Wednesday, 3rd of August 2016 |
Vaccine. 2016 Jul 19;34(33):3823-7. doi: 10.1016/j.vaccine.2016.05.038. Epub 2016 Jun 10.
Perceptions of oral cholera vaccine and reasons for full, partial and non-acceptance during a humanitarian crisis in South Sudan
Peprah D1, Palmer JJ2, Rubin GJ3, Abubakar A4, Costa A4, Martin S4, Perea W4, Larson HJ5.
Abstract
Oral cholera vaccination (OCV) campaigns were conducted from February to April 2014 among internally displaced persons (IDPs) in the midst of a humanitarian crisis in Juba, South Sudan. IDPs were predominantly members of the Nuer ethnic group who had taken refuge in United Nations bases following the eruption of violence in December 2013. The OCV campaigns, which were conducted by United Nations and non-governmental organizations (NGOs) at the request of the Ministry of Health, reached an estimated 85-96% of the target population. As no previous studies on OCV acceptance have been conducted in the context of an on-going humanitarian crisis, semi-structured interviews were completed with 49 IDPs in the months after the campaigns to better understand perceptions of cholera and reasons for full,partial or non-acceptance of the OCV. Heightened fears of disease and political danger contributed to camp residents´ perception of choleraas a serious illness and increased trust in United Nations and NGOs providing the vaccine to IDPs. Reasons for partial and non-acceptance of the vaccination included lack of time and fear of side effects, similar to reasons found in OCV campaigns in non-crisis settings. In addition, distrust in national institutions in a context of fears of ethnic persecution was an important reason for hesitancy and refusal. Other reasonsincluded fear of taking the vaccine alongside other medication or with alcohol. The findings highlight the importance of considering the target populations´ perceptions of institutions in the delivery of OCV interventions in humanitarian contexts. They also suggest a need for better communication about the vaccine, its side effects and interactions with other substances.
Copyright © 2016 Elsevier Ltd. All rights reserved.
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