民眾對疫苗的態度與傳染病預防信念--以流感、SARS及水痘為例

Public Attitudes toward Vaccines and the Beliefs of Preventability--The Cases of Influenza, SARS and Varicella

郭瑋淋(Wei-Lin Kuo)

指導教授 ： 丁志音

國立臺灣大學/公共衛生學院/衛生政策與管理研究所/碩士(2004年)

https://doi.org/10.6342/NTU.2004.02006

摘要

民眾對疫苗的態度與傳染病預防信念，攸關防治策略的設計與成效。本研究以流感、SARS與水痘為例，探討台灣成年民眾對疫苗的看法、傳染病的預防信念，以及民眾對注射疫苗的接受程度與影響因素。
研究資料來自「2004年台灣民眾對疫苗及傳染病態度調查」，共收集1587名20歲以上成人的資料(完訪成必v為96.5%)。其重要結果如下：
1.有關民眾對疫苗的一般性看法部分：多數民眾認為預防傳染病，靠自己比靠疫苗有效，也覺得打疫苗未必就能保障其不生病，但仍有56.2%的民眾認為疫苗是預防新傳染病最重要的方法。而從個人特質來看，年輕人、高教育程度與曾聽聞負向疫苗事件之民眾較不仰賴疫苗。
2.在對特定傳染病疫苗的態度方面：半數以上的民眾認為打流感疫苗不具有預防SARS或禽流感的附帶效用，特別是年輕、高教育程度者。而面對水痘這種普遍的傳染病，儘管多數民眾同意出水痘比打疫苗所獲得的免疫效果好，但卻有76.6%的民眾認為兒童有必要施打水痘疫苗，特別是年輕、高學歷者。
3.至於傳染病的預防信念方面：多數民眾對靠自己預防流感及SARS的信心頗為正向，尤以老人、低教育程度及自覺免疫力佳者為甚。此外，養成良好的衛生習慣及行為乃是民眾認為最佳的預防途徑，對疫苗尚未產生過度的依賴。
4.有關接種疫苗的行為及意願部分：87.4%的民眾於這個冬天未接種流感疫苗，主要是基於健康狀況的考量。69.7%的民眾表示願意接種水痘疫苗，不願接種的理由多為儘可能避免醫療行為，以及自覺水痘並非嚴重的疾病。
整體而言，民眾對疫苗尚未抱持盲從或依賴的心態，簡單的衛生習慣成為人們所關注之焦點，但面對水痘這類普遍且嚴重性低的疾病，民眾仍仰賴疫苗以避免感染。由於本研究為一初探性研究，因此未來可針對接種疫苗組與未接種組，或是一些高危險群作更深入的探討。而今後政府在傳染病的防治宣導上，應確實瞭解民眾對疫苗的看法與需求，提供多元且充分的資訊，以便讓民眾選取最適當的預防方法。

關鍵字

SARS ； 流感 ； 預防信念 ； 疫苗 ； 水痘

並列摘要

The general public’s attitudes toward vaccines and the beliefs in the preventability of infectious diseases are critical to the implementation and effectiveness of intervention programs. This study takes influenza, SARS and varicella as examples to explore the public’s attitudes toward vaccines, their beliefs of prevention, and factors affecting the acceptability of immunization.
Data for the present research were drawn from the telephone survey “Public Attitudes toward Vaccines and Infectious Disease in Taiwan” which was carried out in February 1994. The final data included 1587 valid interviews with persons over twenty years of age (response rate=96.5%). The major findings are:
1.General outlook on vaccines: The majority of respondents believed in the relative effectiveness of self-protection and reliance rather than vaccination in the prevention of infectious diseases. While vaccination was deemed not fully effective, which was still recognized by 56.2% of respondents as the most important approach to prevent emerging infectious diseases. Respondents who were younger, with higher educational levels, and having exposed to negative immunization events were less likely to rely on vaccines.
2.In response to vaccines for specific diseases: Younger and more educated respondents tended to disbelieve the additional effects of certain vaccines, such as influenza vaccines on SARS or avian influenza. In terms of attitudes towards active versus passive immunization, taking varicella as an example, although most people agreed upon the better immunity effect of varicella disease per se than is the vaccine, they still supported varicella vaccination for children, particularly by those respondents who were younger and more educated.
3.Disease preventability: Most people, particularly those who were older and less educated, had confidences on the effects of self-preventive strategies on influenza and SARS. Personal hygienic habits were considered most effective. Overall, people did not rely on vaccines excessively.
4.Vaccination behavior and intention: Perceptions of health (immunity) was the most powerful factor in the determination of influenza vaccination in the last winter. With regard to varicella vaccine, the reluctance to vaccination were due mostly to the avoidance of medical interventions and perceived unseriousness of varicella.

In conclusion, the general public did not heartily rely on vaccines. They still value the fundamental personal hygiene. Nevertheless, in contrary, people were willing to get vaccinated in the face of varicella, usually regarded as common and minor illness by lay people. Future research should compare those who were vaccinated and none vaccinated, or conduct among high-risk people. Finally, the government should understand the general public’s attitudes toward vaccines and vaccination, and accordingly provide sound information to help people choose appropriate preventive methods.

並列關鍵字

beliefs of preventability ； influenza ； varicella ； SARS ； vaccine

參考文獻

丁志音、陳欣欣：預防為最上策-民眾的愛滋病性病防治信念與對保險套的看法。中華衛誌 2000；19(3)：180-91(b)。

丁志音、林怡靜、徐美苓、邢一如：傳染病爆發時民眾的預防行為-1998年的腸病毒流行。中華衛誌 2000；19(5)：397-406(a)。

行政院衛生署疾病管制局網站，2004：http://www.cdc.gov.tw/ch/

行政院衛生署疾病管制局：民眾對政府SARS防疫相關政策意見調查。台北：行政院衛生署疾病管制局，2003。

李守義、周碧瑟、晏涵文：健康信念模式的回顧與前瞻。中華衛誌 1989；9(3)：123-37。