Influensa är en vanligt förekommande sjukdom i hela världen. Äldre över 65 år är en riskgrupp där det föreligger ökad risk för komplikationer, sjuklighet och dödlighet till följd av insjuknande i influensa. Forskning visar att det mest effektiva sättet att skydda sig mot sjukdomen är genom vaccination. Vaccinationstäckningen för influensa bland äldre personer är låg och behöver öka. Syftet med litteraturstudien var att undersöka vad som påverkar äldre i deras val om att motta eller avböja influensavaccination. Studien genomfördes som en integrativ litteraturstudie där resultatet baserades på 18 artiklar. Fem kategorier identifierades: uppfattningen om effekt och biverkningar, tillgänglighet och kostnader, kunskap och brist på kunskap, omgivningens påverkan och preventivt hälsobeteende. Litteraturstudien bidrar med förståelse och kunskap om vad som kan påverka äldre i valet om att motta eller avböja influensavaccination som distriktssköterskan sedan kan använda i arbetet för att främja ett ökat vaccinationsupptag. Dock behövs vidare forskning kring vilka insatser äldre upplever att distriktssköterskan kan bidra med för att äldre personer skall kunna ta välgrundade beslut om influensavaccination. / Influenza is a common disease throughout the world. Older people over the age of 65 are a risk group in which there is an increased risk of complications, morbidity and mortality as a result of infected influenza. Research shows that the most effective way of protecting against the disease is by vaccination. The vaccination cover for influenza among elderly people is low and needs to increase. The purpose of the literature study was to investigate what affects elderly people in their choices to receive or reject influenza vaccination. The study was conducted as an integrative literature study based on 18 articles. Five categories were identified: perception of effects and side effects, availability and costs of the vaccine, knowledge and lack of knowledge, environmental impact and preventive health behavior. The literature study contributes with understanding and knowledge of what can affect elderly in their choices to receive or reject influenza vaccination that the district nurse can use in the work to promote an increased vaccination intake. However, research is needed on what efforts elderly people believe that the district nurse can contribute with to making informed decisions about influenza vaccination.

The aim of this survey is also to determine vaccination coverage in compulsory vaccination of kids in the first years of life, compliance of vaccine dose timing with vaccination schedule and reasons why some children were not vaccinated. Another goal is to analyse the reasons for some kids in the first years of life being vaccinated late and whether some kids in groups most at risk are vaccinated against tuberculosis. We used a quantitative research method in the form of a cross-sectional study comprised of data collection and analysis. Our research sample consisted of children born in the years 2009, 2010 and 2011 in České Budějovice district. The reason why we have chosen this particular group of children is that (if applicable vaccination schedule had been adhered to) they were supposed to be fully vaccinated against diphtheria, tetanus, whooping cough, haemophilus influenzae b, Hepatitis B virus, poliomyelitis (DTPHibHB). This group of 831 children (427 boys and 404 girls) have been chosen by random sampling from practising paediatricians. These selected physicians provided us with data about all children born in above mentioned years. The results showed that overall vaccination coverage for Infanrix Hexa vaccine (four doses) is 98.2% and 97.26% for Priorix vaccine (two doses). Vaccination coverage for tuberculosis in the years 2009 and 2010 was 90.05%. In the first years of life, up to 88.1% of newborns were vaccinated against tuberculosis ? at least, according to vaccination schedule (and applicable Order). In the first year of life, 99.9% of children have been given three doses of Infanrix Hexa vaccine against diphtheria, tetanus, whooping cough, poliomyelitis, Haemophilus influenzae b invasive disease and Hepatitis B virus. In the first eighteen months of life, 97.4% of children in analysed sample were given fourth dose of said vaccine. 68.6% of children were given the first dose of Priorix-Tetra vaccine in the first fifteen months of life. In the following six to ten months, 75.4% of children were given the second dose. Further analysis revealed that in 40.5% of analysed records some vaccine dose timings were not met. The most common reason for vaccination delay was the state of health of the child. Two instances of vaccination delay were also caused by the omissions of parents. In 2010, indication for vaccination against tuberculosis was recorded for one newborn. In 2011, for four children from the analysed sample vaccination against tuberculosis was recommended. In all cases, vaccination against tuberculosis has been carried out in calmetisation centre. Taking into account my study and its results I can safely assume that the goals of my diploma thesis have been met and the hypotheses set forth have been confirmed by the research.

v anglickém jazyce (Abstract) The aim of this diploma thesis is to analyze and compare the system of compulsory vaccination in the Czech Republic and in the French Republic. The first part of this diploma thesis is dedicated to international law context of compulsory vaccination. Relevant international organizations in which is the Czech Republic and also French Republic taking part is described. Then the focus of interest is also on all relevant binding sources of international law, or more precisely on promulgated international treaties, ratified and by which the Czech Republic and the French Republic is bound with the rule that if a treaty provides something other than national law, the treaty shall apply. The second part of this diploma thesis is dedicated to the connection between compulsory vaccination and constitutional law of the Czech Republic and French Republic, or rather how could be compulsory vaccination justified by the constitutional law of both countries. The case law coming from supervising constitutional institutions related to compulsory vaccination is also examined. In the third part, the legal regulation of key aspects of compulsory vaccination is examined. The focus of interest is on the amount of regulation made by statute and by secondary legislation. The aim of this part...

Submitted by Liliane Ferreira (ljuvencia30@gmail.com) on 2018-07-17T13:12:41Z No. of bitstreams: 2 Dissertação - Thairiane Guimarães Oliveira - 2018.pdf: 3935527 bytes, checksum: b2d64a8b08632bbd37415a47356f6a37 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) / Approved for entry into archive by Luciana Ferreira (lucgeral@gmail.com) on 2018-07-17T13:45:37Z (GMT) No. of bitstreams: 2 Dissertação - Thairiane Guimarães Oliveira - 2018.pdf: 3935527 bytes, checksum: b2d64a8b08632bbd37415a47356f6a37 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) / Made available in DSpace on 2018-07-17T13:45:37Z (GMT). No. of bitstreams: 2 Dissertação - Thairiane Guimarães Oliveira - 2018.pdf: 3935527 bytes, checksum: b2d64a8b08632bbd37415a47356f6a37 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Previous issue date: 2018-05-23 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES / INTRODUCTION: The oral polio vaccine (OPV) can cause a vaccine-derived poliovirus, which is a deterrent to the complete eradication of the disease. Globally, there is a gradual replacement of OPV by the poliomyelitis vaccine (VIP). Brazil has adopted an IPV-OPV mixed schedule since 2012, but no study was conducted to evaluate and compare the completeness and delay of vaccinations before and after the replacement of the oral vaccination with the inactivated poliovirus vaccination. OBJECTIVES: To compare the completion and delay of vaccination of children under 12 months of age before and after the introduction of the VIP vaccine in routine vaccination. METHODOLOGY: Before-and-after study with two live birth cohorts in the city of Goiânia, Goiás. A cohort of live births in 2010 received the vaccine regimen exclusively with OPV, and another cohort of live births in 2014 received the mixed vaccine regimen IPV-OPV. Two sources of nominal secondary data were used: the Ambulatory Care Control System, which contains data on vaccines and the Live Birth Information System, which contains data on the child and the mother. Completeness of vaccination schedule was defined as the receipt of three valid doses from the primary series up to 12 months of age. Vaccination delay was defined as the dose of vaccine given >28 days after the recommended age. The SICAA and SINASC databases were linked by deterministic linkage to identify the records of the same child. The follow-up time for each child was 12 months. RESULTS: A total of 23,335 children were included, 9,563 of the cohort born in 2010 and 13,772 of the cohort born in 2014. The proportion of children who received the IPV-OPV mixed regimen presented 78.0% of vaccine completeness, while the proportion of children who received only OPV schedule presented 72.4% of vaccine completeness (p=0.000). A higher proportion of vaccine delay of the 1st dose was observed: 6.9% and 5.8%, the second dose was 25.4% and 18.2%, and the third dose was 31.1% and 19.3% for the IPV-OPV and exclusively VOP vaccination schemes, respectively. Children who received the IPV-OPV mixed schedule had a highest median age at all doses, more days of delay and longer intervals between doses, when compared to children who received the OPV schedule. CONCLUSION: Children who received the VIP-VOP mixed schedule presented higher vaccine delay, but a greater proportion of vaccine completeness when compared to the children who received only OPV schedule. Efforts to achieve at-risk groups with delays are still needed despite improvements in the completeness of polio vaccines. / INTRODUÇÃO: A vacina oral contra poliomielite (VOP) pode provocar uma poliovirose derivada da vacina, o que constitui um empecilho à completa erradicação da doença. Mundialmente, está ocorrendo uma substituição gradual da VOP pela vacina injetável contra poliomielite (VIP). O Brasil adotou um esquema misto VIP-VOP desde 2012, mas nenhum estudo foi realizado para avaliar e comparar a completude e atraso aos esquemas antes e após a substituição da vacinação oral pela injetável. OBJETIVOS: Comparar a completude e o atraso vacinal de crianças menores de doze meses de idade antes e após a introdução da vacina VIP na vacinação de rotina. METODOLOGIA: Estudo tipo antes-e-depois da introdução da vacina injetável contra poliomielite, com duas coortes de nascidos vivos no município de Goiânia, Goiás. Uma coorte de nascidos vivos em 2010 recebeu o esquema vacinal exclusivamente com VOP e, outra coorte de nascidos vivos em 2014 recebeu o esquema vacinal misto VIP-VOP. Foram utilizadas duas fontes de dados secundários nominais: o do Sistema de Controle do Atendimento Ambulatorial (SICAA) que contém dados de vacinas e o Sistema de Informação de Nascidos Vivos (SINASC) que contém dados sobre a criança e a mãe. Completude do esquema vacinal foi definido como o recebimento de três doses válidas da série primária até os 12 meses de idade. Atraso vacinal foi definido como a dose de vacina administrada >28 dias após a idade recomendada. As bases de dados SICAA e SINASC foram vinculadas por meio de linkage determinístico para identificação dos registros de mesma criança. O tempo de seguimento de cada criança foi de 12 meses. RESULTADOS: Foram incluídas 23.335 crianças, sendo 9.563 da coorte de nascidos em 2010 e 13.772 da coorte de nascidos em 2014. A proporção de crianças que recebeu o esquema misto VIP-VOP apresentou 78,0% de completude vacinal, enquanto que a proporção de crianças que recebeu o esquema exclusivamente VOP apresentou 72,4% de completude vacinal (p=0.000). Ainda se observou maior proporção de atraso vacinal da 1º dose: 6,9% e 5,8%, 2° dose: 25,4% e 18,2% e, 3° dose: 31,1% e 19,3% para os esquemas vacinais VIP-VOP e exclusivamente VOP, respectivamente. As crianças que receberam o esquema misto VIP-VOP apresentaram maior mediana da idade em todas as doses, mais dias de atraso e maiores intervalos entre as doses, quando comparado com as crianças que receberam o esquema exclusivamente VOP. CONCLUSÃO: Crianças que receberam o esquema misto VIP-VOP apresentaram maior atraso vacinal, mas maior proporção de completude vacinal quando comparadas com as crianças que receberam o esquema exclusivamente VOP. Apesar de melhorias alcançadas na completude das vacinas contra a poliomielite, ainda são necessários esforços para atingir grupos de risco com atrasos.

Humant papillomvirus är ett mycket vanligt förekommande sexuellt överförbart virus som kan orsaka allvarliga sjukdomar såsom livmoderhalscancer. I Sverige vaccineras flickor i årskurs 5 – 6, vars vårdnadshavare har gett sitt skriftliga samtycke, mot humant papillomavirus via skolsköterskan. Vaccinet har minskat förekomsten av livmoderhalscancer. För att minska antalet dödsfall i denna sjukdom är det av stor vikt att uppnå hög vaccinationstäckning hos flickor före tonåren. Syftet med litteraturstudien var att belysa orsaker till att vårdnadshavare avböjer vaccination mot humant papillomvirus till sina döttrar. Studien genomfördes som en litteraturstudie med integrativ ansats. Resultatet baserades på 19 artiklar. Orsakerna till att vårdnadshavarna avböjer att vaccinera sina döttrar mot humant papillomvirus resulterade i sex teman: oro för vaccinets säkerhet; bristande kunskap; otillräcklig information; otydliga rekommendationer; värderingar och övertygelser; misstro gentemot myndigheter. Skolsköterskor bör utbildas och fördjupa sin kunskap om humant papillomvirus och om vaccinet för att förmå framföra korrekt och adekvat information. Detta kan minska vårdnadshavarnas oro, vilket i sin tur kan leda till att täckningsgraden ökar och folkhälsan förbättras. / Human papillomavirus is a very common sexually transmitted virus that can cause serious diseases such as cervical cancer. In Sweden, vaccination against human papillomavirus is administered by the school nurse to girls in grades 5 – 6 whose parents have given their written consent. The vaccine has shown to reduce the incidence of cervical cancer. In order to reduce the number of deaths in this disease it is very important to achieve high vaccination coverage in adolescent girls. The purpose of the literature study was to highlight the reasons why parents decline human papillomavirus vaccination for their daughters. The study was conducted as a literature study with an integrative approach. The result was based on 19 articles. The reasons why parents decline vaccination for their daughters resulted in six themes: concern about the safety of the vaccine; lack of knowledge; insufficient information; unclear recommendations; values and beliefs; distrust of authorities. School nurses should receive further education and improve their knowledge about human papillomavirus and the vaccination in order to provide accurate and adequate information. This can reduce parents’ concerns, which in turn can increase coverage and improve public health.

La vaccination du tissu cutané présente un fort potentiel, car elle permet le ciblage de l’antigène aux populations de cellules dendritiques uniques et spécialisées de la peau, et le recrutement de cellules inflammatoires du sang.Les cellules T helper folliculaires (TFH) jouent un rôle crucial dans l’établissement de la réponse humorale. Cependant, les interactions cellulaires et moléculaires qui gouvernent leur induction dans un contexte de vaccination restent à élucider.Mon projet de thèse a eu pour but de mieux comprendre les mécanismes d’induction des réponses TFH et humorales, par l’étude des événements précoces ayant lieu aux sites d’immunisation et d’induction de l’immunité adaptative après vaccination cutanée. L’utilisation de modèles murins nous a permis d’évaluer la contribution de différentes populations de la peau, du ganglion, et du sang dans la mise en place de ces réponses après immunisation intradermique avec un antigène particulaire présentant l’antigène modèle p24 du VIH. Cette étude a révélé un rôle crucial des cellules de Langerhans et des cellules dendritiques migratoires de la peau dans l’induction de réponses TFH et humorales.Nous avons ensuite évalué la capacité de différentes formulations d’adjuvants à polariser la réponse TFH et humorale contre un antigène de l’enveloppe du VIH à fort potentiel vaccinal. L’utilisation de l’émulsion IFA favorise l’induction des cellules TFH et induit la production d’anticorps neutralisants des souches du VIH.Ces résultats soulignent l’importance de cibler les DCs de la peau par l’utilisation de voies de vaccination pertinentes et l’utilisation d’adjuvants capables de favoriser la réponse cellulaire TFH. / Skin vaccination is of great interest, as it enables targeting of the antigen to unique and specialized dendritic cell populations of the skin, as well as recruitment of inflammatory blood cells.T follicular helper (TFH) cells play a critical role in the setting of the humoral response. However, the cellular and molecular interactions that underlie their induction after vaccination remain unknown.My thesis project aimed at understanding the immune mechanisms by which skin vaccination could favor the induction of TFH and humoral immune responses by studying the early events that take place in tissue and lymph node.Using mice models, we evaluated the relative contributions of various populations from the skin, lymph node and blood in the setting of TFH cell responses after intradermal immunization with nanoparticles coated with p24 antigen from HIV. This revealed a crucial role of Langerhans cells and skin migratory dendritic cells in the induction of TFH and germinal center responses.We then evaluated the ability of different adjuvant formulations to polarize the TFH and humoral response against a promising vaccine antigen from HIV envelope protein. Emulsifying the antigen in IFA favors the induction of TFH cells and induces the production of neutralizing antibodies able to block viral infection.This work highlights the relevance of targeting skin dendritic cells by using relevant vaccination routes and adjuvant formulation able to induce TFH cell responses.

Bakgrund: Vaccinering mot allvarliga, smittsamma sjukdomar är en av de mest effektiva åtgärderna till god folkhälsa i världen. Det förhindrar många dödsfall och svåra komplikationer av sjukdomarna varje år. Sverige har en hög vaccinationstäckning, och en av distriktssköterskans roller är att nå ut till tveksamma föräldrar med information om varför barnvaccinering är viktig. Syfte: Att belysa vilka strategier distriktssköterskor tillämpar i mötet med föräldrar som tvekar till att vaccinera sina barn enligt vaccinationsprogrammet. Metod: Studiedesignen var en semistrukturerad intervjustudie med enskilda eller gemensamma intervjuer, och metoden var en kvalitativ innehållsanalys med induktiv ansats. Resultat: Distriktssköterskorna beskrev att det viktigaste i mötet med tveksamma föräldrar var att vara påläst, att inte stressa utan låta det ta den tid det tar. Att de först bygger på en relation och skapar förtroende, och sedan genom att vara lyhörd och respektfull kunna få förmedla en anpassad information. Viktigt var också att ha stöd och hjälp av kollegor och BHV-team. Diskussion: Det distriktssköterskorna beskrev visar på att det regionalt finns ett bra nätverk och fortbildning, samt nationellt kunskapsunderlag, som stöd som de kan ta del av för att anpassa sina strategier, oavsett vilken erfarenhet de har av möten med tveksamma föräldrar. Slutsats: Denna studie visar på olika tips och strategier som en distriktssköterska kan ha användning av i sitt arbete oavsett vilket BVC de arbetar på. / Background: Vaccination against serious, contagious diseases is one of the most effective interventions for public health in the world. It prevents many deaths and serious complications of these diseases every year. Sweden has a high vaccination rate, and one of the roles of the Community Health nurse (CH nurse) is to reach hesitant parents with information about the importance of child vaccination. Aim: To illustrate which strategies CH nurses use in meeting parents who hesitate to vaccinate their children according to the National Child Vaccination Program. Method: Design of the study was a semi-structured interview study containing single and joint interviews, and the method was a qualitative content analysis with an inductive approach. Results: The CH nurses described that what was most important in the meeting with hesitant parents was to be well informed, not to stress but to take the required time necessary. The nurses found that by first building a relationship and a trust, by being responsive in listening and respectful, they could receive permission to give individualized information. Also of importance was to have support and help from colleagues and the regional Child Health Care Team. Discussion: What the CH nurses described show that they have a working regional network and access to further education, and also that there is a national base of knowledge, as support to adjust their strategies, no matter what experience they have in meeting hesitant parents. Conclusion: This study presents different tips and strategies that a CH nurse may have of use, no matter which Child Health Care Center they work on.Keywords: / <p>Godkännandedatum: 2019-11-12</p>

Rabies is a fatal but preventable neurotropic disease of potentially all mammals. The disease is caused by lyssaviruses. Rabies is recognized as the 10th most common lethal infectious disease in the world, rendering it one of the most feared zoonotic diseases known to man. Nevertheless, rabies can be prevented by application of pre- or post exposure treatments. Rabies vaccines have been available since the time of Pasteur, more that one hundred years ago. Since, vaccine research focused on the development of safer and more effective vaccines. Topics of current interest in the field of rabies vaccinology were addressed in this study. A primary concern regarding the disease is human mortalities, in the range of 60 000, reported every year. Most of these are linked to exposure to rabid dogs. In addition, a great number of post exposure treatments are administered each year at great costs. Despite availability of efficacious biologics, several factors influence the optimal use and accessibility of these agents in the countries of interest, with cost and availability being the major contributing factors. A proven approach is mass oral vaccination of target animals, such as dogs, which indirectly infers protection to susceptible hosts, including man. Currently available vaccines present several disadvantages of use though, including issues of safety or doubtful stability. Safer but effective alternative vaccines that could be used in oral baits would be valuable. Here the use of two candidate host restricted poxvirus vaccine vectors were explored, particularly also in regard to oral innocuity. The construction, convenient isolation and use of a recombinant Lumpy skin disease virus (Neethling strain) expressing rabies virus glycoprotein in a mouse model were investigated. In addition, a recombinant Modified Vaccinia virus Ankara expressing rabies virus glycoprotein was prepared and tested as a vaccine in mice, dogs and raccoons. In both cases it was clear that the severe attenuation of these viruses did affect the efficacy of the recombinant vaccines in the non-permissive hosts. With the recombinant MVA a clear dosage effect could be shown, and equivalent humoral responses could only be attained at much higher titers of vaccine virus as with replication competent counterparts. Secondly, the cross-protection of rabies vaccines across the spectrum of lyssaviruses was addressed. Lyssaviruses can be divided into two groups based on sequence analysis and pathogenesis. Viruses belonging to the so-called phylogroup II, are the Mokola, Lagos and West Caucasian Bat viruses. Classic rabies biologics fail to fully protect against the viruses attributed to a lack of cross-neutralization. Here, cross-protection and cross-reactive immune responses induced by recombinant vaccinia viruses expressing rabies, Mokola or West Caucasian Bat virus glycoproteins, in single or dual combinations, were investigated. As expected, there was a lack of cross-protection of rabies and Mokola glycoprotein vaccines. There was also a clear lack of cross-protection of West Caucasian Bat virus glycoprotein vaccine and rabies and Mokola viruses. The dual antigen expressing vaccines did not appear to offer any additional protective effect in the tested model. The Mokola virus glycoprotein vaccines induced neutralizing antibody responses that significantly cross-neutralized Lagos Bat virus. / Thesis (PhD (Microbiology))--University of Pretoria, 2006. / Microbiology and Plant Pathology / unrestricted

Objetivos: Estimar la prevalencia y los factores asociados a la intención de vacunación (IDV) contra la COVID-19 en el Perú. Materiales y métodos: Estudio transversal analítico utilizando una encuesta realizada por la Universidad de Maryland, EUA, en Facebook. La variable dependiente fue la IDV. Se calcularon razones de prevalencia (RP) crudas y ajustadas, con sus intervalos de confianza al 95% (IC95%), mediante modelos lineales generalizados de la familia Poisson para evaluar la asociación de variables sociodemográficas, el cumplimiento de estrategias comunitarias de mitigación, los síntomas de la COVID-19, la salud mental y la aceptación de la vacunación ante la recomendación (AVR) por diversos actores y autoridades sanitarias. Resultados: Se analizaron los datos de 17 162 adultos. La prevalencia general de la IDV fue del 74,9%. Se asociaron a una menor prevalencia de la IDV ser de sexo femenino (RP = 0,95; IC95%: 0,94-0,97), vivir en un pueblo (RP = 0,95; IC95%: 0,91-0,99) o en una aldea u otra área rural (RP = 0,90; IC95%: 0,86-0,93) y la AVR de políticos (RP = 0,89; IC95%: 0,87-0,92). Contrariamente, tener síntomas de COVID-19 (RP = 1,06; IC95%: 1,03-1,09), inseguridad económica (RP = 1,04; IC95%: 1,01-1,06), miedo a enfermar o que un familiar enferme de COVID-19 (RP = 1,49; IC95%: 1,36-1,64) y la AVR de familiares y amigos (RP = 1,10; IC95%: 1,08-1,12), trabajadores de la salud (RP = 1,29; IC95%: 1,26- 1,32), la Organización Mundial de la Salud (RP = 1,34; IC95%: 1,29-1,40) y funcionarios del gobierno (RP = 1,18; IC95%: 1,15-1,22) se asociaron con mayor prevalencia de IDV. Conclusiones: Tres cuartas partes de los encuestados manifiestan IDV. Existen factores potencialmente modificables que podrían mejorar la aceptación de la vacuna. / Objectives: To estimate the prevalence and factors associated with COVID-19 vaccination intention (VI) in Peru. Materials and methods: Analytical cross-sectional study using the survey conducted by the University of Maryland, USA, on Facebook. The dependent variable is VI. Crude and adjusted prevalence ratios (PR) were calculated, with their 95% confidence intervals (95%CI) using generalized linear models of the Poisson family, to evaluate the association of sociodemographic variables, com- pliance with community mitigation strategies, symptoms of COVID-19, mental health and acceptance of vaccination before the recommendation (AVR) by various actors and health authorities, with the ITV. Results: Data from 17,162 adults were analyzed. The overall prevalence of VI was 74.9%. A lower prevalence of VI was associated with the female sex (PR=0.95; 95%CI:0.94-0.97), living in a town (PR=0.95; 95%CI:0.91-0.99) or village or other rural area (PR=0.90; 95%CI:0.86-0.93) and the AVR of politicians (PR=0.89; 95%CI:0.87-0.92). Conversely, having COVID-19 symptoms (PR=1.06; 95%CI:1.03-1.09), economic insecurity (PR=1.04; 95%CI:1.01-1.06), fears of becoming seriously ill or that a family member becomes seriously ill from COVID-19 (PR=1.49; 95%CI:1.36-1.64) and the AVR of family and friends (PR=1.10; 95%CI: 1.08-1.12), healthca- re workers (PR=1.29; 95%CI: 1.26-1.32), World Health Organization (PR=1.34; 95%CI: 1.29-1.40) and government officials (PR=1.18; 95%CI: 1.15-1.22) was associated with a higher prevalence of VI. Conclusio of the respondents had VI. There are potentially modifiable factors that could improve vaccine acceptance.

Bakgrund: Immunisering är en vital del av folkhälsan. I Sverige är vaccinationstäckningenför barn hög och förtroende för immunisering god. I Australien är vaccinationsskepsisvanligare och både förtroendet och vaccinationstäckningen lägre än i Sverige, trots att bådaländerna har liknande policy kring vaccination. Den låga vaccinationstäckningen har lett tillatt nya åtgärder vidtagits för att öka vaccinationstäckningen i Australien.Syfte: Att analysera etiska argument för och emot barnvaccination genom att analyserapolicys, litteratur och samhällsdebatter samt undersöka de olika ståndpunkterna kringvaccination i Sverige och Australien.Metod: Deskriptiv argumentationsanalys och innehållsanalys används för att identifiera etiskaargument och innehåll i policydokument, vetenskaplig litteratur och debattartiklar. Dessaetiska argument analyseras sedan och jämförs med grundläggande etiska principer och teorier.Resultat: Det råder starka åsikter kring vaccinationsfrågan både från vaccinationsskeptikeroch förespråkare. De mest återkommande ämnena i litteratur och samhällsdebatt är autonomi,icke skada och tvångsvaccinering. Diskussionen kring dessa ämnen i den vetenskapligadiskussionen och i samhället pekar på komplexa frågor där argument kring vilka och varförolika beslut bör tas av beslutsfattande organ. I vetenskaplig litteratur beskrivs hur tvingandeåtgärder kan påverka samhället och i samhällsdebatten ligger stort fokus på föräldrarsrättigheter och vad som är bäst för barnen.Slutsats: Studien pekar på att en existerande etisk argumentation präglar både Sverige ochAustralien, där policyskapande kring vaccination av barn är en laddad och komplexsamhällsfråga. / Background: Immunization is a vital part of public health. In Sweden, vaccination coveragefor children is high and confidence in immunization is good. In Australia, vaccinationskepticism is more common and both confidence and vaccination coverage are lower than inSweden even though the countries have similar policies regarding vaccination. The lowvaccination coverage has led to implementation of measures to increase vaccination coveragein Australia.Purpose: To analyze ethical arguments for and against vaccination by analyzing scientificmaterial, policy documents on vaccination and debates in Sweden and Australia. As well asexamining the positions on vaccination that exist in these countries.Method: Descriptive argumentation analysis and qualitative text analysis have been used toidentify ethical arguments and content in policy documents, scientific literature and debatearticles. These ethical arguments are then analyzed and compared with basic ethicalprinciples.Results: The most recurring topics in the scientific literature and public debate are autonomy,the harm principle and compulsory vaccination. The discussion on these topics in thescientific discussion points out that it is difficult to answer these complex questions aboutvaccination. Where arguments about which and why different decisions should be made bydecision-making bodies and what is best for public health. The scientific literature alsodescribes how coercive measures can have a negative effect on public health. The publicdebate has a strong focus on parents' rights and mandatory vaccinations in preschools.Conclusion: The study demonstrates a prevailing ethical discussion that characterizes both Sweden and Australia, where policy-making regarding vaccination of children is complexsocietal issue and autonomy, mandatory vaccinations and the harm principle are central to thedebate.