Bir Üniversitenin Eğitim Aile Sağlığı Merkezlerinde Aşı Reddi

Year 2020, Volume: 12 Issue: 3, 430 - 434, 20.10.2020

Mehmet Akif Nas , Gökburak Atabay , Furkan Şakiroğlu , Yasemin Çayır

https://doi.org/10.18521/ktd.744687

Cited By: 3

Abstract

Amaç: Bu çalışmada bir Aile Hekimliği Anabilim Dalı’na bağlı Eğitim Aile Sağlığı Merkezleri'nde (EASM) aşı reddi oranlarının ve etkileyen faktörlerin belirlenmesi amaçlanmıştır.

Yöntem: Bu çalışma karma bir araştırma olarak tasarlanmış ve Atatürk Üniversitesi Aile Hekimliği Anabilim Dalı'nın iki EASM’sinde yürütülmüştür. Çalışmaya 2018 yılında Sağlık Bakanlığı'nın Genişletilmiş Bağışıklık Programı kapsamında yapılması gerekli aşılardan en az birini almayan ebeveynler dahil edilmiştir. Veri toplama yöntemi olarak telefonda yarı yapılandırılmış görüşme tekniği kullanılmış ve içerik analizi uygulanmıştır. Çalışmaya katılmaya gönüllü 6 ebeveyn ile derinlemesine bir görüşme yapılmıştır.

Bulgular: Her iki ebeveyn için ortalama yaş 30±1.2 yıldı. Aşı reddi yapan tüm ebeveynler (n=6) üniversite mezunuydu. Ebeveynlerin %66,7'si (n=4) yüksek gelir düzeyine sahipti. 2018 yılında aşılanması gereken 0-16 yaş arası 749 çocuğun tıbbi kayıtlarına göre, 9 çocukta (%1,2) en az bir aşının eksik olduğu gözlendi. Dört çocuğa aşıya güvensizlik nedeniyle aşı yapılmamıştı. Ebeveynlerden üçü ise önceki aşılardan sonra gelişen komplikasyonlar nedeniyle aşılamayı reddetmişti.

Sonuç: EASM'lerde aşı reddi oranları düşük bulundu ve aşı reddi yapan ebeveynlerin sosyoekonomik düzeyleri yüksekti. Aşı reddini etkileyen en önemli faktörler, aşı içeriğine duyulan güvensizlik ve aşılar hakkında yetersiz bilgi idi.

Keywords

aşı reddi, aşı kararsızlığı, aşı karşıtı ebeveyn, aile sağlığı merkezi

Vaccine Rejection In A University’s Training Family Health Centers

Abstract

Objective: It was aimed to determine the vaccine rejection rates and affecting factors in the Training Family Health Centers (TFHC) affiliated with a department of family medicine.

Method: This study was designed as a mixed research and conducted in two TFHC of Department of Family Medicine of Ataturk University. In 2018, parents who did not receive at least one of the vaccines required under the Ministry of Health's Extended Immunity Program were included. Semi-structured interview technique was used on the telephone as the data collection method. Content analysis was applied statistically. It was observed that in 9 children at least one vaccine was missing. An in-depth interview was done with 6 volunteering parents.

Results: The mean age was 30±1.2 years for both parents. All parents (n=6) who refused vaccination were university graduates. 66.7% of the parents (n=4) had high monthly income. Missing vaccinations were observed in 3 (3.3%) out of 89 children aged 0-2 years registered to the TFHC-1 (3 units), and 4 (1.32%) of 301 children between the ages of 0-2 registered to the second TFHC-2 (2 units). Four children were not vaccinated due to distrust to the vaccine. Three of the parents refused vaccination due to complications developed after previous vaccinations. One parent rejected the immunization due to the different schedules between countries and changes in the schedules. One parent thought that the vaccine was not so important because it was not obligatory. One child was not vaccinated because he was afraid of vaccination.

Conclusion: Vaccine rejection rates were found low in our TFHCs and socioeconomic levels of those who rejected the vaccine were high. The most important factors affecting vaccine rejection were the lack of confidence in the vaccine content and insufficient information about vaccines.

Keywords

vaccine rejection, vaccine hesitancy, anti-vaccination parents, family health center

References

• 1. Omer SB, Salmon DA, Orenstein WA, Dehart MP, Halsey N. Vaccine refusal, mandatory immunization, and the risks of vaccine-preventable diseases. New England Journal of Medicine. 2009;360(19):1981-8.
• 2. Larson HJ, Jarrett C, Schulz WS, Chaudhuri M, Zhou Y, Dube E, et al. Measuring vaccine hesitancy: the development of a survey tool. Vaccine. 2015;33(34):4165-75.
• 3. World Health Organisation. Ten Threats to Global Health in 2019. Erişim tarihi:11.06.2019 https://www.who.int/emergencies/ten-threats-to-global-health-in-2019.
• 4. Bozkurt HB. Aşı Reddine Genel Bir Bakış ve Literatürün Gözden Geçirilmesi. KAFKAS.71.
• 5. Blume S. Anti-vaccination movements and their interpretations. Social science & medicine. 2006;62(3):628-42.
• 6. Black S, Rappuoli R. A crisis of public confidence in vaccines. American Association for the Advancement of Science; 2010.
• 7. Larson HJ, Jarrett C, Eckersberger E, Smith DM, Paterson P. Understanding vaccine hesitancy around vaccines and vaccination from a global perspective: a systematic review of published literature, 2007–2012. Vaccine. 2014;32(19):2150-9.
• 8. Fefferman NH, Naumova EN. Dangers of vaccine refusal near the herd immunity threshold: a modelling study. The Lancet Infectious Diseases. 2015;15(8):922-6.
• 9. Dubé E, Gagnon D, Nickels E, Jeram S, Schuster M. Mapping vaccine hesitancy—Country-specific characteristics of a global phenomenon. Vaccine. 2014;32(49):6649-54.
• 10. Türkiye Cumhuriyeti Sağlık Bakanlığı. Genişletilmiş Bağışıklama Programı Genelgesi. Erişim Tarihi: 16.06.2019 https://dosyasb.saglik.gov.tr/Eklenti/1117,gbpgenelge2008pdf.pdf [11.06.2019]. Available from: https://dosyasb.saglik.gov.tr/Eklenti/1117,gbpgenelge2008pdf.pdf.
• 11. Altınkaynak S, Ertekin V, Güraksın A, Kılıc A. Effect of several sociodemographic factors on measles immunization in children of Eastern Turkey. Public health. 2004;118(8):565-9.
• 12. Topçu S, Almış H, Başkan S, Turgut M, Orhon FŞ, Ulukol B. Evaluation of childhood vaccine refusal and hesitancy intentions in Turkey. The Indian Journal of Pediatrics. 2019;86(1):38-43.
• 13. 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 Reports. 2011;126(2_suppl):13-23.
• 14. Dubé E, Vivion M, MacDonald NE. Vaccine hesitancy, vaccine refusal and the anti-vaccine movement: influence, impact and implications. Expert review of vaccines. 2015;14(1):99-117.
• 15. Taddio A, Ipp M, Thivakaran S, Jamal A, Parikh C, Smart S, et al. Survey of the prevalence of immunization non-compliance due to needle fears in children and adults. Vaccine. 2012;30(32):4807-12.
• 16. Benin AL, Wisler-Scher DJ, Colson E, Shapiro ED, Holmboe ES. Qualitative analysis of mothers' decision-making about vaccines for infants: the importance of trust. Pediatrics. 2006;117(5):1532-41.
• 17. Marlow LA, Waller J, Wardle J. Trust and experience as predictors of HPV vaccine acceptance. Human vaccines. 2007;3(5):171-5.
• 18. van der Weerd W, Timmermans DR, Beaujean DJ, Oudhoff J, van Steenbergen JE. Monitoring the level of government trust, risk perception and intention of the general public to adopt protective measures during the influenza A (H1N1) pandemic in the Netherlands. BMC public health. 2011;11(1):575.
• 19. Hviid A, Hansen JV, Frisch M, Melbye M. Measles, Mumps, Rubella Vaccination and Autism: A Nationwide Cohort Study. Annals of internal medicine. 2019.
• 20. Taylor LE, Swerdfeger AL, Eslick GD. Vaccines are not associated with autism: an evidence-based meta-analysis of case-control and cohort studies. Vaccine. 2014;32(29):3623-9.
• 21. Türkiye Cumhuriyeti Sağlık Bakanlığı. Aşı İçerikleri. Erişim Tarihi: 16.06.2019 https://asi.saglik.gov.tr/genel-bilgiler/36-asi-icerikleri.html.
• 22. Hoffman BL, Felter EM, Chu K-H, Shensa A, Hermann C, Wolynn T, et al. It’s not all about autism: The emerging landscape of anti-vaccination sentiment on Facebook. Vaccine. 2019.
• 23. The LCAH. Vaccine hesitancy: a generation at risk. The Lancet Child & adolescent health. 2019;3(5):281.
• 24. BBC. YouTube takes ads off 'anti-vax' video channels. Erişim Tarihi: 17.06.2019 https://www.bbc.com/news/technology-47357252.
• 25. Zimmerman LA, Muscat M, Singh S, Mamou MB, Jankovic D, Datta S, et al. Progress toward measles elimination—European Region, 2009–2018. Morbidity and Mortality Weekly Report. 2019;68(17):396.
• 26. Thornton J. Measles cases in Europe tripled from 2017 to 2018. British Medical Journal Publishing Group; 2019.
• 27. European Centre for Disease Prevention and Control. Measles. Erişim Tarihi: 02.07.2019 https://ecdc.europa.eu/en/measles.