FACTORS AFFECTING ANTI-VACCINATION

Yıl 2019, , 244 - 258, 14.05.2019

Gülsüm Hatice Yüksel , Ahmet Topuzoğlu

https://doi.org/10.35232/estudamhsd.525983

Cited By: 30

Öz

The main purpose of health
services is to protect the health of individuals and prevent diseases. One of
the most important public health practices in the prevention of infectious
diseases is vaccination. The success of childhood vaccination programs in our
country is very high. Increasing concerns about vaccination in recent years are
noteworthy. Elimination of concerns about vaccination practices; achieving the
objectives of the Extended Immunization Program is important to protect the
community against diseases with death and serious complications. Although there
is an increase in vaccination rates in our country, as in many countries,
hesitations about vaccines are increasing. Therefore, the need to revise the
factors that affect the vaccination has arisen. In 2012, the World Health Organization
established a commission to investigate vaccination rejections. According to
the report prepared as a result of the work of this commission, vaccine
rejection and vaccine hesitancy are defined as different concepts. This
concept, which is a combination of many social, cultural, political and
personal factors, affects the continuity and successful implementation of
vaccination practices. In a number of studies, the reasons for rejecting,
delaying or hesitating the vaccination of the children of their parents were
investigated. In vaccination rejections, parents' lack of knowledge is one of
the most important reasons. Physicians play an important role in parental
education as the most reliable source of information on vaccination. Although
the safety of the contents of the vaccines has been demonstrated by studies,
the public opinion on the vaccination schedule was determined by the vaccine
producers. The fact that diseases and complications are seen less during
vaccination does not eliminate the need for vaccines. What can happen if the
vaccination is terminated is explained by the CDC's report. Studies have shown
that if parents can be informed about efficacy and risks of vaccines and
vaccination components; the potential side effects and the potential benefits
of vaccination; they can be conscious of their children.

AŞI REDLERİNİN ARTMASI VE AŞI KARŞITLIĞINI ETKİLEYEN FAKTÖRLER

Öz

Sağlık
hizmetlerinin temel amacı, bireylerin sağlığını korumak ve hastalıkları
engellemektir. Bulaşıcı hastalıkların önlenmesinde en önemli halk sağlığı
uygulamalarından biri aşılamadır. Ülkemizde çocukluk çağı aşılama
programlarının başarısı oldukça yüksektir. Aşı uygulamalarına ve etkilerine
yönelik son yıllarda artan endişeler dikkat çekmektedir. Aşı uygulamalarına
yönelik endişelerin giderilmesi; GBP hedeflerine ulaşılabilmesi, toplumu
ölüm ve ciddi komplikasyon riskleri olan hastalıklara karşı korumak için
önemlidir. Ülkemizde aşılanma oranlarında artış olsa da birçok ülkede olduğu
gibi aşılar konusunda tereddütler artmaktadır. Bu nedenle aşı uygulamalarını
etkileyen faktörlerin yeniden gözden geçirilmesi ihtiyacı doğmuştur.

Aşı
redlerinde, ebeveynlerin bilgisiz olması en önemli nedenlerden biridir. Aşılama
konusunda en güvenilir bilgi kaynağı olarak hekimler, ebeveyn eğitiminde önemli
bir rol oynamaktadır. Aşıların içeriğinin güvenilirliği her ne kadar yapılan
çalışmalarla ortaya konmuş olsa da, aşı takviminin aşı üreticileri tarafından
belirlendiğine dair kamuoyunu meşgul eden görüşler ortaya atılmıştır. Aşılama
sonucunda hastalıkların ve komplikasyonlarının daha az görülüyor olması, aşıya
olan ihtiyacı ortadan kaldırmamaktadır. Aşılamaya son verilmesi halinde neler
olabileceği CDC’nin raporuyla açıklanmıştır.

İncelenen
çalışmalar göstermiştir ki, ebeveynlerin çocukluk çağı aşılamaları hakkında,
özellikle aşıların ve aşı bileşenlerinin etkinliğine; olası yan etkiler ve
aşılamanın yararları gibi risklere ilişkin yeterince bilgilendirilmesi,
çocuklarını aşılatma konusunda bilinçli bir seçim yapmalarını sağlayabilir.

Anahtar Kelimeler

aşı, aşılama, bağışıklama, aşı reddi, aşı tereddüdü, aşı uyumu, aşı karşıtlığı, aşı güvenliği

Kaynakça

• 1. http://www.halksagligi.hacettepe.edu.tr; Hacettepe Üniversitesi. Halk Sağlığı Kavramı. (Erişim Tarihi: 06.10.2018)
• 2. http://www.healthypeople. gov/2020/topicsobjectives/topic/immunization-and- infectious-diseases; Healthy People. Immunization and infectious diseases. (Erişim Tarihi: 29.10.2018)
• 3. UNICEF, Türkiye’de Çocukların Durumu Raporu (2011). s.36.
• 4. WHO, UNICEF, World Bank State of the World’s Vaccines and İmmunization, 3rd Ed. Geneva, World Health Organization, 2009
• 5. T.C. Sağlık Bakanlığı. Genişletilmiş Bağışıklama Programı Genelgesi. Ankara. 2009
• 6. Kutlu R. Çocukluk Çağı Aşıları; Childhood Vaccinations; Turkiye Klinikleri J Fam Med-Special Topics 2017;8(5):311–8.
• 7. http://millipediatri.org.tr ; Ülkemizde Güncel Aşılama. (Erişim tarihi 23.10.2018)
• 8. Haverkate M., D’Ancona F., Giambi C., Johansen K., Lopalco PL., Cozza V., Appelgren E. (2012) Results of the VENICE 2010 Survey on the Ways of Implementing National Vaccination Programmes. EuroSurveill 2018;17(22):1–3.
• 9. http://www.who.int/mediacentre/factsheets/fs378/en/ (Erşim tarihi: 08.11.2018)
• 10. https://www.saglik.gov.tr/TR,11080/genisletilmis-bagisiklama- programi-genelgesi.html (Erişim tarihi: 15.12.2018)
• 11. Topaç O. Ülkemizde Aşı Uygulamaları Genişletilmiş Bağışıklama Programı 23-25 EKİM 2017 6. Puader Kongresi / ANTALYA
• 12. Boom, Julie A., Cunningham, Rachel M. Understanding and Managing Vaccine Concerns.2014, VI.
• 13. WHO, The SAGE Vaccine Hesitancy Working Group What Influences Vaccine Acceptance: A Model of Determinants of Vaccine Hesitancy (Erişim Tarihi: 16.12.2018)
• 14. Larsona HJ., Jarrett C., Schulz WS, Chaudhuri M., Zhouc Y., Dube E., Schuster M., MacDonaldf NE., Wilsona R., the SAGE Working Group on Vaccine Hesitancy. Measuring vaccine hesitancy: The development of a survey tool. Vaccine 33(2015)4165–4175
• 15. http://www.ttb.org.tr/halk_sagligi/2018/04/13/saglik-bakanligini-asilama-konusunda-goreve-davet-ediyoruz/ (Erişim Tarihi: 09.12.2018)
• 16. Kestenbaum and Feemster; Identifying and Addressing Vaccine Hesitancy; Pediatr Ann. 2015 April; 44(4)
• 17. Chephra McKee, PharmD and Kristin Bohannon BS; Exploring the Reasons Behind Parental Refusal of Vaccines; J Pediatr Pharmacol Ther 2016;21(2):104–109
• 18. Irene A. Harmsen, Robert A. C. Ruiter, Theo G. W. Paulussen, Liesbeth Mollema, Gerjo Kok and Hester E. de Melker; Factors That Influence Vaccination Decision-Making by Parents Who Visit an Anthroposophical Child Welfare Center: A Focus Group Study; Advances in Preventive Medicine Volume 2012, Article ID 175694
• 19. Jennifer A Reich; "We are fierce, independent thinkers and intelligent": Social capital and stigma management among mothers who refuse vaccines.; Soc Sci Med. 2018 Oct 30. pii: S0277-9536(18)30623-3. doi: 10.1016/j.socscimed.2018.10.027.
• 20. Kajetanowicz A, Kajetanowicz A; Why parents refuse immunization?; Wiad Lek. 2016;69(3 Pt 1):346-51.
• 21. Saad B. Omer, M.B., B.S., Ph.D., M.P.H., Daniel A. Salmon, Ph.D., M.P.H., Walter A. Orenstein, M.D., M. Patricia deHart, Sc.D., and Neal Halsey, MD.; Vaccine Refusal, Mandatory Immunization, and the Risks of Vaccine-Preventable Diseases; N Engl J Med 2009;360:1981-8.
• 22. Redsell SA, Bedford H, Siriwardena AN, Collier J, Atkinson P; Exploring communication strategies to use with parents on childhood immunisation.; Nurs Times. 2010 May 18-24;106(19):19-22.
• 23. Tymińska J1, Wysocki J2. Is one minute enough to convince parents to vaccinate their child? Przegl Epidemiol. 2017;71(3):439-455.
• 24. Moran MB, Frank LB, Chatterjee JS, Murphy ST, Baezconde-Garbanati L; Information scanning and vaccine safety concerns among African American, Mexican American, and non-Hispanic White women; Patient Educ Couns. 2016 Jan;99(1):147-53. doi: 10.1016/j.pec.2015.08.016. Epub 2015 Aug 18.
• 25. Henrikson NB, Anderson ML, Opel DJ, Dunn J Marcuse EK, Grossman DC; Longitudinal Trends in Vaccine Hesitancy in a Cohort of Mothers Surveyed
in Washington State, 2013-2015; Public Health Rep. 2017 Jul/Aug;132(4):451-454. doi: 10.1177/0033354917711175. Epub 2017 Jun 6.
• 26. Repalust A, Šević S, Rihtar S, Štulhofer A ; Childhood vaccine refusal and hesitancy intentions in Croatia: insights from a population-based study. Psychol Health Med. 2017 Oct;22(9):1045-1055. doi: 10.1080/13548506.2016.1263756. Epub 2016 Nov 29.
• 27. Irene A. Harmsen I, Robert A. C. Ruiter, Theo G. W. Paulussen, Liesbeth Mollema, Gerjo Kok, and Hester E. de Melker; Factors That Influence Vaccination Decision-Making by Parents Who Visit an Anthroposophical Child Welfare Center: A Focus Group Study; Adv Prev Med. 2012;2012:175694. doi: 10.1155/2012/175694. Epub 2012 Nov 20.
• 28. Smith PJ, Humiston SG, Marcuse EK, Zhao Z, Dorell CG, Howes C, Hibbs B; Parental delay or refusal of vaccine doses, childhood vaccination coverage at 24 months of age, and the Health Belief Model; Public Health Rep. 2011 Jul-Aug;126 Suppl 2:135-46.
• 29. Leib S, Liberatos P, Edwards K; Pediatricians' experience with and response to parental vaccine safety concerns and vaccine refusals: a survey of Connecticut pediatricians; Public Health Rep. 2011 Jul-Aug;126 Suppl 2:13-23
• 30. Gomez PL, Robinson JM, Rogalewicz JA. Vaccine manufacturing. In: Plotkin SA, Orenstein WA, Offit PA (eds). Vaccines. 6th ed. China: Elsevier, 2013:44-57
• 31. Gomez PL, Robinson JM, Rogalewicz JA. Vaccines. 6th ed. China: 2013.
• 32. Vaccine Knowledge Project-University of Oxford. (Erişim tarihi: 29.12.2018.)
• 33. Töreci K. Aşıların tarihçesi. Badur S, Bakır M (editörler). Aşı Kitabı. 1. Baskı. İstanbul: Akademi Yayıncılık, 2012:1-12.
• 34. Jacobson RM, St. Sauver JL, Finney Rutten LJ. Vaccine Hesitancy. Mayo Clin Proc 2015;90(11):1562-8
• 35. Centers for Disease Control and Prevention. (Erişim tarihi: 10.12.2018)
• 36. (Centers for Disease Control and Prevention. (Erişim tarihi: 09.01.2019)
• 37. Pharmaceutical Research and Manufacturers of America; http://phrma-docs. phrma.org/sites/default/files/pdf/PhRMA_Vaccine_FactBo- ok_2013.pdf. (Erişim tarihi: 28.12.2018.
• 38. Oak Ridge Institute for Science and Education. https://www.orau.gov/ cdcynergy/web/im/Content/activeinformation/resources/ IM_what_would_hpn.pdf. (Erişim tarihi: 28.12.2018)
• 39. Wolfe RM, Sharp LK, Lipsky MS. Content and design attribu- tes of antivaccination web sites. JAMA 2002;287(24):3245- 8.
• 40. Vademecum online; Pegasys Sc ve Euvax B Ürün Bilgileri; (Erişim tarihi: 15.12.2018)
• 41. Karafillakis E, Larson HJ; ADVANCE consortium. The benefit of the doubt or doubts over benefits? A systematic literature review of perceived risks of vaccines in European populations. Vaccine 2017;35(37):4840-50].
• 42. Allan N, Harden J. Parental decision-making in uptake of the MMR vaccination: a systematic review of qualitative li- terature. J Public Health (Oxf) 2015;37(4):678-87.
• 43. Gerber JS, Offit PA. Vaccines and autism: a tale of shifting hypotheses. Clin Infect Dis 2009;48(4):456-61.)
• 44. Kutlu H.H, Altındiş M, Anti-Vaccination; FLORA 2018;23(2):47-58; doi: 10.5578/flora.6635545. Bernard S, Enayati A, Roger H, Binstock T, Redwood L. The role of mercury in the pathogenesis of autism. Mol Psychi- atry 2002;7(Suppl 2): S42-S43.)
• 46. Yurdakök K. Thiomersal ve aşılar; Hacettepe Tıp Derg 2006; 37:35-42.
• 47. DeStefano F. Thimerosal-containing vaccines: evidence versus public apprehension; Expert Opin Drug Saf 2009;8(1):1-4
• 48. Price CS, Thompson WW, Goodson B, Weintraub ES, Croen LA, Hinrichsen VL, et al. Prenatal and infant exposure to thimerosal from vaccines and immunoglobulins and risk of autism. Pediatrics 2010;126(4):656-64.
• 49. Centers for Disease Control and Prevention, Science Summary: CDC Studies on Thiomerosal in Vaccines. (Erişim tarihi: 05.12.2018)
• 50. Gołos A, Lutynska A. Aluminium-adjuvanted vaccines, a review of the current state of knowledge; Przegl Epidemiol 2015;69(4):731-4, 871-4
• 51. Yenen OŞ. Aşı adjuvanları. Badur S, Bakır M (editörler). Aşı Kitabı. 1. Baskı. İstanbul: Akademi Yayıncılık, 2012:139-68.
• 52. Offit PA, Moser CA. The problem with Dr Bob’s alternative vaccine schedule. Pediatrics 2009;123(1): e164-9.
• 53. Flarend RE, Hem SL, White JL, Elmore D, Suckow MA, Rudy AC, et al. In vivo absorption of aluminium-containing vacci- ne adjuvants using 26Al. Vaccine 1997;15(12-13):1314-8
• 54. Global Advisory Committee on Vaccine Safety (GACVS): aluminium adjuvants. Weekly Epidemiological Record 2012;87(30):277-88.)
• 55. Badur S. Aşı karşıtı gruplar ve aşılara karşı yapılan haksız suçlamalar. ANKEM Derg 2011;25(Ek 2): E82-E86.
• 56. Zerbo O, Modaressi S, Goddard K, Lewis E, Fireman BH, Daley MF, Irving SA, Jackson LA, Donahue JG, Qian L, Getahun D, DeStefano F, McNeil MM, Klein NP; Vaccination Patterns in Children After Autism Spectrum Disorder Diagnosis and in Their Younger Siblings; JAMA Pediatr. 2018 May 1;172(5):469-475. doi: 10.1001/jamapediatrics.2018.0082.
• 57. Joan Gilmour, LLB, JSD, a Christine Harrison, MA, PHD, b Leyla Asadi, MD, c Michael H. Cohen, JDA, MBA, d and Sunita Vohra, MD, MSce, f; Childhood immunization: when physicians and parents disagree; Pediatrics November 2011, VOLUME 128 / ISSUE Supplement 4
• 58. Alexander K, Lacy TA, Myers AL, Lantos JD.; Should Pediatric Practices Have Policies to Not Care for Children With Vaccine-Hesitant Parents?; Pediatrics. 2016 Oct;138(4). pii: e20161597. Epub 2016 Sep 2.
• 59. Rossen I, Hurlstone MJ, Lawrence C.; Going with the Grain of Cognition: Applying Insights from Psychology to Build Support for Childhood Vaccination.; Front Psychol. 2016 Sep 30;7:1483. eCollection 2016.