AŞI KARŞITLIĞI VE EKONOMİSİ

DEMIR, HÜSEYIN; yalcın balcık, pınar

AŞI KARŞITLIĞI VE EKONOMİSİ

Pınar YALÇIN BALÇIK, (Hacettepe Üniversitesi, İktisadi ve İdari Bilimler, Fakültesi, Sağlık Yönetimi Bölümü, Ankara, Türkiye)

Hüseyin DEMİR (İzmir Katip Çelebi Üniversitesi, İktisadi ve İdari Bilimler Fakültesi, Sağlık Yönetimi Bölümü, İzmir, Türkiye)

Hacettepe Sağlık İdaresi Dergisi

12 8

Yıl: 2021 Cilt: 24 Sayı: 2 Sayfa Aralığı: 375 - 398 Metin Dili: Türkçe İndeks Tarihi: 18-01-2022

AŞI KARŞITLIĞI VE EKONOMİSİ

Öz:

Onlarca yıllık deneyim, insanlar arasında aşılara karşı olumsuz algı ve tutumda çarpıcı bir artış olduğunu göstermiştir. Aşı karşıtlığı, aşı kapsamı oranlarının düşük olması gibi sağlık sistemleri üzerinde maliyet oluşturan ve toplumsal bağışıklığı tehdit eden durumları beraberinde getirmektedir. Aşı karşıtlığı, bireyin sağlığını etkileyebileceği gibi toplum sağlığını da olumsuz olarak etkileyebilmektedir. Bulaşıcı hastalıklar söz konusu olduğunda bu durum daha da zorlayıcı hale gelmektedir. Aşı karşıtlığı hareketinin bilimsel dayanakları bulunmamasına rağmen aktivistlerin liderlik ettiği bu süreçte, internet ve sosyal medyanın etkisiyle yanlış kaynaklardan üretilen yanlış bilgilerle beslenen insanlarda aşıya karşı olumsuz algı ve tutum ortaya çıkabilmektedir, bu durum en nihayetinde aşı kapsamının düşük olmasına neden olan aşı reddi davranışı ile son bulmaktadır. Literatürde aşı karşıtlığı ile ilgili üzerinde uzlaşı sağlanmış faktörler bulunmamaktadır. Bunun yanı sıra aşı karşıtlığı, sağlık sistemleri üzerinde oluşturabileceği maliyetler ve aşı olmamanın beraberinde getireceği dışsallıkların üreteceği toplumsal maliyetler nedeniyle sağlık ekonomisini yakından ilgilendirmektedir. Buradan hareketle, birey ve toplum sağlığı üzerinde yıkıcı etkileri bulunan aşı karşıtlığının temel nedenleri ile ilgili anlayış ve kavrayış sağlamaya çalışmak ve aşı karşıtlığını sağlık ekonomisi bağlamında değerlendirmek bu çalışmanın çıkış noktasını oluşturmaktadır. Çalışmada literatüre dayanılarak aşı karşıtlığında çeşitli faktörlere dikkat çekilmiş olup aşı karşıtlığının birey ve toplum üzerindeki maliyetleri sağlık ekonomisi perspektifinden kapsamlı olarak değerlendirilmeye çalışılmıştır. Çalışmanın bu yönüyle Türkiye’de aşı karşıtlığı ile ilgili oluşmaya başlayan literatüre katkı sağlayacağı düşünülmektedir.

Anahtar Kelime:

ANTI-VACCINATION AND ITS ECONOMICS

Öz:

The decades of experience have shown that there is a dramatic increase in negative perceptions and attitudes related to vaccines among people. This emerging trend, which is labelled as anti-vaccination movement, not only costs health systems but it also threatens herd immunity due to such low coverage rates of vaccines. Anti-vaccination can affect herd immunity as well as individuals. This situation becomes more challenging if infectious diseases are taken into account. Despite there is no convincing scientific basis for the movement, negative perception and attitudes relating vaccination may occur among people who are fed with the wrong information shared from the wrong sources through the internet and social media. There is no consensus and understanding about factors related to anti-vaccination in literature. Besides, anti-vaccination is closely related to the health economics due to the costs that may make high burden on health systems, and the social costs that will be accompanied by the externalities associated with not being vaccinated. Therefore, the study aims to examine the possible causes of anti-vaccination which has destructive effects on individual and public health, and to evaluate the movement in the context of the health economics perspective. Various factors relating anti-vaccination were examined, and the costs of anti-vaccination on individuals and the herd immunity were tried to be comprehensively evaluated from the health economics perspective. With this regard, it is thought the study contributes to the literature about anti-vaccination in Turkey.

Anahtar Kelime:

Belge Türü: Makale Makale Türü: Derleme Erişim Türü: Erişime Açık

Andersen, R. M. (1995). Revisiting the behavioral model and access to medical care: Does it matter?. Journal of Health and Social Behavior, 36(1), 1-10.
Anwari, P., Debellut, F., Pecenka, C., Parwiz, S. M., Clark, A., Groman, D., & Safi, N. (2018). Potential impact and cost-effectiveness of rotavirus vaccination in Afghanistan. Vaccine, 36(51), 7769-7774.
Attwell, K., Navin, M. C., Lopalco, P. L., Jestin, C., Reiter, S., & Omer, S. B. (2018a). Recent vaccine mandates in the United States, Europe and Australia: A comparative study. Vaccine, 36(48), 7377-7384.
Attwell, K., Ward, P. R., Meyer, S. B., Rokkas, P. J., & Leask, J. (2018b). “Do-it-yourself”: Vaccine rejection and complementary and alternative medicine (CAM). Social Science and Medicine, 196, 106-114
Betsch, C., Böhm, R., & Chapman, G. B. (2015). Using behavioral insight to increase vaccination policy effectiveness. Policy Insight from the Behavioral and Brain Sciences, 2(1), 61-73.
Bos, J. M., & Postma, M. J. (2001). The economics of HIV vaccines: Projecting the impact of HIV vaccination of infants in sub-saharan Africa. Pharmacoeconomics, 19(9), 937-946.
Bos, J. M., Rümke, H. C., Welte, R., Postma, M. J., & Jager, J. C. (2002). Health economics of a hexavalent meningococcal outer-membrane vesicle vaccine in children: Potential impact of introduction in the Dutch vaccination program. Vaccine, 20(1-2), 202-207.
Bozkurt, H. B. (2018). Aşı reddine genel bir bakış ve literatürün gözden geçirilmesi. Kafkas Tıp Bilimleri Dergisi, 8(1), 71-76.
Brewer, N. T., Chapman, G. B., Gibbons, F. X., Gerard, M., McCaul, K. D., & Weinstein, N. D. (2007). Meta-analysis of the relationship between risk perception and health behavior: The example of vaccination. Health Psychology, 26(2), 136-145.
Browne, M., Thomson, P., Rockloff, M. J., & Pennycook, G. (2015). Going against the herd: Psychological and cultural factors underlying the “vaccination confidence gap”. PLoS ONE, 10(9), 1-14.
Bryden, G. M., Browne, M., Rockloff, M., & Unsworth, C. (2018). Anti-vaccination and pro-CAM attitudes both reflect magical beliefs about health. Vaccine, 36(9), 1227-1234.
Bryden, G. M., Browne, M., Rockloff, M., & Unsworth, C. (2019). The privilege paradox: Geographic areas with highest socio-economic advantage have the lowest rates of vaccination. Vaccine, 37(32), 4525-4532.
Callender, D. (2016). Vaccine hesitancy: More than a movement. Human Vaccines & Immunotherapeutics, 12(9), 2464-2468.
Chen, F., & Toxvaerd, F. (2014). The economics of vaccination. Journal of Theoretical Biology, 363, 105-117.
Coburn, D. (2014). Eşitsizlik ve sağlık. İçinde Panitch, L. & Leys, C. (Hzr.), Haskan, U. (Çev.), Kapitalizmde sağlık sağlıksızlık semptomları (ikinci baskı, s. 54-73). Yordam Kitap
Cooper, S., Betsch, C., Sambala, E. Z., Mchiza, N., & Wiysonge, C. S. (2018). Vaccine hesitancy–a potential threat to the achievements of vaccination programmes in Africa. Human Vaccines and Immunotherapeutics, 14(10), 2355-2357.
Deppe, H. U. (2014). Sağlık hizmetlerinin doğası: Metalaştırmaya karşı dayanışma. İçinde Panitch, L. & Leys, C. (Hzr.), Haskan, U. (Çev.), Kapitalizmde sağlık sağlıksızlık semptomları (ikinci baskı, s. 43-53). Yordam Kitap.
Dorso, C. O., Medus, A., & Balenzuela, P. (2017). Vaccination and public trust: A model for the dissemination of vaccination behaviour with external intervention. Statistical Mechanics and Its Applications, 482, 433-443.
Drummond, M. F., Sculpher, M. J., Claxton, K., Stoddart G. L., & Torrance, G. W. (2015). Methods for the economic evaluation of health care programmes. Oxford University Press.
Dube, E., Gagnon, D., Nickels, E., Jeram, S., Schuster, M. (2014). Mapping vaccine hesitancy- country-specific characteristics of a global phenomenon. Vaccine, 32(49), 6649-6654.
Dubé, E., Gagnon, D., Ouakki, M., Bettinger, J. A., Guay, M., Halperin, S., Wilson, K., Graham, J., Witteman, H. O., MacDonald, S., Fisher, W., Monnais, L., Tran, D., Gagneur, A., Guichon, J., Saini, V., Heffernan, J. M., Meyer, S., Driedger, M., Greenberg, J., & MacDougall, H. (2016). Understanding vaccine hesitancy in Canada: Results of a consultation study by the Canadian immunization research network. PloS One, 11(6), 1-16.
Ehreth, J. (2003). The global value of vaccination. Vaccine, 21(7–8), 596-600.
Gargano, L. M., Herbert, N. L., Painter, J. E., Sales, J. M., Morfaw, C., Rask, K., Murray, D., DiClemente, R. J., & Hughes, J. M. (2013). Impact of a physician recommendation and parental immunization attitudes on receipt or intention to receive adolescent vaccines. Human Vaccines and Immunotherapeutics, 9(12), 2627-2633.
Genovese, C., La Fauci, V., Squeri, A., Trimarchi, G., & Squeri, R. (2018). HPV vaccine and autoimmune diseases: Systematic review and meta-analysis of the literature. Journal of Preventive Medicine and Hygiene, 59(3), 194-199.
Gilmour, J., Harrison, C., Asadi, L., Cohen, M. H., & Vohra, S. (2011). Childhood immunization: When physicians and parents disagree. Pediatrics, 128(4), 167-174.
Gordon, S. (2015). Sosyal bilimler tarihi ve felsefesi. Küre Yayınları.
Gorman, D. R., Bielecki, K., Willocks, L. J., & Pollock, K. G. (2019). A qualitative study of vaccination behaviour amongst female polish migrants in Edinburgh, Scotland. Vaccine, 37(20), 2741-2747.
Grignolio, A. (2018). Vaccines: Are they worth a shot?. Springer International Publishing.
Gualano, M. R., Bert, F., Voglino, G., Buttinelli, E., D’Errico, M. M., De Waure, C., Di Giovanni, P., Fantini, M. P., Giuliani, A. R., Marranzano, M., Masanotti, G., Massimi, A., Nante, N., Pennino, F., Squeri, R., Stefanati, A., Signorelli, C., Siliquini, R., & Zappalà, G. (2018). Attitudes towards compulsory vaccination in Italy: Results from the NAVIDAD multicentre study. Vaccine, 36(23), 3368-3374.
Harari, Y. N. (2016). Homo deus: Yarının kısa bir tarihi. Kolektif Kitap.
Hobson, C., Maakaroun, Z., Dieckmann, K., Bernard, L., Amsellem-Jager, J., & Lemaignen, A. (2019). A preliminary prospective study: Could the labeling of a health-care message on a consumer product limit forgetfulness in parents confronted with immunization? Archives de Pediatrie, 26(2), 65-70.
Hoffman, B. L., Felter, E. M., Chu, K. H., Shensa, A., Hermann, C., Wolynn, T., Williams, D., & Primack, B. A. (2019). It’s not all about autism: The emerging landscape of anti-vaccination sentiment on Facebook. Vaccine, 37(16), 2216-2223.
Holt, E. (2018). 41 000 measles cases in Europe since the beginning of 2018. Lancet, 392, https://www.thelancet.com/action/showPdf?pii=S0140-6736%2818%2932031-2
Horne, Z., Powell, D., Hummel, J. E., & Holyoak, K. J. (2015). Countering anti-vaccination attitudes. Proceedings of the National Academy of Sciences, 112(33), 10321-10324.
Hussain, A., Ali, S., Ahmed, M., & Hussain, S. (2018). The anti-vaccination movement: A regression in modern medicine. Cureus, 10(7), e2919.
Kaku, M. (2015). Geleceğin fiziği. ODTÜ Geliştirme Vakfı Yayıncılık.
Kata, A. (2010). A postmodern Pandora’s Box: Anti-vaccination misinformation on the internet. Vaccine, 28(7), 1709-1716.
Keuffel, E. L., Stevens, M., Gunnarsson, C., Rizzo, J., Sessler, D. I., & Maheshwari, K. (2019). A Monte Carlo simulation estimating us hospital cost reductions associated with hypotension control in septic icu patients. Journal of Medical Economics, 22(4), 383-389.
Khan, M. M. (2008). Economics of polio vaccination in the post-eradication era: Should opv-using countries adopt IPV?. Vaccine, 26(16), 2034-2040.
Krishnamoorthy, Y., Eliyas, S. K., Nair, N. P., Sakthivel, M., Sarveswaran, G., & Chinnakali, P. (2019). Impact and cost effectiveness of pneumococcal conjugate vaccine in India. Vaccine, 37(4), 623-630.
Larson, H. J., Jarrett, C., Schulz, W.S., Chaudhuri, M., Zhou, Y., Dube, E., Schuster, M., MacDonald, N. E., & Wilson, R. (2015). Measuring vaccine hesitancy: The development of a survey tool. Vaccine, 33(34), 4165-4175.
Li, B., Forbes, T. L., & Byrne, J. (2018). Integrative medicine or infiltrative pseudoscience?. Surgeon, 16(5), 271-277.
Luyten, J., Bruyneel, L., & van Hoek, A. J. (2019). Assessing vaccine hesitancy in the UK population using a generalized vaccine hesitancy survey instrument. Vaccine, 37(18), 2494-2501.
Ma, J., & Stahl, L. (2017). A multimodal critical discourse analysis of anti-vaccination information on Facebook. Library and Information Science Research, 39(4), 303-310.
MacDonald, N. E. & the SAGE Working Group on Vaccine Hesitancy (2015). Vaccine hesitancy: Definition, scope and determinants. Vaccine, 33, 4161-4164.
Makarovs, K., & Achterberg, P. (2017). Contextualizing educational differences in “vaccination uptake”: A thirty nation survey. Social Science and Medicine, 188, 1-10.
Meyer, S. B., Violette, R., Aggarwal, R., Simeoni, M., MacDougall, H., & Waite, N. (2019). Vaccine hesitancy and web 2.0: Exploring how attitudes and beliefs about influenza vaccination are exchanged in online threaded user comments. Vaccine, 37(13), 1769-1774.
Nyhan, B., Reifler, J., Richey, S., & Freed, G. L. (2014). Effective messages in vaccine promotion: A randomized trial. Pediatrics, 133(4), 835-842.
Okuhara, T., Ishikawa, H., Kato, M., Okada, M., & Kiuchi, T. (2018a). A qualitative analysis of the beliefs of Japanese anti-influenza vaccination website authors. Heliyon, 4(4), 1-19.
Okuhara, T., Ishikawa, H., Okada, M., Kato, M., & Kiuchi, T. (2017a). A readability comparison of anti- versus pro-influenza vaccination online messages in Japan. Preventive Medicine Reports, 6, 47-52.
Okuhara, T., Ishikawa, H., Okada, M., Kato, M., & Kiuchi, T. (2017b). Readability comparison of pro- and anti-HPV-vaccination online messages in Japan. Patient Education and Counseling, 100(10), 1859-1866.
Okuhara, T., Ishikawa, H., Okada, M., Kato, M., & Kiuchi, T. (2018b). Contents of Japanese pro- and anti-HPV vaccination websites: A text mining analysis. Patient Education and Counseling, 101(3), 406-413.
Osman, J. (2016). Dünyayı değiştiren 100 fikir. Kolektif Yayınları.
Rat-Aspert, O., & Fourichon, C. (2010). Modelling collective effectiveness of voluntary vaccination with and without incentives. Preventive Veterinary Medicine, 93(4), 265-75.
Razzaghi, M. R., & Afshar, L. (2016). A conceptual model of physician-patient relationships: A qualitative study. Journal of Medical Ethics and History of Medicine, 9(14), 1-7.
Rheingans, R. D., Heylen, J., & Giaquinto, C. (2006). Economics of rotavirus gastroenteritis and vaccination in Europe: What makes sense? Pediatric Infectious Disease Journal, 25(1), 48-55.
Roberts, J. A., Cumberland, P., Sockett, P. N., Wheeler, J., Rodrigues, L. C., Sethi, D., & Roderick, P. J. (2003). The study of infectious intestinal disease in England: Socio-economic impact. Epidemiology and Infection, 130, 1-11.
Rosenthal, S. L., Weiss, T. W., Zimet, G. D., Ma, L., Good, M. B., & Vichnin, M. D. (2011). Predictors of HPV vaccine uptake among women aged 19-26: Importance of a physician’s recommendation. Vaccine, 29(5), 890-895.
Rozbroj, T., Lyons, A., & Lucke, J. (2019). Psychosocial and demographic characteristics relating to vaccine attitudes in Australia. Patient Education and Counseling, 102(1), 172-179.
Sarathchandra, D., Navin, M. C., Largent, M. A., & McCright, A. M. (2018). A survey instrument for measuring vaccine acceptance. Preventive Medicine, 109, 1-7.
Savaş, E. & Tanrıverdi, D. (2010). Knowledge, attitudes and anxiety towards Influenza A/H1N1 vaccination of healthcare workers in Turkey. BMC Infectious Diseases, 10(281), 1-6.
Shapiro, G. K., Tatar, O., Dube, E., Amsel, R., Knauper, B., Naz, A., Perez, S., & Rosberger, Z. (2018). The vaccine hesitancy scale: Psychometric properties and validation. Vaccine, 36(5), 660-667.
Siddiqui, M., Salmon, D. A., & Omer, S. B. (2013). Epidemiology of vaccine hesitancy in the United States. Human Vaccines & Immunotherapeutics, 9(12), 2643-2648.
Sundstrom, B., Smith, E., Delay, C., Luque, J. S., Davila, C., Feder, B., Paddock, V., Poudrier, J., Pierce, J. Y., & Brandt, H. M. (2019). A reproductive justice approach to understanding women’s experiences with HPV and cervical cancer prevention. Social Science and Medicine, 232, 289-297.
Takala, A. K., Koskenniemi, E., Joensuu, J., Makela, M., & Timo Vesikari, T. (1998). Economic evaluation of rotavirus vaccinations in Finland: Randomized, double-blind, placebo- controlled trial of tetravalent rhesus rotavirus vaccine. Clinical Infectious Diseases, 27(2), 272-282.
Thaler, R. & Sunstein, C. R. (2017). Dürtme: Sağlık, zenginlik ve mutlulukla ilgili kararları uygulamak. Pegasus Yayınları.
Topçu, S., Almış, H., Başkan, S., Turgut, M., Orhon, F. Ş., & Ulukol, B. (2019). Evaluation of childhood vaccine refusal and hesitancy intentions in Turkey. Indian Journal of Pediatrics, 86(1), 38-43.
Torun, S. D., & Torun, F. (2010). Vaccination against pandemic influenza a/h1n1 among healthcare workers and reasons for refusing vaccination in Istanbul in last pandemic alert phase. Vaccine, 28(35), 5703-5710.
Tosun, S., Olut, A. I., & Tansug, N. (2017). Adverse effects of single-component measles vaccine in school children. Vaccine, 35(52), 7309-7311.
Van Oorschot, D., Anastassopoulou, A., Poulsen Nautrup, B., Varghese, L., von Krempelhuber, A., Neine, M., Lorenc, S., & Curran, D. (2019). Cost-effectiveness of the recombinant zoster vaccine in the German population aged ≥ 60 years old. Human Vaccines and Immunotherapeutics, 15(1), 34-44.
Verger, P., Fressard, L., Collange, F., Gautier, A., Jestin, C., Launay, O., Raude, J., Pulcini, C., & Peretti-Watel, P. (2015). Vaccine hesitancy among general practitioners and its determinants during controversies: A national cross-sectional survey in France. EBioMedicine, 2(8), 891-897.
Wainstein, B. K., Sterling-Levis, K., Baker, S. A., Taitz, J., Brydon, M. (2006). Use of the internet by parents of pediatrics patients. Journal of Paediatrics and Child Health, 42(9), 528-532.
Wardle, J., Frawley, J., Adams, J., Sibbritt, D., Steel, A., & Lauche, R. (2017). Associations between complementary medicine utilization and influenza/pneumococcal vaccination: Results of a national cross-sectional survey of 9151 Australian women. Preventive Medicine, 105, 184-189.
Wheelan, C. (2015). Çıplak ekonomi: Küresel ekonomiyi eğlenceli bir dille okumak. Pegasus Yayınları.
WHO, World Health Organization. (2012). Global measles and rubella - strategic plan (2012-2020). Switzerland.
WHO, World Health Organization. (2014). Report of the sage working group on vaccine hesitancy. Switzerland.
WHO, World Health Organization. (2018). Assessment report of the global vaccine action plan. Switzerland.
Wiley, K. E., Cooper, S. C., Wood, N., & Leask, J. (2015). Understanding pregnant women’s attitudes and behavior toward influenza and pertussis vaccination. Qualitative Health Research, 25(3), 360-370.
Yalçın-Balçık, P. & Kartal, N. (2019). Bağışıklamanın dışsallığının sağlık ekonomisi perspektifinden değerlendirilmesi. Türkiye Klinikleri Sağlık Bilimleri Dergisi, 4(2), 219-230

APA	yalcın balcık p, DEMIR H (2021). AŞI KARŞITLIĞI VE EKONOMİSİ. , 375 - 398.
Chicago	yalcın balcık pınar,DEMIR HÜSEYIN AŞI KARŞITLIĞI VE EKONOMİSİ. (2021): 375 - 398.
MLA	yalcın balcık pınar,DEMIR HÜSEYIN AŞI KARŞITLIĞI VE EKONOMİSİ. , 2021, ss.375 - 398.
AMA	yalcın balcık p,DEMIR H AŞI KARŞITLIĞI VE EKONOMİSİ. . 2021; 375 - 398.
Vancouver	yalcın balcık p,DEMIR H AŞI KARŞITLIĞI VE EKONOMİSİ. . 2021; 375 - 398.
IEEE	yalcın balcık p,DEMIR H "AŞI KARŞITLIĞI VE EKONOMİSİ." , ss.375 - 398, 2021.
ISNAD	yalcın balcık, pınar - DEMIR, HÜSEYIN. "AŞI KARŞITLIĞI VE EKONOMİSİ". (2021), 375-398.

APA	yalcın balcık p, DEMIR H (2021). AŞI KARŞITLIĞI VE EKONOMİSİ. Hacettepe Sağlık İdaresi Dergisi, 24(2), 375 - 398.
Chicago	yalcın balcık pınar,DEMIR HÜSEYIN AŞI KARŞITLIĞI VE EKONOMİSİ. Hacettepe Sağlık İdaresi Dergisi 24, no.2 (2021): 375 - 398.
MLA	yalcın balcık pınar,DEMIR HÜSEYIN AŞI KARŞITLIĞI VE EKONOMİSİ. Hacettepe Sağlık İdaresi Dergisi, vol.24, no.2, 2021, ss.375 - 398.
AMA	yalcın balcık p,DEMIR H AŞI KARŞITLIĞI VE EKONOMİSİ. Hacettepe Sağlık İdaresi Dergisi. 2021; 24(2): 375 - 398.
Vancouver	yalcın balcık p,DEMIR H AŞI KARŞITLIĞI VE EKONOMİSİ. Hacettepe Sağlık İdaresi Dergisi. 2021; 24(2): 375 - 398.
IEEE	yalcın balcık p,DEMIR H "AŞI KARŞITLIĞI VE EKONOMİSİ." Hacettepe Sağlık İdaresi Dergisi, 24, ss.375 - 398, 2021.
ISNAD	yalcın balcık, pınar - DEMIR, HÜSEYIN. "AŞI KARŞITLIĞI VE EKONOMİSİ". Hacettepe Sağlık İdaresi Dergisi 24/2 (2021), 375-398.