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Rachel M. Cunningham Charles G. Minard Danielle Guffey Laurie S. Swaim Douglas J. Opel Julie A. Boom 《Academic pediatrics》2018,18(2):154-160
Objective
Nonmedical exemptions continue to rise because of increasing proportions of vaccine-hesitant parents. The proportion of expectant parents who are vaccine-hesitant is currently unknown. We assessed the prevalence of vaccine hesitancy among expectant parents receiving care at an obstetrics clinic in Houston, Texas.Methods
We conducted a cross-sectional survey of expectant parents between 12 and 31 weeks gestation who received care at Texas Children's Pavilion for Women between July 2014 and September 2015. Using convenience sampling, participants completed a questionnaire that included questions on demographic items, self-assessed pregnancy risk, receipt of annual influenza vaccine, and the 15-item Parents Attitudes About Childhood Vaccines survey, a validated tool to identify vaccine-hesitant parents. We used multivariable logistic regression to determine the association of demographic characteristics, pregnancy risk, and influenza vaccine receipt with vaccine hesitancy after controlling for variables significant in univariable analyses.Results
Six hundred ten expectant mothers and 38 expectant fathers completed the Parents Attitudes About Childhood Vaccines survey. Overall, 50 of 610 expectant mothers (8.2%; 95% confidence interval [CI], 6.1%–10.7%) were vaccine-hesitant. Expectant mothers were primarily non-Hispanic white, 30 years old or older, and married. The odds of being vaccine-hesitant were 2.2 times greater (95% CI, 1.2–4.1) among expectant mothers with a college level of education or less compared with those with more than a 4-year degree. The odds of being vaccine-hesitant were 7.4 times greater (95% CI, 3.9-14.0) among expectant mothers who do not receive an annual influenza vaccine compared with those who do.Conclusions
Our findings suggest the need to identify and address vaccine hesitancy among expectant parents before birth. 相似文献9.
《Journal of pediatric health care》2014,28(6):541-549
IntroductionHealth care provider recommendations are critical for human papillomavirus (HPV) vaccine uptake. We sought to describe providers' HPV vaccine recommendation practices and explore their perceptions of parental hesitancy.MethodA statewide sample (n = 575) of Minnesota health care providers (20% pediatricians, 47% family medicine physicians, and 33% nurse practitioners) completed our online survey in April 2013.ResultsOnly 76% of health care providers reported routinely recommending HPV vaccine for girls ages 11 to 12 years, and far fewer (46%) did so for boys (p < .001). A majority of providers reported asking questions about parents' concerns (74%), but many lacked time to probe reasons (47%) or believed that they could not change parents' minds (55%). Higher levels of self-efficacy and outcome expectations were associated with routine recommendations (p < .05).DiscussionFindings suggest that providers' perceptions of hesitancy may discourage them from routinely recommending the HPV vaccine. Improving providers' self-efficacy to address hesitancy may be important for improving vaccination rates. 相似文献
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Karlen E. APRN FNP Renea L. PhD RN CCRN Neil E. RN BS 《Journal of pediatric health care》2009,23(6):388-393
IntroductionOne reason for lower immunization rates is that some parents hesitate to have their children immunized. A hesitancy questionnaire was developed to identify reasons parents hesitate in having their children immunized.MethodsThe hesitancy questionnaire was distributed from local pediatric and family practice offices and from the area's county health department. To be eligible, participants needed to be present in the clinic with a child needing a minimum of one immunization that was at least 6 months overdue.ResultsWhen questioned why their child was overdue for immunizations, the most common response was that participants were confused about the immunization schedule and not sure when to return. Of the participants who reported having concerns regarding immunizations, the child's pain/crying/anxiety was the most commonly occurring answer. When asked where they receive the majority of childhood immunization information, participants frequently identified their health care provider as the main source of information.DiscussionHealth care providers may be missing opportunities to educate hesitant parents about immunizations. Parents may not have ample opportunities to discuss their immunization concerns in detail with their health care provider during regularly scheduled clinic visits. It is important for health care providers to suggest ways parents can cope with their child's pain/crying/anxiety when receiving immunizations. 相似文献
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A. Rybak F. Vié le Sage S. Béchet A. Werner G. Thiebault P. Bakhache B. Virey E. Caulin R. Cohen C. Levy 《Archives de pédiatrie》2019,26(2):56-64
Objectives
The vaccine schedule was changed in 2013 in France, which resulted in fewer vaccinations. However, to maintain disease protection, both vaccine timeliness and high coverage should be respected. In the context of growing vaccine hesitancy, we aimed to describe compliance with the immunization program according to the age recommended for each dose for non-preterm children less than 2 years old.Methods
Between May 2013 and April 2016, we used automated electronic data capture of electronic medical records for non-preterm children less than 2 years old. Children were followed up by 92 randomly selected pediatricians from the French ambulatory pediatricians group. Delayed immunization was defined as more than 15 days after the recommended age for the primary series of diphtheria-tetanus-pertussis-polio-Haemophilus influenzae b-hepatitis B (DTaP-IPV-Hib±HB) and 13-valent pneumococcal vaccine (PCV13), 2 months for boosters, 1 month for measles-mumps-rubella (MMR)/meningococcal C conjugate (Men-C), and 6 months for the second dose of MMR. An association between delayed first dose and other doses delayed were described with odds ratios (ORs) and their 95% confidence intervals (CIs).Results
Data for 22,097 children in France with 124,702 vaccinations were analyzed: 21.8%, 20.4%, and 30.7% of children had one or more delayed doses of DTaP-IPV-Hib±HB, PCV13, and MMR vaccines, respectively. For 47.6% of children, the single-dose Men-C vaccination was delayed. A delayed first dose of DTaP-IPV-Hib±HB, PCV13, and MMR was associated with a delayed second dose of the same vaccine (OR 7.5 [95% CI 6.6–8.6], 39.0 [34.1–44.8], and 23.5 [19.1–29.0], respectively) and with a third dose of DTaP-IPV-Hib±HB and PCV13 (14.7 [13.3–17.7] and 3.7 [3.1–4.5]).Conclusion
This large study shows that the proportion of children with delayed vaccination in France was globally high and substantial for Men-C and the first MMR vaccination. Risk of a delayed second and third dose was increased with a delayed first dose, which may reflect vaccine hesitancy. 相似文献15.
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Rivera-Luna R 《Pediatric hematology and oncology》1999,16(2):95-99
The Instituto Nacional de Pediatria (National Institute of Pediatrics) is a referral, non-profit, teaching hospital. This government-funded institution is dedicated only and exclusively for clinical and research in pediatrics. In their 29 years, it has dictated the norms for patient care through a multitude of research projects in all fields of pediatrics. The purpose of our institution is to continue developing human professional resources in order to improve patient care across the country, especially in pediatric oncology, in which there is a tremendous shortage of professionals. We believe that all Mexican children with this disease have the right to have as good treatment and prognosis as the children from developed countries. 相似文献
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《Academic pediatrics》2022,22(8):1399-1406
ObjectiveWe surveyed a diverse group of US participants to understand parental coronavirus disease 2019 (COVID-19) vaccine hesitancy.MethodsWe administered a telephone and online survey from May 7 to June 7, 2021 using stratified sampling to ensure robust sample sizes of racial and ethnic minorities. Of the 20,280 contacted, 12,288 respondents completed the survey (response rate 61%). We used chi-square tests and adjusted risk ratios to compare results by racial/ethnic group.ResultsOverall, 23% of parents stated that they plan to (or have) vaccinated their children; 30% said that they would not vaccinate their children, and 25% were unsure. Latino/a, Native American, and Asian American-Pacific Islander (AAPI) parents were generally more likely to vaccinate their children than Black or White parents. After adjusting for demographic factors, AAPI parents were significantly more likely to vaccinate their children than were others. Of parents who said that they would not vaccinate their child, 55% stated it was due to insufficient research. However, over half of parents stated that they would follow their child's health care provider's recommendations. After adjusting for demographic factors, trust in their primary care doctor was significantly lower among AAPI, Black, and Native American parents than White parents.ConclusionsParental vaccine hesitancy was similar overall, but drivers of hesitancy varied by racial/ethnic groups. While the perception that vaccines had been “insufficiently researched” was a major concern among all groups, we found that parents are generally inclined to follow health providers’ recommendations. Health professionals can play an important role in COVID-19 vaccine education and should provide access to vaccines. 相似文献