新型流感疫苗接種影響因素之探討

面對一個新興傳染疾病，疫苗發展與接種策略是有效控制傳染病防治最經濟、有效的方法，可有效預防感染後引發的嚴重合併症，減少病人住院或死亡。本研究是以健康信念模式為理論基礎，採用自擬結構式問卷，經IRB審核通過，以高雄縣27鄉鎮年滿18歲以上民眾為研究對象，依人口比例採分層隨機抽樣，於西元2009年12月24日至2010年2月28日止進行資料收集，共得1106位有效樣本，整體問卷回收率為77％，問卷整體信度為0.706。本研究結果顯示民眾對H1N1流感及疫苗接種相關知識答對率為79.7％（Mean=11.9，SD=2.1），民眾對H1N1流感疫苗廠牌的選擇，則以外國製(諾華藥廠)的為主(49.5％)。此波H1N1流感疫苗接種過程，雖因媒體的大肆負面報導疫苗不良反應通報事件，導致整體的疫苗接種率下降，但本研究結果發現居住在非都會區（OR= 1.9）、醫療相關人員（OR=2.9）、曾有接種季節性流感疫苗經驗（OR=5.0）以及有獲得H1N1新型流感相關資訊者（OR=3.8）、健康信念的自覺罹患性（OR=1.3）、自覺行動效益（OR=1.8）、自覺行動障礙（OR=0.4）、行動線索（OR=2.2）等變項，在此波H1N1流感疫情中，仍為H1N1疫苗接種意願和實際接種重要的預測因子。 2009年全球爆發的H1N1新型流感疫情，絕對不會是新興傳染性疾病的最後一個，此研究結果建議政府衛生機關應加強提高每年季節性流感疫苗的接種率，及建立民眾流感疫苗正向的健康信念及知識，減少媒體疫苗的負面障礙性報導，並透過行動線索增加民眾對流行疾病與疫苗接種正確資訊的獲得，以提升新型流感疫苗的接種率，達有效實施公衛預防、疾病防治之政策。

關鍵字

H1N1新型流感疫苗；健康信念模式

並列摘要

Face emerging infectious diseases, vaccine development and vaccination strategy is most cost-effective method of infectious disease control, effective in preventing serious complications caused by infection, reduces hospitalization or death. Based on health belief model, we survey people aged 18 or above from 27 townships of Kaohsiung County about the knowledge of influenza vaccination and their willingness to accept vaccination using IRB approved self-designed structural questionnaire. A total of 1,106 valid samples were obtained for analysis.The response rate was 77%. The results showed that 79.7% of people answered correctly aboutH1N1 influenza vaccination (Mean = 11.9, SD = 2.1). 49.5 % of people preferred to accept foreign-made (Novartis Pharmaceuticals) H1N1 influenza vaccine. Our results also showed the overall vaccination rate dropped significantly when the media had negative reports about the adverse event especially concerning patient death.that the results revealed that people living in non-metropolitan areas (OR = 1.9), medical and related personnel (OR = 2.9), those had the experience of vaccination against seasonal influenza vaccine ( OR = 5.0) and have accessed to information about H1N1 pandemic influenza (OR = 3.8), health beliefs of perceived susceptibility (OR = 1.3), perceived benefits of taking action (OR = 1.8), perceived barriers of taking action (OR = 0.4), and cues to action (OR = 2.2) were significantly associated with their willingness to accept vaccination again H1N1 influenza. Since the global outbreak of the H1N1 pandemic influenza in 2009 will be continuing and come again in the future,the need of effective strategy to increase the vaccination rate is important.Based on our results, we suggest that government health organization should strive to encourage people to accept annual seasonal influenza vaccine, and to educate people about health beliefs and knowledge in influenza vaccine using various ways. The potential media effects on the vaacination rate should be concerned.