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Систематический обзор эмпирических исследований факторов отказа от вакцинации
The worldwide reduction of vaccination uptake due to the voluntary refusal by some subpopulations constitutes a significant threat to public health. The study aims to provide systematic description of the factors which influence attitudes or behaviors associated with a vaccination rejection. A systematic review was carried out in 2015 using the Web of Science database. The analysis included English-language articles published from 1980 to 2015 containing the results of original empirical research of the phenomenon of refusal of vaccination. Of the 679 records found 30 publications met the inclusion criteria. The results showed that the determination of non-vaccination is extremely variable. All factors refusal of vaccination discovered in the research were divided into four content blocks: 1) demographics and socioeconomic status; 2) cognitive; 3) behavioral and 4) other factors (a) vaccine-specific, b) health and medical conditions, c) social environment, d) informational influence. The active studying the vaccination refusal as a socio-psychological phenomenon last for about 15 years, the majority of studies performed in the United States and Canada. In more than 5 independent studies there were found links of non-vaccination attitudes or behavior to the following factors: the perceived low vaccine efficacy (cognitive factor); the idea of a high probability of serious side effects of vaccination and general vaccines unsafety (cognitive factor); low level of trust to "official" medicine and public entities (cognitive factor); use of complementary and alternative medicine by family members (behavioral factors). Other potentially important factors found in 5 studies were: low perceived risk of vaccine preventable diseases and the perceived potential harm of vaccination to the immune system of the child (cognitive factors). The systematic review revealed a general underestimation of the social and psychological factors in the study of the phenomenon of non-vaccination and an emphasis on cognitive factors.