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Vaccination refusing and its ethical coherence
BISCHOFOVÁ, Jana
This thesis is named: Vaccination refusing and its ethical coherence. The work consists of several parts. The first part is formed by theoretical possibilities. In this part we focus on the question of ethics. The basic question of this issue is a matter of imaginary dispute which also the ethics describes in its basic principles and which is the principle of nonmaleficence (not to inflict harm intentionally) and principle of beneficence (act for the benefit of others); and also the principle of autonomy and justice. This part further contains overview of compulsory and voluntary vaccination, a short description of each disease, side effects, division of the vaccines, principles of correct immunization and storage of vaccines, and an overview of reasons why the parents refuse vaccination given by the literature. The second chapter is the methodology. We set as a target of our work to identity and analyze ethical problems connected with refusing vaccination and to find out and describe the main reasons of the parents for refusing vaccination of their children. To reach these targets we interviewed twelve mothers and five pediatricians. The third chapter comprises of case studies, which shortly introduce the families, where the parents refuse vaccination for their children and briefly explain the problem in accepting children without vaccination by the pediatricians and society. There are twelve of these case studies. The fourth chapter includes results of the research, which were divided into three parts. The first part consists of reasons why the parents refuse vaccination for their children. There we analyzed five the most given reasons (side effects, different approach to life, composition of the vaccines, no occurrence of the diseases + small risk of infection, low age for vaccination). The second part is created by ethical problems connected with refusing vaccination from the perspective of the parents. During the interview we analyzed seven problems (truthfulness of the information, preventing from collective incorporation, denial of free choice, authority of the state, collective immunity, vaccination as a business, testing of vaccinations). In the third part there are the results of interviews with the doctors. After that follows the discussion. In the discussion there is a confrontation of the perspective of the parents, doctors, other specialists, and my own of the given problematic. In the conclusion I present an overview of the issue and proposals to think about and to the possible solutions.
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Health and social issues of vaccination
OLIVOVÁ, Vladimíra
The system of vaccination in the Czech Republic has a long tradition and the protection of public health and maintenance of a high immunization coverage in the population have always been a priority. The main goal of this bachelor's thesis is to perform an analysis of the morbidity levels of infectious diseases against which voluntary or mandatory vaccination is available in children and adults and of their social and health impacts, provide a rationale for vaccination and demonstrate the consequences of vaccine denialism. The theoretical part of the bachelor's thesis is based upon the analysis of scientific literature and represents a comprehensive introduction to the concept of vaccination, including a brief overview of the course, consequences and current spread of selected infectious diseases against which vaccination is available. The practical part of the bachelor's thesis is a combination of a secondary data analysis and quantitative research investigation utilizing the method of anonymous questionnaires, aimed at uncovering the opinions of citizens on the vaccination of children and adults. Three hypotheses were formulated. The H1 hypothesis that "The opinions of respondents concerning vaccination will differ based on their age", The H2 hypothesis that "Respondents with tertiary education have more information on the course and potential consequences of infectious diseases which can be vaccinated against" and The H3 hypothesis that "Younger respondents make use of the subsidization of non-mandatory vaccination provided by the insurance companies more often". The issue of vaccination has become an often-discussed topic in the recent years, in particular in relation to vaccination mandates. Vaccination objectors and organized anti-vaccination movements have begun to appear, resulting in undue emphasis being placed on detrimental side effects of vaccination, while ignoring the risks of infectious diseases and their health and social impacts.
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Pertussis, possibilities of managing unsatisfactory epidemiological situation in the Czech Republic.
PINĎÁKOVÁ, Lucie
This thesis deals with the problems of pertussis epidemiological problems in the Czech Republic, especially the possibilities of improvement of the epidemiological situation of pertussis. Pertussis is a serious infectious disease of the respiratory system and is monitored long-term in Czech Republic. The incidence of pertussis in its epidemic cycles continues to increase since the 90s. Last year's reported sickness rate was 11.7 of 100 000 people (1233 cases total).The thesis is divided into theoretical and practical part. The theoretical part shows the characteristics of pertussis and describes the preventive and repressive measures. Last part of the theoretical section describes epidemiological situation of pertussis from history to the present day while last four years are described in more detail. The practical part of the thesis consists of research.The research was conducted using qualitative method. As data collection method was chosen interviews with first contact physicians, which are pediatricians and physicians for adults. Two objectives were set in research area. The first objective was to map the compliance with the conditions laid down under the "case" definition of pertussis and its methods of diagnosis for pediatricians and physicians for adults (first contact physicians). The second objective was to create intervention for affecting the adverse epidemiological situation of pertussis. Intervention is based on the results of research aimed at compliance with procedures of "case" definition of pertussis and on knowledge of pediatricians and physicians for adults about the epidemiology of pertussis issue and their views on vaccination.
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Refusing of vaccination in the Vysočina region in the period 2010 - 2013
PALÁTOVÁ, Ilona
Vaccination in the Czech Republic has had a long tradition, belonging to the basic care within the paediatric prevention. It is a very effective protection for children and adults not only from infectious diseases but also their consequences. In these modern times, however, there are some voices questioning the usefulness and importance of mandatory vaccination. Fighting for its abolition comes from individuals as well as from organized groups that call the vaccination to be unethical, immoral and inhuman. The most common reason to refuse the vaccination is the belief that some vaccinations are not necessary. This issue is increasingly becoming the subject of many discussions, so I see it very topical.
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Implementation of the National Action Plan to increase vaccination coverage against influenza in the district of Trutnov.
KISSOVÁ, Petra
Influenza is a highly contagious viral disease with epidemic and pandemic spread of the character, which annually affects 10% of the world's population, in the course of a pandemic even 40-50%. The originator of the disease is a virus that is present as a type A, type B or type C. Source of infection is the man to transfer air or contaminated objects. Susceptibility is widespread. The disease predominantly affects the respiratory tract, has a sudden beginning and manifests itself primarily with fever, chills, muscle pain, joint pain and headache. The most common complication is inflammation of the lungs. In the diagnosis are rapid tests for the detection of the Antigen. Treatment is symptomatic, antivirals are available the type of neuraminidase inhibitors M2, which easily gives rise to a resistance of influenza virus. The basis for the prevention of influenza is annual vaccination, which dramatically reduces the risk of hospitalization and death, especially among the elderly and the chronically ill. Coverage in our population is low, and that despite the fact that the flu is the cause of the deaths of thousands of people around the world. A year in the Czech Republic will die according to qualified estimates the flu one to two thousand people. Due to the possible prevention of influenza, it is important to disseminate information on the possibilities of prevention by vaccination and educate the general public about the seriousness of this disease. Diploma thesis discusses influenza disease as such and on the issue of vaccination against influenza among the elderly in connection with the adoption of the NAP to increase vaccination coverage against the flu. The theoretical part summarises the commonly known knowledge on the causative agent of the disease, the way of transmission, symptoms, diagnosis, complications, treatment, and prevention by vaccination.
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The issues of vaccination against influenza in the elderly
VÁVROVÁ, Marie
This bachelor thesis deals with influenza vaccination for the elderly, their awareness of the flu, its severity, complications and risks. Influenza is among the most frequent infection in the Czech Republic. Many people confuse the common cold and upper respiratory tract infections, which usually have mild symptoms, with flu, which can cause very serious, even fatal complications. Risk groups include mainly people above 65 years old and it is this group of people my thesis and research concentrate on. The thesis is devided into two parts, theoretical and practical respectfully. The theoretical part consists primarily with familiarisation with major flu pandemics and continues with chapters that deal with essential characteristics of the influenza virus, a description of the flu and flu complications in the elderly. I concern myself in the research part with finding out how much older persons know about the disease, if it is perceived as a serious illness or not, if they are aware of the risks and complications the disease can cause them at their age. The paper sets out three objectives. My first goal is to find out how much the seniors are informed about the severity of influenza disease, next goal is to map vaccination rates of the elderly against influenza in the Český Krumlov region and the third objective is to determine whether there are differences in immunization rates between homes for the elderly and elderly people living independently. Quantitative research method using an anonymous questionnaire was used to obtain the data. 100 questionnaires completed by respondents above the age of 50 from the Český Krumlov region were used for processing. I predicted two hypotheses in the context of the objectives of my thesis which were subsequently disproved. My first hypothesis was: Most seniors considered the influenza disease as serious. I was not able to confirm this hypothesis. Only about a half of the respondents consider influenza as serious. This ratio is not dependent on age, place of residence or level of educational, however significantly depends on gender. The ratio of men who consider influenza as a serious illness is significantly lower when compared with women. Second hypothesis: the vaccination coverage in homes for the elderly is higher than among elderly people living independently. I was unable to confirm this hypothesis either. Information about the vaccine and its cost mostly come from the attending physician, the press and media. Mapping immunization coverage showed that only 23 of 100 respondents (23%) were vaccinated against influenza. The proposed objectives based on the obtained data have been met. The bachelor thesis may serve specialists as a source of information in the future. The concluded data and information can be mediated to the elderly either by general practicioners or in nursing homes. The results and information about the severity of influenza illness covered in this thesis can also serve as a source of information about this issue to the general public.
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The Incidence of Pertussis in South Bohemia
HOLINKOVÁ, Petra
The thesis deals with the problem of the occurrence of whooping cough in the South Bohemian Region in the period of 2003-2012. Despite the high level of vaccination the incidence of this illness after a significant fall in the 1980s has been growing constantly since 1993. This trend evidently also applies in other developed countries with a high rate of vaccination. The main aim is to draw up an overview of the occurrence of whooping cough in the South Bohemian Region in the monitored period of the last 10 years, compare this occurrence with other regions in the Czech Republic and map out the changes which have occurred in whooping cough vaccination. Quantitative and qualitative research was chosen to process the empirical part. Data for quantitative research was acquired from the database of infectious diseases (EPIDAT), and consisted of reported cases of whooping cough. Another essential group of data were demographic figures about the number and age structure of the population. The second qualitative part was drawn up on the basis of a literary search. I acquired additional information by communicating with individual territorial workplaces of the Regional Hygiene Station of the South Bohemian Region based in České Budějovice. Using the processed data I discovered that the incidence of whooping cough in the South Bohemian Region does not have an ascending trend in 2003-2012 unlike the trend in the whole of the Czech Republic. The highest occurrence of whooping cough in the Czech Republic in the monitored period was reported in the 10-14 age group. The research also showed that in the period of 2003-2012 individual regions differed greatly in the occurrence and can be divided into two groups ? regions with the highest reached incidence below 10 cases/100,000 people and regions with incidence with the highest reached incidence above 10 cases/100,000 people which includes the South Bohemian Region. There have been many changes in the vaccination of whooping cough and the most important was the transition from whole cell vaccine to acellular in 2007 and adding a 6th booster dose between the 10th and 11th year in 2009. The greatest attention should be paid above all to increase information or test the knowledge of the lay public, especially women preparing for pregnancy and people taking care of newborn babies and infants about the occurrence, potential risks and possibilities of vaccination against this infection even at an adult age. In my opinion a further necessity is the consolidation of diagnostics, definition of a case and procedures of surveillance throughout the Czech Republic, education of paediatricians and general practitioners about the illness and topicality of the problem, an appeal to report the occurrence of this infection to epidemiologists, observing the isolation of the patient, monitoring possible epidemiological connections between cases and making use of the offer of the NRL (National Reference Laboratory) services against whooping cough and diphtheria. This thesis can be used in practice as a summary of information material for the lay and professional public about the occurrence of whooping cough in the South Bohemian Region and throughout the Czech Republic and overview of vaccination against whooping cough. It can be an incentive for further anti-epidemic measures and the need for further research into this problem.
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Comparison of vaccination strategies and schemes in the European union and in the Czech Republic
VLČKOVÁ, Iva
Vaccination is one of the most important preventive epidemiological measures. My thesis focuses on comparing vaccination strategies of the EU countries with those of the Czech Republic. When collecting information, I studied the present situation of all twenty seven EU countries, including WHO recommendations on immunization, and suggestions of both ECDC and vaccine producers. Available incidence data about particular preventable diseases and vaccination coverage are also mentioned. Furthermore, I also point out the effectiveness of vaccination, illustrating the fact on the occurrence of specific illnesses. This is especially apparent from Czech vaccination schedule for measles, which, owing to taken measures, occur only as an imported malady. Vaccination schedules vary considerably among the EU countries. The Czech Republic follows same schedules as most of the EU countries and has a well-developed vaccination system, established in Notice no. 537/2006 Sb. of vaccination against infectious diseases, as amended. The number of illnesses, vaccination against which is prescribed, almost doesn?t differ from other European countries, and neither does the sickness rate. Quite to the contrary; compared to certain EU states, vaccination coverage in the Czech Republic is steadily high and recommendations to update vaccination schedules arise only from new findings and freshly emerged epidemiological situation. New vaccines against infectious diseases are being introduced to the market each year and individual countries therefore often reappraise, adjust and update their vaccination schedules. It?s imperative that they take into consideration present epidemiological situation, both in the countries themselves and in surrounding states, and also the knowledge of trends in infectious diseases occurrence. It?s necessary to update vaccination schedules and to increase the number of vaccines ? be it within periodic vaccinations covered by state, or personally requested vaccinations compensated by insurance companies ?, thus improving vaccination coverage. 5 Attempts at unification are unrealistic. In view of various epidemiological situations, means of individual countries, and attitudes towards vaccination in certain liberal leaning states, it is not possible to dictate vaccine use or vaccination schedules to any country. Considering the scope of the issue, the aim of my thesis isn?t to suggest solutions, but rather to monitor the present circumstances in individual states, find sources of information, and compare the situation in the EU and Czech Republic.
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Knowledge, attitudes and practice of vaccination against HPV - the male and female population
MANOVÁ, Michaela
The theoretical part summarizes information about cervical cancer, which is caused by the human papilloma virus. Cervical cancer is ranked on the second place in the incidence of cancers world wide. Virus HPV affects both men and women. For men, it results in the emergence of genital warts or cancer of the penis. Although there are existing opportunites for effective prevention for men, the focus is more on the female population.This thesis looks at the current problems in the prevention of cervical cancer, which affects an ever growing number of women and men. In this work, we find out how informed are the young people about cervical cancer, their knowledge about possibilities of prevention, and experience of vaccinated respondents in the age in which this vaccination is recommended, that is, before the start of an active sexual life. In the research part, is a summary of a questionnaire, which was done among pupils of a primary school in Plzen. The age range of respondents was 13- 16 years. The research included both girls and boys. The assumption that girls are more informed and are more interested in information regarding cervical cancer and boys on the contrary don?t search for this information because they think that this problem does not concern them , was largely confirmed by this research.
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