Atitudes, hesitações, preocupações e inconsistências relacionadas a vacinas relatadas por pais de crianças pré-escolares

Olbrich Neto, Jaime; Olbrich, Sandra Regina Leite Rosa

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Brasil

Revista Paulista de Pediatria

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Brasil

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Sumário

ORIGINAL ARTICLE • Rev. paul. pediatr. 41 • 2023 • https://doi.org/10.1590/1984-0462/2023/41/2022009 copiar

Atitudes, hesitações, preocupações e inconsistências relacionadas a vacinas relatadas por pais de crianças pré-escolares

Autoria SCIMAGO INSTITUTIONS RANKINGS

RESUMO

Objetivo:

Este estudo procurou avaliar atitudes, preocupações, informações e conhecimentos sobre vacinas por parte de responsáveis por crianças em idade pré-escolar que frequentam instituições de ensino infantil em um município do interior de São Paulo, Brasil, por meio de questionário autoaplicável.

Métodos:

Estudo transversal com o uso de questionário dirigido aos pais de crianças de até 72 meses, em escolas públicas e privadas, sobre conhecimentos e atitudes quanto à vacinação das crianças entre 2018 e 2019.

Resultados:

Entre 2.528 questionários entregues, 1.261 foram respondidos e agrupados conforme a escolaridade dos entrevistados. De acordo com as informações, 96,6% das crianças estavam com vacinas em dia. A prevalência de hesitação vacinal foi de 5,0%. Quanto menor a escolaridade, menor a renda, maior o número de habitantes na casa e maior o desconhecimento sobre vacinas. Quanto maior a escolaridade, menor hesitação e maior insatisfação com as informações recebidas.

Conclusões:

Em geral, os pais consideram as vacinas importantes para prevenir doenças, como proteção, e dizem que os benefícios superam os riscos. Manifestações positivas foram acompanhadas por dúvidas, preocupações, hesitações e inconsistências. O nível de escolaridade faz diferença no acesso a informações, no atendimento médico por pediatras e no sentimento de obrigatoriedade em vacinar. Os pais têm vacinado e ainda pretendem vacinar, mas garantir níveis de cobertura vacinal adequados será um desafio pós-pandemia.

Palavras-chaves:
Vacinas; Atitudes; Pais; Hesitação vacinal

Question	Responses (%)	Educational level*						Overall
Question	Responses (%)	IES	CES	IHS	CHS	IHE	CHE	Overall
Are your child’s vaccines up to date?	Yes	94.7^a	96.8^a	96.4^a	96.8^a	98.0^a	96.0^a	96.5^a
	No	5.3	3.2	3.0	3.2	2.0	4.0	3.4
	Did not get vaccinated	0	0	0.6	0	0	0	0.1
Where does your child get vaccinated (service)?	Only SUS	100.0^a	98.9^a	100.0^a	97.9^a	91.9^b	73.2^c	90.8
	Only private	0	0.0	0	0.4	1.0	7.0	2.1
	SUS and private	0	1.1	0	1.7	7.1	19.7	7.1
How many vaccines did your child get?	Reported	36.0	28.7	45.2	57.2	54.6	59.7	52.4
How many vaccines did your child get?	Does not know	64.0^a	71.3^a	54.8^ab	42.8^bc	45.5^c	40.3^d	47.6
How many diseases is your child protected against?	Reported	21.3	20.2	31.0	37.9	44.4	58.7	40.2
How many diseases is your child protected against?	Does not know	78.7	79.8	69.1	62.1	55.6	41.3	59.8
Has your child ever had a reaction to vaccines?	Yes	24.0^a	26.6^a	30.5^a	32.2^a	43.4^b	49.7^b	36.3
Has your child ever had a reaction to vaccines?	No	76.0	73.4	69.5	67.8	56.6	50.3	63.7
Who decides about the vaccination?	Mother and father	17.3	31.2	29.8	38.2	36.4	56.9	39.7
Who decides about the vaccination?	Predominantly the mother	82.7^a	68.8^ab	70.2^ab	61.8^b	63.6	43.1^c	60.4
Can we take a picture of the vaccine card?	Yes	0	0	0.6	0	0	0	0.1
Can we take a picture of the vaccine card?	No	100.0^a	98.9^a	100.0^a	97.9^a	91.9^b	73.2^c	90.8

Question	Responses (%)	Educational level*						Overall
Question	Responses (%)	IES	CES	IHS	CHS	IHE	CHE	Overall
Would you say: my child may have a severe illness if he or she is not vaccinated?	I strongly agree	63.0	76.3	65.1	70.8	72.5	83.7	73.3
	I partially agree	13.7	15.1	13.9	17.2	23.5	14.2	16.1
	I do not agree	2.7	2.2	4.2	2.8	1.0	1.4	2.4
	I don’t know	20.6^a	6.5^b	16.9^a	9.3^b	3.1^c	0.7^c	8.2
Would you say: it is important to vaccinate my child to prevent the spread of the disease in the community?	I strongly agree	70.3	76.3	72.9	75.4	80.6	87.1	78.1
	I partially agree	13.5	19.4	16.9	16.7	17.4	10.2	15.2
	I do not agree	0.0	1.1	0.6	2.8	1.0	2.0	1.8
	I don’t know	16.2^a	3.2^b	9.6^ab	5.1^bc	1.0^cd	0.7^d	4.9
If children are not vaccinated, what is the risk that they will have a disease that vaccines prevent?	Very high	72.2^a	71.3^a	72.5^a	60.3^ab	59.6^ab	55.3^b	62.3
	Low	2.8	2.1	2.4	4.1	4.0	5.5	3.9
	High	20.8^a	25.5^a	22.2^a	33.7^b	33.3^ab	37.5^b	31.6
	Very low	4.2	1.1	3.0	1.9	3.0	1.7	2.2
How important do you think immunizations are in keeping children healthy?	Extremely important	78.4^a	83.7^a	80.2^a	78.2^a	84.7^a	77.7^a	79.3
	Important	0.0	1.1	0.6	0.2	0.0	0.0	0.3
	Fairly important	0.0	2.2	0.0	0.6	2.0	1.0	0.8
	Not important	21.6	13.0	19.2	21.0	13.3	21.3	19.6
If only your child is not vaccinated, what is the risk of having a disease that vaccines prevent?	Very high	63.5^ab	68.1^a	64.1^a	54.9^bc	44.4^cd	37.6^d	52.6
	Low	5.4	8.5	5.4	7.7	15.2	21.0	11.2
	High	31.1	22.3	29.3	35.1	37.4	37.0	33.7
	Very low	0.0	1.1	1.2	2.3	3.0	4.4	2.5

Question	Responses (%)	Educational level*						Overall
Question	Responses (%)	IES	CES	IHS	CHS	IHE	CHE	Overall
Are they too many vaccines?	Yes	21.3^a	20.2^a	26.2^a	19.3^a	25.3^a	21.7^a	21.5
Are they too many vaccines?	No	78.7	79.8	73.8	80.7	74.8	78.3	78.5
I thought a lot about vaccinate	I didn’t think much	52.8	58.7	61.5	57.1	58.1	52.2	56.5
	I thought a lot and I agree	16.7^a	8.7^ab	8.4^ab	6.5^b	7.2^b	8.8^ab	8.2
	I didn’t think about	30.6^a	32.6^a	30.1^a	36.4^a	34.7^a	38.9^a	35.4
As to your certainty about vaccinating your child	# I was not sure and so I did not vaccinate	2.8	1.0	1.2	1.1	2.0	0.34	1.1
	# I was sure and I did not vaccinate	1.4	2.2	1.2	1.3	2.0	0.4	1.2
	# I was not sure and I postponed some vaccines	5.6	2.2	1.8	2.4	4.1	2.7	2.7
	I was not sure but I vaccinated	13.9	11.8	14.5	11.2	12.2	8.5	11.3
	I was sure and vaccinated	76.4^a	82.8^ab	81.3^ab	84.1^ab	79.6^ab	88.1^b	83.8
About your plans for vaccinating your child	Will receive all	90.4^a	91.1^a	96.3^a	95.1^a	92.9^a	94.2^a	94.3
	Will receive if I think they are necessary	8.2	6.7	3.7	4.1	5.1	5.8	5
	Will not receive all vaccines	1.4	2.2	0.0	0.9	2.0	0.0	0.8**

Question	Responses (%)	Educational level*						Overall
Question	Responses (%)	IES	CES	IHS	CHS	IHE	CHE	Overall
Where do you look for information?	SUS	81.3^ab	87.1^a	80.8^ab	74.9^b	62.6^c	37.0^d	66.8
	Pediatrician	0.0	1.1	0.6	2.3	5.1	12.7	4.6
	Various sources	18.7^ab	11.9^b	18.6^ac	22.7^ac	32.3^ac	50.3^d	28.7
The immune system could be weakened by too many vaccines.	I agree	24.4	19.1	20	22.2	20.6	15.3	19.9
	I do not agree	35.1^a	50.0^abc	46.1^ab	55.1^bc	62.9^c	76.3^d	58.1
	I don’t know	40.5^a	30.9^ab	33.9^a	22.8^b	16.5^bc	8.5^d	22
The benefits of vaccines outweigh their risks.	I strongly agree	42.5^ab	53.2^ab	42.9^a	45.9^a	57.6^b	70.7^c	52.9
	I partially agree	15.1	21.3	22.0	24.5	30.3	24.6	23.8
	I do not agree	4.1	1.1	1.2	3.0	4.0	0.7	2.2
	I don’t know	38.4	24.5	33.9	26.6	8.1	4.1	21.1
How safe do you think vaccines are?	Very safe	67.1^a	66.7^a	62.5^a	57.1^a	62.7^a	55.6^a	59.3
	Safe	1.4	3.2	4.8	3.8	3.0	2.0	3.3
	Fairly unsafe	0.0	0.0	1.2	1.3	1.0	0.7	0.9
	Unsafe	31.5	30.1	31.6	37.7	33.3	41.7	36.5
Have you ever felt obligated to vaccinate your child?	Yes. I felt obligated (job. health service. school)	31.0	23.3	27.0	19.2	19.2	11.6	19.4
Have you ever felt obligated to vaccinate your child?	I did not feel obligated	69.0a	76.7ab	73.0abc	80.8bc	80.8cd	88.4d	80.6

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[1] *Corresponding author. E-mail: jaime.olbrich-neto@unesp.br (J. Olbrich Neto).