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Scandinavian Journal of Public Health
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Immunization against Haemophilus infl uenzae type b in Sweden- A study of the introduction process

Örjan Garpenholt

Unit of Infectious Diseases Epidemiology, Department of Clinical Microbiology, Örebro Medical Centre Hospital, Örebro, Sweden, orjan.garpenholt{at}orebroll.se, Department of Caring Sciences, Örebro University, Sweden, Division of Social and Preventive Medicine and Public Health, Department of Health and Environment, Faculty of Health Science, Linköping University, Sweden

Hans Fredlund

Unit of Infectious Diseases Epidemiology, Department of Clinical Microbiology, Örebro Medical Centre Hospital, Örebro, Sweden

Toomas Timpka

Division of Social and Preventive Medicine and Public Health, Department of Health and Environment, Faculty of Health Science, Linköping University, Sweden

Aims: To study the introduction of Haemophilus infl uenzae type b (Hib) vaccination in Sweden, and to identify factors promoting and inhibiting the process. Methods: The introduction of general childhood vaccination against Hib in Sweden in 1992-93 was studied using the Cultural Historical Activity Theory as a theoretical framework. Results: Five activity systems were found to be involved in the introduction process, the systems of vaccine production, government administration, news distribution, science, and disease prevention. The critical factors for introduction of the programme were found to be the vaccine product, conception of the disease, government economy and public decision-making. Conclusions: The results show that a broad range of non-biomedical aspects must be considered when a public health intervention such as a general vaccination programme is introduced.

Key Words: decision-making • evaluation • haemophilus infl uenzae type b (Hib) • Sweden • vaccination.

Scandinavian Journal of Public Health, Vol. 29, No. 4, 271-278 (2001)
DOI: 10.1177/14034948010290041201
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