Unit

VACCINATIONS

HepatitisA and B are serious infections that are easily prevented throughvaccines. The vaccines are recommended for people of all ages but areusually administered to babies at birth. The vaccine is given in 2-4shots spread out over a period of 6-8 months. However, differentcultural, religious, and personal views influence perceptions towardhepatitis A (HAV) and B (HBV) vaccines and all vaccines in general.Asians have a particularly culture-informed perception towardshepatitis A and B vaccines and all vaccines in general as discussed.

Asianpeoples’ view on vaccines was brought to the limelight recentlyafter some Chinese immigrants were linked to measles outbreak in theUS. The case was however, not directly linked to perceptions towardsvaccines. In the US, hepatitis vaccinations at birth are mandatory.However, some other vaccines are voluntary giving individuals theright to reject vaccines. In China on the other hand, mostvaccinations including HBV/HAV are mandatory giving little space fortheir individual views. The American Medical association opposesmandatory vaccinations and thus offers room for personal views tothrive. A recent survey showed that majority of Americans at 78%favor mandatory vaccinations including for Hepatitis A and B (Bell2015).

Inthe US, Asian Americans are at a higher risk of contracting HAV/HBV.In fact, one in every 12 Asian Americans is chronically infected withhepatitis B compared to one in 1000 non-Hispanic whites (CDC 2015).The CDC attributes the high prevalence to older Asians usually bornout of the US. This older Asian population shies away from hepatitisA and B screening and subsequent vaccination for fear of testingpositive which can lead to stigmatization (Tanaka, Gehan, Chen &ampWang, 2014). Other barriers to vaccination among Asian and Pacificislanders include system deficiencies such as discomfort with thewestern medical system, language barrier, poor knowledge and lack ofawareness (ibid). The high regard for Chinese herbal remedies andmistrust of western medicine have been significant hindering factorsto vaccinations police sin the US especially among adults. Forparents, the option to deliver away from hospitals to avoidvaccination altogether has been cited to be a cause of significantcases of hepatitis a and B infections among children. The governmenthas responded through developing culturally specific hepatitis A andB education materials and offering screening at schools.

Vaccinationshave been vital in cutting down hepatitis A and B prevalence rates.Since the 1990’s prevalence has dropped by 90% (CDC 2015).Previously, some US states including Arizona, Alaska, Oregon, NewMexico, Utah, Washington, Oklahoma, South Dakota, Idaho, Nevada, and California have recorded higher prevalence rates that have coincidedwith lower intake of vaccinations in those states (CDC 2015). Anotherstudy by Xiong (2013) and colleagues identified Minnesota as a highrisk state in Hepatitis A and B due to low vaccination rates. Thestudy estimated that Asians were 80 times more likely to be infectedwith HAV/HBV than whites. Vaccinations uptake was also lower amongAsians. Knowledge about HBV was most critical in influencing uptakeof HBV vaccination. In a sample of immigrants from Laos, only 14(8.4%) of the over 160 adults participants had received HBVvaccination with only two completing the required three doses (Xionget al 2013). In another study, Frew and colleagues (2014) revealedthat collective reasoning was key to influencing attitudes anduptakes of vaccinations among Americans of Vietnamese heritage.

Thediscussion clearly shows that vaccination uptake is a significantimpediment to fighting HBV/HAV. Knowledge about the infections andcultural influences such as stigmatization and a negative attitudetowards western medicine among Asian Americans and Asians in generalcontribute to the high prevalence rates in this particular ethnicgroup. Future strategies to address vaccination should look atincreasing culturally relevant education to different ethnic groupsto promote uptake of vaccinations and achieve public health goals.

References

Bell,A. (2015). BigU.S. Majority Favors Mandatory Vaccinations. Retrievedfrom

http://www.huffingtonpost.com/2015/02/24/poll-big-us-majority-fa_n_6742162.html

CDC(2015) virala hepatitis populations. Retrieved from

http://www.cdc.gov/hepatitis/Populations/api.htm

Frew,P., Alhanti, B., vo-Green, L., Zhang, S., Liu, C., Nuyen (2014).Multilevel Factors

InfluencingHepatitis B Screening and Vaccination among Vietnamese Americans inAtlanta, Georgia. YaleJ. Biol Med 87(4): 455–471.

Tanaka,Gehan, Chen &amp Wang, 2014). Hepatitis B Screening Practice amongOlder Chinese in

theGreater Washington, DC, Area. SouthMed J.107(10): 655–660.

Xiong,M., Nguyen, R., Strayer, L., Chanthanouvong, S. &amp Yuan, J.(2013). Knowledge and

Behaviorstoward Hepatitis B and the Hepatitis B Vaccine in the LaotianCommunity in Minnesota. JImmigr Minor Health15(4): 771–778.

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