Çocukluk Çağı Aşı Tereddüdü ile Karşılaşma Sıklığı, Nedenleri ve Çözüm Önerileri: Samsun İli Aile Sağlığı Merkezlerindeki Sağlık Çalışanlarıyla Kesitsel Bir Çalışma

Amaç: Bu çalışmada, Samsun ilindeki aile sağlığı merkezlerinde görev alan sağlık çalışanlarının çocukluk çağı aşı tereddüdü ile karşılaşma sıklığı, nedenleri ve çözüm önerilerinin değerlendirilmesi amaçlanmıştır. Gereç ve Yöntem: Kesitsel tipte bir çalışmadır. Samsun’da Mayıs-Eylül 2021’de online bir anket ile yürütülmüştür. Çalışmaya 165 aile hekimi, 131 aile sağlığı çalışanı katılmıştır. Bu çalışma kapsamında, aile sağlığı biriminde çalışan hekim ve diğer sağlık personeli tek tek telefonla aranarak ve çalışılan aile sağlığı merkezlerine gidilerek kendi özel numaraları veya mail adresleri alınmıştır. Google formlar aracılığıyla hazırlanan anket formu elektronik (WhatsApp veya mail aracılığı ile) olarak Samsun’daki aile sağlığı merkezlerinde çalışan aile hekimleri ve aile sağlığı elemanlarına ulaştırılmıştır. Kişiler gönüllülük esasına dayanılarak çalışmaya dahil edilmiştir. Bulgular: Katılımcıların %61,1’i kadın, %85,5’i evli, %55,7’si aile hekimiydi. Katılımcıların aşı tereddüdü olan ebeveynler ile karşılaşma sıklığı %75 olarak bulunmuştur. Aşı tereddüdünün en önemli nedeni, aşıların içeriğindeki maddeler olarak saptanmıştır. Sağlık çalışanlarına göre, aşı tereddüdünü azaltacak en önemli yöntem advers etkiler ile ilgili bilgilendirme yapılması olarak görülmüştür. Sonuç: Çalışmamızda, katılımcıların büyük bir çoğunluğu aşı tereddüdü olan en az bir aile ile daha önce karşılaştığını belirtmişlerdir. Sağlık çalışanlarına aşı tereddüdü ile ilgili eğitimlerin verilmesi fayda sağlayabilir.

Anahtar Kelimeler:

Aile hekimliği, aile sağlığı çalışanı, aşı tereddüdü, çocukluk çağı aşılaması

The Frequency, Causes, and Solution Suggestions of Childhood Vaccination Hesitance: A Cross-sectional Study with Healthcare Workers in Samsun Family Health Centers

Aim: In this study, it was aimed to evaluate the frequency, causes, and solution suggestions of healthcare professionals working in family health centers in Samsun province with childhood vaccination hesitations. Materials and Methods: It is a cross-sectional study. It was conducted with an online survey in Samsun in May-September 2021. 165 family physicians and 131 family health workers participated in the study. Within the scope of this study, physicians working in the family health unit were called one by one and their private numbers or e-mail addresses were obtained by going to the family health centers where they worked. The questionnaire form, which was prepared via Google forms, was delivered electronically (via WhatsApp or mail) to family physicians and family health personnel in family health centers in Samsun. İndividuals were included in the study on a voluntary basis. Results: 61.1% of the participants were women, 85.5% were married and 55.7% were family physicians. The frequency of encountering parents who were hesitant about vaccination was found to be 75%. The most important reason for vaccine hesitancy was determined to be the ingredients in the vaccines. According to healthcare professionals, the most important method to reduce vaccine hesitancy was to inform about adverse effects. Conclusions: In our study, the majority of the participants stated that they had encountered at least one family with hesitation before. It may be beneficial to provide training on vaccine hesitancy to healthcare workers.

Keywords:

Childhood vaccination, family health worker, family medicine, vaccine hesitation,

PDF

___

1. Bulun MA, Acuner D. Turkish Adaptation and Reliability and Validity Study of Parent Attitudes About Childhood Vaccines Survey. Journal of Pedıatrıc Research. 2020;7(4).
2. Reuben R, Aitken D, Freedman JL, Einstein G. Mistrust of The Medical Profession and Higher Disgust Sensitivity Predict Parental Vaccine Hesitancy. Plos One 2020;15(9).
3. Betti L, De Francisci Morales G, Gauvin L, et al. Detecting Adherence to The Recommended Childhood Vaccination Schedule from User-Generated Content in a US Parenting Forum. Plos Computatıonal Bıology. 2021;17(4).
4. Robinson P, Wiley K, Degeling C. Public Health Practitioner Perspectives on Dealing With Measles Outbreaks if High Anti-Vaccination Sentiment is Present. Bmc Public Health. 2021;21(1).
5. Özlem A. Çocukluk Çağı Aşılarında Aşı Reddine veya Aşı Tereddütüne Yol Açan Sebeplerin Araştırılması [Tıpta Uzmanlık Tezi ]. Ankara: Çocuk Sağlığı ve Hastalıkları Ana Bilim Dalı, Sağlık Bilimleri Üniversitesi Ankara Keçiören Eğitim ve Araştırma Hastanesi; 2020.
6. Duzgun MV, Isler Dalgic A. Can Vaccine Rejection, an Increasing Danger to Public Health, be Prevented? Guncel Pedıatrı-Journal Of Current Pedıatrıcs. 2019;17(3):424.
7. Soysal G. Tokat İl Merkezindeki Beş Yaş Altı Çocukların Ebeveynlerinde Aşı Tereddüdü Reddi ve İlişkili Faktörler [Doktora ]: Halk Sağlığı, Başkent Üniversitesi 2021.
8. Özden M. Ankara Merkez İlçelerde Çalışmakta Olan Aile Hekimlerinin Çocukluk Çağı Rutin Aşı Uygulamaları ve Aşı Tereddütüne Sahip Ebeveyne Yaklaşımlarının Değerlendirilmesi [Tıpta Uzmanlık]: Halk Sağlığı Hacettepe Üniversitesi; 2020.
9. Napolitano F, D'Alessandro A, Angelillo IF. Investigating Italian Parent's Vaccine Hesitancy: A Cross-Sectional Survey. Human Vaccines &Immunotherapeutics. 2018;14(7):1558-1565.
10. Shapiro GK, Tatar O, Dube E, et al. The Vaccine Hesitancy Scale: Psychometric Properties and Validation. Vaccine. 2018;36(5):660-667.
11. Williams SE. What are the factors that contribute to parental vaccine-hesitancy and what can we do about it? Hum Vaccin Immunother. 2014;10(9):2584-2596.
12. Celik K, Turan S, Uner S. 'I'm a Mother, Therefore I Question': Parent's Legitimation Sources of and Hesitancy Towards Early Childhood Vaccination. Social Science & Medicine. 2021;282:114132.
13. Yüksel GH, Topuzoğlu A. Aşı Redlerinin Artmasına Bağlı Aşılama Oranlarındaki Düşme ve Aşı Karşıtlığı Etkileyen Faktörler – Güncel Bir Gözden Geçirme. ESTÜDAM Halk Sağlığı Dergisi. 2019;4(2):244-258.
14. Caudal H, Briend-Godet V, Caroff N, Moret L, Navas D, Huon J. Vaccine Distrust: Investigation of The Views and Attitudes of Parents in Regard to Vaccination of Their Children. Annales Pharmaceutiques Françaises. 2020;78(4):294-302.
15. Giambi C, Fabiani M, D'Ancona F, et al. Parental Vaccine Hesitancy in Italy - Results from a National Survey. Vaccine. 2018;36(6):779-787.
16. Puri N, Coomes EA, Haghbayan H, Gunaratne K. Social Media and Vaccine Hesitancy: New Updates for the Era of COVID-19 and Globalized Infectious Diseases. Human Vaccines & Immunotherapeutics. 2020;16(11):2586-2593.
17. Cataldi JR, Dempsey AF, O'Leary ST. Measles, the media, and MMR: Impact of the 2014-15 measles outbreak. Vaccine. 2016;34(50):6375-6380.
18. Dube E, Vivion M, MacDonald NE. Vaccine hesitancy, vaccine refusal and the anti-vaccine movement: influence, impact and implications. Expert Rev Vaccines. 2015;14(1):99-117.
19. Aquino F, Donzelli G, De Franco E, Privitera G, Lopalco PL, Carducci A. The Web and Public Confidence in MMR Vaccination in Italy. Vaccine. 2017;35(35 Pt B):4494-4498.
20. McClure CC, Cataldi JR, O'Leary ST. Vaccine Hesitancy: Where We Are and Where We Are Going. Clinical Therapeutics. 2017;39(8):1550-1562.
21. Kaydirak MM, Gumusay M, Gulec Y, Sahin NH. Parental Opinions and Approaches about Childhood Vaccinations: Are Anti-vaccination Approaches and Indecisiveness Parental Rights? J Community Health Nurs. 2020;37(4):222-232.
22. Nour R. A Systematic Review of Methods to Improve Attitudes Towards Childhood Vaccinations. Cureus. 2019;11(7):e5067.
23. Paterson P, Chantler T, Larson HJ. Reasons for Non-Vaccination: Parental Vaccine Hesitancy and the Childhood Influenza Vaccination School Pilot Programme in England. Vaccine. 2018;36(36):5397-5401.
24. Wong LP, Wong PF, AbuBakar S. Vaccine Hesitancy and the Resurgence of Vaccine Preventable Diseases: the Way Forward for Malaysia, a Southeast Asian Country. Human Vaccines &Immunotherapeutics 2020;16(7):1511-1520.
25. Azizi FSM, Kew Y, Moy FM. Vaccine Hesitancy Among Parents in a Multi-Ethnic Country, Malaysia. Vaccine. 2017;35(22):2955-2961.
26. Zulkarnain NN, Anuar N, Abd Rahman N, et al. Cell-Based Influenza Vaccine: Current Production, Halal Status Assessment, and Recommendations Towards Islamic-Compliant Manufacturing. Human Vaccines &Immunotherapeutics. 2021;17(7):2158-2168.
27. Chang K, Lee SY. Why do some Korean parents hesitate to vaccinate their children? Epidemiol Health. 2019;41:e2019031.
28. Budhwani H, Maycock T, Murrell W, Simpson T. COVID-19 Vaccine Sentiments Among African American or Black Adolescents in Rural Alabama. Journal of Adolescent Health. 2021;69(6):1041-1043.
29. Berry NJ, Henry A, Danchin M, Trevena LJ, Willaby HW, Leask J. When Parents Won't Vaccinate their Children: a Qualitative Investigation of Australian Primary Care Provider's Experiences. BMC Pediatr. 2017;17(1):19.
30. Wheeler M, Buttenheim AM. Parental Vaccine Concerns, Information Source, and Choice of Alternative Immunization Schedules. Human Vaccines &Immunotherapeutics. 2013;9(8):1782-1789.
31. McDuffie D. Sacred Immunity: Religion, Vaccines, and the Protection of Public Health in America. J Public Health-Heid. 2021;29(6):1365-1371.
32. MacDonald NE, Butler R, Dube E. Addressing Barriers to Vaccine Acceptance: an Overview. Human Vaccines & Immunotherapeutics. 2018;14(1):218-224.
33. Meleo-Erwin Z, Basch C, MacLean SA, Scheibner C, Cadorett V. 'To Each His Own': Discussions of Vaccine Decision-Making in top Parenting Blogs. Human Vaccines & Immunotherapeutics. 2017;13(8):1895-1901.
34. Fokoun C. Strategies Implemented to Address Vaccine Hesitancy in France: A Review Article. Human Vaccines &Immunotherapeutics. 2018;14(7):1580-1590.
35. Stockwell MS, Fiks AG. Utilizing Health Information Technology to Improve Vaccine Communication and Coverage. Human Vaccines &Immunotherapeutics. 2013;9(8):1802-1811.
36. Brunelli L, Antinolfi F, Malacarne F, Cocconi R, Brusaferro S. A Wide Range of Strategies to Cope with Healthcare Workers' Vaccine Hesitancy in A North-Eastern Italian Region: Are They Enough? Healthcare (Basel). 2020;9(1).
37. Kumar D, Chandra R, Mathur M, Samdariya S, Kapoor N. Vaccine Hesitancy: Understanding Better to Address Better. Israel Journal of Health Policy Research. 2016;5.
38. Novoa Jurado AJ. Vaccine Hesitancy and Democracy. Aten Primaria. 2017;49(3):127-128.
39. Rezza G. Mandatory Vaccination for Infants and Children: the Italian Experience. Pathog Glob Health. 2019;113(7):291-296.
40. Mahase E. Vaccine Hesitancy: an Interview with Stanley Plotkin, Rubella Vaccine Developer. BMJ. 2019;367:l6926.
41. Ward JK, Peretti-Watel P, Bocquier A, Seror V, Verger P. Vaccine Hesitancy and Coercion: All Eyes on France. Nature Immunology. 2019;20(10):1257-1259.
42. Bryden G, Browne M, Rockloff M, Unsworth C. The Privilege Paradox: Geographic Areas With Highest Socio-Economic Advantage Have the Lowest Rates of Vaccination. Vaccine. 2019;37(32):4525-4532.