Commencing on 1 January 2016, the Australian Government's ‘No Jab, No Pay’ policy revised the immunisation requirements for eligibility of families to receive family assistance payments, including: the Family Tax Benefit Part A (FTB‐A) end‐of‐year supplement; Child Care Benefit (CCB); and Child Care Rebate (CCR).1, 2 Eligibility for the payments was extended to require children of all ages up to and including 19 years of age to be fully immunised or on a recognised catch‐up program. Two catch‐up programs, one ongoing and the other restricted to two years, were established for children aged less than 10 years, and children aged 10–19 years, respectively. Conscientious objection and vaccination on non‐medical grounds have been removed as valid exemptions from immunisation requirements, and strict criteria for a medical exemption retained. Government budget papers reported that the new measures would save $508.3 million over five years.3

The suggestion that low coverage may be associated with socioeconomic status (SES) has been of particular interest to those looking at reasons for under‐ or non‐vaccination. Publicly available data from the National Health Performance Authority in December 2015 reportedly showed that the percentage of fully immunised 5‐year‐old children was lower in the ‘rich’ suburbs of Melbourne and Sydney, among other affluent suburbs, and this sparked much public debate.4, 5 In fact, it has been suggested that childhood immunisation coverage might be lower at either end of the socioeconomic spectrum, potentially exposing inherent inequity in the ‘No Jab, No Pay’ policy as the financial penalty is more likely to be incurred by those at the lower end, who are more reliant on family assistance payments. To investigate this hypothesis, we undertook an ecological study in Victoria to determine if childhood immunisation coverage, by vaccine and age cohort, varied by postcode‐level SES in the preceding five years (2011 to 2015).

The Australian Childhood Immunisation Register (the Australian Immunisation Register [AIR] since September 2016) provides immunisation coverage data to the Victorian Department of Health and Human Services Immunisation Section each quarter, stratified by three age cohorts (12‐<15; 24‐<27; and 60‐<63 months), postcode, and vaccine (diphtheria‐tetanus‐acellular pertussis; inactivated poliomyelitis; Haemophilus influenzae type b; hepatitis B; pneumococcal conjugate; measles‐mumps‐rubella; meningococcal C; varicella), based on the National Immunisation Program (NIP) Schedule.6

All Victorian immunisation coverage data for children from 2011 to 2015 were aggregated by age cohort, postcode and vaccine, and merged by postcode with three of the publicly available Socio‐Economic Indexes for Areas (SEIFA) data published by the Australian Bureau of Statistics.7 Each index is based on a weighted combination of selected variables from Census data. Areas are scored based on ordinal measures that represent a rank, rather than a quantity, of advantage or disadvantage. The Index of Relative Socio‐Economic Advantage and Disadvantage (IRSAD) scores areas on a continuum from most disadvantaged to most advantaged, the Index of Economic Resources (IER) scores areas on financial aspects of socio‐economic dis/advantage, and the Index of Education and Occupation (IEO) scores areas on skills and qualifications.7 Seventy‐three postcodes, comprising 0.5% of the eligible population, had immunisation data but no SEIFA score. Postcodes were ranked by score of each SEIFA index and assigned a quintile (quintile 1 representing the lowest SEIFA scores and 5 the highest) determined by age cohort. Data were aggregated to calculate the percentage of children immunised for each vaccine within each age cohort, index and quintile. An AIR representative confirmed that HREC approval was not required for the analysis.

Figure 1 shows immunisation coverage by SEIFA index quintile, age cohort and vaccine. In the 12‐<15 month cohort, coverage is lowest in the lowest SES quintile, for all vaccines and indexes. When ranked according to financial status using the IER, immunisation coverage was also lowest in the first SES quintile for both the 24‐<27 and 60‐<63 months cohorts. However, when ranked by education and occupation using the IEO, immunisation coverage was lowest in the fifth SES quintile for all vaccines (except varicella) in the 24‐<27 and 60‐<63 months age cohorts. When ranked by IRSAD, the lowest immunisation coverage for all vaccines was split between the first and fifth quintiles in the 24‐<27 and 60‐<63 months age cohorts. The spilt in the IRSAD findings probably reflects the composite variables that includes most of those in the IER and IEO.7 The findings for varicella vaccine were distinct: immunisation coverage was lowest in the first quintile for all SEIFA indexes, and lower than other vaccines for the 24‐<27 months age cohort overall by 1.7–3.8%, indicating the lowest uptake of all the vaccines in this cohort. The difference between the highest and lowest immunisation coverage quintiles was greatest for all indexes in the 12‐<15 months age cohort (1.5–2.1%), and in the IER (1.7–1.8%) and IEO (2.0–2.3%) in the 60‐<63 months age cohorts.

Продолжение тут https://onlinelibrary.wiley.com/doi/full/10.1111/1753-6405.12676

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На форуме с 2010 .

Public health
Research
Do parental education and income matter? A nationwide register-based study on HPV vaccine uptake in the school-based immunisation programme in Norway
Berit Feiring1, Ida Laake1, Tor Molden1, Inger Cappelen2, Siri E Håberg3, Per Magnus3, Ólöf Anna Steingrímsdóttir4, Bjørn Heine Strand4, Jeanette Stålcrantz1, Lill Trogstad1
Author affiliations

Abstract

Objective Vaccine against human papillomavirus (HPV) has been offered free of charge to all 12-year-old girls in Norway since 2009. Nevertheless, the uptake of HPV vaccine is lower than for other childhood vaccines. The aim of this study was to examine whether parental education and income are associated with initiation and completion of HPV vaccination.

Design Nationwide register-based study.

Setting Publicly funded childhood immunisation programme in Norway.

Participants 91 405 girls born between 1997 and 1999 and registered in the Norwegian Central Population Registry were offered HPV vaccine during the first 3 programme years. Of these, 84 139 had complete information on all variables and were included in the study.

Measurements Information on HPV-vaccination status was obtained from the Norwegian Immunisation Registry. Data on socioeconomic factors were extracted from Statistics Norway. Risk differences (RDs) and CIs were estimated with Poisson regression.

Results In the study sample, 78.3% received at least one dose of HPV vaccine and 73.6% received all three doses. High maternal education was significantly associated with lower probability of initiating HPV vaccination (multivariable RD=−5.5% (95% CI −7.0% to −4.0%) for highest compared with lowest education level). In contrast, high maternal income was significantly associated with higher probability of initiating vaccination (multivariable RD=10.1% (95% CI 9.0% to 11.3%) for highest compared with lowest quintile). Paternal education and income showed similar, but weaker, associations. The negative association between education and initiation was only seen for incomes below the median value.

Conclusions In spite of the presumably equal access to HPV vaccine in Norway, we found socioeconomic disparities in vaccine uptake. More studies are needed to explain the underlying factors responsible for the observed socioeconomic differences. Insight into these factors is necessary to target information and increase vaccination coverage to ultimately reduce HPV-related disease across socioeconomic barriers.

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial.


https://bmjopen.bmj.com/content/5/5/e006422

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На форуме с 2010 .

Родители, которые знают кого-то, чей ребенок пострадал от вакцинации, реже прививают своих детей, и чаще откладывают вакцинацию на более поздний срок.
Многие родители сомневаются в рекомендациях врачей, потому что они знают, что врачи должны достичь определенного охвата вакцинации, и имеют финансовую заинтересованность в прививках.

Influences on Immunization Decision-Making among US Parents of Young Children
Yunmi Chung et al. Matern Child Health J. 2017 Dec.
Free PMC article
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Abstract

Objectives This study assessed influences on vaccination decisions among parents of young children and examined common vaccination information and advice sources. Methods Using panel samples of parents of children under 7 years, web-based surveys were conducted in 2012 (n = 2603) and 2014 (n = 2518). A vaccine decision-making typology (non-hesitant acceptors, hesitant acceptors, delayers, and refusers) was established and weighted population estimates of potential factors influencing parental vaccination decision (e.g., provider influence, source of information and advice) were computed by year and decision type. Results Delayers and refusers were more likely than acceptors to know someone whose child experienced a severe reaction to a vaccine or delayed/refused vaccine(s). High proportions of delayers (2012: 33.4%, 2014: 33.9%) and refusers (2012: 49.6%, 2014: 58.6%) reported selecting their healthcare provider based on whether the provider would allow them to delay/refuse vaccines. Providers were the most frequently reported trusted vaccine information source among all parents, though more often by acceptors than refusers (2012, 2014: p < 0.01). We found differing patterns of provider advice-seeking and internet as a reliable vaccine information source by group. Among those who had considered delay/refusal, trust in their healthcare provider's advice was the most common reason cited for their decision reversal. Conclusions for Practice Provider trust and communication along with varying degrees of personal-network influences likely contribute to immunization decisions of parents. Vaccine hesitant parents often seek providers amenable to accommodating their vaccine beliefs. Providers may benefit from vaccine communication training as their recommendations may influence hesitant parents to immunize their children.

Keywords: Parental decision-making; Pediatric populations; Vaccine acceptability; Vaccine delay; Vaccine hesitancy; Vaccine refusal.

https://pubmed.ncbi.nlm.nih.gov/28755045/

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На форуме с 2010 .

Gen Pract. 2001 Nov; 51(472): 904–910.
PMCID: PMC1314147
PMID: 11761204
Parents' perspectives on the MMR immunisation: a focus group study.
M Evans, H Stoddart, L Condon, E Freeman, M Grizzell, and R Mullen
Author information Copyright and License information Disclaimer
See commentary "MMR and the age of unreason." on page 875.
See letter "Risks and benefits of MMR." in volume 52 on page 234a.
This article has been cited by other articles in PMC.
Abstract
BACKGROUND: The uptake of the combined measles, mumps and rubella immunisation (MMR) in Britain has fallen since 1998, when a link was hypothesised with the development of bowel disorders and childhood autism. Despite reassurances about the safety of MMR, uptake levels remain lower than optimal. We need to understand what influences parents' decisions on whether to accept MMR or not so that health professionals can provide a service responsive to their needs. AIM: To investigate what influences parents' decisions on whether to accept or refuse the primary MMR immunisation and the impact of the recent controversy over its safety. DESIGN: Qualitative study using focus group discussions. SETTING: Forty-eight parents, whose youngest child was between 14 months and three years old, attended groups at community halls in six localities in Avon and Gloucestershire. METHODS: Purposive sampling strategy was used to include parents from a variety of socioeconomic backgrounds. Three groups comprised parents who had accepted MMR and three groups comprised parents who had refused MMR. Data analysis used modified grounded theory techniques incorporating the constant comparative method. RESULTS: All parents felt that the decision about MMR was difficult and stressful, and experienced unwelcome pressure from health professionals to comply. Parents were not convinced by Department of Health reassurances that MMR was the safest and best option for their children and many had accepted MMR unwillingly. Four key factors influenced parents' decisions: (a) beliefs about the risks and benefits of MMR compared with contracting the diseases, (b) information from the media and other sources about the safety of MMR, (c) confidence and trust in the advice of health professionals and attitudes towards compliance with this advice, and (d) views on the importance of individual choice within Government policy on immunisation. CONCLUSIONS: Parents wanted up-to-date information about the risks and benefits of MMR to be available in advance of their immunisation appointment. Many parents did not have confidence in the recommendations of health professionals because they were aware that GPs needed to reach immunisation targets. Most parents would, however, welcome more open discussion about immunisation with health professionals.

Full Text https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1314147/

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На форуме с 2010 .

Раньше были сумки и чеки а теперь длинные простыни. Модератор Пудик, проведите разведку боем, какой пулеметчик строчит с ника Амалия? У вас под носом завелась крыса.

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У Самурая нет цели, только путь.

Можно эту ахинею про прививки убрать куда-нибудь в детский раздел? Мы поняли, что отсутствие мозгов у амалии скорее всего следствие полученных в детстве прививок, но нельзя же так убиваться, полно людей живут без них (мозгов), и ты, амалия, проживешь.

Ужос нах ,
Уберите ее отсюда в песочницу

Маш, спасибо, что тебе хватает терпения - отвечать нормально, спокойно и логично.

Может хоть кто-то - кто способен думать - твои посты прочитает, какие-то выводы для себя сделает.

А так - "спор" между человеком со специальным медицинским образованием и опытом работы в медицине, и человеком, постящим простыни из Гугла, или какие-то свои воображаемые идеи.... Депрессивно.

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Мужчина и женщина никогда не поймут друг друга,потому что они хотят разного:
мужчина хочет женщину,а женщина-мужчину :)

Джой,я проматываю это все. Так и до вышек 5G тут дойдём если будем такое по серьёзному читать. Тем более что выбор не вакцинировать у родителей в этой стране есть. И среди невакцинированых Тоже полно аутизма и эпилепсии, к сожалению.

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Все непросто в наших душах, белый с чёрным перемешан

думала приду- че нить интересного прочту

1. доллар в конце 2020 до 90 дойдет
2. остальное без изменений
3. людей начнут прививать от короны, всплывут два лагеря- бойтесь/бегите делайте

перед развалом ссср тоже людям квартиры безплатно раздавали, в наше время деньги суют всем- подозрительно

взяли непонятную генетическую структуру, прикрепили к воздухопередаваемому вирусу, заразили людей по крупным городам мира, дали название вирусу, вирус проникает в спинномозговое вещество и блокирует центры кровоснабжения и дыхания, мутируя в организме, изменняя какой-то генный компанент, развезли реагентов для определения мутации, подогнали вакцину для не заразившихся. При том сначала заразили темнокожых население планеты, когда типо Эбола была в Африке, потом желтое население, и потом белое население. У первых двух не произошло должного результата, поэтому остановились на белом населении. Ищут что-то.

Мне думается, что те у кого веселье с алкоголем и разными партнерами как раз обычно умудряются родить несколько раз от этих разных партнеров :) Намного больше становится тех, кто строит карьеру до 40-45 лет и детей не рожает до этого умышленно

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Life in a cage cowering in fear isn't life at all. Let those who wish to cower, cower, let those who wish to live, live!

ой , ну прям про меня - вышла в замуж в 35 лет и родила первую дочку в 35 лет, до этого все было и алкоголь и любви страстные (каждая следующая страстнее) и карьера. Теперь вот Счастлива в браке с 2 прекрасными дочками и 1 мужем .

все эти истории - типа в 27 лет старородящая это все прошлый век. Главное любить жизни, быть на позитве, и иметь мечты и цели и добиваться их реализации. и все получится.

Не ну слушай я твои вопросы не очень понимаю так как они так абстрактные ...
Но у нас так мы все вместе обсуждаем
и Слава Богу мы на одной волне по этой теме.
Мужу я своему доверяю в плане медицины 100%!
Во первых он умный образованный мужчина который с логикой и common sense очень дружит( Phd Phisics / Engeenirings)
И в плане медицины да и вообше если какая проблема он все изучит досконально он как компьютер и выдаст the best option
И я ему доверяю так как практика показала что он выбирает правильные решения.по жизни!

А у вас как?

Это конечно не мое дело и очень sensitive, и я очень извиняюсь за вопрос
Но у вас что есть проблемы с дочкой?

Еще раз я извиняюсь и не в коем случае не хочу тебя обидеть или задеть
Я тоже мама и понимаю что каждая мать хочет самое лучшее для своего ребенка

Так Амалия в России же да? Так в России же и план по прививкам составят и обследуют и температуру померяют! Не как в америке где влепят за раз пять уколов!