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Qualitative Assessment of Vaccination Hesitancy Among Members of the Apostolic Church of Zimbabwe: A Case Study

机译:津巴布韦使徒教会成员中疫苗接种犹豫的定性评估:一个案例研究

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摘要

Vaccine hesitancy or lack of confidence in vaccines is considered a threat to the success of vaccination programs. The rise and spread of measles outbreaks in southern Africa in 2009–2010 were linked to objections among Apostolic Church members, estimated at about 3.5 million in Zimbabwe as of 2014. To inform planning of interventions for a measles–rubella vaccination campaign, we conducted an assessment of the factors contributing to vaccine hesitancy using data from various stakeholders. Among nine districts in three regions of Zimbabwe, we collected data on religious attitudes toward, and perceptions of, vaccines through focus group discussions with health workers serving Apostolic communities and members of the National Expanded Programme on Immunization; semi-structured interviews with religious leaders; and open-ended questions in structured interviews with Apostolic parents/caregivers. Poor knowledge of vaccines, lack of understanding and appreciation of the effectiveness of vaccinations, religious teachings that emphasize prayers over the use of medicine, lack of privacy in a religiously controlled community, and low levels of education were found to be the main factors contributing to vaccine hesitancy among key community members and leaders. Accepting vaccination in public is a risk of sanctions. Poor knowledge of vaccines is a major factor of hesitancy which is reinforced by religious teachings on the power of prayers as alternatives. Because parents/caregivers perceive vaccines as dangerous for their children and believe they can cause death or disease, members of the Apostolic Church have more confidence in alternative methods such as use of holy water and prayers to treat diseases. Under these circumstances, it is important to debunk the myths about the power of holy water on the one hand and disseminate positive information of the efficacy of vaccines on the other hand in order to reduce hesitancy. Education about vaccines and vaccination in conjunction with government intervention, for example, through the use of social distancing policies can provide a framework for reducing hesitancy and increasing demand for vaccination.
机译:疫苗犹豫或对疫苗缺乏信心被视为对疫苗接种计划成功的威胁。 2009-2010年南部非洲麻疹暴发的蔓延和蔓延与使徒教会成员之间的反对有关,据估计,截至2014年,津巴布韦约有350万。我们为开展针对麻疹-风疹疫苗接种运动的干预计划提供了信息,使用来自各利益相关方的数据评估导致疫苗犹豫的因素。在津巴布韦三个地区的九个地区中,我们通过与为使徒社区服务的卫生工作者和国家免疫规划扩大计划的成员进行的焦点小组讨论,收集了有关疫苗对宗教态度和观念的数据。对宗教领袖的半结构化访谈;以及与使徒父母/看护者进行的结构化访谈中的开放式问题。人们发现,疫苗知识不足,对疫苗接种的有效性缺乏了解和欣赏,强调对药物使用进行祈祷的宗教教义,在宗教控制下的社区缺乏隐私以及教育水平低是造成这种情况的主要因素。关键社区成员和领导人对疫苗犹豫不决。在公共场所接受疫苗接种有受到制裁的风险。疫苗知识不佳是犹豫的一个主要因素,有关宗教信仰的祷告教义替代了这一点,这加剧了犹豫。由于父母/照顾者认为疫苗对孩子有危险,并认为它们会导致死亡或疾病,使徒教会的成员对使用替代方法(例如使用圣水和祈祷来治疗疾病)更有信心。在这种情况下,一方面要揭开关于圣水功效的神话,另一方面要传播有关疫苗功效的积极信息,以减少犹豫,这一点很重要。与政府干预相结合的有关疫苗和疫苗接种的教育,例如,通过使用社会疏远政策,可以提供一个减少犹豫和增加疫苗接种需求的框架。

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