Журнал «Здоровье ребенка» 7 (50) 2013

Early age children remain the target population for vaccination due to the high risk of morbidity and mortality. However, one of the current problems of vaccination is increased number of parental refusals. The increase of negative attitudes towards active immunization of children occurs in spite of clear medical and social efficacy of vaccination.

Objective: to identify the main causes of parent refusal from active immunization of children to develop targeted sanitary and prophylactic activities which will facilitate formation of positive attitude of parents towards vaccination.

We conducted a social psychological survey of 170 respondents (41 male and 129 female) who have different attitude to the necessity for active immunization.

In accordance with the attitude to immunization, all of the parents were divided into 3 groups:

1) The parents with positive attitude to vaccination (108 people);

2) The parents with negative attitude to vaccination (39 people);

3) The parents with uncertain attitude to vaccination (23 people).

Each participant in the survey was suggested 55 questions of anonymous questionnaire that was developed in collaboration with the staff of the Dnepropetrovsk center of psycho-physiological research.

According to the survey, the number of parents who have ever refused to vaccinate their child, was 23% of all respondents (including 2 people from the first group, 23 people from the second group and 6 people from the third group).

In the course of the survey 245 children's vaccination history was studied (the total number of children of all respondents). According to our data, not fully vaccinated children were 3.3% (8 people). Partially vaccinated children made up to 48.6% (119 people), while 3.3% (8 children) were vaccinated with BCG vaccine alone.

Depending on the attitude of parents towards vaccination rates were the following:

• In the first group of respondents (parents with positive attitude to vaccination), 88 children (56.8%) were vaccinated according to the schedule, 65 children (41.9%) were vaccinated by individual schedule, 1 child (0.65%) was only vaccinated at hospital and 1 child (0.65%) did not receive any vaccinations;

• In the second group (parents with negative attitude to vaccination) only 8 children (12.6%) were vaccinated according to immunization schedule, 45 (70.3%) were vaccinated by the individual schedule (most of them were only vaccinated with BCG and DPT-1, 2, 3), 5 children (7.8%) were vaccinated only in the hospital and 6 children (9.3%) were not vaccinated;

• In the third group (parents with uncertain attitude to vaccination), 10 children (45.5%) were vaccinated appropriate to the schedule, 10 children (45.5%) were vaccinated according to the individual schedule, 2 (9%) were only vaccinated in the hospital.

We analyzed the reasons for the adoption of negative attitude to vaccination in children; the assessment of the extend of influence of certain medical and social factors on the attitudes of parents towards immunization.

According to the results of the survey the following reasons for refusal from vaccination are highlighted:

• conviction in low quality of domestic vaccines - 3%;

• skepticism towards traditional medicine and pharmaceutical industry - 3%;

• fear of possible development of vaccine-related complications - 32%;

• complete lack of understanding why the child should be vaccinated - 2%;

• the opinion that -

- An active immunization is useless - 10%;

- Vaccination is not necessary because such diseases as diphtheria, polio, whooping cough, mumps, tetanus are rare in this country - 2%;

- Vaccines weaken the immune system - 10%;

- Several components of vaccine in the same syringe is too much load on the child's immunity - 9%;

- Vaccinations possess the threat for spiritual and mental development of the child - 2%;

• one’s own negative experience of vaccinations - 6%;

• Information received from media materials, from relatives and friends, about specific cases of complications or death, resulting from vaccination - 16%;

• advice of a physician to refuse vaccination - 8%.

To assess the effects of certain medical and social factors (parental age, level of education, occupation, etc.) on the formation of attitudes of parents towards immunization relative risk (RR) of negative decision regarding vaccination was calculated.

Analyzing the factors influencing the formation of parents’ attitudes towards immunization, it should be noted that the outreach of physicians should be first done in the groups with the highest relative risk (RR) of negative decision regarding vaccination, which will significantly increase the level of childhood immunization.

Resume

1. The main reasons for refusal from vaccination are the following: fear of possible complications development, the false belief that the performance of active immunization is useless, that the vaccines weaken the immune system; negative information from media materials, from relatives and friends about specific cases of complications or death resulting from vaccination, as well as unqualified doctor's advice to refuse the vaccination.

2. Risk group of unfavorable attitude to active immunization comprise those with incomplete higher education, high financial income, low level of medical education, small town inhabitants towns, middle level healthcare professionals, transportation workers and economists.

3. Individual health education to create positive attitude towards immunization should be carried out, especially in the groups of parents who have a high diagnostic rate of negative influence on the formation of attitudes towards vaccination.

4. It is necessary to strengthen the cooperation of the medical community and the media in the promotion of active immunization, as there is no alternative method of prevention of major infectious diseases. Vaccination simulates the infectious process with predictable favorable outcome and prevents the possibility of further development of certain diseases that can occur with an unpredictable outcome.