英国伦敦卫生与热带医学院Heidi J Larson团队绘制了全球疫苗信心的趋势图。2020年9月10日，该研究发表在《柳叶刀》杂志上。

越来越多的证据表明，由于对疫苗的重要性、安全性或有效性缺乏信任，以及持续存在的获取问题，疫苗被推迟或拒绝接种。尽管全世界范围内都报告了免疫覆盖率，但对于疫苗信心并没有类似的强大监控系统。

在这项大规模的回顾性数据驱动分析中，研究组使用了2015年9月至2019年12月在149个国家（包括284381名参与者）进行的290项调查数据，研究了疫苗信心的全球趋势，评估了公众对疫苗的安全性、重要性和有效性的看法。

研究组估计，2015年11月至2019年12月，阿富汗、印度尼西亚、巴基斯坦、菲律宾和韩国对疫苗的重要性、安全性和有效性的信心有所下降。2015-2019年间，阿富汗、阿塞拜疆、印度尼西亚、尼日利亚、巴基斯坦和塞尔维亚这六个国家/地区的大量受访者强烈反对疫苗的安全性。

研究组发现有迹象表明，2018-2019年，包括芬兰、法国、爱尔兰和意大利在内的一些欧盟成员国的疫苗信心有所改善，但最近在波兰有所下降。与其他决定因素相比，对疫苗重要性的信心（而非对安全性或有效性的信心）与疫苗接种具有最强的单变量关联。个人宗教信仰与疫苗接种存在一定相关性，少数宗教团体的疫苗接种率较低。

总之，研究组进行了一项关于疫苗信心的全球最大规模研究，强调了定期监测新趋势、采取干预措施建立和维持疫苗信心的重要性。

附：英文原文

Title: Mapping global trends in vaccine confidence and investigating barriers to vaccine uptake: a large-scale retrospective temporal modelling study

Author: Alexandre de Figueiredo, Clarissa Simas, Emilie Karafillakis, Pauline Paterson, Heidi J Larson

Issue&Volume: 2020-09-10

Abstract:

Background

There is growing evidence of vaccine delays or refusals due to a lack of trust in the importance, safety, or effectiveness of vaccines, alongside persisting access issues. Although immunisation coverage is reported administratively across the world, no similarly robust monitoring system exists for vaccine confidence. In this study, vaccine confidence was mapped across 149 countries between 2015 and 2019.

Methods

In this large-scale retrospective data-driven analysis, we examined global trends in vaccine confidence using data from 290 surveys done between September, 2015, and December, 2019, across 149 countries, and including 284381 individuals. We used a Bayesian multinomial logit Gaussian process model to produce estimates of public perceptions towards the safety, importance, and effectiveness of vaccines. Associations between vaccine uptake and a large range of putative drivers of uptake, including vaccine confidence, socioeconomic status, and sources of trust, were determined using univariate Bayesian logistic regressions. Gibbs sampling was used for Bayesian model inference, with 95% Bayesian highest posterior density intervals used to capture uncertainty.

Findings

Between November, 2015, and December, 2019, we estimate that confidence in the importance, safety, and effectiveness of vaccines fell in Afghanistan, Indonesia, Pakistan, the Philippines, and South Korea. We found significant increases in respondents strongly disagreeing that vaccines are safe between 2015 and 2019 in six countries: Afghanistan, Azerbaijan, Indonesia, Nigeria, Pakistan, and Serbia. We find signs that confidence has improved between 2018 and 2019 in some EU member states, including Finland, France, Ireland, and Italy, with recent losses detected in Poland. Confidence in the importance of vaccines (rather than in their safety or effectiveness) had the strongest univariate association with vaccine uptake compared with other determinants considered. When a link was found between individuals' religious beliefs and uptake, findings indicated that minority religious groups tended to have lower probabilities of uptake.

Interpretation

To our knowledge, this is the largest study of global vaccine confidence to date, allowing for cross-country comparisons and changes over time. Our findings highlight the importance of regular monitoring to detect emerging trends to prompt interventions to build and sustain vaccine confidence.

DOI: 10.1016/S0140-6736(20)31558-0

Source: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31558-0/fulltext