Barriers to adult immunization.
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Am J Med. Factors associated with influenza and pneumococcal vaccination behavior among high-risk adults. Factors mediating seasonal and influenza A H1N1 vaccine acceptance among ethnically diverse populations in the urban south. Retraction: lleal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children.
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Noninfluenza vaccination coverage among adults — United States, Flu vaccination coverage, United States, — influenza season. Influenza vaccination coverage among health-care personnel — United States — influenza season. This content is owned by the AAFP. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference. This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP.
Contact fpmserv aafp. Want to use this article elsewhere? Get Permissions. Read the Issue. Sign Up Now. Next: Docphin. Previous article. Mar-Apr Issue. Author disclosures: no relevant financial affiliations disclosed. Article Sections Introduction Who or what most influences a patient's decision to get immunized? Why patients refuse vaccination — and how to respond A matter of trust References. Who or what most influences a patient's decision to get immunized? Abstract Who or what most influences a patient's decision to get immunized? Personal physician 69 percent Family member 19 percent Celebrity physician, public figure, other 7 percent None of the above 4 percent No answer 1 percent Source: National Foundation for Infectious Diseases, National Adult ImmunizationConsumer Survey.
Read the full article. Get immediate access, anytime, anywhere. Choose a single article, issue, or full-access subscription. Earn up to 6 CME credits per issue. Purchase Access: See My Options close. Best Value! But risk communication is vital. The AAP suggests tailoring the conversation to the parents, understanding and responding to their specific concerns. Physicians should talk to parents about managing common side effects and what to do if a more serious reaction occurs.
For some parents, quantifying the risks of vaccinating versus not vaccinating could be helpful. Providing written materials to explain risk is another strategy. It is important to note, however, that more research is needed. A study on what influences adults to the get the flu shot suggests people may be more likely to get vaccinated if their peers do it.
Though adults are most concerned about their personal risk of getting sick, they can also be sensitive to the societal benefits of vaccination. However, when it comes to parents deciding whether to vaccinate their children, it may be more important to focus on the direct benefits of immunization for the child.
Though mentioning societal benefits of vaccination will likely not hurt. These investigators question the appropriateness of shared decision making in the context of vaccine decisions. What is clear from existing research is that respectful, tailored communications and recommendations to immunize coming directly from the health-care provider are associated with increased vaccination uptake. Screen music and the question of originality - Miguel Mera — London, Islington.
UEA Inaugural lecture: Alternative performance measures: do managers disclose them to inform us, or to mislead us? Edition: Available editions United Kingdom. Kristin S.
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Hendrix , Indiana University School of Medicine. Author Kristin S. Written informed consent was obtained from the study participants prior to commencement of the interviews. Parents who had not vaccinated, partially vaccinated or delayed some vaccinations for their children were recruited from separate studies in Fremantle, Western Australia and Adelaide, South Australia. Both studies used an interpretative, qualitative, methodological approach; undertaking semi-structured interviews to better understand parental vaccine hesitancy and influences upon parental experiences.
Face-to-face interventions to inform or educate parents about early childhood vaccination
Adelaide interviews October-December targeted parents whose postal code was identified as having low immunisation coverage rates. Parents were recruited at a suburban organic community market and by snowballing. Fremantle parents September April came from postcodes surrounding the City of Fremantle, which also had low immunisation coverage rates, and were recruited through posters, advertisements in the local newspapers, social media and snowballing.
Interviews in both studies focused on exploring the various factors that led parents not to or selectively vaccinate their children, including their broad perceptions of different vaccinations and vaccine preventable diseases. The interviews did not set out in either study to probe parenting practices, but they emerged spontaneously as parents talked at length about how they attempted to make and keep their children healthy.
In order to operationalise empathic neutrality within the interviews, the researchers attempted to understand not prove pre-existing reasons for deciding not to or to partially vaccinate children. There was a non-judgemental stance towards whatever content emerged during the interviews and within our analytical and publication processes. We firmly believe that, in SA in particular, our empathic neutrality facilitated trust with our participants and led to positive feedback loops within their social networks, facilitating positive responses from subsequent participants.
Since we used some snowball sampling, participants were very willing to talk with other non-vaccinating parents in order for their voices also to be heard, based we believe on our positive and non-judgemental interviews with them. The age range of parents was 25—50 years, 19 parents were aged between 36 and The Fremantle parents were younger due to the age requirements of the youngest child.
Over half of the parents held a university qualification. Thirteen participants had never vaccinated, 5 had ceased vaccinating, 7 were delaying or partially vaccinating, and 4 had previously delayed but were now up-to-date. The interviews were transcribed verbatim and coded and analysed using the NVivo 10 software package. Three stages of analysis were undertaken: coding, conceptual categorisation and theoretical categorisation [ 24 ]. Conceptual categorisation was undertaken by grouping the initial codes into larger categories.
In particular, the researchers explored differences and similarities between participants with different histories of vaccinating their children, some of whom originally vaccinated but ceased, some who delayed but eventually caught up, and some of whom have never vaccinated their children.
Frequent discussions within the research team validated emerging codes. All names have been replaced by pseudonyms. Capacity, epistemological critiques of medical and scientific knowledge and specific salutogenic activities mutually and repeatedly reinforced each other, such that parents saw their rejection, selection or refusal of vaccines not as a deficit, but rather as an asset.
The choice to vaccinate or not was a central theme running through all interviews, based on a process of gathering information and making a conscious decision. Parents, first and foremost, saw themselves as active and capable agents who could and should arm themselves with information and act in the best interests of their children. They believed that their capacity qualified them sufficiently to make good decisions, and were quick to point this out, particularly in the face of those who thought otherwise.
Pippa SA felt that her research and informed choice not to vaccinate her child was not met with the respect she felt she deserved,. I was so shocked by that. This constant quest for research and education fits with the work of others in the US [ 4 , 6 , 25 ] and, for our participants, the increased effort in research generally resulted in the decision to cease vaccinating.
For example, Kavita SA , who started out vaccinating her son, said,. This capacity differentiated them—in their view—from other parents who did not vaccinate for reasons that have been identified as being linked to system failure and social disadvantage [ 26 ]. For example, Charlotte saw no problem with vaccine refusal occurring on a larger scale, so long as it was accompanied by appropriate reasoning and buttressed by suitable behaviours.
Already, readers will note participants hailing the specific lifestyle activities that we will document later in the paper. Hence, our job is not to show how any one of these factors cause the others, but rather how they become part of a self-referential logic of care for parents.
Parents who self-consciously value their capacity to reason also value their capacity to question and distrust traditional scientific evidence, and formulate alternative systems of parsing evidence. Similar to previous qualitative studies in the US [ 6 , 9 ], parents in our study talked at length about not only the evidence underpinning vaccinations, but more broadly about the evidence underpinning numerous health-promoting and illness-preventing activities they undertook with and for their children.
Their interrogation of, and engagement with, this evidence took the form of critiquing Western medical epistemology and making space for a different one. Consequently, much of what they had to say related to the very nature of knowledge and evidence itself. This certainly resonates with our study. For example, Kavita SA talked about the different knowledges around vaccinations, stating that people need to gather their own evidence before blindly trusting a doctor,. Before you just trust in that doctor, just do your research and make your informed decision.
Your doctor is saying that to you based on his knowledge base and that might end up being quite different to your knowledge base. Similar questioning of herd immunity by vaccine rejecting parents has been found elsewhere [ 27 ]. Owen SA talked about the difficulties involved in searching for and synthesising evidence in order to make the best possible decisions for his children, and how he is open to new information,. We perceive their search for truth as a perhaps futile realist quest in a postmodern paradigm; our parents displayed an ontological need for closing down rather than opening up possibilities.
Participants talked at length about the variety of health promoting and illness-preventing activities they engaged in, within which not vaccinating their children was contextualised and justified. Their praxis, eclectic yet often uniform, was held together by a milieu and identity that appeared utterly coherent to those within it.
Often, this had been a long time in the making. Holly SA talked about the development of her logic of care over time, from before her child was born. Dianne SA talked about the variety of activities and practices that she engaged with, for the physical, emotional and psychological health of her daughter,. I stepped back… I think it was great for me because it enabled me to achieve a certain lifestyle, creating my own food from scratch.
I grow vegetables and I have chickens I mean, I feed my children organic food, I cook everything from scratch. We have no chemicals in the house.calorconsulting.es/libraries/winter/espiar-whatsapp-sms-llamadas.php
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So why would I then go and put all those chemicals in my child? She went on to talk about her reasons for limiting TV access to her daughter,. They are limited to one channel. In the SA participants, where attitudes towards health promoting practices were probed in more detail, all participants talked at length about the benefits of organic food, which was linked to the fruit and vegetables having no chemicals.
Some of the first participants in SA were originally recruited from an organic market in Adelaide, which may have skewed some of the discussion during interviews, although later participants were recruited through snowball sampling and they also talked at length about organic food. Holly SA talked about her strategies for both trying to prevent and treat illness through healthy eating. In attempting to prevent illness, Holly said,. So my children eat the best quality food, whole food.
Eat a rainbow, as I would say, in colour. We get sunshine every day. Play outside every day. We eat organic. Kavita described her use of coconut oil as a sunscreen to avoid the chemicals in commercial sunscreen,. This demonstrates their endless cycle of vigilance, their sense of capacity to question, research and make their own decisions, and their mistrust of forces that might seek to exploit them. Dianne SA said.
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In SA, a number of participants sent their children to independent schools, such as Steiner and Montessori, due to the perceived weaknesses of public schools for dealing with individual learning needs and the benefits of the philosophies that underpin these particular pedagogical methods. Similar schooling choices have been found in the US with non-vaccinating parents [ 5 , 6 ]. Charlotte SA talked about how her interactions with her children, her limits on TV, her emphasis on outdoor play and natural materials fitted with those of Steiner schools,.
Their brain is developing and growing and TV is just like messing with that… they rarely get to touch my phone. Charlotte grew her own vegetables, bought organic food, cooked from scratch, did not use chemicals, did not trust government or big business rarely shopped in supermarkets and did not vaccinate her children. She regarded all these practices as logical and internally consistent in promoting the health of her family—salutogenic parenting. In addition to the comprehensive explanations of the logic of care already outlined, participants talked specifically about breastfeeding and homebirths as health promoting and illness preventing activities for their children, improving natural immunity and therefore, as they saw it, negating the need for vaccinations.
Wu et al [ 28 ] found that women who intended to breastfeed were less likely to trust childhood vaccinations in one US hospital study.