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Dtsch Med Wochenschr 2019; 144(04): 254-261
DOI: 10.1055/a-0479-3756
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© Georg Thieme Verlag KG Stuttgart · New York

Risiko Impfen?

Warum Menschen sich und ihre Kinder nicht impfen lassenVaccination As A Risk?Why People and Their Children Do Not Get Vaccinated
Frank Kowalzik
,
Fred Zepp
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Publikationsverlauf

Publikationsdatum:
13. Februar 2019 (online)

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Abstract

Skepticism about vaccination is not new, but the perception of vaccine-related risks has changed in recent decades. In addition to aspects such as knowledge about vaccines, trust in medical care structures and political institutions, socio-economic, cultural and religious views also play an important role. These factors differ significantly worldwide and regionally. In almost all surveys, confidence in vaccines and/or the healthcare system is identified as essential for a positive vaccination decision. Confidence in vaccines correlates with the assessment of the specific individual disease risk and the potential side effects of the vaccines. Subjective perception of risk seldom corresponds to objectively measurable facts. Rather, it is distorted by individual perception in both directions (underestimation and overestimation). Transparent, science-based communication is helpful in promoting and maintaining trust in healthcare. Pediatricians and family physicians are the most important confidants for parents on questions about health care and vaccination recommendations.

Grundsätzlich sind die Erfolge von Impfungen und Impfprogrammen für die Prävention von Infektionskrankheiten und deren Komplikationen weltweit anerkannt. Dennoch fällt aktuell gerade in industrialisierten Staaten ein Vertrauensschwund auf: Impfungen und öffentlich empfohlene Impfprogramme werden immer weniger wahrgenommen. Stichwort „Impfskepsis“. Die WHO sieht darin mittlerweile ein komplexes globales Problem. Doch wie ist es lösbar?

Schlüsselwörter

Impfskepsis - Pflichtimpfung - Vertrauen - Risikowahrnehmung - Unterschätzung

Key words

skepticism about vaccination - compulsory vaccination - confidence - risk perception - underestimation
 

  • Literatur

  • 1 Glanz JM, McClure DL, Magid DJ. et al. Parental refusal of pertussis vaccination is associated with an increased risk of pertussis infection in children. Pediatrics 2009; 123 (06) 1446-1451 . doi:10.1542/peds.2008-2150
    CrossrefPubMedGoogle Scholar
  • 2 Glanz JM, Narwaney KJ, Newcomer SR. et al. Association between undervaccination with diphtheria, tetanus toxoids, and acellular pertussis (DTaP) vaccine and risk of pertussis infection in children 3 to 36 months of age. JAMA Pediatr 2013; 167: 1060-1064
    CrossrefPubMedGoogle Scholar
  • 3 Poland GA, Jacobson RM. The age-old struggle against the antivaccinationists. N Engl J Med 2011; 364 (02) 97-99 . doi:10.1056/NEJMp1010594
    CrossrefPubMedGoogle Scholar
  • 4 Larson HJ, Schulz WS, Tucker JD. et al. Measuring vaccine confidence: introducing a global vaccine confidence index. PLoS Curr 2015; DOI: 10.1371/currents.outbreaks.ce0f6177bc97332602a8e3fe7d7f7cc4.
    CrossrefPubMedGoogle Scholar
  • 5 Larson HJ, de Figueiredo A, Xiahong Z. et al. The State of Vaccine Confidence 2016: Global Insights Through a 67-Country Survey. EBioMedicine 2016; 12: 295-301 . doi:10.1016/j.ebiom.2016.08.042
    CrossrefPubMedGoogle Scholar
  • 6 Rey D, Fressard L, Cortaredona S. et al. On Behalf Of The Baromètre Santé Group. Vaccine hesitancy in the French population in 2016, and its association with vaccine uptake and perceived vaccine risk-benefit balance. Euro Surveill 2018; 23 (17) DOI: 10.2807/1560-7917.ES.2018.23.17.17-00816.
    CrossrefPubMedGoogle Scholar
  • 7 Baumgaertner B, Carlisle JE, Justwan F. The influence of political ideology and trust on willingness to vaccinate. PLoS One 2018; 13 (01) e0191728 . doi:10.1371/journal.pone.0191728
    CrossrefPubMedGoogle Scholar
  • 8 Danis K, Georgakopoulou T, Stavrou T. et al. Socio-economic factors play a more important role in childhood vaccination coverage than parental perceptions: a cross-sectional study in Greece. Vaccine 2010; 28 (07) 1861-1869
    CrossrefPubMedGoogle Scholar
  • 9 Babalola S. Maternal reasons for non-immunization and partial immunization in northern Nigeria. J Paediatr Child Health 2011; 47 (05) 276-281
    CrossrefPubMedGoogle Scholar
  • 10 Brown K, Fraser G, Ramsay M. et al. Attitudinal and demographic predictors of measles-mumps-rubella vaccine [MMR] uptake during the UK catch-up campaign 2008–2009: cross-sectional survey. PLoS ONE 2011; e19381 . doi:10.1371/journal.pone.0019381
    PubMedGoogle Scholar
  • 11 Falagas ME, Zarkadoulia E. Factors associated with suboptimal compliance to vaccinations in children in developed countries: a systematic review. Curr Med Res Opin 2008; 24 (06) 1719-1741
    CrossrefPubMedGoogle Scholar
  • 12 Rainey JJ, Watkins M, Ryman TK. et al. Reasons related to non-vaccination and under-vaccination of children in low and middle income countries: findings from a systematic review of the published literature 1999–2009. Vaccine 2011; 29 (46) 8215-8221
    CrossrefPubMedGoogle Scholar
  • 13 Prematunge C, Corace K, McCarthy A. et al. Factors influencing pandemic influenza vaccination of healthcare workers – a systematic review. Vaccine 2012; 30 (32) 4733-4743
    CrossrefPubMedGoogle Scholar
  • 14 Trim K, Nagji N, Elit L. et al. Parental knowledge, attitudes, and behaviours towards human papillomavirus vaccination for their children: a systematic review from 2001 to 2011. Obstet Gynecol Int 2012; 2012: 921236 . doi:10.1155/2012/921236
    PubMedGoogle Scholar
  • 15 Mills EJ, Montori VM, Ross CP. et al. Systematically reviewing qualitative studies complements survey design: an exploratory study of barriers to paediatric immunizations. J Clin Epidemiol 2005; 58 (11) 1101-1108
    CrossrefPubMedGoogle Scholar
  • 16 Betsch C, Schmid P, Heinemeier D. et al. Beyond confidence: Development of a measure assessing the 5C psychological antecedents of vaccination. Preprint Psyarxiv, last edited August 11, 2018 DOI: 10.31234/osf.io/ytb7w
    CrossrefPubMedGoogle Scholar
  • 17 McClure CC, Cataldi JR, O’Leary ST. Vaccine Hesitancy: Where We Are and Where We Are Going. Clinical Therapeutics 2017; 39 (08) 1550-1562 . doi:10.1016/j.clinthera.2017.07.003
    CrossrefPubMedGoogle Scholar
  • 18 Schwermer B. Objektives Gripperisiko, subjektive Risikowahrnehmung und Impfbereitschaft: Wie reagiert die Bevölkerung auf Gesundheitskommunikation?. Das Gesundheitswesen 2013; 75 (05) e23-e27 . doi:10.1055/s-0032-1331789
    Artikel in Thieme ConnectPubMedGoogle Scholar
  • 19 Renner B, Schupp HS, Schmälzle R. Risikowahrnehmung und Risikokommunikation. In: Bengel J. et al. Hrsg. Handbuch der Gesundheitspsychologie und Medizinischen Psychologie. Göttingen [u. a.]: Hogrefe; 2009: 113-121
    Google Scholar
  • 20 Lichtenstein S, Slovic P, Fischhoff B. et al. Judged frequency of lethal events. Journal of Experimental Psychology: Human Learning and Memory 1978; 4: 551-578
    CrossrefPubMedGoogle Scholar
  • 21 Brewer NT, Chapman GB, Gibbons FX. et al. Meta-analysis of the relationship between risk perception and health behavior: the example of vaccination. Health Psychol 2007; 26 (02) 136-145
    CrossrefPubMedGoogle Scholar
  • 22 Gerber JS, Offit PA. Vaccines and autism: A tale of shifting hypotheses. Clin Infect Dis 2009; 48 (04) 456-461
    CrossrefPubMedGoogle Scholar
  • 23 Dokumentation „Eingeimpft“ und eine Art wissenschaftliche Rezension. Science Media Center Germany. 17.08.2018. Im Internet: www.sciencemediacenter.de/alle-angebote/rapid-reaction/details/news/dokumentation-eingeimpft-und-eine-art-wissenschaftliche-rezension
    PubMedGoogle Scholar
  • 24 Gangarosa EJ, Galazka AM, Wolfe CR. et al. Impact of anti-vaccine movements on pertussis control: the untold story. Lancet 1998; 351 (9099) 356-361
    CrossrefPubMedGoogle Scholar
  • 25 Betsch C, Brewer NT, Brocard P. et al. Opportunities and challenges of Web 2.0 for vaccination decisions. Vaccine 2012; 30 (25) 3727-3733
    CrossrefPubMedGoogle Scholar
  • 26 Myers MG, Pineda D. Misinformation about Vaccines. In: Barrett ADT, Stanberry LR. eds. Vaccines for Biodefense and Emerging and Neglected Diseases. Oxford: Academic Press; 2009: 256-271
    Google Scholar
  • 27 Larson HJ, Cooper LZ, Eskola J. et al. Addressing the vaccine confidence gap. Lancet 2011; 378: 526-535
    CrossrefPubMedGoogle Scholar