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      Why do some Korean parents hesitate to vaccinate their children?

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          Abstract

          OBJECTIVES

          Vaccinations for infectious diseases are opposed despite their achievement, and this opposition has recently been revealed in Korea. However, research in Korea has not been vigorous. The authors studied why some Korean parents hesitate to vaccinate their children by applying the health belief model.

          METHODS

          Parents who hesitate to vaccinate and parents who do not were surveyed in alternative education preschools and elementary schools. They were classified into four types of hesitancy and statistically compared.

          RESULTS

          Among the 129 subjects, 43 vaccinated without hesitancy, 20 vaccinated on time with hesitancy, 32 vaccinated with a deliberate delay of one month or longer, and 34 did not vaccinate. Vaccination increased with an increase in the awareness that severe outcomes can occur when unvaccinated. Concerns about adverse reactions from vaccinations or direct/indirect experiences affected refusal. Furthermore, perceptions of the lack of meaningfulness of vaccinations, distrust of policy and safety management, influence of leaders or activists in joined organizations, and experts of Korean traditional or alternative medicine affected refusal. Explanations by doctors, text messages and mails from institutions, and concerns about disadvantages caused by not complying with government policies increased vaccination.

          CONCLUSIONS

          The reasons for vaccine hesitancy and acceptance were similar to the results of international research. Health authorities and professionals should communicate sufficiently and appropriately with hesitant parents and find ways to rationally resolve social conflicts. However, this sample was small and there is little Korean research, so more in-depth and diverse researchs are needed.

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          Most cited references31

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          The State of Vaccine Confidence 2016: Global Insights Through a 67-Country Survey

          Background Public trust in immunization is an increasingly important global health issue. Losses in confidence in vaccines and immunization programmes can lead to vaccine reluctance and refusal, risking disease outbreaks and challenging immunization goals in high- and low-income settings. National and international immunization stakeholders have called for better monitoring of vaccine confidence to identify emerging concerns before they evolve into vaccine confidence crises. Methods We perform a large-scale, data-driven study on worldwide attitudes to immunizations. This survey – which we believe represents the largest survey on confidence in immunization to date – examines perceptions of vaccine importance, safety, effectiveness, and religious compatibility among 65,819 individuals across 67 countries. Hierarchical models are employed to probe relationships between individual- and country-level socio-economic factors and vaccine attitudes obtained through the four-question, Likert-scale survey. Findings Overall sentiment towards vaccinations is positive across all 67 countries, however there is wide variability between countries and across world regions. Vaccine-safety related sentiment is particularly negative in the European region, which has seven of the ten least confident countries, with 41% of respondents in France and 36% of respondents in Bosnia & Herzegovina reporting that they disagree that vaccines are safe (compared to a global average of 13%). The oldest age group (65+) and Roman Catholics (amongst all faiths surveyed) are associated with positive views on vaccine sentiment, while the Western Pacific region reported the highest level of religious incompatibility with vaccines. Countries with high levels of schooling and good access to health services are associated with lower rates of positive sentiment, pointing to an emerging inverse relationship between vaccine sentiments and socio-economic status. Conclusions Regular monitoring of vaccine attitudes – coupled with monitoring of local immunization rates – at the national and sub-national levels can identify populations with declining confidence and acceptance. These populations should be prioritized to further investigate the drivers of negative sentiment and to inform appropriate interventions to prevent adverse public health outcomes.
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            Anti-vaccination movements and their interpretations.

            Over the last two or three decades, growing numbers of parents in the industrialized world are choosing not to have their children vaccinated. In trying to explain why this is occurring, public health commentators refer to the activities of an anti-vaccination 'movement'. In the light of three decades of research on (new) social movements, what sense does it make to attribute decline in vaccination rates to the actions of an influential anti-vaccination movement? Two sorts of empirical data, drawn largely from UK and The Netherlands, are reviewed. These relate to the claims, actions and discourse of anti-vaccination groups on the one hand, and to the way parents of young children think about vaccines and vaccination on the other. How much theoretical sense it makes to view anti-vaccination groups as (new) social movement organizations (as distinct from pressure groups or self-help organizations) is as yet unclear. In any event there is no simple and unambiguous demarcation criterion. From a public health perspective, however, to focus attention on organized opponents of vaccination is appealing because it unites health professionals behind a banner of reason. At the same time it diverts attention from a potentially disruptive critique of vaccination practices; the critique in fact articulated by many parents. In the light of current theoretical discussion of 'scientific citizenship' this paper argues that identifying anti-vaccination groups with other social movements may ultimately have the opposite effect to that intended.
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              Countering Vaccine Hesitancy

              Immunizations have led to a significant decrease in rates of vaccine-preventable diseases and have made a significant impact on the health of children. However, some parents express concerns about vaccine safety and the necessity of vaccines. The concerns of parents range from hesitancy about some immunizations to refusal of all vaccines. This clinical report provides information about addressing parental concerns about vaccination.
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                Author and article information

                Journal
                Epidemiol Health
                Epidemiol Health
                EPIH
                Epidemiology and Health
                Korean Society of Epidemiology
                2092-7193
                2019
                9 July 2019
                : 41
                : e2019031
                Affiliations
                Department of Preventive Medicine and Public Health, Ajou University School of Medicine, Suwon, Korea
                Author notes
                Correspondence: Soon Young Lee Department of Preventive Medicine and Public Health, Ajou University School of Medicine, 164 World cup-ro, Yeongtong-gu, Suwon 16499, Korea E-mail: solee5301@ 123456gmail.com
                Author information
                http://orcid.org/0000-0001-6607-4756
                http://orcid.org/0000-0002-3160-577X
                Article
                epih-41-e2019031
                10.4178/epih.e2019031
                6661469
                31319656
                4b7795b0-2743-4135-a336-11ad8b55327f
                ©2019, Korean Society of Epidemiology

                This is an open-access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 3 April 2019
                : 15 June 2019
                Categories
                Original Article

                Public health
                vaccine hesitancy,vaccination refusal,health belief model,korea
                Public health
                vaccine hesitancy, vaccination refusal, health belief model, korea

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