Can Vaccine Rejection, an Increasing Danger to Public Health, be Prevented?

Yıl 2019, Cilt: 17 Sayı: 3, 424 - 434, 02.12.2019

Mustafa Volkan Düzgün Ayşegül İşler Dalgıç

Öz

Vaccination is an effective,
cost-effective, and accepted method for reducing mortality and morbidity of
various diseases. It is also considered one of the most important achievements
of public health. The World Health Organization's March 2018 report states that
global immunization prevents 2-3 million deaths annually, proving how important
vaccination is important to public health. Although the proven benefits of
vaccination are well known, there has been a global decline in immunization
rates in childhood in recent years. According to 2017 data in Europe, the
number of measles cases increased approximately threefold compared to the
previous year and 87% of the diagnosed cases refused to be vaccinated. The
immunization rate with pertussis, tetanus and diphtheria vaccines has decreased
to 92% in Europe and  91% in the US.  In Turkey, it was determined that the overall vaccination
rates declined. Immunization rates of measles, rubella, mumps, diphtheria,
acellular pertussis, tetanus, conjugated pneumococcal and hepatitis B vaccines
decreased from 98% in 2016 to 96% in the following year. The World Health
Organization has included vaccine rejection among the 10 global problems
identified for 2019. A multidisciplinary effort is needed to reduce vaccine
hesitation and increase vaccination rates in the community. In this context,
preventing anti-vaccination is a social responsibility and it imposes important
duties for health personnel, media workers and even politicians. Although there
are studies on the causes of vaccine rejection in the literature, no studies have
been found to prevent it.The purpose of this review is to suggest interventions
to prevent anti-vaccine in line with the reasons for vaccine rejection and
hesitation.Vaccine rejection and hesitations are thought to be prevented by
interventional studies in line with the recommendations given in the review.

Anahtar Kelimeler

Vaccine rejection, vaccination hesitation, child, anti-vaccination, immunization

TOPLUM SAĞLIĞI İÇİN GİDEREK ARTAN TEHLİKE AŞI REDDİ ÖNLENEBİLİR Mİ?

Öz

Aşılama çeşitli
hastalıkların mortalite ve morbiditesini azaltmada etkili, uygun maliyetli ve
kabul edilmiş bir yöntem olarak toplum sağlığının en önemli başarıları arasında
gösterilmektedir. Dünya Sağlık Örgütü’nün Mart 2018 raporunda küresel
bağışıklamanın yılda 2–3 milyon ölümü engellediği açıklaması aşılamanın toplum
sağlığı için ne kadar önemli olduğunun bir göstergesidir. Son yıllarda
aşılamanın kanıtlanmış faydaları iyi bilinmesine rağmen çocukluk çağındaki
aşılanma oranlarında global bir düşüş yaşanmaktadır. Avrupa’da 2017 verilerine
göre kızamık vaka sayısı bir önceki yıla göre yaklaşık üç kat arttığı ve tanı
alan vakaların %87’sinin aşılanmayı reddettiği tespit edilmiştir. Yine
Avrupa’da boğmaca, tetanoz ve difteri aşısı ile bağışıklama oranı %92’ye,
Amerika’da %91’e kadar düşmüştür. Türkiye’de ise genel aşılanma oranlarında
düşüş yaşandığı belirlenmiştir. Kızamık, kızamıkçık, kabakulak, difteri,
aselüler boğmaca, tetanoz, konjuge pnömokok ve hepatit B aşıları ile
bağışıklama oranları 2016 yılında %98 iken sonraki yılda %96’ya gerilemiştir.
Bu nedenle DSÖ 2019 yılı için belirlediği 10 küresel sorun içerisinde aşı
reddine de yer vermiştir. Bu bağlamda aşı karşıtlığını önlemek toplumsal bir
sorumluluk olup sağlık personelinden, medya çalışanlarına hatta politikacılara
önemli görevler düşmektedir. Literatürde aşı reddinin nedenlerine yönelik
çalışmalar olmakla birlikte önlemeye yönelik herhangi bir çalışmaya
rastlanılmamıştır. Bu derlemenin amacı aşı ret ve tereddüt nedenleri
doğrultusunda aşı karşıtlığını önlemeye yönelik girişimlerin sunulmasıdır.
Derlemede verilen öneriler doğrultusunda yapılacak girişimsel çalışmalarla aşı
ret ve tereddütlerinin önlenebileceği düşünülmektedir.

Anahtar Kelimeler

Aşı reddi, aşı tereddüdü, çocuk, aşı karşıtlığı

Kaynakça

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