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引用次数: 0
摘要
澳大利亚的强制疫苗接种政策历来允许非医疗豁免 (NME),但这一情况在 2016 年发生了变化,联邦政府停止了儿童疫苗接种要求的非医疗豁免。在 COVID-19 大流行期间,澳大利亚各州针对包括医护人员 (HCWs) 在内的一系列职业推出了进一步的强制疫苗接种政策。全球有证据表明,在国家医疗豁免(NMEs)终止后,医疗豁免(MEs)会增加;COVID-19 强制性疫苗接种的新政策很可能也对许多地区的医疗豁免系统造成了进一步的压力。本文通过概述儿童疫苗和 COVID-19 强制性疫苗接种政策的结构和运行情况,并以高危产妇强制接种为例,探讨了澳大利亚强制接种疫苗和 ME 政策的现状。接下来,本文探讨了医护人员为患者(尤其是 ME 患者)提供疫苗豁免的经验。最后,本文对现有文献进行了总结,并反思了作为不愿接种疫苗的人和照顾他们的临床医生的压力点的 ME 所面临的挑战,提出了未来研究和行动的领域。
Medical exemptions to mandatory vaccinations: The state of play in Australia and a pressure point to watch.
Australia's mandatory vaccination policies have historically allowed for non-medical exemptions (NMEs), but this changed in 2016 when the Federal Government discontinued NMEs for childhood vaccination requirements. Australian states introduced further mandatory vaccination policies during the COVID-19 pandemic for a range of occupations including healthcare workers (HCWs). There is global evidence to suggest that medical exemptions (MEs) increase following the discontinuation of NMEs; the new swathe of COVID-19 mandatory vaccination policies likely also placed further pressure on ME systems in many jurisdictions. This paper examines the state of play of mandatory vaccination and ME policies in Australia by outlining the structure and operation of these policies for childhood vaccines, then for COVID-19, with a case study of HCW mandates. Next, the paper explores HCWs' experiences in providing vaccine exemptions to patients (and MEs in particular). Finally, the paper synthesizes existing literature and reflects on the challenges of MEs as a pressure point for people who do not want to vaccinate and for the clinicians who care for them, proposing areas for future research and action.
期刊介绍:
Epidemiology & Infection publishes original reports and reviews on all aspects of infection in humans and animals. Particular emphasis is given to the epidemiology, prevention and control of infectious diseases. The scope covers the zoonoses, outbreaks, food hygiene, vaccine studies, statistics and the clinical, social and public-health aspects of infectious disease, as well as some tropical infections. It has become the key international periodical in which to find the latest reports on recently discovered infections and new technology. For those concerned with policy and planning for the control of infections, the papers on mathematical modelling of epidemics caused by historical, current and emergent infections are of particular value.