PERCEPTIONS ON THE IMPORTANCE OF VACCINATION AND VACCINE REFUSAL IN A MEDICAL SCHOOL

ABSTRACT Objective: To identify the perception of medical students and physicians on the importance of vaccination and the risks of vaccine refusal. Methods: Cross-sectional study with application of questionnaires about vaccines, vaccine refusal and its repercussions on public and individual health. A sample of 92 subjects was selected from a private medical school: group 1 (53 students from first to fourth grades) and group 2 (39 physicians). Data collected were tabulated in the Microsoft Excel Program and analyzed by Fisher’s exact test. Results: Both groups considered the National Immunization Program reliable and recognized the importance of vaccines, but 64.2% of students and 38.5% of physicians are unaware of the vaccine-preventable infectious diseases in the basic immunization schedule. Most of the interviewees had a personal vaccine registry, but not all had received the 2015 influenza vaccine. Both groups had known people who refused vaccines for themselves or for their children (respectively, 54.7 and 43.3% of students and 59.0 and 41.0% of physicians). The total of 48.7% of physicians had already assisted vaccine refusers. Appointed causes of vaccine refusal were: fear of adverse events, philosophical and religious reasons and lack of knowledge about severity and frequency of diseases. Ethical aspects of vaccine refusal and legal possibilities of vaccine requirements for children are not consensus. Conclusions: Medical students and doctors are not adequately vaccinated and have queries about the vaccination schedule, vaccine safety and vaccine refusal. Improving these professionals’ knowledge is an important strategy to maintain vaccine coverage and address vaccine refusal ethically.

摘要
研究目的：明确医学生与医师对疫苗接种重要性及疫苗拒绝接种行为的风险认知。
研究方法：本研究为横断面研究，针对疫苗、疫苗拒绝接种及其对公共与个体健康的影响开展问卷调查。研究从某私立医学院选取92名研究对象，分为两组：组1（53名一至四年级医学生）与组2（39名医师）。收集的数据采用Microsoft Excel软件进行制表，并通过费希尔精确检验（Fisher’s exact test）进行统计学分析。
研究结果：两组研究对象均认可国家免疫规划（National Immunization Program）具有可靠性，并认同疫苗接种的重要性，但64.2%的医学生与38.5%的医师不了解基础免疫规划程序中可通过疫苗预防的传染病。多数受访者均拥有个人疫苗接种记录，但并非所有人都接种了2015年流感疫苗（influenza vaccine）。两组均有认识的人曾为自身或子女拒绝接种疫苗（医学生群体中该比例分别为54.7%与43.3%，医师群体中分别为59.0%与41.0%）。总计48.7%的医师曾接诊过拒绝接种疫苗的患者。受访者提及的疫苗拒绝接种原因包括：对不良反应的恐惧、哲学与宗教层面的理由，以及对疾病严重程度与发病频率的认知匮乏。关于疫苗拒绝接种的伦理问题，以及儿童强制接种疫苗的法律可能性，目前尚未达成共识。
研究结论：医学生与医师群体的疫苗接种覆盖率不足，且对免疫规划程序、疫苗安全性及疫苗拒绝接种行为存在疑问。提升该群体的相关医学知识，是维持疫苗接种覆盖率、以伦理方式应对疫苗拒绝接种问题的重要策略。