Recusa da vacinação em área urbana do norte de Portugal

Abstract

AIMS: To know the number of vaccine refusals and to investigate the reasons for non-compliance with vaccination by the parents of children and adolescents living in an urban area of northern Portugal.METHODS: A cross-sectional study was carried out with a sample of children/adolescents up to the age of 14 enrolled in health units in a metropolitan area of Porto, Portugal, belonging to the health centers groupings of Porto Ocidental, Porto Oriental, Gaia, Gondomar and Matosinhos, whose parents refused any vaccination of the National Vaccination Program in the period from January 2009 to December 2015. We studied the characterization of the sample and the reasons for vaccine rejection through the application of a questionnaire to parents.RESULTS: We identified 150 cases of children/adolescents to whom the parents refused any vaccine, in a global population of 103,406 children, resulting in a vaccine refusal rate of 0.14%. The highest rate occurred in the Porto Ocidental health centers grouping: 0.31%. Among the 150 cases, 86 parents accepted to respond to the questionnaire, corresponding to an adhesion rate of 64%. The median age of children/adolescents whose parents refused vaccination was seven years; most of them were healthy and had no perinatal problems. All parents were adults, mostly married and female. Most parents had a college degree and were professionally active. The Porto Oriental health centers grouping was the one where the parents who refused vaccines were mostly males, had a higher academic level and were more professionally active. The vaccine with the highest refusal rate was BCG, followed by anti-human papillomavirus and measles, mumps and rubella vaccine. The four main reasons for vaccination refusal by the parents were "vaccines are not a priority", "vaccines are not safe", "indication of the attending physician" and "fear of side effects." The reason for the "indication of the attending physician" was in all cases referred to the BCG vaccine.CONCLUSIONS: In this population the vaccination refusal rate was low; however, based on the results obtained, intervention efforts can be directed towards the families, aiming at combating the arguments without scientific basis and obtaining an unequivocal adhesion to the National Vaccination Program in Portugal.