, Beijing 102206, China)

机构地区：[1]中国疾病预防控制中心免疫规划中心

出　　处：《中国疫苗和免疫》2018年第3期334-338,共5页Chinese Journal of Vaccines and Immunization

摘　　要：目的调查儿童父母肠道病毒71型灭活疫苗（EV71疫苗）犹豫,分析其影响因素。方法采用便利抽样方法在云南、四川选择4个地市12个接种门诊的6-18月龄儿童父母进行问卷调查,采用单因素和多因素方法分析疫苗犹豫及其影响因素。结果儿童父母中疫苗犹豫比例为33.8%（111/328）。EV71疫苗价格（昂贵vs可接受,OR=3.04,95%CI：1.26-7.33;不知道vs可接受,OR=3.03,95%CI：1.29-7.15）、担心EV71疫苗严重不良反应（OR=2.47,95%CI：1.04-5.88）、曾拒绝接种（OR=2.76,95%CI：1.07-7.15）、不满意的接种经历（OR=2.21,95%CI：1.16-4.20）会导致疫苗犹豫;儿童年龄大（13-18月龄vs 6-12月龄,OR=0.32,95%CI：0.11-0.90）,接种医生推荐（OR=0.32,95%CI：0.16-0.63）、了解EV71疫苗（OR=0.38,95%CI：0.17-0.84）、认为手足口病（Hand,foot and mouth disease,HFMD）易感（OR=0.39,95%CI：0.19-0.80）、认为HFMD严重（OR=0.38,95%CI：0.17-0.85）、相信疫苗效力（OR=0.27,95%CI：0.14-0.51）不易引起疫苗犹豫。结论 EV71疫苗犹豫比例较高,需加强HFMD及EV71疫苗知识的宣传沟通,特别是HFMD的易感性与严重性、EV71疫苗的有效性与安全性。Objective To determine whether parents were hesitant to vaccinate their children with inactivated enterovirus 71（ EV71） vaccine and to evaluate factors influencing parental hesitancy to vaccinate.Methods We conducted a questionnaire-based survey of a convenience sample of parents of 6-18 month old children recruited from 12 immunization clinics in 4 prefectures of Yunnan and Sichuan provinces.We evaluated factors influencing vaccine hesitancy with univariate and multivariate analyses. Results Among the participating parents,33. 8%（ 111/328） were hesitant to vaccinate their children with EV71 vaccine. Risk factors for parental hesitancy to vaccinate were：（ 1） price of EV71 vaccine（ expensive vs acceptable,OR = 3. 04,95% CI： 1. 26-7. 33; not sure vs acceptable,OR = 3. 03,95% CI： 1. 29-7. 15）,（ 2） concern of severe adverse reactions after EV71 vaccination（ OR = 2. 47,95% CI： 1. 04-5. 88）,（ 3） prior experience with rejecting a vaccine（ OR = 2. 76,95% CI： 1. 07-7. 15）,and（ 4）prior unsatisfactory vaccination experience（ OR = 2. 21,95% CI： 1. 16-4. 20）. Factors associated with a low level of parental hesitancy were：（ 1） older age of child（ 13-18 months vs 6-12 months,OR =0. 32,95% CI： 0. 11-0. 90）,（ 2） a recommendation by vaccination staff to use EV71 vaccine（ OR =0. 32,95% CI： 0. 16-0. 63）,（ 3） knowing basic information about EV71 vaccine（ OR = 0. 38,95%CI： 0. 17-0. 84）,（ 4） believing their child is at high risk of hand,foot and mouth disease（ HFMD）（ OR = 0. 39,95% CI： 0. 19-0. 80）,（ 5） believing that HFMD is severe（ OR = 0. 38,95% CI：0. 17-0. 85）,and（ 6） trusting the effectiveness of EV71 vaccine（ OR = 0. 27,95% CI： 0. 14-0. 51）. Conclusions EV71 vaccine hesitancy was high among parents. We recommend strengthening public education and communications about HFMD and EV71 vaccine,including providing information about susceptibility and severity of HFMD and the effectiveness and safety of EV71 vaccine.

关 键 词：手足口病 肠道病毒71型灭活疫苗 疫苗犹豫 影响因素 

分 类 号：R186[医药卫生—流行病学]