Wybór programu realizacji szczepień ochronnych to jedna z istotniejszych decyzji, jaką podejmują matki na wczesnym etapie życia dziecka. Skorzystać z bezpłatnych szczepień obowiązkowych, czy wybrać wariant skojarzony? – to pytanie kobiety zadają sobie zwykle tuż po porodzie1, choć nie brakuje takich, które odpowiedź na nie znają już na etapie planowania ciąży.1 Sam temat szczepień, zwłaszcza skojarzonych, był w ostatnich latach szeroko dyskutowany, szczególnie w Internecie. Narosło wokół niego wiele negatywnych emocji, które zaowocowały spadkiem zaufania wobec tej formy ochrony przed chorobami zakaźnymi wśród matek i przyszłych matek.1

Jak pokazują tegoroczne badania, zrealizowane przez Millward Brown (Vaccine Tracking1 oraz Bariery przed szczepieniem 6w11), nastawienie do szczepień skojarzonych nie jest obecnie aż tak nieprzychylne, jak by się mogło wydawać wnosząc po internetowych przekazach. Nie jest jednak również całkowicie pozytywne. Jak szczepienia skojarzone odbierają rodzice? Przedstawiamy kilka istotniejszych trendów w tym obszarze w oparciu o wyniki przeprowadzonej analizy.

 Skojarzone – constans, obowiązkowe – in plus

Jak podaje Millward Brown, choć nastawienie kobiet wobec szczepień w ogóle nie jest tak pozytywne jak jeszcze kilka lat temu, to  jednak nieznacznie poprawiło się ono na przestrzeni ostatnich miesięcy. Przeprowadzone badanie pokazało, że trwający od 2013 roku trend wyraźnego pogarszania się nastawienia do szczepień, po raz pierwszy uległ zatrzymaniu.1

Kobiety pytane o swój stosunek do szczepień w ogóle,  prawie  w ¾ przypadków deklarują nastawienie pozytywne, a spora część z nich – 37 proc. z tendencją wzrostową – sądzi, że szczepienia obowiązkowe powinny obejmować ochronę przed jak największą liczbą chorób.1,2  Sytuacja komplikuje się, gdy przychodzi do wyboru między wariantami bezpłatnym dla dzieci zdrowych a szczepieniami wysoce skojarzonymi (5w1 lub 6w1). Wiedza na temat dostępności szczepień wysoce skojarzonych jest wprawdzie od kilku lat raczej stała i utrzymuje się na poziomie 50-52 proc. spontanicznych wskazań1, ale wiele kobiet, utwierdzonych przez niefachowe źródła internetowe (np. fora internetowe, grupy na facebooku) w negatywnym obrazie tych szczepień, wciąż boi się po nie sięgać.1  Niekorzystny klimat wokół szczepień zdaje się kumulować szczególnie wokół szczepień wysoce skojarzonych, które w oczach respondentek, nawet świadomych zalet tych preparatów, budzą najwięcej obaw.1

 Wiedza medyczna bardzo pożądana

 Obawy względem szczepień wysoce skojarzonych są ściśle związane z chaosem informacyjnym, na który skarżą się matki i przyszłe matki.1 Typowa droga do zdobycia przez nie wiedzy na ten temat prowadzi najpierw przez mnóstwo przekazów, z których należy wyłuskać korzyści, a następnie – jeśli korzyści te wydają się przekonujące – drugie tyle czasu poświęcić na ugruntowanie przekonań w taki sposób, by irracjonalne argumenty przeciw nie przeważyły.1 Kluczowa rola przypada tu w udziale personelowi medycznemu, a szczególnie pediatrom, którzy mogą pomóc w podjęciu decyzji na temat szczepienia dziecka. Jak pokazują badania,  znaczna większość kobiet, które konsultowały z lekarzem program szczepień swojego dziecka, potwierdza, iż porada lekarska co do wyboru szczepień wysoce skojarzonych  była obiektywna, nie wskazująca na konkretne preparaty.1

Równolegle zaobserwować można inną tendencję w zdobywaniu przez matki wiedzy na temat szczepień. Średnio połowa matek noworodków i kobiet w ciąży po pierwszą poradę co do wyboru pomiędzy szczepieniami bezpłatnymi a wysoce skojarzonymi, płatnymi dla  zdrowych niemowląt2 udaje się do rodziny lub doświadczonych koleżanek, a na rozmowę z lekarzem przychodzi już wyposażona w argumenty za i przeciw.1 Niezależnie jednak od stopnia samodzielności decyzji, większość badanych potwierdza, że autorytet lekarza jest dla nich w tej materii istotny i pożądany.1

6w1 – korzystne, ale…

Jak już wspomniano, kwestia postrzegania i znajomości szczepień 6w1 od kilku lat pozostaje na poziomie niezmiennym.1 Wśród zwolenniczek tego wariantu dominują matki bardziej otwarte na nowoczesne rozwiązania i przekonane o niepodważalnym autorytecie lekarza w kwestii podejmowania medycznych wyborów.1 Kobiety, które już skorzystały ze szczepień skojarzonych (1/6 badanych), doceniają związane z nimi korzyści, wśród których wymieniają przede wszystkim możliwość ochrony dziecka przed bólem, jedno wkłucie zamiast kilku i mniejszy stres dziecka podczas każdej z wizyt szczepiennych.1 Dodatkowo, wśród sympatyków wariantu 6w1 funkcjonuje ugruntowane przekonanie o nowoczesności i jakości szczepień wysoce skojarzonych.1

Zwolenniczki szczepień 6w1 znajdują się jednak w mniejszości w stosunku zarówno do grupy osób korzystających ze szczepień bezpłatnych, jak też matek wybierających płatne szczepienia skojarzone 5w1. Dla tych ostatnich 5w1 bywa często „złotym środkiem” pomiędzy szczepieniem finansowanym przez państwo, oznaczającym więcej zastrzyków w ramach jednej wizyty,2* a wariantem 6w1, wizerunkowo powiązanym ze wszelkimi możliwymi obawami w kwestii szczepień wysoce skojarzonych.1 Jakimi konkretnie? Szczepienia wysoce skojarzone, a 6w1 w szczególności, wywołują wątpliwość czy ochrona dziecka przed kilkoma chorobami w jednym zastrzyku nie jest aby większym jednorazowym obciążeniem dla organizmu niż zastrzyk szczepionki chroniącej przed jedną chorobą.1 Matki obawiają się też o bezpośrednią reakcję dziecka na szczepienie i długoterminowy wpływ szczepionki na zdrowie, a także wnikliwie sprawdzają skład szczepionek, ponieważ wypowiedzi internetowe sugerują, że rzekomo zawierają rtęć.1

Co dalej w kwestii szczepień?

Jak widać, postrzeganie szczepień skojarzonych przez matki i przyszłe matki jest nie tylko ambiwalentne, ale też  silnie podlega trendom społecznym i modom. Choć korzyści z wyboru wariantu odpłatnego są dla matek często oczywiste, na drugim biegunie sytuują się liczne obawy i wątpliwości, które rozwiać może w zasadzie tylko lekarz, który przekazuje merytoryczną wiedzę na temat szczepień, o ile…zostanie wysłuchany i wygra z przekazem internetowym.1

Informacje na temat badań wykorzystanych w tekście:

Nazwa badania Vaccine tracking
Wykonawca Millward Brown
Zleceniodawca GSK
Przedmiot badania Monitoring postaw dotyczących szczepień obowiązkowych i zalecanych, a także wskaźnika znajomości, intencji zakupu, wiedzy i postaw względem szczepień skojarzonych (oraz innych szczepień, nie będących przedmiotem powyższego tekstu).
Próba badawcza Próba n=309.

Respondentki – kobiety będące w III trymestrze ciąży oraz matki dzieci w wieku do 6 miesięcy, nie mające poważnych problemów zdrowotnych, deklarujące dochód w gospodarstwie domowym co najmniej 750 zł/os. netto, z miast >100 tys. mieszkańców.

Metodologia Wywiad indywidualny face-to-face
Czas realizacji 19.11.2015 – 18.12.2015 r.
Nazwa badania Bariery przed szczepieniem 6w1. Badanie jakościowe – perspektywa lekarzy i matek
Wykonawca Millward Brown
Zleceniodawca GSK
Przedmiot badania Pozyskanie opinii matek i przyszłych matek na temat szczepień skojarzonych 6w1, w tym w szczególności diagnoza barier przed korzystaniem z nich, a także pozyskanie opinii pediatrów w ww. kwestiach.
Próba badawcza Próba n=34

Respondentki – kobiety będące w 3. trymestrze ciąży; matki dzieci przed  pierwszą wizytą szczepienną; matki dzieci będących po pierwszej wizycie szczepiennej (w tym te, które zaszczepiły dzieci szczepieniami bezpłatnymi, 5w1 i 6w1). Wszystkie: bez problemów zdrowotnych w ciąży i po porodzie.

Dodatkowo n=12: lekarze pediatrzy.

Metodologia Rozmowy za pomocą mini grup fokusowych (MG) i narzędzia Ideablog.
Czas realizacji 18-25.02.2016 r.

 

Referencje:

  1. Millward Brown na zlecenie GSK, Postrzeganie szczepień skojarzonych
    przez matki niemowląt oraz kobiety w ciąży
    , raport z badań, Warszawa, czerwiec 2016 r. (http://www.gsk.com.pl/Aktualnosc-media/Raport-Postrzeganie-szczepien-skojarzonych-przez-matki-niemowlat-oraz-kobiet-w-ciazy.html?vid=484, ostatni dostęp: czerwiec 2016)
  1. Program Szczepień Ochronnych na rok 2016, Komunikat Głównego Inspektora Sanitarnego z dnia 16 października 2015r. (poz. 63).; http://dziennikmz.mz.gov.pl/DUM_MZ/2015/63/akt.pdf [dostęp 16.06.2016].
  • nie obejmuje bezpłatnych szczepień DTaP u dzieci z trwałymi przeciwwskazaniami do  szczepienia DTPw oraz dzieci urodzonych przed ukończeniem 37 tygodni ciąży lub urodzonych z masą urodzeniową poniżej 2500 g.
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