Vaccine Hesitancy in Canada: Scope, Determinants, and Impact of Trust in Parents of Two-Year Old Children
Notice bibliographique
Résumé
Vaccine hesitancy and trust are two factors impacting vaccine decisions for parents of preschoolers in Canada. However, previous research has left gaps in determining the prevalence and predictors of vaccine decisions (i.e., reluctance, refusal and delay) and the impact of whom parents trust for vaccine information on vaccine decisions. This thesis addressed these gaps through two papers using data from the 2017 Childhood National Immunization Coverage Survey(cNICS) of parents of 2-year-old children who were born in Canada and who had received at least one vaccine. Socio-demographics, vaccine decisions and vaccine knowledge, attitudes and beliefs (KAB) were described (proportion) and analyzed for associations (Chi Square) and predictors (Binomial multivariate logistic regression). \nThe objective of the first paper was to describe and examine the associations and predictors of vaccine decisions. The findings show that 16.8% of parents refused a vaccine for their child, specifically the influenza (73%), rotavirus (13%) and varicella (9%) vaccines; female parents or those from Quebec or the Territories were more likely to refuse. 12.8% were reluctant to accept a vaccine, most often the influenza (34%), measles, mumps, rubella (MMR) (21%) and varicella (19%) vaccines, but eventually accepted them due to advice from a health care provider. About one in eight (13.1%) had delayed a vaccine, most often because their child had health issues (54%) or was too young (18.6%) and was predicted by households of five or six people. Recent immigration to Canada decreased likelihood of refusal, delay, or reluctance; however, after 10 years in Canada, these parents were as likely to refuse or be reluctant as parents born in Canada. Poor KAB increased likelihood of refusal and delay by 5 times, and reluctance by 15 times, while moderate KAB also increased likelihood of refusal (1.6 times), delay (2.3 times) and reluctance (3.6 times). \nThe objective of the second paper was to determine the predictors and impact of whom parents trust for vaccine information. The findings show that 83% of parents trust doctors for vaccine information; 70-79% trust pharmacists, the Provincial Ministry of Health (PMH), nurses and Health Canada/Public Health Agency of Canada (HC/PHAC); 33% trust family and 22% trust friends and alternative health care providers (HCPs). However, parents found to have poor or moderate KAB were less likely to trust doctors, nurses, pharmacists, PMH and HC/PHAC. Parents were also less likely to trust the PMH or HC/PHAC if they had high school education or less or trade/college education, or were widowed, separated, or divorced. Parents who had never been reluctant to vaccinate their 2-year-old child were over 2 times more likely to trust doctors, nurses, pharmacists, PMH and HC/PHAC while parents who trusted family and friends were less likely to delay or refuse vaccines. There was regional variation within Canada. Parents from Quebec were most likely to trust doctors, nurses, pharmacists, friends, PMH and HC/PHAC. Parents from the Territories were less likely to trust doctors, nurses and pharmacists, but more likely to trust family. Parents were less likely to trust doctors if they were from the Prairies, and pharmacists if they were from BC, and parents from the Prairies and BC were less likely to trust HC/PHAC. Parents from Ontario were less likely to trust family or friends, but more likely to trust the PMH.\n In addition to these findings, this study has demonstrated the importance of considering the temporal context as our results show that parents change their vaccine decisions over time (e.g., time since immigration to Canada, changes in marital status, or through conversations with HCPs). Given these findings, vaccine programming is needed that is focused on addressing parents’ concerns within their unique contexts, which ultimately, will protect children from vaccine preventable diseases.
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Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».