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      Vaccine confidence in China after the Changsheng vaccine incident: a cross-sectional study

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          Abstract

          Background

          China’s achievements in immunization are being threatened by a vaccine crisis. This paper aims to investigate vaccine confidence in China after the Changsheng vaccine incident and attempts to identify the factors contributing to it.

          Methods

          An online cross-sectional investigation was conducted from 1 to 25 September 2018. Descriptive analysis and logistic regression were performed to examine the associations between socio-demographic factors, cognition and attitudes towards the Changsheng vaccine incident and vaccine confidence.

          Results

          We included 1115 respondents in the final analysis, and found that approximately 70% (783) of the respondents did not have vaccine confidence. More than half of the respondents (54.53%) were dissatisfied with the government’s response measures to the Changsheng vaccine incident. The logistic regression model indicated that vaccine confidence was positively associated with the degree of satisfaction with the government’s response measures (OR = 1.621, 95% CI = 1.215–2.163), attitudes towards the risks and benefits of vaccination (OR = 1.501, 95% CI = 1.119–2.013), concerns about vaccine safety (OR = 0.480, 95% CI = 0.317–0.726), and vaccine efficacy (OR = 0.594, 95% CI = 0.394–0.895).

          Conclusions

          A majority of the respondents held negative attitudes towards vaccines after the Changsheng vaccine incident. A coordinated effort is required to restore public confidence in vaccines, especially in China, where a nationwide mandatory immunization policy is implemented. To end dissent towards inoculation, a series of actions is crucial and multiple parties should work together to advance efforts and explore the possibility of establishing an open and transparent regulatory system.

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          Most cited references40

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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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            Vaccine Hesitancy: Where We Are and Where We Are Going.

            Vaccines represent one of the most important aspects of pediatric preventive care. However, parents are increasingly questioning the safety of and need for vaccines, and as a result, vaccination rates have fallen to dangerously low levels in certain communities. The effects of vaccine hesitancy are widespread. Community pediatricians who interact regularly with vaccine-hesitant parents report higher levels of burnout and lower levels of job satisfaction. Not surprisingly, vaccine hesitancy has also had direct influence on vaccination rates, which in turn are linked to increased emergency department use, morbidity, and mortality.
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              Autism and measles, mumps, and rubella vaccine: no epidemiological evidence for a causal association

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                Author and article information

                Contributors
                + 86-0451-87502851 , wuqunhong@163.com
                + 86-0451-87502860 , ningninghyd@163.com
                Journal
                BMC Public Health
                BMC Public Health
                BMC Public Health
                BioMed Central (London )
                1471-2458
                27 November 2019
                27 November 2019
                2019
                : 19
                : 1564
                Affiliations
                [1 ]ISNI 0000 0001 2204 9268, GRID grid.410736.7, Department of Social Medicine, School of Health Managment, , Harbin Medical University, ; Harbin, Heilongjiang China
                [2 ]Harbin Center for disease control and prevention, Harbin, Heilongjiang China
                [3 ]ISNI 0000 0000 9530 8833, GRID grid.260483.b, Department of Health Management, School of Public Health, , Nantong University, ; Nantong, Jiangsu China
                Author information
                http://orcid.org/0000-0002-2873-5266
                Article
                7945
                10.1186/s12889-019-7945-0
                6880575
                31771543
                749726a6-bfb8-4d37-bfcf-e1e66ce18fa1
                © The Author(s). 2019

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 22 March 2019
                : 13 November 2019
                Funding
                Funded by: Think Tank of Public Health Security and Health Reform of Heilongjiang Province
                Funded by: FundRef http://dx.doi.org/10.13039/501100004572, National Health and Family Planning Commission of the People's Republic of China;
                Award ID: Grant No.201002028
                Award Recipient :
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2019

                Public health
                vaccine confidence,vaccine,confidence,negative vaccine incident
                Public health
                vaccine confidence, vaccine, confidence, negative vaccine incident

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