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

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Abstract
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.