Parental willingness to vaccinate their children with the influenza vaccine in Guangzhou, China
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摘要:
目的 了解广州市家长对儿童流感疫苗接种的意愿及影响因素, 为有效提高儿童流感疫苗的覆盖率提供科学依据。 方法 采用分层整群抽样方法, 按照经济水平在广州市中心和周边行政区各抽取1所中学和1所小学, 对5 133名中小学生家长进行问卷调查, 问卷内容主要包括儿童及其家长的基本情况, 家长对儿童接种流感疫苗知识的知晓情况等。 结果 14.57%(748/5 133)的家长不愿意为孩子接种流感疫苗。多因素Logistic回归显示, 与年龄≤35岁的家长相比, 41~45和≥46岁的家长不愿意为儿童接种疫苗的可能性分别增高49%(调整OR=1.49, 95% CI=1.11~2.00)和86%(调整OR=1.86, 95% CI=1.33~2.60);与家庭年收入 < 10万元的家长相比, 年收入≥20万元的家长不愿意的可能性增高52%(调整OR=1.52, 95% CI=1.12~2.06);与从家步行到接种点时间≤10 min的家长相比, 步行时间≥30 min的家长不愿意的可能性增高52%(调整OR=1.52, 95% CI=1.16~1.99);与认为疫苗安全的家长相比, 认为疫苗不太安全及不清楚安全性的家长不愿意的可能性增高(P值均 < 0.01)。 结论 家长年龄、家庭年收入、家长对流感疫苗安全性的认同度以及预防接种点与家庭住址距离等因素影响家长为儿童接种流感疫苗的意愿。医院、社区及学校应联合开展预防接种和科普宣传工作, 同时合理布局疫苗接种点, 提高流感疫苗的覆盖率。 Abstract:Objective To investigate the factors influencing parents'willingness to vaccinate their children against influenza in Guangzhou, and to provide a scientific basic for effectively improving the coverage rate of influenza vaccine in children. Methods According to economic level, one secondary school and one elementary school in each of the central administrative and peripheral districts of Guangzhou were selected by stratified cluster sampling.A questionnaire survey was conducted among 5 133 parents of the school students.Questionnaire content included the basic characteristics of children and their parents, and parents'knowledge of influenza vaccination for children. Results A total of 14.57%(748/5 133) of parents were unwilling to have their children vaccinated against influenza.The results of the multivariate Logistic regression analysis found that, compared with parents aged ≤35 years old, parents aged 41-45 years and ≥46 years were 49%(adjusted OR=1.49, 95% CI=1.11-2.00) and 86%(adjusted OR=1.86, 95% CI=1.33-2.60), respectively, more likely to refuse vaccinating their children.Parents with an annual income ≥200 000 yuan were 52% more likely to be unwilling to vaccinate their children than those with annual income < 100 000 yuan (adjusted OR=1.52, 95% CI=1.12-2.06).Parents living within a walking distance ≥30 minutes from the vaccination clinic were 52% more likely to be vaccine-reluctant than those living within a walking distance of ≤10 minutes (adjusted OR=1.52, 95% CI=1.16-1.99).Compared with parents who regarded the vaccine as safe, parents who did not believe that it was safe or who were unsure of its safety were more likely to refuse vaccinating their children, with adjusted OR (95% CI) of 12.75(9.44-17.23) and 3.37(2.73-4.15), respectively (P < 0.01). Conclusion Parents'age, annual income, recognition of the safety of influenza vaccines, and walking distance to the vaccination clinic are associated with parents'willingness to vaccinate children against influenza.Hospitals, communities and schools should cooperate to carry out vaccination and popular science propaganda, and arrange vaccination sites rationally to improve the coverage of influenza vaccines. -
Key words:
- Influenza vaccines /
- Vaccination /
- Health promotion /
- Regression analysis /
- Legal guardians /
- Child
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表 1 不同组别人群对儿童接种流感疫苗意愿报告率比较
Table 1. Comparison of reporting rate of the willingness to vaccinate children against influenza in different groups of people
组别 人数 接种意愿 χ2值 P值 组别 人数 接种意愿 χ2值 P值 家长年龄/岁 ≤10 908 803(88.44) 12.92 < 0.01 ≤35 953 850(89.19) 32.03 < 0.01 >10~ < 20 1 665 1 433(86.07) 36~40 1 935 1 679(86.77) 20~ < 30 1 083 919(84.86) 41~45 1 562 1 308(83.74) ≥30 1 477 1 230(83.28) ≥46 683 548(80.23) 家长认为学生健康状况 家长最高文化程度 健康 4 770 4 107(86.10) 24.54 < 0.01 初中及以下 1 730 1 482(85.66) 21.93 < 0.01 一般或差 363 278(76.58) 高中、中专、职校 2 313 2 018(87.25) 独生子女家庭 大学本科及以上 1 090 885(81.19) 是 875 697(79.66) 28.21 < 0.01 家长职业 否 4 258 3 688(86.61) 一方为卫生技术人员 151 117(77.48) 20.15 < 0.01 家长知识知晓水平 一方为事业单位人员 584 483(82.71) 低 3 062 2 643(86.32) 5.52 0.06 服务行业工作者 2 523 2 194(86.96) 中 1 987 1 674(84.25) 家务或待业 989 854(86.35) 高 84 68(80.95) 其他 886 737(83.18) 家长对疫苗效果看法 学生性别 100%有效 152 133(87.50) 94.82 < 0.01 男 2 698 2 285(84.69) 2.47 0.12 有一定效果 4 004 3 514(87.76) 女 2 435 2 100(86.24) 无效果或不清楚 977 738(75.54) 学生年龄/岁 家长对疫苗安全性看法 ≤10 1 922 1 672(86.99) 7.46 0.02 比较安全 3 645 3 341(91.66) 526.38 < 0.01 11~15 3 070 2 589(84.33) 不太安全 231 105(45.45) ≥16 141 124(87.94) 不清楚 1 257 939(74.70) 学生学段 近3年学生患流感 小学一至三年级 1 575 1 380(87.62) 9.03 0.01 是 1 608 1 402(87.19) 5.84 0.02 小学四至六年级 1 191 1 011(84.89) 否 3 525 2 983(84.62) 中学 2 367 1 994(84.24) 近3年学生接种流感疫苗 家庭年收入/万元 是 946 898(94.93) 84.05 < 0.01 < 10 3 634 3 133(86.21) 25.77 < 0.01 否 4 187 3 487(83.28) 10~ < 20 942 816(86.62) 近3年家长接种流感疫苗 ≥20 557 436(78.28) 是 713 639(89.62) 11.70 < 0.01 从家步行到接种点时间/min 否 4 420 3 746(84.75) 注: ()内数字为报告率/%。 表 2 家长对儿童接种流感疫苗意愿的影响因素Logistic回归分析(n=5 133)
Table 2. Logistic regression analysis on influencing factors ofparents' willingness to vaccinate children against influenza(n=5 133)
变量 粗OR值(95%CI) 调整OR值(95%CI) 变量 粗OR值(95%CI) 调整OR值(95%CI) 家长年龄/岁 从家步行到接种点时间/min ≤35 1.00 1.00 ≤10 1.00 1.00 36~40 1.26(0.99~1.61) 1.17(0.89~1.54) >10~ < 20 1.24(0.97~1.58) 1.39(0.99~1.68) 41~45 1.60(1.26~2.05)** 1.49(1.11~2.00)** 20~ < 30 1.36(1.05~1.77)* 1.31(0.98~1.74) ≥46 2.03(1.54~2.69)** 1.86(1.33~2.60)** ≥30 1.54(1.20~1.96)** 1.52(1.16~1.99)** 家长最高文化程度 独生子女家庭 初中及以下 1.00 1.00 是 1.00 1.00 高中、中专、职校 0.87(0.73~1.05) 1.08(0.88~1.32) 否 0.61(0.50~0.73)** 0.73(0.59~0.91)** 大学本科及以上 1.38(1.13~1.70)** 1.33(0.99~1.79) 家长知识知晓水平 家长职业 低 1.00 1.00 一方为卫生技术人员 1.00 1.00 中 1.18(1.01~1.38)* 1.15(0.97~1.38) 一方为事业单位人员 0.72(0.46~1.12) 0.61(0.38~1.00)* 高 1.49(0.85~2.58) 1.61(0.87~2.98) 服务行业工作者 0.52(0.35~0.77)** 0.55(0.35~0.88)* 家长对疫苗效果看法 家务或待业 0.54(0.36~0.83)** 0.46(0.28~0.75)** 100%有效 1.00 1.00 其他 0.70(0.46~1.06) 0.64(0.39~1.04) 有一定效果 0.98(0.60~1.59) 0.93(0.55~1.59) 学生年龄/岁 无效果或不清楚 2.27(1.37~3.75)** 1.29(0.74~2.26) ≤10 1.00 1.00 家长对疫苗安全性看法 11~15 1.24(1.05~1.47)** 0.84(0.59~1.21) 比较安全 1.00 1.00 ≥16 0.92(0.54~1.55) 0.67(0.34~1.30) 不太安全 13.19(9.92~17.53)** 12.75(9.44~17.23)** 学生的学段 不清楚 3.72(3.13~4.43)** 3.37(2.73~4.15)** 小学一至三年级 1.00 1.00 近3年学生患流感 小学四至六年级 1.26(1.01~1.57)* 1.07(0.76~1.51) 是 1.00 1.00 中学 1.32(1.10~1.60)** 1.01(0.66~1.53) 否 1.24(1.04~1.47)* 1.24(1.02~1.50)* 家庭年收入/万元 近3年学生接种流感疫苗 < 10 1.00 1.00 是 1.00 1.00 10~ < 20 0.97(0.78~1.19) 1.02(0.80~1.30) 否 3.76(2.78~5.08)** 3.21(2.29~4.51)** ≥20 1.74(1.39~2.17)** 1.52(1.12~2.06)** 近3年家长接种流感疫苗 家长认为学生健康状况 是 1.00 1.00 健康 1.00 1.00 否 1.55(1.21~2.00)** 0.85(0.63~1.14) 一般或差 1.89(1.47~2.45)** 1.53(1.15~2.04)** 注: *P < 0.05,**P < 0.01。 -
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