| ObjectiveThe vaccine safety events which repeatedly occurred in China are leading to vaccine hesitancy(the delay in acceptance or refusal of vaccines despite availability of vaccination services)and greatly challenging the immunization program.This study,taking the example of the Changchun Changsheng Vaccine Event in 2018,aims to analyze the communication and impacts of the event,to explore the influencing factors of parents’ attitude change towards vaccination,and to provide more evidence for domestic research on vaccine hesitancy as well as policy recommendations for departments concerned to response to vaccine safety events.MethodsThis study adopted a multi-stage stratified cluster sampling to conduct a questionnaire survey two weeks after the event among those who were pregnant or had given birth to a baby within one week(or their spouses)at six medical institutions in Hangzhou,Ningbo,Huzhou,Jinhua and Quzhou,which were selected by their geographical situation and economic development level within Zhejiang province.The questionnaire was drafted through literature review and tested by a pilot study,which contains 1)sociodemographic characteristics;2)communication situation,including access to information,participation in information dissemination and trust in official institutions;3)event impacts on respondents’ emotions(anger and anxiety),cognitions(basic perceptions,vaccine literacy and acceptance of the importance of vaccination)and intentions(attitude change towards vaccination).On the basis of descriptive analysis,chi-tests were used to analyze the association between socio-demographic characteristics and communication situation as well as event impacts,and chi-tests and Logistic regression method were used to analyze the influencing factors of parents’ attitude change towards vaccination.ResultsCommunication situation: based on data of 1065 valid questionnaire reserved for analysis,89.7% of the parents obtained information through new media such as Wechat;72.3%,60.3% and 25.3% had discussed with others,initiatively searched for or forwarded related reports respectively,overall 81.2% had participatrf in information dissemination;as for the official institutions which offered information,44.2%,25.6% and 34.9% of the parents showed their trust in WHO,FDA and CDC respectively,totally 50.5% trusted in at least one of the above three institutions.Event impacts: 1)Emotion: 86.0% of the parents were angry or very angry and 72.9% were anxious or very anxious about the event.2)Basic perceptions: 59.3% of the parents were aware that the production link should be accused in the event;46.2% could tell that FDA was the supervision department of vaccine safety,while 56.5% and 32.3% believed CDC or WHO were responsible for the issue;58.6% and 59.4% could recognize hydrophobia vaccines and DPT vaccines as the unqualified vaccines in the event,while 21.7% and 12.0% thought hepatitis B vaccines or influenza A vaccines were involved;generally 70.0% of the parents had a poor cognition of the basic information.3)Vaccine literacy: 52.9% and 33.6% of the parents thought it difficult to obtain comprehensive and correct information or to understand the knowledge and information about vaccines,and only 17.5% could tell that the unqualified vaccines in the event were ineffective rather than harmful.4)Acceptance of the importance of vaccination: 95.3% and 95.8% of the parents admitted the importance of vaccination for their own children and for disease control throughout the nation respectively.5)Change of attitude towards vaccination: before and after the event,the proportion of the parents who were willing or very willing to make their children receive domestic vaccines declined from 69.4% to 17.3%,64.8% held a more negative attitude towards domestic vaccines;the proportion of the parents who were willing or very willing to vaccinate their children declined from 91.6% to 47.9%,61.4% showed a more negative attitude towards vaccines.Influencing factors of attitude change towards vaccination: 1)parents who had the following characteristics were more likely to hold a more negative attitude towards domestic vaccines after the event: feeling angry for the event(a OR=2.37,95%CI: 1.64-3.44,p<0.001),feeling anxious for the event(a OR=1.98,95%CI: 1.48-2.64,p<0.001),admitting the importance of vaccination for national disease control(a OR=2.71,95%CI: 1.15-6.37,p<0.05);2)those who had the following characteristics were more likely to hold a more negative attitude towards vaccines after the event: participation in information dissemination(a OR=1.58,95%CI: 1.13-2.21,p<0.01),feeling angry for the event(a OR=2.62,95%CI: 1.80-3.80,p < 0.001),feeling anxious for the event(a OR=2.45,95%CI: 1.84-3.26,p<0.001),thinking it difficult to obtain comprehensive and correct information of the event(a OR=1.45,95%CI: 1.09-1.93,p<0.05),thinking it difficult to understand the knowledge and information about vaccines(OR=1.47,95%CI: 1.08-2.01,p<0.05),admitting the importance of vaccination for their own children(a OR=2.92,95%CI: 1.28-6.68,p < 0.05);3)those who had the following characteristics were less likely to hold a more negative attitude towards vaccines after the event: trust in information released by at least one of the official institutions(a OR=0.62,95%CI: 0.48-0.80,p<0.001),being aware that the unqualified vaccines in the event were ineffective rather than harmful(a OR=0.52,95%CI: 0.37-0.73,p<0.001).ConclusionDespite the widely recognized importance of vaccination for both individuals and the whole nation,the Changchun Changsheng Vaccine Event still showed a severely negative influence on parents’ attitude towards vaccination during the process of communication.Although most of the parents did participate in information dissemination through new media,they showed limited trust in official institutions and inadequate understanding of the event.The event led to an atmosphere of anger and anxiety among the parents and reflected poor vaccine literacy.This study further found out that negative emotions,low vaccine literacy and lack of government credibility could play an essential role in vaccine hesitancy after a vaccine safety event.The departments concerned such as FDA should fulfill their responsibilities to carry on strict supervision over the development,production,circulation and vaccination of the vaccines together with other relevant agencies like CDC,and take advantage of emerging media to improve public involvement,vaccine literacy and government credibility;in case of a vaccine safety event,timely investigations and social disclosure are in urgent need to acquaint and comfort the public. |
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