Knowledge and vaccination: The response to the 1990 National Urban Immunization Campaign in the Philippines.

摘要

This dissertation examines the role of caretaker's knowledge about vaccination in explaining their children's vaccination status in the context of a national media campaign promoting measles vaccination. I also investigated the source of that knowledge--whether it can be attributed to contact with public health services or to the National Urban Vaccination Campaign that was run between March and September 1990. The source of information was two cross-sectional surveys carried out in urban areas of the Philippines before and after the national campaign. The analysis (a) examined the effect of exposure to the national media campaign and to health services on knowledge about vaccination, then (b) investigated the effect of knowledge on vaccination. For the first type of analysis, the basic analysis strategy was to examine the change in the coefficient of the variable indicating timing (before or after the campaign) in a series of twenty-six logistic regressions predicting different items of knowledge when variables reflecting either exposure to the campaign or to health services were included in the regression. For the second analysis, I examined the effect on the timing variable of including the knowledge variables and variables reflecting exposure to the campaign and to health services in a series of logistic regressions predicting a child's vaccination status. Both vaccination coverage and some types of knowledge about vaccination, particularly knowledge about measles vaccination and about the age a child should start and finish getting vaccinations, increased substantially between 1989 and 1990. Exposure to the campaign accounted for about 25-50% of the 1989-1990 increases in individual items of knowledge, while exposure to health services accounted for 2-7% of the 1989-1990 increases. Among the items of knowledge considered, the maximum amount of the 1989-1990 increase in measles vaccination that any individual item could account for was 15%. Exposure to the campaign accounted for an additional 40-50%.