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Understanding parental vaccine refusal: Implicit and explicit associations about vaccines as potential building blocks of vaccine beliefs and behavior. Soc Sci Med 2022; 310:115275. [PMID: 36037608 PMCID: PMC9374490 DOI: 10.1016/j.socscimed.2022.115275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 06/29/2022] [Accepted: 08/06/2022] [Indexed: 11/22/2022]
Abstract
Objective A movement of parents refusing vaccines for their children has contributed to increasingly large outbreaks of diseases that are preventable by vaccines. Research has identified multiple factors that relate to parents' vaccination behaviors (i.e., whether not they vaccinate their children), including their beliefs about vaccines' safety and utility and their trust in those who recommend vaccines. Here we examine the role of more fundamental psychological processes that may contribute to multiple vaccine-related beliefs and behaviors: cognitive associations. Methods Using a large sample of U.S. parents (pre-COVID-19), we investigated parents' associations between vaccines and helpfulness/harmfulness, as well as between the self and vaccines (vaccine identity), and their relation to parents' beliefs about vaccine safety and utility, trust in authorities' vaccine recommendations, and prior vaccination refusal for their children. To capture a more complete understanding of people's associations, we examined both explicit associations (measured via self-report) and implicit associations (measured by the Implicit Association Test). Results Both implicit and explicit associations correlated with beliefs, trust, and vaccination refusal. Results from structural equation models indicated that explicit vaccine-identity and vaccine-helpfulness associations and implicit vaccine helpfulness associations were indirectly related to vaccination refusal via their relation with vaccine beliefs. Conclusions Collectively, study findings suggest that vaccine associations—especially those related to helpfulness/harmfulness—may serve as psychological building blocks for parental vaccine beliefs and behaviors.
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Abstract
The current study examined various types of misinformation related to the COVID-19 vaccines and their relationships to vaccine hesitancy and refusal. Study 1 asked a sample of full-time working professionals in the US (n = 505) about possible misinformation they were exposed to related to the COVID-19 vaccines. Study 2 utilized an online survey to examine U.S. college students' (n = 441) knowledge about COVID-19 vaccines, and its associations with vaccine hesitancy and behavioral intention to get a COVID-19 vaccine. Analysis of open-ended responses in Study 1 revealed that 57.6% reported being exposed to conspiratorial misinformation such as COVID-19 vaccines are harmful and dangerous. The results of a structural equation modeling analysis for Study 2 supported our hypotheses predicting a negative association between the knowledge level and vaccine hesitancy and between vaccine hesitancy and behavioral intention. Vaccine hesitancy mediated the relationship between the vaccine knowledge and behavioral intention. Findings across these studies suggest exposure to misinformation and believing it as true could increase vaccine hesitancy and reduce behavioral intention to get vaccinated.
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Singh H, Chase AJ. Measuring vaccine acceptance and knowledge within health professions education. Vaccine 2022; 40:5452-5458. [PMID: 35933277 DOI: 10.1016/j.vaccine.2022.07.039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 07/14/2022] [Accepted: 07/25/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND Recent rises in the incidence of vaccine-preventable illnesses and suboptimal vaccine acceptance are considered a consequence of accumulating misinformation. Evidence-based approaches to patient-provider communication are key to addressing vaccine hesitancy. OBJECTIVES The aim of this study was to assess vaccination attitudes and foundational knowledge among healthcare professions students. METHODS A 72-item survey was developed to assess vaccine attitudes and knowledge about vaccination among health professions students. The survey incorporated 14 demographics questions, 41 attitude questions, and 17 knowledge questions. 16 of the attitude questions, derived from a set of core questions used to diagnose vaccine hesitancy from the WHO Strategic Advisory Group of Experts on Immunization (SAGE) Vaccine Hesitancy Matrix, were analyzed together to derive a vaccine acceptance score. RESULTS 295 anonymous survey responses were collected between July 2019 and November 2020. Respondents represented students enrolled in medical, dental, pharmacy, optometry, and biomedical science health professions programs. Respondents scored 82.0% ± 0.8% (mean ± standard error of the mean) on questions that gauged vaccine acceptance. The mean vaccine acceptance score was 85.4% ± 1.0% for medical students and 88.0% ± 1.6% for biomedical science students. The mean knowledge score across all programs was 67.7% ± 1.1%. The greatest proficiency in knowledge scores was seen amongst medical students (79.0% ± 1.3%). CONCLUSIONS Amongst the different health professions, students in the fields of medicine and biomedical sciences had the highest levels of vaccine acceptance attitudes and knowledge. The vaccine acceptance score can be utilized by health professions educators to guide vaccine education for future health professionals to better prepare them to address vaccine hesitancy and educate patients on vaccination.
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Affiliation(s)
- Harmandip Singh
- Department of Anesthesiology & Perioperative Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA; Department of Medical Education, Dr. Kiran C. Patel College of Allopathic Medicine, Nova Southeastern University, Fort Lauderdale, FL, USA
| | - Amanda J Chase
- Department of Medical Education, Dr. Kiran C. Patel College of Allopathic Medicine, Nova Southeastern University, Fort Lauderdale, FL, USA.
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Parents' perceptions on COVID-19 vaccination as the new routine for their children ≤ 11 years old. Prev Med 2022; 161:107125. [PMID: 35792197 PMCID: PMC9250244 DOI: 10.1016/j.ypmed.2022.107125] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 06/09/2022] [Accepted: 06/27/2022] [Indexed: 11/30/2022]
Abstract
Canadian children 5-11 years old became eligible for COVID-19 vaccination on November 19, 2021, with eligibility for younger children expected later. We aimed to descriptively assess parents' COVID-19 vaccine intentions and acceptability of future doses, including co-administration and annual vaccination for their children. We conducted a cross-sectional Canadian online survey of parents from October 14-November 12, 2021, just prior to authorization of the pediatric formulation of the BNT162b2 COVID-19 vaccine for children aged 5-11 years. We assessed parents' intention to vaccinate their children aged 5-11 years, 2-4 years, and 6-23 months; reasons for their intention; and preferences for delivery and access to vaccines. Of 1129 parents, 56% intended to vaccinate their child aged 5-11 years against COVID-19; intentions were lower for children aged 6-23 months (41.9%) and 2-4 years (45.4%). Most parents who intended to vaccinate supported co-administration with routine (61.1%) or influenza (55.4%) vaccines, administration at school (63.6%), receipt of booster doses of COVID-19 vaccine (57.8%), and annual vaccination (56.4%) for their child. Despite parents' high COVID-19 vaccination uptake for themselves (88.8%), intentions for children aged 5-11 years was low. Currently, 56.9% of Canadian children aged 5-11 years have received one dose of a COVID-19 vaccine, and only 37.1% are fully vaccinated. Given that intentions for children <5 years was lower than those 5-11 years, we can also expect low uptake in this group. Parents' preferences regarding delivery and access to COVID-19 vaccination should be considered by public health officials when planning vaccination strategies for children.
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Noh Y, Kim JH, Yoon D, Choe YJ, Choe SA, Jung J, Lee SW, Shin JY. Predictors of COVID-19 booster vaccine hesitancy among fully vaccinated adults in Korea: a nationwide cross-sectional survey. Epidemiol Health 2022; 44:e2022061. [PMID: 35914771 PMCID: PMC9754905 DOI: 10.4178/epih.e2022061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 07/22/2022] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVES This study explored predictors of coronavirus disease 2019 (COVID-19) booster hesitancy among fully vaccinated young adults and parental COVID-19 vaccine hesitancy for their children. METHODS This cross-sectional study administered an online survey from December 2 to December 20, 2021. We enrolled participants aged 18-49 years, for whom ≥2 weeks had passed after their initial COVID-19 vaccination. We estimated odds ratios (ORs) with 95% confidence intervals (CIs) using multivariate logistic regression to evaluate factors associated with booster/vaccine hesitancy. RESULTS Among the 2,993 participants, 48.8% showed hesitancy (wait and see: 40.2%; definitely not: 8.7%). Booster hesitancy was more common among women (OR, 1.25; 95% CI, 1.05 to 1.50), younger people (OR, 1.44; 95% CI, 1.17 to 1.77), those with a lower education level (OR, 2.05; 95% CI, 1.10 to 3.82), those who received the mRNA-1273 vaccine type (OR, 2.01; 95% CI, 1.65 to 2.45), and those who experienced serious adverse events following previous COVID-19 vaccination (OR, 2.03; 95% CI, 1.47 to 2.80). The main reasons for booster hesitancy were concerns about safety (54.1%) and doubts about efficacy (29.8%). Among the 1,020 respondents with children aged <18 years, 65.8% were hesitant to vaccinate their children against COVID-19; hesitancy was associated with younger parental age, education level, the type of vaccine the parent received, and a history of COVID-19 infection. CONCLUSIONS Concerns about the efficacy and safety of COVID-19 vaccines were the major barrier to booster acceptance. The initial COVID-19 vaccine type (mRNA-1273), young age, gender (women), a low education level, and adverse events after the first COVID-19 vaccine were key predictors of booster hesitancy.
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Affiliation(s)
- Yunha Noh
- School of Pharmacy, Sungkyunkwan University, Suwon, Korea
| | - Ju Hwan Kim
- School of Pharmacy, Sungkyunkwan University, Suwon, Korea
| | - Dongwon Yoon
- School of Pharmacy, Sungkyunkwan University, Suwon, Korea
| | - Young June Choe
- Department of Pediatrics, Korea University Anam Hospital, Seoul, Korea
| | - Seung-Ah Choe
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, Korea,Division of Life Sciences, Korea University, Seoul, Korea
| | - Jaehun Jung
- Department of Preventive Medicine, Gachon University College of Medicine, Incheon, Korea
| | - Sang-Won Lee
- School of Pharmacy, Sungkyunkwan University, Suwon, Korea,Department of Biohealth Regulatory Science, Sungkyunkwan University, Suwon, Korea,Co-correspondence: Sang-Won Lee School of Pharmacy, Sungkyunkwan University, 2066 Seobu-ro, Jangan-gu, Suwon 16419, Korea E-mail:
| | - Ju-Young Shin
- School of Pharmacy, Sungkyunkwan University, Suwon, Korea,Department of Biohealth Regulatory Science, Sungkyunkwan University, Suwon, Korea,Department of Clinical Research Design & Evaluation, Samsung Advanced Institute for Health Sciences & Technology (SAIHST), Sungkyunkwan University, Seoul, Korea,Correspondence: Ju-Young Shin School of Pharmacy, Sungkyunkwan University, 2066 Seobu-ro, Jangan-gu, Suwon 16419, Korea E-mail:
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Dhungana M, Hoben M, O’Brien C, MacDonald SE. Immunization status of children at kindergarten entry in Alberta, Canada. CANADIAN JOURNAL OF PUBLIC HEALTH = REVUE CANADIENNE DE SANTE PUBLIQUE 2022; 114:82-92. [PMID: 35864307 PMCID: PMC9849539 DOI: 10.17269/s41997-022-00663-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 06/14/2022] [Indexed: 01/22/2023]
Abstract
OBJECTIVES Little is known about immunization coverage among kindergarten-aged children in jurisdictions that do not require children's immunization records to be provided at school entry. Thus, we assessed immunization coverage and associated characteristics of a 2008 birth cohort of Alberta children at kindergarten entry as compared with at the end of grade one. METHODS This retrospective cohort study used population-based administrative health data for childhood vaccines in Alberta, Canada. We categorized and compared immunization status of children as follows: (a) complete at kindergarten entry; (b) incomplete at kindergarten entry but complete at the end of grade one; and (c) still incomplete at the end of grade one. To assess factors associated with immunization status, we used multinomial logistic regression. RESULTS Immunization coverage for the complete vaccine series for children (N = 41,515) at kindergarten entry was suboptimal (44.5%, 95% CI 44.0-45.0) and substantially lower than for children at the end of grade one (74.8%, 95% CI 74.3-75.2). Young maternal age, not living with a partner, and having > 1 child in a household were associated with incomplete immunization status at kindergarten entry. Midwife-assisted hospital and home delivery was strongly associated with incomplete immunization status at the end of grade one. CONCLUSION Immunization coverage at kindergarten entry was strikingly low. Risk factors for incomplete immunization status were identified that require particular attention when addressing immunization coverage. The school-based catch-up immunization program in grade one seems to have substantially improved coverage among children, suggesting a potential benefit of shifting the catch-up program from grade one to kindergarten entry.
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Affiliation(s)
- Manisha Dhungana
- Faculty of Nursing, Edmonton Clinic Health Academy, University of Alberta, 11405-87 Ave NW, Edmonton, Alberta T6G 1C9 Canada
| | - Matthias Hoben
- Faculty of Nursing, Edmonton Clinic Health Academy, University of Alberta, 11405-87 Ave NW, Edmonton, Alberta T6G 1C9 Canada
| | - Celine O’Brien
- Immunization & Communicable Disease Control, Alberta Health, Edmonton, Alberta Canada
| | - Shannon E. MacDonald
- Faculty of Nursing, Edmonton Clinic Health Academy, University of Alberta, 11405-87 Ave NW, Edmonton, Alberta T6G 1C9 Canada
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Responding to Parents’ Questions Regarding Polysorbate 80, Aluminum, and Thimerosal in Vaccines. J Nurse Pract 2022. [DOI: 10.1016/j.nurpra.2022.05.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Lu P, Yankey D, Fredu B, Hung M, Sterrett N, Markowitz LE, Elam–Evans LD. Human Papillomavirus Vaccination Trends Among Adolescents: 2015 to 2020. Pediatrics 2022; 150:e2022056597. [PMID: 35730334 PMCID: PMC10961167 DOI: 10.1542/peds.2022-056597] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/25/2022] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To assess trends in recent human papillomavirus (HPV) vaccination initiation and factors associated with vaccination among adolescents. METHODS The 2015 to 2020 National Immunization Survey-Teen data were used to assess vaccination trends. Multivariable logistic regression analysis were conducted to assess factors associated with vaccination. RESULTS Overall, HPV vaccination coverage (≥1 dose) among adolescents significantly increased from 56.1% in 2015 to 75.4% in 2020. There were larger increases in coverage among males (4.7 percentage points annually) than females (2.7 percentage points annually) and coverage differences between males and females decreased in 2015 through 2020. Coverage in 2020 was 75.4% for adolescents aged 13 to 17 years; 73.7% for males and 76.8% for females (P < .05); 80.7% for those with a provider recommendation and 51.7% for those without (P < .05); and 80.3% for those with a well child visit at age 11 to 12 years, and 64.8% for those without (P < .05). Multivariable logistic regression results showed that main characteristics independently associated with a higher likelihood of vaccination included: a provider recommendation, age 16 to 17 years, non-Hispanic Black, Hispanic, or American Indian or Alaskan Native, Medicaid insurance, ≥2 provider contacts in the past 12 months, a well-child visit at age 11 to 12 years and having 1 or 2 vaccine providers (P < .05). CONCLUSIONS Overall, HPV vaccination coverage among adolescents increased during 2015 to 2020. Coverage increased faster among males than females and differences by sex narrowed during this time. Receiving a provider recommendation vaccination was important to increase vaccination coverage.
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Affiliation(s)
- Peng–jun Lu
- Divisions of Immunization Services, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - David Yankey
- Divisions of Immunization Services, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Benjamin Fredu
- Divisions of Immunization Services, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Mei–Chun Hung
- Divisions of Immunization Services, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Natalie Sterrett
- Divisions of Immunization Services, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Lauri E. Markowitz
- Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Laurie D. Elam–Evans
- Divisions of Immunization Services, Centers for Disease Control and Prevention, Atlanta, Georgia
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Watts AW, Hutchison SM, Bettinger JA, Gadermann A, Oberle E, Oberlander TF, Goldfarb DM, Lavoie PM, Mâsse LC. COVID-19 Vaccine Intentions and Perceptions Among Public School Staff of the Greater Vancouver Metropolitan Area, British Columbia, Canada. Front Public Health 2022; 10:832444. [PMID: 35570951 PMCID: PMC9092339 DOI: 10.3389/fpubh.2022.832444] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 03/21/2022] [Indexed: 11/18/2022] Open
Abstract
Background The purpose of this study was to explore factors associated with COVID-19 vaccine intentions among school staff as high vaccine uptake is essential to ensure schools return to normal activities. Methods Staff (e.g., teachers, administrators, student support workers) from three urban school districts in the Greater Vancouver Area of British Columbia, Canada completed a survey between February and June 2021 (n = 2,393) on COVID-19 vaccine intentions and perceptions (i.e., acceptance of routine vaccines, benefits and risks of vaccination, susceptibility to, and severity of COVID-19, recommendation by authority figures, information mistrust and conspiracy beliefs) as part of a COVID-19 seroprevalence study. Confirmatory factor analysis followed by multiple logistic regression models adjusting for relevant covariates were used to identify vaccine perceptions uniquely associated with (a) intention to get the COVID-19 vaccine (intention), and (b) intention to get vaccinated right away (urgency). Results In total, 95.4% of participants of the seroprevalence study completed the vaccine questionnaire, corresponding to 17.7% of the target population. Vaccine intention was associated with staff who valued expert recommendations (AOR = 10.5, 95% CI = 7.39–14.90) accepted routine vaccines (AOR = 1.94, 95% CI = 1.26–2.98) and perceived higher benefits (AOR = 1.29, 95% CI = 1.01–1.65) and lower safety risks of vaccination (AOR = 0.40, 95% CI = 0.29–0.54). Comparable associations were found with vaccine urgency. Perceived susceptibility to the COVID-19 virus was uniquely associated with vaccine urgency (AOR = 1.30, 95% CI = 1.05–1.61). A significant interaction effect (p = 0.01) revealed that staff who expressed mistrust in COVID-19 information intended to get vaccinated only if they also perceived high benefits of vaccination. Conclusions Education about the risks and benefits of COVID-19 vaccines from a trusted source had the strongest relationship with vaccine intentions among this occupational group. Notably, those who expressed mistrust in information still intended to get vaccinated if they also perceived strong benefits of the vaccine.
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Affiliation(s)
- Allison W Watts
- Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Sarah M Hutchison
- Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.,British Columbia Children's Hospital Research Institute, University of British Columbia, Vancouver, BC, Canada
| | - Julie A Bettinger
- Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.,Vaccine Evaluation Center, British Columbia Children's Hospital Research Institute, BC Children's Hospital, Vancouver, BC, Canada
| | - Anne Gadermann
- Human Early Learning Partnership, School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada.,Centre for Health Evaluation and Outcome Sciences, Providence Health Care Research Institute, St. Paul's Hospital, Vancouver, BC, Canada
| | - Eva Oberle
- Human Early Learning Partnership, School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - Tim F Oberlander
- British Columbia Children's Hospital Research Institute, University of British Columbia, Vancouver, BC, Canada.,British Columbia Children's and Women's Health Centre, Vancouver, BC, Canada
| | - David M Goldfarb
- British Columbia Children's Hospital Research Institute, University of British Columbia, Vancouver, BC, Canada.,British Columbia Children's and Women's Health Centre, Vancouver, BC, Canada
| | - Pascal M Lavoie
- Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.,British Columbia Children's Hospital Research Institute, University of British Columbia, Vancouver, BC, Canada.,British Columbia Children's and Women's Health Centre, Vancouver, BC, Canada
| | - Louise C Mâsse
- British Columbia Children's and Women's Health Centre, Vancouver, BC, Canada.,School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
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Hijazi R, Gesser-Edelsburg A, Feder-Bubis P, Mesch GS. Pro-vaccination Groups Expressing Hesitant Attitudes: A Cross-Sectional Study About the Difference Between Attitudes and Actual Behavior in Israel. Front Public Health 2022; 10:871015. [PMID: 35570981 PMCID: PMC9092369 DOI: 10.3389/fpubh.2022.871015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 04/04/2022] [Indexed: 11/21/2022] Open
Abstract
Background Vaccines have contributed to the decline in mortality, morbidity, and even the eradication of various infectious diseases. Over time, the availability of information to the public and the request for public involvement in the health decision-making process have risen, and the confidence in vaccines has dropped. An increasing number of parents and individuals are choosing to delay or refuse vaccines. Objectives (1) Identifying hesitant attitudes among pro-vaccination parents; (2) testing the difference between the rate of hesitant attitudes and the rate of hesitancy in practice among pro-vaccination parents; and (3) examining the association of sociodemographic characteristics (gender, age, marital status education and religious affiliation) with the difference between hesitant attitudes and hesitancy in practice among pro-vaccination parents. Methods Descriptive cross-sectional survey using an online survey that measured vaccine hesitancy among pro-vaccination parents (n = 558) whose children were in kindergarten (3–5 years), according to a variety of sociodemographic characteristics. Results A significant difference was found between the rate of hesitant attitudes and the rate of hesitation in actual vaccination among pro-vaccination and hesitant parents, where despite that 26% of the parents had hesitant attitudes, only 19% hesitated in practice [P = 0.0003]. There was also a significant difference between the rate of hesitant attitudes and the rate of hesitancy in practice among women [P = 0.0056] and men [P = 0.0158], parents between 30 and 39 years of age [P = 0.0008], traditional parents [P = 0.0093], Non-academic parents [P = 0.0007] and parents with BA degree [P = 0.0474]. Conclusion Pro-vaccination individuals may have hesitant attitudes regarding vaccines. Therefore, it is very important for health authorities to address the public's fears and concerns, including those who are classified as pro-vaccination.
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Affiliation(s)
- Rana Hijazi
- School of Public Health, University of Haifa, Mount Carmel, Haifa, Israel
| | - Anat Gesser-Edelsburg
- Head of the Health Promotion Program and Head of the Health and Risk Communication Lab, School of Public Health, University of Haifa, Mount Carmel, Haifa, Israel
| | - Paula Feder-Bubis
- Department of Health Policy and Management, Faculty of Health Sciences and Guilford Glazer Faculty of Business and Management, Ben-Gurion University of the Negev, Be'er Sheva, Israel
| | - Gustavo S Mesch
- Department of Sociology, University of Haifa, Mount Carmel, Haifa, Israel
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Vaccine Hesitancy in Saudi Arabia: A Cross-Sectional Study. Trop Med Infect Dis 2022; 7:tropicalmed7040060. [PMID: 35448835 PMCID: PMC9025486 DOI: 10.3390/tropicalmed7040060] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 03/27/2022] [Accepted: 04/07/2022] [Indexed: 02/01/2023] Open
Abstract
(1) Background: vaccine hesitancy can put the public’s health at risk from vaccine-preventable diseases. This study aimed to address vaccine hesitancy in Saudi Arabia and understand the problem’s magnitude and causes. (2) Methods: this was a descriptive observational study using quantitative and qualitative evaluation methods conducted in Saudi Arabia between December 2020 and February 2021. Public survey forms, exit interviews, and healthcare professional survey forms were used. (3) Results: our study involved 2030 public survey participants, 119 exit interviews of caregivers, and 500 healthcare professionals, demonstrating that vaccine hesitancy was relatively low. Ninety percent of the participants agreed that it was essential for everyone to receive the recommended vaccines with their children (p < 0.001), 92% believed that vaccines are safe for their children (p < 0.001), 91% of the participants agreed to give their new children all the recommended doses (p < 0.001), 86% welcomed mass/school vaccination campaigns (p < 0.001), and 81% were willing to pay for additional vaccines for themselves and their children (p < 0.001). (4) Conclusions: vaccine hesitancy is low in Saudi Arabia, and a positive attitude toward vaccination was detected among most of the participants. Vaccination decision-making is complex and includes emotional, cultural, social, spiritual, and political aspects.
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Thorpe A, Fagerlin A, Drews FA, Butler J, Stevens V, Riddoch MS, Scherer LD. Communications to Promote Interest and Confidence in COVID-19 Vaccines. Am J Health Promot 2022; 36:976-986. [PMID: 35411819 PMCID: PMC9008475 DOI: 10.1177/08901171221082904] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE Communicating about COVID-19 vaccine side effects and efficacy is crucial for promoting transparency and informed decision-making, but there is limited evidence on how to do so effectively. DESIGN A within-subjects experiment. SETTING Online survey from January 21 to February 6, 2021. SUBJECTS 596 US Veterans and 447 non-Veterans. INTERVENTION 5 messages about COVID-19 vaccine side effects and 4 messages about COVID-19 vaccine efficacy. MEASURES COVID-19 vaccine interest (1 = "I definitely do NOT want the vaccine" to 7 = "I definitely WANT the vaccine" with the midpoint 4 = "Unsure"). Confidence about COVID-19 vaccine efficacy (1= "Not at all confident," 2 = "Slightly confident," 3 = "Somewhat confident," 4 = "Moderately confident," 5 = "Extremely confident"). RESULTS Compared to providing information about side effects alone (M = 5.62 [1.87]), messages with additional information on the benefits of vaccination (M = 5.77 [1.82], P < .001, dz = .25), reframing the likelihood of side effects (M = 5.74 [1.84], P < .001, dz = .23), and emphasizing that post-vaccine symptoms indicate the vaccine is working (M = 5.72 [1.84], P < .001, dz = .17) increased vaccine interest. Compared to a vaccine efficacy message containing verbal uncertainty and an efficacy range (M = 3.97 [1.25]), messages conveying verbal certainty with an efficacy range (M = 4.00 [1.24], P = .042, dz=.08), verbal uncertainty focused on the upper efficacy limit (M = 4.03 [1.26], P < .001, dz = .13), and communicating the point estimate with certainty (M = 4.02 [1.25], P < .001, dz = .11) increased confidence. Overall, Veteran respondents were more interested (MVeterans = 5.87 [1.72] vs MNonVeterans = 5.45 [2.00], P < .001, d = .22) and confident (MVeterans = 4.13 [1.19] vs MNonVeterans = 3.84 [1.32], P < .001, d = .23) about COVID-19 vaccines than non-Veterans. CONCLUSIONS These strategies can be implemented in large-scale communications (e.g., webpages, social media, and leaflets/posters) and can help guide healthcare professionals when discussing vaccinations in clinics to promote interest and confidence in COVID-19 vaccines.
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Affiliation(s)
- Alistair Thorpe
- University of Utah Spencer Fox Eccles School of Medicine, Salt Lake City, UT, USA
| | - Angela Fagerlin
- University of Utah Spencer Fox Eccles School of Medicine, Salt Lake City, UT, USA.,Salt Lake City VA Informatics Decision-Enhancement and Analytic Sciences (IDEAS) Center for Innovation, Salt Lake City, UT, USA
| | - Frank A Drews
- Salt Lake City VA Informatics Decision-Enhancement and Analytic Sciences (IDEAS) Center for Innovation, Salt Lake City, UT, USA.,University of Utah College of Social and Behavioral Science, Salt Lake City, UT, USA
| | - Jorie Butler
- University of Colorado School of Medicine, Aurora, CO, USA.,VA Denver Center for Innovation, Denver, CO, USA
| | - Vanessa Stevens
- University of Utah Spencer Fox Eccles School of Medicine, Salt Lake City, UT, USA.,Salt Lake City VA Informatics Decision-Enhancement and Analytic Sciences (IDEAS) Center for Innovation, Salt Lake City, UT, USA
| | - Marian S Riddoch
- University of Utah Spencer Fox Eccles School of Medicine, Salt Lake City, UT, USA
| | - Laura D Scherer
- University of Colorado School of Medicine, Aurora, CO, USA.,VA Denver Center for Innovation, Denver, CO, USA
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Factors associated with COVID-19 vaccine intent among Latino SNAP participants in Southern California. BMC Public Health 2022; 22:653. [PMID: 35382803 PMCID: PMC8981200 DOI: 10.1186/s12889-022-13027-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 03/18/2022] [Indexed: 01/04/2023] Open
Abstract
Background COVID-19 is significantly impacting the health and well-being of the country, particularly for ethnic minority populations and low-income groups. Our goal was to determine COVID-19 vaccination intent in a low-income, Latino population receiving aid from the Supplemental Nutrition Assistance Program (SNAP) in Southern California, and identify contributing factors and concerns. Methods A cross-sectional, mixed-methods survey was conducted among participants in the Southern California Nutrition Incentives Program (¡Más Fresco! More Fresh). Only Latino respondents were included in this analysis. Primary outcome was vaccine intent trichotomized into: “definitely/likely yes”, “not sure/don’t know”, and “definitely/likely not.” Results The majority of participants (n = 486) were female (93%), Spanish speaking (74%), with a median age of 40 years (IQR = 13). Approximately half (48%) reported they would get a COVID-19 vaccine, 39% were unsure, and 13% reported “definitely/likely not”. In the multivariable multinomial logistic regression model, participants with a household member with a COVID-19 health risk factor were more likely to be unsure about getting the vaccine. Participants who were primarily English speaking, did not receive the influenza vaccine last season, and reported not reading or talking about COVID-19 were more likely to report not intending to receive the vaccine. Many respondents were concerned about “side effects and ingredients”, and did not trust the vaccine development process, particularly with how fast it happened. Conclusion Low-income Latinos in Southern California were generally hesitant to get a COVID-19 vaccine. Culturally sensitive vaccine promotion campaigns need to address the concerns of minority populations who experience increased morbidity and mortality from COVID-19. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13027-w.
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Skitarelić N, Vidaić M, Skitarelić N. Parents’ versus Grandparents’ Attitudes about Childhood Vaccination. CHILDREN 2022; 9:children9030345. [PMID: 35327717 PMCID: PMC8946897 DOI: 10.3390/children9030345] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 02/01/2022] [Accepted: 02/28/2022] [Indexed: 11/16/2022]
Abstract
Background: We investigated and compared practices and attitudes about childhood vaccination between young parents and their parents and identified influences and sources of information in the County of Zadar, Croatia. Methods: This research was conducted in six general practice and paediatric medical clinics. It included 300 volunteers, including 150 younger parents and 150 older grandparents. Information was collected with a survey questionnaire. The survey data were statistically processed. Results: The 300 participants were divided into 2 groups. Most of the respondents were married, employed, had a high school education, and had a good economic status, often with two children and living in the city. Generally, the attitude towards vaccination was positive. Healthcare workers made the most important influence on the decision for vaccination. The younger age group was significantly affected by social networks and the internet and wanted more information. They were afraid of the adjuvants in vaccines. The older respondents held that vaccination must be legally regulated and did not believe the anti-vaccine media headlines. Conclusions: Our respondents had positive attitudes towards childhood vaccination, noticed the benefits of vaccinating children, and held that untreated children represent a risk for the community. They were well informed and satisfied with the collaboration with medical professionals, although the media and social networks had some impact on attitudes.
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Affiliation(s)
- Nataša Skitarelić
- Department of Health Studies, University of Zadar, 23000 Zadar, Croatia; (M.V.); (N.S.)
- Zadar General Hospital, 23000 Zadar, Croatia
- Correspondence: ; Tel.: +385-23-400414
| | - Marija Vidaić
- Department of Health Studies, University of Zadar, 23000 Zadar, Croatia; (M.V.); (N.S.)
| | - Neven Skitarelić
- Department of Health Studies, University of Zadar, 23000 Zadar, Croatia; (M.V.); (N.S.)
- Zadar General Hospital, 23000 Zadar, Croatia
- Medicine Faculty, University of Rijeka, 51000 Rijeka, Croatia
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Kemeugni Ngandjon J, Ostermann T, Kenmoe V, Laengler A. Insights into Predictors of Vaccine Hesitancy and Promoting Factors in Childhood Immunization Programs-A Cross-Sectional Survey in Cameroon. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19052721. [PMID: 35270416 PMCID: PMC8910338 DOI: 10.3390/ijerph19052721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Revised: 02/01/2022] [Accepted: 02/16/2022] [Indexed: 12/10/2022]
Abstract
Background: Vaccination is claimed to be a key intervention against the COVID-19 pandemic. A major challenge today is to increase vaccine acceptance as vaccine hesitancy has delayed the eradication of polio. This study aimed to identify predictors associated with vaccine acceptance in the context of the Expanded Program on Immunization among parents of children between the ages of 12 to 23 months in the Foumbot district, Cameroon. Methods: The design of this study is a cross-sectional survey. A total of 160 mothers of children between the ages of 12 to 23 months were selected using a simple random sampling technique. A pre-tested structured questionnaire was used for data collection. Incomplete vaccination status was considered “vaccine hesitancy”. Data was analyzed along with 95% confidence intervals and the p-value < 0.05. The results showed 60% vaccine acceptance and 40% vaccine hesitancy. Factors such as age-appropriate vaccination, knowledge of vaccine-preventable diseases (VPD), and religion were associated with vaccine acceptance. Conclusion: Poor knowledge of VPDs is a matter of concern as it contributes to vaccine hesitancy. The study findings provide the basis to heighten health education, the public perceived threat of the VPDs, and the consequences if no measures are taken to ensure health.
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Affiliation(s)
- Jonas Kemeugni Ngandjon
- Institute of Pediatric, Faculty of Health, University of Witten/Herdecke, 58448 Witten, Germany
- Correspondence: ; Tel.: +49-9131-605-5913
| | - Thomas Ostermann
- Department for Psychology and Statistics, Faculty of Health, University of Witten/Herdecke, 58448 Witten, Germany;
| | - Virgile Kenmoe
- Department for Human Medicine , Faculty of Health, Université des Montagnes, Bangangté BP 208, Cameroon;
| | - Alfred Laengler
- Department for Human Medicine, Institute of Pediatric, Faculty of Health, University of Witten/Herdecke, 58448 Witten, Germany;
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Tandy CB, Odoi A. Geographic disparities and predictors of vaccination exemptions in Florida: a retrospective study. PeerJ 2022; 10:e12973. [PMID: 35223209 PMCID: PMC8877400 DOI: 10.7717/peerj.12973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 01/31/2022] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND In the United States, state-level policies requiring vaccination of school-going children constitute a critical strategy for improving vaccination coverage. However, policies allowing vaccination exemptions have also been implemented and contribute to reductions in vaccination coverage and potential increases in the burden of vaccine-preventable diseases. Understanding the geographic disparities in the distribution of vaccination exemptions and identifying high risk areas is necessary for guiding resource allocation and public health control strategies. This study investigated geographic disparities in vaccination exemptions as well as socioeconomic and demographic predictors of vaccination exemptions in Florida. METHODS Vaccination exemption data were obtained from the Florida Department of Health's Florida HealthCHARTS web interface. Spatial patterns in geographic distribution of total and non-medical vaccination exemptions were assessed using county-level choropleth maps. Negative binomial models were used to identify significant predictors of county-level risks of both total and non-medical vaccination exemptions. RESULTS Total exemptions varied from 0 to 30.2 per 10,000 people. Nine counties had exemption risks in the top two classes (10.4-15.9 and 15.9-30.2 exemptions per 10,000 people). These counties were distributed in five distinct areas: Western Panhandle, central northern area, central, South-eastern coastal area, and the southern coastal border of the state. Non-medical exemptions varied from 0 to 10.4 per 10,000 people. Fifteen counties had exemption risks in the top two classes (3.7-5.6 and 5.6-10.4 exemptions per 10,000 people), and were located in six distinct areas: Western and Central Panhandle, Northeastern, Central-eastern coastal area, Central-western coastal area, and the South-western coastal border of the state. Predictors of high risk of total vaccination exemptions were high density of primary care providers (p < 0.001), high median income (p = 0.001), high percentage of Hispanic population (p = 0.046), and low percentage of population with a college education (p = 0.013). A predictor of high risk of non-medical vaccination exemptions was high percentage of White population (p = 0.045). However, predictors of low risks of non-medical exemptions were high percentages of population: living in rural areas (p = 0.023), with college education (p = 0.013), with high school education (p = 0.009), and with less than high school education (p < 0.001). CONCLUSIONS There is evidence of county-level geographic disparities in both total and non-medical vaccination exemption risks in Florida. These disparities are explained by differences in county-level socioeconomic and demographic factors. Study findings are important in guiding resource allocation for health planning aimed at improving vaccination rates and reducing incidence of vaccine-preventable diseases.
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Huynh G, Nguyen HTN, Van Tran K, Le An P, Tran TD. Determinants of COVID-19 vaccine hesitancy among parents in Ho Chi Minh City, Vietnam. Postgrad Med 2022; 134:303-308. [DOI: 10.1080/00325481.2022.2044142] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Giao Huynh
- Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Han Thi Ngoc Nguyen
- Infection Control Department, University Medical Center Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Khanh Van Tran
- Department of Scientific Research, District 2 Hospital, Ho Chi Minh City, Vietnam
| | - Pham Le An
- Family Medicine Training Center, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Tuan Diep Tran
- Faculty of Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
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Lyu H, Wang J, Wu W, Duong V, Zhang X, Dye TD, Luo J. Social media study of public opinions on potential COVID-19 vaccines: informing dissent, disparities, and dissemination. INTELLIGENT MEDICINE 2022; 2:1-12. [PMID: 34457371 PMCID: PMC8384764 DOI: 10.1016/j.imed.2021.08.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 07/25/2021] [Accepted: 08/06/2021] [Indexed: 01/15/2023]
Abstract
Background The current development of vaccines for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is unprecedented. Little is known, however, about the nuanced public opinions on the vaccines on social media. Methods We adopted a human-guided machine learning framework using more than six million tweets from almost two million unique Twitter users to capture public opinions on the vaccines for SARS-CoV-2, classifying them into three groups: pro-vaccine, vaccine-hesitant, and anti-vaccine. After feature inference and opinion mining, 10,945 unique Twitter users were included in the study population. Multinomial logistic regression and counterfactual analysis were conducted. Results Socioeconomically disadvantaged groups were more likely to hold polarized opinions on coronavirus disease 2019 (COVID-19) vaccines, either pro-vaccine ( B = 0.40 , SE = 0.08 , P < 0.001 , OR = 1.49 ; 95 % CI = 1.26 -- 1.75 ) or anti-vaccine ( B = 0.52 , SE = 0.06 , P < 0.001 , OR = 1.69 ; 95 % CI = 1.49 -- 1.91 ). People who have the worst personal pandemic experience were more likely to hold the anti-vaccine opinion ( B = - 0.18 , SE = 0.04 , P < 0.001 , OR = 0.84 ; 95 % CI = 0.77 -- 0.90 ). The United States public is most concerned about the safety, effectiveness, and political issues regarding vaccines for COVID-19, and improving personal pandemic experience increases the vaccine acceptance level. Conclusion Opinion on COVID-19 vaccine uptake varies across people of different characteristics.
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Affiliation(s)
- Hanjia Lyu
- Goergen Institute for Data Science, University of Rochester, Rochester, New York 14627, United States
| | - Junda Wang
- Department of Computer Science, University of Rochester, Rochester, New York 14627, United States
| | - Wei Wu
- Goergen Institute for Data Science, University of Rochester, Rochester, New York 14627, United States
| | - Viet Duong
- Department of Computer Science, University of Rochester, Rochester, New York 14627, United States
| | - Xiyang Zhang
- Department of Psychology, University of Akron, Akron, Ohio 44325, United States
| | - Timothy D. Dye
- Department of Obstetrics and Gynecology, University of Rochester School of Medicine and Dentistry, Rochester, New York 14642, United States
| | - Jiebo Luo
- Department of Computer Science, University of Rochester, Rochester, New York 14627, United States
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Ennaceur S, Al-Mohaithef M. Parents’ Willingness to Vaccinate Children against COVID-19 in Saudi Arabia: A Cross-Sectional Study. Vaccines (Basel) 2022; 10:vaccines10020156. [PMID: 35214616 PMCID: PMC8875640 DOI: 10.3390/vaccines10020156] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 01/13/2022] [Accepted: 01/17/2022] [Indexed: 12/24/2022] Open
Abstract
Objectives: The present study aimed to investigate parents’ willingness to vaccinate their children under the age of 18 with a COVID-19 vaccine. Methods: This cross-sectional study was conducted in Saudi Arabia from January 2021 to March 2021. The univariate analysis using Mann–Whitney U-test, t-test, and chi-squared/Fisher’s exact test was performed to identify sociodemographic factors associated with the acceptance of COVID-19 vaccine in children. Factors with statistical significance (p < 0.05) were analyzed using multivariate regression analysis to determine the variables affecting parents’ decisions to vaccinate children. Results: Overall, 44% (167) of parents reported that they would accept vaccinating their children with a COVID-19 vaccine. Young (86; 22.7%), married (135; 35.6%), and Saudi (114; 30%) parents seemed to be more concerned about their children being infected. Parents who intended to vaccinate themselves (OR: 0.599, 95% CI: 0.367–0.980) and who trust the healthcare system (OR: 0.527, 95% CI: 0.327–0.848) reported greater acceptance of children’s vaccination. Among parents, the most frequent (40.9%) reason for vaccinating children was to prevent infection in other family members. What may underlie this result is that some parents understand that children can carry pathogens from persons in school to thoseat home. The most frequent (22.2%) reason for refusing vaccination was concerns about the side effects of the vaccine. Conclusions: Parents have differing opinions on frequencies and risks of coronavirus disease transmission and medical complications and of effectiveness and adverse effects of a vaccine. These results could be of use in designing public health information campaigns and health promotion programs based on perceived parental behavior and positive attitudes.
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Affiliation(s)
- Soukaina Ennaceur
- Department of Public Health, College of Health Sciences, Saudi Electronic University, Jeddah 11673, Saudi Arabia
- Correspondence:
| | - Mohammed Al-Mohaithef
- Department of Public Health, College of Health Sciences, Saudi Electronic University, Riyadh 13323, Saudi Arabia;
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Ellithorpe ME, Adams R, Aladé F. Parents' Behaviors and Experiences Associated with Four Vaccination Behavior Groups for Childhood Vaccine Hesitancy. Matern Child Health J 2022; 26:280-288. [PMID: 34993751 PMCID: PMC8736300 DOI: 10.1007/s10995-021-03336-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/26/2021] [Indexed: 11/28/2022]
Abstract
Objectives Increasing vaccine hesitancy and decreasing acceptance of the Centers for Disease Control and Prevention’s (CDC) recommended schedule for childhood vaccines represent a crucial public health issue. The present study directly compares vaccine acceptance behavior across four different groups: those who are fully accepting of the CDC-recommended schedule, those who are accepting but on a delayed schedule, those who only partially vaccinate, and those who do not vaccinate at all. Methods A total of 779 adults residing in the United States with at least one child under the age of 18 years participated in an online survey. Results Logistic and Ordinary Least Squares regression analyses revealed clear differences between the vaccination behavior groups on a variety of demographic, psychographic, and behavioral metrics. Results suggest financial and insurance-related barriers still hinder full vaccination, and there are differences by race, ethnicity, and educational attainment. Sources of information about vaccines also differed by vaccination behavior group, with those who never vaccinate more likely to rely on friends and family for information. Finally, those whose child experienced what the parent interpreted as an adverse reaction to a previous vaccine, even if that reaction was within the bounds of “normal”, were more likely to report they delay or partially vaccinate. Conclusions for practice These results have implications for public health policy and intervention campaigns, in particular that two-step flow campaigns and increased knowledge of normal vaccine side effects may ameliorate some vaccine hesitancy. Supplementary Information The online version contains supplementary material available at 10.1007/s10995-021-03336-8.
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Affiliation(s)
- Morgan E Ellithorpe
- Department of Communication, University of Delaware, 125 Academy St., Newark, DE, 19716, USA.
| | - Robyn Adams
- Department of Advertising & Public Relations, Michigan State University, 404 Wilson Rd., East Lansing, MI, 48824, USA
| | - Fashina Aladé
- Department of Advertising & Public Relations, Michigan State University, 404 Wilson Rd., East Lansing, MI, 48824, USA
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Parental childhood vaccine hesitancy and predicting uptake of vaccinations: a systematic review. Prim Health Care Res Dev 2022; 23:e68. [PMID: 36330835 PMCID: PMC9641700 DOI: 10.1017/s1463423622000512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Aim: This review aims are to (1) identify relevant quantitative research on parental childhood vaccine hesitancy with vaccine uptake and vaccination intention being relevant outcomes and (2) map the gaps in knowledge on vaccine hesitancy to develop suggestions for further research and to guide interventions in this field. Background: Vaccine hesitancy recognises a continuum between vaccine acceptance and vaccine refusal, de-polarising past anti-vaccine, and pro-vaccine categorisations of individuals and groups. Vaccine hesitancy poses a serious challenge to international efforts to lessen the burden of vaccine-preventable diseases. Potential vaccination barriers must be identified to inform initiatives aimed at increasing vaccine awareness, acceptance, and uptake. Methods: Five databases were searched for peer-reviewed articles published between 1998 and 2020 in the fields of medicine, nursing, public health, biological sciences, and social sciences. Across these datasets, a comprehensive search technique was used to identify multiple variables of public trust, confidence, and hesitancy about vaccines. Using PRISMA guidelines, 34 papers were included so long as they focused on childhood immunisations, employed multivariate analysis, and were published during the time frame. Significant challenges to vaccine uptake or intention were identified in these studies. Barriers to vaccination for the target populations were grouped using conceptual frameworks based on the Protection Motivation Theory and the World Health Organization’s Strategic Advisory Group of Experts on Immunization Working Group model and explored using the 5C psychological antecedents of vaccination. Findings: Although several characteristics were shown to relate to vaccine hesitancy, they do not allow for a thorough classification or proof of their individual and comparative level of influence. Understudied themes were also discovered during the review. Lack of confidence, complacency, constraints, calculation, and collective responsibility have all been highlighted as barriers to vaccination uptake among parents to different degrees.
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Durach F, Buturoiu R, Craiu D, Cazacu C, Bargaoanu A. Crisis of confidence in vaccination and the role of social media. Eur J Paediatr Neurol 2022; 36:84-92. [PMID: 34933130 DOI: 10.1016/j.ejpn.2021.12.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 12/08/2021] [Accepted: 12/08/2021] [Indexed: 12/18/2022]
Abstract
INTRODUCTION The aim of this paper is to review the current situation of vaccine hesitancy, with emphasis on children with neurological disorders, and to present the role social media plays in this situation. METHODS A literature review using the following search words was performed: vaccine∗ OR immune∗ AND hesitancy OR confidence AND social media. RESULTS The search retrieved 277 results; 17 duplicates and 234 irrelevant articles were excluded. 43 articles were fully analyzed. CONCLUSIONS An increasing number of parents are becoming vaccine hesitant. Their motives are complex and nuanced and involve factors related to vaccine safety and efficiency, perceived personal risks and benefits, socio-demographic and psychological characteristics. Attitudes toward vaccination differ in adolescents from their parents. In children with neurological disorders, factors involved in vaccination decision included physicians' knowledge of neurological diseases and parents' concerns that vaccination would exacerbate the chronic disorder. Unfortunately, the current pandemic is associated with an increase in vaccine hesitancy and brought forward unique determinants. The social media platforms can be a tool for the anti-vaccine movement to spread misinformation, but it can also be valued as a way for promoting health and pro-vaccine information.
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Affiliation(s)
- Flavia Durach
- National University of Political Studies and Public Administration, Bulevardul Expozitiei 30A, postal code 012244, Bucharest/S1, Romania.
| | - Raluca Buturoiu
- National University of Political Studies and Public Administration, Bulevardul Expozitiei 30A, postal code 012244, Bucharest/S1, Romania.
| | - Dana Craiu
- Carol Davila University of Medicine and Pharmacy, Faculty of Medicine, Department of Neurosciences, Pediatric Neurology Discipline II, Strada Dionisie Lupu No. 37, postal code: 020021, Bucharest/S2, Romania; Alexandru Obregia Clinical Hospital, Pediatric Neurology Clinic, Center of Expertise for Rare Disorders in Pediatric Neurology, EpiCARE member, Sos. Berceni 10, Bucharest/S4, Romania.
| | - Cristina Cazacu
- Alexandru Obregia Clinical Hospital, Pediatric Neurology Clinic, Center of Expertise for Rare Disorders in Pediatric Neurology, EpiCARE member, Sos. Berceni 10, Bucharest/S4, Romania.
| | - Alina Bargaoanu
- National University of Political Studies and Public Administration, Bulevardul Expozitiei 30A, postal code 012244, Bucharest/S1, Romania.
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Hook SA, Hansen AP, Niesobecki SA, Meek JI, Bjork JKH, Kough EM, Peterson MS, Schiffman EK, Rutz HJ, Rowe AJ, White JL, Peel JL, Biggerstaff BJ, Hinckley AF. Evaluating public acceptability of a potential Lyme disease vaccine using a population-based, cross-sectional survey in high incidence areas of the United States. Vaccine 2021; 40:298-305. [PMID: 34895785 DOI: 10.1016/j.vaccine.2021.11.065] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 11/09/2021] [Accepted: 11/22/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Lyme disease incidence is increasing, despite current prevention options. New Lyme disease vaccine candidates are in development, however, investigation of the acceptability of a Lyme disease vaccine among potential consumers is needed prior to any vaccine coming to market. We conducted a population-based, cross-sectional study to estimate willingness to receive a potential Lyme disease vaccine and factors associated with willingness. METHODS The web-based survey was administered to a random sample of Connecticut, Maryland, Minnesota, and New York residents June-July 2018. Survey-weighted descriptive statistics were conducted to estimate the proportion willing to receive a potential Lyme disease vaccine. Multivariable multinomial logistic regression models were used to quantify the association of sociodemographic characteristics and Lyme disease vaccine attitudes with willingness to be vaccinated. RESULTS Surveys were completed by 3313 respondents (6% response rate). We estimated that 64% of residents were willing to receive a Lyme disease vaccine, while 30% were uncertain and 7% were unwilling. Compared to those who were willing, those who were uncertain were more likely to be parents, adults 45-65 years old, non-White, have less than a bachelor's degree, or have safety concerns about a potential Lyme disease vaccine. Those who were unwilling were also more likely to be non-White, have less than a bachelor's degree, or have safety concerns about a potential Lyme disease vaccine. In addition, the unwilling had low confidence in vaccines in general, had low perceived risk of contracting Lyme disease, and said they would not be influenced by a positive recommendation from a healthcare provider. DISCUSSION Overall, willingness to receive a Lyme disease vaccine was high. Effective communication by clinicians regarding safety and other vaccine parameters to those groups who are uncertain will be critical for increasing vaccine uptake and reducing Lyme disease incidence.
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Affiliation(s)
- Sarah A Hook
- Centers for Disease Control and Prevention, Division of Vector-borne Diseases, 3156 Rampart Rd., Fort Collins, CO 80521, USA.
| | - AmberJean P Hansen
- Connecticut Emerging Infections Program, Yale School of Public Health, One Church Street, 7th Floor, New Haven, CT 06510, USA.
| | - Sara A Niesobecki
- Connecticut Emerging Infections Program, Yale School of Public Health, One Church Street, 7th Floor, New Haven, CT 06510, USA.
| | - James I Meek
- Connecticut Emerging Infections Program, Yale School of Public Health, One Church Street, 7th Floor, New Haven, CT 06510, USA.
| | - Jenna K H Bjork
- Minnesota Department of Health, 625 Robert St N, St Paul, MN 55164, USA.
| | - Erin M Kough
- Minnesota Department of Health, 625 Robert St N, St Paul, MN 55164, USA.
| | - Molly S Peterson
- Minnesota Department of Health, 625 Robert St N, St Paul, MN 55164, USA.
| | | | - Heather J Rutz
- Maryland Department of Health, 201 W. Preston Street, 3rd Floor, Baltimore, MD 21201, USA.
| | - Adam J Rowe
- New York State Department of Health, Empire Plaza, Corning Tower, State St, Albany, NY 12203, USA.
| | - Jennifer L White
- New York State Department of Health, Empire Plaza, Corning Tower, State St, Albany, NY 12203, USA.
| | - Jennifer L Peel
- Colorado State University, Environmental Health Building, 350 W. Lake St., Fort Collins, CO 80523, USA.
| | - Brad J Biggerstaff
- Centers for Disease Control and Prevention, Division of Vector-borne Diseases, 3156 Rampart Rd., Fort Collins, CO 80521, USA.
| | - Alison F Hinckley
- Centers for Disease Control and Prevention, Division of Vector-borne Diseases, 3156 Rampart Rd., Fort Collins, CO 80521, USA.
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Hallgren E, Moore R, Purvis RS, Hall S, Willis DE, Reece S, CarlLee S, Gurel-Headley M, McElfish PA. Facilitators to vaccination among hesitant adopters. Hum Vaccin Immunother 2021; 17:5168-5175. [PMID: 34893018 PMCID: PMC8903968 DOI: 10.1080/21645515.2021.2010427] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 11/22/2021] [Indexed: 12/30/2022] Open
Abstract
To end the COVID-19 pandemic, it is essential to increase vaccine coverage in the United States (U.S.). In this study, we examine the facilitators that helped hesitant adopters - those who are both vaccinated and report some degree of hesitancy - overcome barriers to vaccination. Drawing on a sample of 867 hesitant adopters in Arkansas, we find social networks, individual actions, health care organizations and professionals, employers, religious communities and leaders, and the media all play a role in helping the vaccine hesitant overcome barriers to vaccination. Our findings demonstrate vaccine hesitancy and uptake occur simultaneously, and overcoming hesitancy in the U.S. population requires multifaceted strategies from multiple entities. We provide recommendations for overcoming barriers, including hesitancy, based on our findings.
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Affiliation(s)
- Emily Hallgren
- College of Medicine, University of Arkansas for Medical Sciences Northwest, Fayetteville, AR, USA
| | - Ramey Moore
- College of Medicine, University of Arkansas for Medical Sciences Northwest, Fayetteville, AR, USA
| | - Rachel S. Purvis
- College of Medicine, University of Arkansas for Medical Sciences Northwest, Fayetteville, AR, USA
| | - Spencer Hall
- Office of Community Health and Research, University of Arkansas for Medical Sciences Northwest, Fayetteville, AR, USA
| | - Don E. Willis
- College of Medicine, University of Arkansas for Medical Sciences Northwest, Fayetteville, AR, USA
| | - Sharon Reece
- College of Medicine, University of Arkansas for Medical Sciences Northwest, Fayetteville, AR, USA
| | - Sheena CarlLee
- College of Medicine, University of Arkansas for Medical Sciences Northwest, Fayetteville, AR, USA
| | - Morgan Gurel-Headley
- College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, USA
- Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Pearl A. McElfish
- College of Medicine, University of Arkansas for Medical Sciences Northwest, Fayetteville, AR, USA
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Francis JK, Rodriguez SA, Dorsey O, Blackwell JM, Balasubramanian BA, Kale N, Day P, Preston SM, Thompson EL, Pruitt SL, Tiro JA. Provider perspectives on communication and dismissal policies with HPV vaccine hesitant parents. Prev Med Rep 2021; 24:101562. [PMID: 34976628 PMCID: PMC8683895 DOI: 10.1016/j.pmedr.2021.101562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 09/10/2021] [Accepted: 09/12/2021] [Indexed: 11/16/2022] Open
Abstract
Providers (29%) experience HPV-specific vaccine hesitancy from parents. Providers feel least confident in responding to families’ religious beliefs. Some providers (25%) agree with dismissal policies for families refusing vaccines.
Parental vaccine hesitancy is a growing concern. Less is known about provider or practice characteristics that encounter HPV-specific vaccine-hesitant parents, the providers’ confidence in responding to HPV vaccine concerns, and the attitudes and use of vaccine dismissal policies (i.e., removing patients from the practice). North Texas providers completed an online survey. Dependent variables assessed: (1) percentage of HPV vaccine-hesitant parents encountered in practice defined as substantive, or high (≥11%, or among more than one out of ten adolescent patient encounters) versus low (≤10%) levels; (2) confidence in responding to 11 HPV vaccine concerns; (3) attitudes and use of vaccine dismissal policies. Chi-square and Fisher’s exact tests were conducted. Among 156 providers, 29% reported high HPV vaccine hesitancy (≥11% of patient population). Overall, providers reported being “very confident” in addressing vaccine concerns (mean: 3.37 out of 4, SD: 0.57). Mean confidence scores were significantly higher for white (vs. non-white) providers and for pediatricians (vs. family practitioners). Providers were least confident in responding to parents’ religious/personal beliefs (69%). Some providers (25%) agreed with policies that dismissed vaccine-hesitant parents after repeated counseling attempts. More providers used dismissal policies for childhood (19%) than adolescent (10%) immunizations. Provider communication training should include parental religious/personal beliefs to effectively address HPV vaccine hesitancy. Other regions should examine their HPV-specific vaccine hesitancy levels to understand how the use of dismissal policies might vary between adolescent and childhood immunizations.
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76
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Ecker F, Kutalek R. 'I'm not an anti-vaxer!'-vaccine hesitancy among physicians: a qualitative study. Eur J Public Health 2021; 31:1157-1163. [PMID: 34580713 PMCID: PMC8675240 DOI: 10.1093/eurpub/ckab174] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Background Over the last years, research interest in vaccine hesitancy has increased.
Studies usually focus on perceptions of parents and have largely neglected
the group of health care providers. However, doctors’ notions on
vaccination have a major impact on the decision-making process of their
patients. We were interested to understand the phenomenon of vaccine
hesitancy among physicians, with a particular focus on the measles vaccine.
Furthermore, we aimed to understand the underlying perceptions of measles
that may be associated with vaccine hesitant decisions. Methods In order to get an in-depth view, semi-structured interviews with physicians
were conducted. Doctors were eligible for the study if they articulated
vaccine hesitant views and/or demonstrated vaccine hesitancy in their
medical practice. Results We interviewed 12 physicians, of whom 11 had a medical practice with no
contract with the Austrian social insurance (‘Wahlarzt’) and
additional training in complementary and alternative medicine. We found
perceptions of immunology, health and illness that were discordant with
evidence-based medicine and closely related to alternative and complementary
medicine. All participants argued for a delayed administration of the
measles vaccine. We found a consistent inclination towards
‘individual vaccination’, which was explained as empowering
parents and to strengthen their decision-making competencies. Most
participants expressed doubts about the reliability of vaccine studies and
were concerned with possible long-term effects. Conclusions Paying closer attention to doctors’ concerns on vaccination might
help to design target-oriented interventions to specifically strengthen
vaccine confidence.
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Affiliation(s)
- Franziska Ecker
- Department of Social and Preventive Medicine, Center
for Public Health, Medical University of Vienna, Vienna, Austria
- Correspondence: Franziska Ecker, Department of Social and
Preventive Medicine, Center for Public Health, Medical University of Vienna,
Kinderspitalgasse 15, Vienna 1090, Austria, Tel: +43 660 46 76 46 9,
e-mail:
| | - Ruth Kutalek
- Department of Social and Preventive Medicine, Center
for Public Health, Medical University of Vienna, Vienna, Austria
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77
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Cheong Q, Au-Yeung M, Quon S, Concepcion K, Kong JD. Predictive Modeling of Vaccination Uptake in US Counties: A Machine Learning-Based Approach. J Med Internet Res 2021; 23:e33231. [PMID: 34751650 PMCID: PMC8623305 DOI: 10.2196/33231] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Revised: 10/17/2021] [Accepted: 11/01/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Although the COVID-19 pandemic has left an unprecedented impact worldwide, countries such as the United States have reported the most substantial incidence of COVID-19 cases worldwide. Within the United States, various sociodemographic factors have played a role in the creation of regional disparities. Regional disparities have resulted in the unequal spread of disease between US counties, underscoring the need for efficient and accurate predictive modeling strategies to inform public health officials and reduce the burden on health care systems. Furthermore, despite the widespread accessibility of COVID-19 vaccines across the United States, vaccination rates have become stagnant, necessitating predictive modeling to identify important factors impacting vaccination uptake. OBJECTIVE This study aims to determine the association between sociodemographic factors and vaccine uptake across counties in the United States. METHODS Sociodemographic data on fully vaccinated and unvaccinated individuals were sourced from several online databases such as the US Centers for Disease Control and Prevention and the US Census Bureau COVID-19 Site. Machine learning analysis was performed using XGBoost and sociodemographic data. RESULTS Our model predicted COVID-19 vaccination uptake across US counties with 62% accuracy. In addition, it identified location, education, ethnicity, income, and household access to the internet as the most critical sociodemographic features in predicting vaccination uptake in US counties. Lastly, the model produced a choropleth demonstrating areas of low and high vaccination rates, which can be used by health care authorities in future pandemics to visualize and prioritize areas of low vaccination and design targeted vaccination campaigns. CONCLUSIONS Our study reveals that sociodemographic characteristics are predictors of vaccine uptake rates across counties in the United States and, if leveraged appropriately, can assist policy makers and public health officials to understand vaccine uptake rates and craft policies to improve them.
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Affiliation(s)
- Queena Cheong
- School of Kinesiology, University of British Columbia, Vancouver, BC, Canada
| | - Martin Au-Yeung
- Faculty of Science, University of British Columbia, Vancouver, BC, Canada
| | - Stephanie Quon
- Faculty of Applied Science, University of British Columbia, Vancouver, BC, Canada
| | - Katsy Concepcion
- Faculty of Science, University of British Columbia, Vancouver, BC, Canada
| | - Jude Dzevela Kong
- Africa-Canada Artificial Intelligence and Data Innovation Consortium, Department of Mathematics and Statistics, York University, Toronto, ON, Canada
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78
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Marshall S, Moore AC, Sahm LJ, Fleming A. Parent Attitudes about Childhood Vaccines: Point Prevalence Survey of Vaccine Hesitancy in an Irish Population. PHARMACY 2021; 9:pharmacy9040188. [PMID: 34842830 PMCID: PMC8628985 DOI: 10.3390/pharmacy9040188] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 11/16/2021] [Accepted: 11/21/2021] [Indexed: 11/16/2022] Open
Abstract
Understanding parental attitudes to their children’s vaccination is critical to developing and implementing interventions that address parents’ hesitancy and improve vaccine uptake. The Parent Attitudes about Childhood Vaccines (PACV) survey is a validated tool for identifying vaccine hesitancy in parents. We evaluated the rate of vaccine hesitancy and areas of concern regarding childhood vaccinations using an adapted version of the PACV survey, in a convenience sample of parents attending a STEM (Science, Technology, Engineering and Mathematics) outreach event in Ireland, in 2018. A score ≥ 50 identified vaccine hesitant parents. Of 105 parents who completed the survey, the prevalence of vaccine hesitancy was 6.7%, (7/105). Parents had concerns around vaccine side effects (36.2%, n = 38), vaccine safety (20%, n = 21) and the number of vaccines administered (13.3%, n = 14). Parents trusted the vaccine information they received (85.6%, n = 90) and 81.9% (n = 86) believed that the vaccine schedule was good for their child. The findings indicate the presence of vaccine hesitancy in parents in Ireland regarding paediatric vaccines with further research necessary to address parents’ vaccine concerns. Future research should explore further, by qualitative methods, parents’ vaccine concerns. There is also potential to identify vaccine hesitant parents with the PACV survey as a surveillance method in healthcare settings; for example, in community pharmacies, family doctor clinics and out-patient clinics.
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Affiliation(s)
- Sarah Marshall
- Pharmaceutical Care Research Group, School of Pharmacy, University College Cork, T12 YN60 Cork, Ireland; (S.M.); (L.J.S.)
| | - Anne C. Moore
- School of Biochemistry and Cell Biology, University College Cork, T12 XF62 Cork, Ireland;
| | - Laura J. Sahm
- Pharmaceutical Care Research Group, School of Pharmacy, University College Cork, T12 YN60 Cork, Ireland; (S.M.); (L.J.S.)
- Pharmacy Department, Mercy University Hospital, T12 WE28 Cork, Ireland
| | - Aoife Fleming
- Pharmaceutical Care Research Group, School of Pharmacy, University College Cork, T12 YN60 Cork, Ireland; (S.M.); (L.J.S.)
- Pharmacy Department, Mercy University Hospital, T12 WE28 Cork, Ireland
- Correspondence:
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79
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Feng H, Zhu H, Zhang H, Cao L, Li L, Wang J, Huang Y, Lai X, Lyu Y, Jing R, Guo J, Yin Z, Fang H. Caregivers' intentions to COVID-19 vaccination for their children in China: a cross-sectional survey. Hum Vaccin Immunother 2021; 17:4799-4805. [PMID: 34756123 DOI: 10.1080/21645515.2021.1985355] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Chinese caregivers' intentions to allow their children to be vaccinated against coronavirus disease 2019 (COVID-19) is unknown. We explored the intention rate of Chinese caregivers to allow their children to be vaccinated and examined potential influencing factors and underlying reasons for their unwillingness or hesitation. From November 30, 2020, to January 31, 2021, we conducted a cross-sectional survey of 3703 caregivers in six representative provinces in China. We assessed intention rates and correlates of caregivers' intentions to vaccinate children against COVID-19, using descriptive analyses and a multiple logistic regression analysis, respectively. In the study sample, about 84.0% of caregivers intended to get their children vaccinated for COVID-19 if the vaccine was available. In particular, 92.2% of caregivers who were willing to be vaccinated themselves for COVID-19 intended to have their children vaccinated, yet among caregivers who were unwilling (or uncertain) whether to be vaccinated, only 41.1% intended to have their children vaccinated. Older age, lower education level, and perceived safety and effectiveness of the COVID-19 vaccine were associated with increased odds of caregivers intending to have their children vaccinated. Of the six provinces included in the study, residence in a province other than Hubei increased the likelihood that caregivers would choose not to have their children vaccinated. We found a relatively high vaccination rate (84.0%) among caregivers by using a cross-sectional sample in China. Concerted efforts are needed to address caregivers' concerns about vaccine safety, especially among caregivers who do not intend to be vaccinated themselves.
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Affiliation(s)
- Huangyufei Feng
- School of Public Health, Peking University, Beijing, China.,China Center for Health Development Studies, Peking University, Beijing, China
| | - He Zhu
- China Center for Health Development Studies, Peking University, Beijing, China
| | - Haijun Zhang
- School of Public Health, Peking University, Beijing, China.,China Center for Health Development Studies, Peking University, Beijing, China
| | - Lingsheng Cao
- National Immunization Program, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Li Li
- National Immunization Program, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jiaohao Wang
- School of Public Health, Peking University, Beijing, China.,China Center for Health Development Studies, Peking University, Beijing, China
| | - Yingzhe Huang
- Department of Statistics, Beijing Weikexing Technology, Beijing, China
| | - Xiaozhen Lai
- School of Public Health, Peking University, Beijing, China.,China Center for Health Development Studies, Peking University, Beijing, China
| | - Yun Lyu
- School of Public Health, Peking University, Beijing, China.,China Center for Health Development Studies, Peking University, Beijing, China
| | - Rize Jing
- School of Public Health, Peking University, Beijing, China.,China Center for Health Development Studies, Peking University, Beijing, China
| | - Jia Guo
- School of Public Health, Peking University, Beijing, China.,China Center for Health Development Studies, Peking University, Beijing, China
| | - Zundong Yin
- National Immunization Program, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Hai Fang
- China Center for Health Development Studies, Peking University, Beijing, China.,Peking University Health Science Center-Chinese Center for Disease Control and Prevention Joint Center for Vaccine Economics, Beijing, China.,Key Laboratory of Reproductive Health National Health Commission of the People's Republic of China, Beijing, China
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80
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Schulz PJ, Hartung U. Unsusceptible to Social Communication? The Fixture of the Factors Predicting Decisions on Different Vaccinations. HEALTH COMMUNICATION 2021; 36:1505-1513. [PMID: 32522030 DOI: 10.1080/10410236.2020.1771119] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Protection Motivation Theory (PMT) holds that individuals under threat base their protection decisions on threat and coping appraisals. In the case of preventable communicable diseases, the theory holds that motivation for vaccination will be higher the more alarming a person's threat appraisals and the more promising her coping appraisals are. This study aims at describing how the influence model of PMT accommodates different changes and conditions: the addition of new factors such as knowledge, health literacy, and attitudes, and the inclusion of several highly similar threats in the form of different communicable diseases. The question raised is: Do people, when making vaccination decisions, think of vaccination as a unified entity or as separate units? In the first case, they would show similar factors across different vaccinations, probably thinking of the common biomedical functioning of vaccination. In the latter case, the predictors would change from vaccination to vaccination, and people might have different treatments of the subject in public communication on their minds. Data came from a representative survey among adult Swiss residents. Among the results are the following: PMT is affirmed; people show a unified way of determining their motivation to vaccinate; knowledge contributes strongly to protection motivation; and neither public discussion of threats nor experiences among acquaintances shows much of an impact.
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Affiliation(s)
- Peter J Schulz
- Institute of Communication and Health, School of Communication Sciences, Università Della Svizzera Italiana (University of Lugano)
| | - Uwe Hartung
- Institute of Communication and Health, School of Communication Sciences, Università Della Svizzera Italiana (University of Lugano)
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Humble RM, Sell H, Dubé E, MacDonald NE, Robinson J, Driedger SM, Sadarangani M, Meyer SB, Wilson S, Benzies KM, Lemaire-Paquette S, MacDonald SE. Canadian parents' perceptions of COVID-19 vaccination and intention to vaccinate their children: Results from a cross-sectional national survey. Vaccine 2021; 39:7669-7676. [PMID: 34688500 PMCID: PMC8500474 DOI: 10.1016/j.vaccine.2021.10.002] [Citation(s) in RCA: 52] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 09/29/2021] [Accepted: 10/04/2021] [Indexed: 11/24/2022]
Abstract
Background Vaccinating children (≤17 years old)
is important for controlling the COVID-19 pandemic. As parents are
primary decision makers for their children, we aimed to assess parents’
perceptions and intentions regarding COVID-19 vaccination for their
children, including for some underserved populations (e.g., newcomers,
Indigenous peoples, and visible minority groups). Methods We conducted a cross-sectional
national survey of Canadian parents in December 2020, just as COVID-19
vaccines were approved for adults, to assess intention to vaccinate their
children (aged 0-17 years) against COVID-19, perceptions of COVID-19
disease and vaccines, previous uptake of influenza and routine vaccines,
and sociodemographic characteristics. Binomial logistic regression was
used to assess the association between parents' COVID-19 vaccination
intention for their children and exposure variables. Results Sixty-three percent of parents
(1074/1702) intended to vaccinate their children against COVID-19. Those
employed part-time (compared to full-time) had lower intention to
vaccinate their children (aOR=1.73, 95% CI: 1.06-2.84), while those who
spoke languages other than English, French, or Indigenous languages were
less likely to have low intention (aOR=0.55, 95% CI: 0.32-0.92). Low
vaccination intention was also associated with children not receiving
influenza vaccine pre-pandemic (aOR=1.51, 95% CI: 1.04-2.21), parents
having low intention to vaccinate themselves against COVID-19 (aOR=9.22,
95% CI: 6.43-13.34), believing COVID-19 vaccination is unnecessary
(aOR=2.59, 95% CI: 1.72-3.91) or unsafe (aOR=4.21, 95% CI: 2.96-5.99),
and opposing COVID-19 vaccine use in children without prior testing
(aOR=3.09, 95% CI: 1.87-5.24). Interpretation Parents’ COVID-19 vaccination
intentions for their children are better predicted by previous decisions
regarding influenza vaccination than routine childhood vaccines, and
other perceptions of COVID-19 vaccine-related factors. Public
communication should highlight the safety and necessity of COVID-19
vaccination in children to support a return to normal activities. Further
research should assess actual COVID-19 vaccination uptake in children,
particularly for underserved populations.
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Affiliation(s)
- Robin M Humble
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Hannah Sell
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada; School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - Eve Dubé
- Department of Anthropology, Laval University, Quebec City, Quebec, Canada
| | - Noni E MacDonald
- Department of Paediatrics, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Joan Robinson
- Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
| | - S Michelle Driedger
- Department of Community Health Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Manish Sadarangani
- Vaccine Evaluation Center, BC Children's Hospital Research Institute; Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada
| | - Samantha B Meyer
- School of Public Health Sciences, Faculty of Health, University of Waterloo, Waterloo, Ontario, Canada
| | - Sarah Wilson
- Public Health Ontario, ICES, Dalla School of Public Health, University of Toronto, Toronto, Ontario, Canada
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82
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Abstract
PURPOSE OF REVIEW We reviewed the literature about parental vaccine hesitancy, focusing on publications from October 2019 to April 2021 to describe patterns and causes of hesitancy and interventions to address hesitancy. RECENT FINDINGS Recent studies expand understanding of the prevalence of vaccine hesitancy globally and highlight associated individual and contextual factors. Common concerns underlying hesitancy include uncertainty about the need for vaccination and questions about vaccine safety and efficacy. Sociodemographic factors associated with parental vaccine hesitancy vary across locations and contexts. Studies about psychology of hesitancy and how parents respond to interventions highlight the role of cognitive biases, personal values, and vaccination as a social contract or norm. Evidence-based strategies to address vaccine hesitancy include presumptive or announcement approaches to vaccine recommendations, motivational interviewing, and use of immunization delivery strategies like standing orders and reminder/recall programs. A smaller number of studies support use of social media and digital applications to improve vaccination intent. Strengthening school vaccine mandates can improve vaccination rates, but policy decisions must consider local context. SUMMARY Vaccine hesitancy remains a challenge for child health. Future work must include more interventional studies to address hesitancy and regular global surveillance of parental vaccine hesitancy and vaccine content on social media.
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Affiliation(s)
- Jessica R Cataldi
- Department of Pediatrics, University of Colorado School of Medicine
- Adult and Child Consortium for Health Outcomes Research and Delivery Science (ACCORDS), University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, Colorado, USA
| | - Sean T O'Leary
- Department of Pediatrics, University of Colorado School of Medicine
- Adult and Child Consortium for Health Outcomes Research and Delivery Science (ACCORDS), University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, Colorado, USA
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83
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Wick JA, Henneman A. Pharmacy student perceptions of their preparedness to address vaccine hesitancy and refusal. CURRENTS IN PHARMACY TEACHING & LEARNING 2021; 13:1324-1331. [PMID: 34521527 DOI: 10.1016/j.cptl.2021.07.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 03/15/2021] [Accepted: 07/15/2021] [Indexed: 05/26/2023]
Abstract
INTRODUCTION Vaccine hesitancy/refusal is a growing issue worldwide. Pharmacists are well suited to address vaccine hesitancy; however, the extent to which they feel trained to do so may vary. The objective of this study was to determine pharmacy student confidence in addressing vaccine hesitancy/refusal. METHODS Students in their penultimate didactic and experiential years at United States schools of pharmacy were invited to participate in a 30-item electronic survey concerning perceptions of preparedness to address vaccine hesitancy/refusal. The primary outcome was pharmacy students' perception of their ability to address vaccine hesitancy/refusal. Secondary outcomes included student confidence in their knowledge of and ability to speak to vaccine controversies and support for pharmacist/patient vaccine responsibilities. Outcomes were addressed using five-point Likert-type items. Median values and interquartile ranges were reported, with chi-square analysis accounting for possible heterogeneity between groups. RESULTS A total of 1433 students (estimated response rate = 20%) completed the survey. Respondents indicated confidence in their preparedness to address patient immunization concerns, hesitancy, and refusal with a median score of 4 (scale of 5, with 1 = the least confident and 5 = the most confident). Secondary outcome analysis revealed varying degrees of confidence regarding specific vaccine hesitancy controversies. CONCLUSIONS Pharmacy students were confident in their ability to address vaccine hesitancy/refusal. Students held beliefs of responsibility for limiting non-vaccination, but felt less confident in addressing concerns regarding specific vaccine components and immune system overload.
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Affiliation(s)
- Jennifer A Wick
- Clinical Pharmacy Specialist, Primary Care, The Christ Hospital, 2123 Auburn Ave., Ste 520, Cincinnati, OH 45219, United States
| | - Amy Henneman
- Associate Professor of Pharmacy Practice, Belmont University, 1900 Belmont Blvd., Nashville, TN 37212, 615-460-8129, United States.
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84
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A K, Lu X, Wang J, Hu L, Li B, Lu Y. Association between Adult Vaccine Hesitancy and Parental Acceptance of Childhood COVID-19 Vaccines: A Web-Based Survey in a Northwestern Region in China. Vaccines (Basel) 2021; 9:1088. [PMID: 34696196 PMCID: PMC8539638 DOI: 10.3390/vaccines9101088] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Revised: 09/21/2021] [Accepted: 09/24/2021] [Indexed: 11/18/2022] Open
Abstract
China has initiated the COVID-19 vaccination for children aged 15-17 years since late July 2020. This study aimed to determine the association between adult vaccine hesitancy and parental acceptance of childhood COVID-19 vaccines in a multi-ethnicity area of northwestern China. A web-based investigation was performed with a convenience sampling strategy to recruit the parents aged 20-49 years. In a total of 13,451 valid respondents, 66.1% had received the COVID-19 vaccination, 26.6% were intent to receive, while 7.3% were not intent, with an increasing vaccine hesitancy (p < 0.001). Moreover, vaccination uptake of four common vaccines in their children remained low (29.0% for influenza vaccine, 17.9% for pneumonia vaccine, 10.9% for rotavirus vaccine, 8.0% for Enterovirus-71 vaccine), while overall parental acceptance of childhood COVID-19 vaccines was 50.0% (32.7% for those aged 0-5, 46.6% for 6-10, 73.3% for 11-18; p < 0.001). Vaccination uptake of these four vaccines and parental acceptance of childhood COVID-19 vaccine were negatively associated with adult vaccine hesitancy. In addition, respondents mostly preferred childhood COVID-19 vaccines with weak mild common adverse events (β = 1.993) and no severe adverse events (β = 1.731), demonstrating a positive association with adult vaccine hesitancy. Thus, it warrants specific countermeasures to reduce adult vaccine hesitancy and improve strategies for childhood vaccination.
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Affiliation(s)
- Kezhong A
- Institute of Immunization, Qinghai Provincial Center for Disease Control and Prevention, Xining 810007, China;
| | - Xinyue Lu
- Department of Epidemiology, Key Laboratory of Public Health Safety, Ministry of Education, School of Public Health, Fudan University, Shanghai 200032, China; (X.L.); (L.H.); (B.L.)
| | - Jing Wang
- Department of Health and Environmental Sciences, Xi’an Jiaotong-Liverpool University, Suzhou 215123, China;
| | - Linjie Hu
- Department of Epidemiology, Key Laboratory of Public Health Safety, Ministry of Education, School of Public Health, Fudan University, Shanghai 200032, China; (X.L.); (L.H.); (B.L.)
| | - Bingzhe Li
- Department of Epidemiology, Key Laboratory of Public Health Safety, Ministry of Education, School of Public Health, Fudan University, Shanghai 200032, China; (X.L.); (L.H.); (B.L.)
| | - Yihan Lu
- Department of Epidemiology, Key Laboratory of Public Health Safety, Ministry of Education, School of Public Health, Fudan University, Shanghai 200032, China; (X.L.); (L.H.); (B.L.)
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85
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Bryan MA, Hofstetter AM, Ramos D, Ramirez M, Opel DJ. Facilitators and Barriers to Providing Vaccinations During Hospital Visits. Hosp Pediatr 2021; 11:1137-1152. [PMID: 34556537 DOI: 10.1542/hpeds.2020-004655] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND Many children are undervaccinated at the time of hospital admission. Our objective was to explore the facilitators and barriers to vaccinating during hospitalization. METHODS We conducted qualitative interviews of parents, primary care pediatricians, emergency department (ED) physicians, and pediatric hospitalists. Parents of undervaccinated hospitalized children who were admitted through the ED were invited to participate. We used purposive sampling to identify physician participants. Semistructured interviews querying participants' perspectives on hospital-based vaccination were audiorecorded and transcribed. Parent demographics and physician practice characteristics were collected. Transcripts were analyzed for facilitators and barriers to vaccinating during acute hospital visits by using inductive content analysis. A conceptual framework was developed on the basis of the social ecological model. RESULTS Twenty-one parent interviews and 10 physician interviews were conducted. Of parent participants, 86% were female; 76% were white. Physician participants included 3 primary care pediatricians, 3 ED physicians, and 4 hospitalists. Facilitators and barriers fell under 4 major themes: (1) systems-level factors, (2) physician-level factors, (3) parent-provider interactional factors, and (4) parent- and child-level factors. Parent participants reported a willingness to receive vaccines during hospitalizations, which aligned with physician participants' experiences. Another key facilitator identified by parent and physician participants was the availability of shared immunization data. Identified by parent and physician participants included the availability of shared immunization data. Barriers included being unaware that the child was vaccine-eligible, parental beliefs against vaccination, and ED and inpatient physicians' perceived lack of skills to effectively communicate with vaccine-hesitant parents. CONCLUSIONS Parents and physicians identified several key facilitators and barriers to vaccinating during hospitalization. Efforts to provide inpatient vaccines need to address existing barriers.
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Affiliation(s)
- Mersine A Bryan
- Department of Pediatrics, School of Medicine .,Seattle Children's Research Institute, Seattle, Washington
| | - Annika M Hofstetter
- Department of Pediatrics, School of Medicine.,Seattle Children's Research Institute, Seattle, Washington
| | - Daniela Ramos
- Seattle Children's Research Institute, Seattle, Washington
| | - Magaly Ramirez
- Department of Health Services, School of Public Health, University of Washington, Seattle, Washington
| | - Douglas J Opel
- Department of Pediatrics, School of Medicine.,Seattle Children's Research Institute, Seattle, Washington
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86
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Mayerová D, Abbas K. Childhood immunisation timeliness and vaccine confidence by health information source, maternal, socioeconomic, and geographic characteristics in Albania. BMC Public Health 2021; 21:1724. [PMID: 34551735 PMCID: PMC8459480 DOI: 10.1186/s12889-021-11724-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 08/29/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Albania is facing decreasing childhood immunisation coverage and delay in timeliness of vaccination despite a growing economy and universal health insurance. Our aim is to estimate childhood immunisation timeliness and vaccine confidence associated with health information source, maternal, socioeconomic, and geographic characteristics in Albania. METHODS We used the 2017-2018 Albania Demographic and Health Survey to analyse childhood immunisation timeliness and vaccine confidence among 2113 and 1795 mothers of under-5-year-old children respectively using simple and multivariable logistic regression. RESULTS Among mothers of under-5-year-old children in Albania, 78.1% [95% CI: 74.3, 81.5] never postponed or rejected childhood vaccines. Immunisation delay was reported by 21.3% [18.0, 25.1] of mothers, but a majority (67.0%) were caused by the infant's sickness at the time of vaccination, while a minority (6.1%) due to mothers' concerns about vaccine safety and side effects. Vaccine confidence was high among the mothers at 92.9% [91.0, 94.4] with similar geographical patterns to immunisation timeliness. Among 1.3% of mothers who ever refused vaccination of their children, the main concerns were about vaccine safety (47.8%) and side effects (23.1%). With respect to childhood immunisation timeliness, after controlling for other background characteristics, mothers whose main health information source was the Internet/social media had 34% (adjusted odds-ratio AOR = 0.66 [0.47, 0.94], p = 0.020) lower odds in comparison to other sources, working mothers had 35% (AOR = 0.65 [0.47, 0.91], p = 0.013) lower odds in comparison to non-working mothers, mothers with no education had 86% (AOR = 0.14 [0.03, 0.67], p = 0.014) lower odds compared to those who completed higher education, and mothers living in AL02-Qender and AL03-Jug regions had 62% (AOR = 0.38 [0.23, 0.63], p < 0.0001) and 64% (AOR = 0.36 [0.24, 0.53], p < 0.0001) lower odds respectively in comparison to those residing in AL01-Veri region (p < 0.0001). With respect to vaccine confidence, mothers whose main health information source was the Internet/social media had 56% (AOR = 0.44 [0.27, 0.73], p = 0.002) lower odds in comparison to other sources, single mothers had 92% (AOR = 0.08 [0.01, 0.65], p = 0.019) lower odds compared to those married/living with a partner, mothers of specific ethnicites (like Roma) had 61% (AOR = 0.39 [0.15, 0.97], p = 0.042) lower odds in comparison to mothers of Albanian ethnicity, and mothers living in AL03-Jug region had 67% (AOR = 0.33 [0.19, 0.59], p ≤ 0.0001) lower odds compared to mothers residing in AL01-Veri region. CONCLUSIONS Reinforcement of scientific evidence-based online communication about childhood immunisation in combination with tracking and analysis of vaccine hesitancy sentiment and anti-vaccination movements on the Internet/social media would be beneficial in improving immunisation timeliness and vaccine confidence in Albania. Since parents tend to search online for information that would confirm their original beliefs, traditional ways of promoting vaccination by healthcare professionals who enjoy confidence as trusted sources of health information should be sustained and strengthened to target the inequities in childhood immunisation timelines and vaccine confidence in Albania.
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Affiliation(s)
- Daniela Mayerová
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, WC1E 7HT UK
| | - Kaja Abbas
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, WC1E 7HT UK
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87
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Kyprianidou M, Tzira E, Galanis P, Giannakou K. Knowledge of mothers regarding children's vaccinations in Cyprus: A cross-sectional study. PLoS One 2021; 16:e0257590. [PMID: 34543326 PMCID: PMC8452034 DOI: 10.1371/journal.pone.0257590] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 09/03/2021] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Vaccine hesitancy is identified as one of the top threats to global health. A significant drop of childhood vaccine coverage is reported worldwide. One of the key reasons that influenced mothers' choice to postpone, or avoid children's vaccination, is knowledge. This study aimed to assess the level of Cypriot mothers' knowledge on certain aspects of vaccination of their children, examine the association between vaccination knowledge and selected socio-demographic factors, and lastly assess the association of mothers' knowledge about vaccination with vaccination coverage and delay, compliance to the recommended schedules, vaccination during pregnancy and mother-pediatrician relationship. METHODS An online-based cross-sectional study conducted to collect information about socio-demographic characteristics, child's characteristics, vaccination, and vaccine knowledge, using a self-administered questionnaire. The survey was conducted between April 2020 and June 2020 and the study population included mothers over 18 years old with at least one child (<18 years old) living in Cyprus. RESULTS A total of 703 Cypriot mothers participated in the study. Most of the participants stated that they vaccined their children (97%) and the most popular source of information about vaccination was their pediatrician (90%). More than half of the participants (57%) have delayed their child/children vaccination with their pediatrician's suggestion being the main reason. 36% of mothers had low knowledge while the overall correct rate was 13.6% and the median (IQR) knowledge score was 11 (9-12). Having a medium knowledge about vaccination was associated with having a medium or high income, whilst high knowledge compared to low knowledge was associated with completed a higher education and having a high income. Our analysis showed that the correct knowledge by mothers with regards to vaccination increases the probability of vaccinating their children, following the local recommendations for vaccine dosages, and acquiring and trusting vaccination-related information from their children's pediatrician. CONCLUSION Our findings show that the majority of mothers in Cyprus had positives perceptions regarding childhood vaccination, as reflected with the high vaccination rate, however, some aspects of mothers' knowledge of vaccination need to be improved. Public health strategies to promote vaccination, education programs as well as improved communication tools between pediatricians and mothers need to be considered to achieve favorable vaccination attitudes and practices for all mothers in Cyprus.
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Affiliation(s)
- Maria Kyprianidou
- Department of Health Sciences, School of Sciences, European University Cyprus, Nicosia, Cyprus
- Cyprus International Institute for Environmental and Public Health, Cyprus University of Technology, Limassol, Cyprus
| | - Eleana Tzira
- Department of Health Sciences, School of Sciences, European University Cyprus, Nicosia, Cyprus
| | - Petros Galanis
- Faculty of Nursing, Centre for Health Services Management and Evaluation, National and Kapodistrian University of Athens, Athens, Greece
| | - Konstantinos Giannakou
- Department of Health Sciences, School of Sciences, European University Cyprus, Nicosia, Cyprus
- * E-mail:
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88
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Ugale JL, Spielvogle H, Spina C, Perreira C, Katz B, Pahud B, Dempsey AF, Robinson JD, Garrett K, O'Leary ST, Opel DJ. "It's Like 1998 Again": Why Parents Still Refuse and Delay Vaccines. Glob Pediatr Health 2021; 8:2333794X211042331. [PMID: 34471653 PMCID: PMC8404635 DOI: 10.1177/2333794x211042331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 08/09/2021] [Indexed: 11/24/2022] Open
Abstract
We conducted a qualitative study from 2018 to 2019 to update the reasons why US parents’ refuse or delay vaccines. Four focus groups and 4 semi-structured interviews involving 33 primary care pediatric providers were conducted in Washington and Colorado. A thematic analysis was conducted to identify themes related to reasons for parental refusal or delay. Five predominant themes were identified: (1) vaccine safety, (2) relative influence of information sources, decision-makers, and timing, (3) low perceived risk of contracting vaccine-preventable disease, (4) lack of trust, and (5) religious objection. Vaccine safety was the theme mentioned most frequently by providers (N = 45 times by 26 providers) and religious objection to vaccination was referred to the least (N = 6 times by 6 providers). Provider-reported reasons for parental refusal or delay of childhood vaccines in 2018 to 2019 remain similar to those reported in previous studies.
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Affiliation(s)
- Jiana L Ugale
- Seattle Children's Research Institute, Seattle, WA, USA
| | | | - Christine Spina
- University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, CO, USA
| | - Cathryn Perreira
- University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, CO, USA
| | - Ben Katz
- Seattle Children's Research Institute, Seattle, WA, USA
| | - Barbara Pahud
- University of Missouri-Kansas City, Kansas City, MO, USA
| | - Amanda F Dempsey
- University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, CO, USA.,University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | | | - Kathleen Garrett
- University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, CO, USA
| | - Sean T O'Leary
- University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, CO, USA.,University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Douglas J Opel
- Seattle Children's Research Institute, Seattle, WA, USA.,University of Washington School of Medicine, Seattle, WA, USA
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89
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Hofstetter AM, Opel DJ, Stockwell MS, Hsu C, Zhou C, Mangione-Smith RM, Englund JA. Associations Between Health Care Professional Communication Practices and Influenza Vaccination of Hospitalized Children. Acad Pediatr 2021; 21:1142-1150. [PMID: 34217901 DOI: 10.1016/j.acap.2021.06.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 06/15/2021] [Accepted: 06/27/2021] [Indexed: 01/08/2023]
Abstract
BACKGROUND Health care professionals (HCPs) (eg, nurses, doctors) play a key role in vaccine uptake. Few studies describe HCP influenza vaccine communication with parents of hospitalized children. METHODS This study included English- and Spanish-speaking parents of influenza vaccine-eligible children hospitalized at a tertiary care pediatric hospital between October 2018 and May 2019. A survey was completed online or via telephone 2 to 15 weeks (median 4 weeks) after discharge. It examined parental intent to vaccinate their child during hospitalization and parent-reported inpatient HCP communication practices (eg, vaccine recommendation strength, format for initiating the recommendation). Multivariable logistic regression examined the associations between HCP communication practices and influenza vaccination during hospitalization, adjusting for demographic, clinical, and visit characteristics. RESULTS Parents (n = 194; 63.0% response rate) were mostly white (66.8%) and English-speaking (97.4%). Their children were primarily 5 through 17 years (67.0%) with chronic disease (68.6%); 24.7% were vaccinated before discharge. Most parents initially had no plan (55.6%) or planned to decline (31.1%) influenza vaccine for their child during hospitalization. Of these parents, 22.2% decided to accept the vaccine, 66.7% citing a HCP conversation as the main reason for changing their mind. Overall, 75.3% recalled a HCP conversation about influenza vaccination. Of these parents, 61.0% reported a HCP recommendation (53.8% described it as "very strong"; 11.1% noted a presumptive initiation format). A parent-reported HCP conversation (adjusted odds ratio [AOR] 5.23, 95% confidence interval [CI] 1.64-16.68) and recommendation (AOR 5.59, 95% CI 2.01-15.51) were associated with influenza vaccination during hospitalization. CONCLUSION This study highlights the importance of discussing and recommending influenza vaccination with parents of hospitalized children.
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Affiliation(s)
- Annika M Hofstetter
- Department of Pediatrics, University of Washington School of Medicine (AM Hofstetter, DJ Opel, C Zhou, and JA Englund), Seattle, Wash; Seattle Children's Research Institute (AM Hofstetter, DJ Opel, C Zhou, and JA Englund), Seattle, Wash.
| | - Douglas J Opel
- Department of Pediatrics, University of Washington School of Medicine (AM Hofstetter, DJ Opel, C Zhou, and JA Englund), Seattle, Wash; Seattle Children's Research Institute (AM Hofstetter, DJ Opel, C Zhou, and JA Englund), Seattle, Wash
| | - Melissa S Stockwell
- Department of Pediatrics, Columbia University (MS Stockwell), New York, NY; Department of Population and Family Health, Mailman School of Public Health, Columbia University (MS Stockwell), New York, NY
| | - Clarissa Hsu
- Kaiser Permanente Washington Health Research Institute (C Hsu and RM Mangione-Smith), Seattle, Wash
| | - Chuan Zhou
- Department of Pediatrics, University of Washington School of Medicine (AM Hofstetter, DJ Opel, C Zhou, and JA Englund), Seattle, Wash; Seattle Children's Research Institute (AM Hofstetter, DJ Opel, C Zhou, and JA Englund), Seattle, Wash
| | - Rita M Mangione-Smith
- Kaiser Permanente Washington Health Research Institute (C Hsu and RM Mangione-Smith), Seattle, Wash
| | - Janet A Englund
- Department of Pediatrics, University of Washington School of Medicine (AM Hofstetter, DJ Opel, C Zhou, and JA Englund), Seattle, Wash; Seattle Children's Research Institute (AM Hofstetter, DJ Opel, C Zhou, and JA Englund), Seattle, Wash
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90
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Gennaro E, Caleb S, Torres R, Alexander-Parrish R, Thoburn E, McLaughlin JM, Fu LY. Parental Beliefs, Logistical Challenges, and Improvement Opportunities for Vaccination among Children Ages 19-35 Months Experiencing Homelessness. J Pediatr 2021; 236:246-252. [PMID: 33895206 DOI: 10.1016/j.jpeds.2021.04.029] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 04/15/2021] [Accepted: 04/16/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To examine parental beliefs and logistical challenges to early childhood vaccination completion as well as opportunities to support improved vaccine uptake among families experiencing homelessness. STUDY DESIGN A cross-sectional survey was conducted between February 2018 and October 2019 with parents of children ages 19-35 months old experiencing homelessness. Participants were recruited from 10 locations that serve families experiencing homelessness in Washington, DC and by referral from other participants. Vaccination records were obtained from health care providers to determine the child's up-to-date (UTD) status with a combined 7-vaccine series. RESULTS Of 135 children of participants, only 69 (51.1%) were UTD. Most participants had at least 1 concern about childhood vaccines and at least 1 logistical barrier to completing vaccination (57% and 85.9%, respectively). The most frequent barriers were getting a convenient appointment time (46.3%), remembering appointments (44.8%), and commuting to appointments (44.4%). Although only 53.3% of the participants' children attended a licensed daycare center and only 43.7% received benefits from the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), use of either of these programs that routinely assess vaccination status was associated with over 3 times higher adjusted odds of being UTD (aOR 3.4, 95% CI 1.6-7.3, and aOR 3.1, 95% CI 1.4-6.5, respectively). CONCLUSIONS Logistical barriers to accessing primary care services are common among children experiencing homelessness, underscoring the importance of health care providers offering vaccines at every opportunity. Government-regulated programs are useful for promoting vaccination, and enrollment should be encouraged because many children experiencing homelessness may not access them.
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Affiliation(s)
- Erica Gennaro
- Department of Pediatrics, Children's National Hospital, Washington, DC
| | - Susan Caleb
- Department of Pediatrics, Children's National Hospital, Washington, DC
| | - Rachel Torres
- Center for Translational Research, Children's National Hospital, Washington, DC
| | | | | | | | - Linda Y Fu
- Department of Pediatrics, Children's National Hospital, Washington, DC; Center for Translational Research, Children's National Hospital, Washington, DC
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91
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Mensah-Bonsu NE, Mire SS, Sahni LC, Berry LN, Dowell LR, Minard CG, Cunningham RM, Boom JA, Voigt RG, Goin-Kochel RP. Understanding Vaccine Hesitancy Among Parents of Children With Autism Spectrum Disorder and Parents of Children With Non-Autism Developmental Delays. J Child Neurol 2021; 36:911-918. [PMID: 34048284 PMCID: PMC8440329 DOI: 10.1177/08830738211000505] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Parents of children with autism spectrum disorder (ASD) may be at greater risk for developing antivaccine beliefs that lead to vaccine delays and/or refusals for their children. We investigated current parental vaccine hesitancy, parents' beliefs about causes of children's developmental delays, and children's vaccination histories among parents of children with ASD or non-ASD developmental delays. Data were analyzed from 89/511 parents (17.4%) who completed the Parent Attitudes About Childhood Vaccines questionnaire and the Revised Illness Perception Questionnaire; 46.1% had childhood vaccination records available. Overall, 21/89 (23.6%, 95% confidence interval [CI]: 15.0-34.0) of parents were vaccine hesitant (ASD n = 19/21 [90.5%], non-ASD n = 2/21 [9.5%]). Parents of children with ASD were significantly more likely to agree with "toxins in vaccines" as a cause of their child's developmental delays (28.4% vs 5.0%, P = .034). The odds of being vaccine hesitant were 11.9 times (95% CI 2.9-48.0) greater among parents who agreed versus disagreed that toxins in vaccines caused their children's developmental delays. Rates of prior vaccine receipt did not differ between hesitant and nonhesitant groups.
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Affiliation(s)
- Noël E. Mensah-Bonsu
- Department of Pediatrics, Baylor College of Medicine,Autism Center, Texas Children’s Hospital
| | - Sarah S. Mire
- Department of Psychological, Health, & Learning Sciences, University of Houston
| | | | - Leandra N. Berry
- Department of Pediatrics, Baylor College of Medicine,Autism Center, Texas Children’s Hospital
| | - Lauren R Dowell
- Department of Pediatrics, Baylor College of Medicine,Autism Center, Texas Children’s Hospital
| | - Charles G. Minard
- Dan L. Duncan Institute for Clinical and Translational Research, Baylor College of Medicine
| | | | - Julie A. Boom
- Department of Pediatrics, Baylor College of Medicine,Immunization Project, Texas Children’s Hospital
| | - Robert G. Voigt
- Department of Pediatrics, Baylor College of Medicine,Autism Center, Texas Children’s Hospital
| | - Robin P. Goin-Kochel
- Department of Pediatrics, Baylor College of Medicine,Autism Center, Texas Children’s Hospital
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Predictors of Willingness to Receive the COVID-19 Vaccine after Emergency Use Authorization: The Role of Coping Appraisal. Vaccines (Basel) 2021; 9:vaccines9090967. [PMID: 34579204 PMCID: PMC8471613 DOI: 10.3390/vaccines9090967] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Revised: 08/19/2021] [Accepted: 08/25/2021] [Indexed: 11/17/2022] Open
Abstract
The current study aims to identify psychosocial factors based on protection motivation theory (PMT) influencing Chinese adults’ willingness to receive the COVID-19 vaccine after the emergency use authorization of the New Coronavirus Inactivated Vaccine in China. A cross-sectional online survey was conducted among Chinese residents aged 18–59 years, and 2528 respondents from 31 provinces and autonomous regions were included in the current study. Based on PMT, threat appraisals and coping appraisals were measured. Hierarchical multiple regressions and multivariate logistic regressions were used to identify the relationships between the PMT constructs and vaccination willingness after other covariates were controlled for. A total of 1411 (55.8%) respondents reported being willing to receive the COVID-19 vaccine. The PMT model explained 26.6% (p < 0.001) of the variance in the vaccine willingness. The coping appraisals, including response efficacy, self-efficacy, and response costs, were significantly correlated with the willingness to receive the COVID-19 vaccine, and response efficacy was the strongest influencing factor (adjusted OR = 2.93, 95% CI: 2.42–3.54). In conclusion, the coping appraisals for vaccination, instead of threat appraisals regarding the pandemic itself, mainly influenced people’s willingness to get vaccinated after the emergency use authorization of the COVID-19 vaccine in China. These findings are helpful for developing education and interventions to promote vaccination willingness and enhance public health outcomes during a pandemic.
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93
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Mant M, Aslemand A, Prine A, Jaagumägi Holland A. University students' perspectives, planned uptake, and hesitancy regarding the COVID-19 vaccine: A multi-methods study. PLoS One 2021; 16:e0255447. [PMID: 34343202 PMCID: PMC8330905 DOI: 10.1371/journal.pone.0255447] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 07/19/2021] [Indexed: 12/18/2022] Open
Abstract
PURPOSE To investigate university students' willingness to receive a COVID-19 vaccine when it becomes available to them. METHOD A multi-methods approach was used-online convenience sample surveys and semi-structured interviews-of young adults attending a large Canadian public university. Two survey samples were collected (June 20-July 28, 2020 and September 22-October 17, 2020). Semi-structured interviews were conducted following each survey, interviewing 20 students in each round. RESULTS In June 77.8% of surveyed students (n = 483) were willing to get the COVID-19 vaccine; in September 79.6% were willing (n = 1269). Multinomial and binary logistic regression analyses found that increasing perception of the severity of COVID-19 predicted the likelihood that a respondent was willing to get the COVID-19 vaccine in both surveys. In the latter survey students who indicated they would be encouraged to get the COVID-19 vaccine if their doctor/pharmacist recommended it were 76 times more likely to be willing to get the vaccine than those who would not be encouraged by medical advice. Interviews revealed concerns about the speed of the vaccine roll out, safety, and efficacy. CONCLUSIONS The majority of university students intend to get the COVID-19 vaccine, but there are nuanced concerns about efficacy and safety that must be taken into account by public health authorities as the vaccine becomes available to this group. Ensuring that family doctors, pharmacists, and other front-line healthcare workers have consistent and clear information regarding the benefits of vaccination will be critical to encouraging uptake among young adults.
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Affiliation(s)
- Madeleine Mant
- Department of Anthropology, University of Toronto Mississauga, Mississauga, Ontario, Canada
| | - Asal Aslemand
- Department of Mathematical & Computational Sciences, University of Toronto Mississauga, Mississauga, Ontario, Canada
| | - Andrew Prine
- Groves Memorial Community Hospital, Fergus, Ontario, Canada
| | - Alyson Jaagumägi Holland
- Department of Family Medicine, Faculty of Medicine, McMaster University, Hamilton, Ontario, Canada
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Olarewaju VO, Jafflin K, Deml MJ, Zimmermann C, Sonderegger J, Preda T, Staub H, Kwiatkowski M, Kloetzer A, Huber BM, Merten S, Tarr PE. Application of the Parent Attitudes about Childhood Vaccines (PACV) survey in three national languages in Switzerland: Exploratory factor analysis and Mokken scale analysis. Hum Vaccin Immunother 2021; 17:2652-2660. [PMID: 33760690 PMCID: PMC8475569 DOI: 10.1080/21645515.2021.1894894] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 02/12/2021] [Accepted: 02/19/2021] [Indexed: 01/24/2023] Open
Abstract
Vaccine hesitancy (VH) is a complex and context-specific phenomenon that is linked to under-immunization and poses challenges to immunization programs. The Parent Attitudes about Childhood Vaccines (PACV) is an instrument developed to measure VH. We translated the PACV into three languages (German, French and Italian) and administered it to 1388 Swiss parents. We used exploratory factor analysis (EFA) to confirm the scale sub-domains, Cronbach's alpha to assess internal consistency reliability, and Mokken scale analysis (MSA), to explore unidimensionality of each language version. We determined to construct validity by linking parental PACV score to children's immunization status for the first dose of measles vaccine. For the 15-item PACV, EFA extracted three sub-domains in German and French and four sub-domains in Italian. Cronbach's alpha was >0.8 across the three languages, and MSA produced a 13-item German, 14-item French, and 11-item Italian PACV. EFA and MSA of the short version PACV extracted a single factor and scale with Cronbach's alpha >0.7 in all three language versions. VH was significantly associated with non-timely receipt of the first dose of measles in all languages (odds ratio of 20.7, 21.3, and 8.3 for German, French, and Italian languages, respectively). The translated and revised PACV-15 versions are valid and reliable instruments for VH measurement. The structure and reliability of the short version of the PACV was as good as the long version. Our results suggest that the PACV can be used to measure parental VH outside the US in the validated languages.
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Affiliation(s)
- Victoria O. Olarewaju
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Kristen Jafflin
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Michael J. Deml
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Clara Zimmermann
- University of Basel, Basel, Switzerland
- University Department of Medicine, University of Basel, Bruderholz, Switzerland
| | - Joanna Sonderegger
- University of Basel, Basel, Switzerland
- University Department of Medicine, University of Basel, Bruderholz, Switzerland
| | - Thierry Preda
- University of Basel, Basel, Switzerland
- University Department of Medicine, University of Basel, Bruderholz, Switzerland
| | - Hanna Staub
- University of Basel, Basel, Switzerland
- University Department of Medicine, University of Basel, Bruderholz, Switzerland
| | - Marek Kwiatkowski
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Andrea Kloetzer
- University of Basel, Basel, Switzerland
- University Department of Medicine, University of Basel, Bruderholz, Switzerland
| | - Benedikt M. Huber
- Department of Pediatrics, HFR Fribourg Cantonal Hospital, Fribourg, Switzerland
| | - Sonja Merten
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Philip E. Tarr
- University of Basel, Basel, Switzerland
- University Department of Medicine, University of Basel, Bruderholz, Switzerland
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Lackner CL, Wang CH. Demographic, psychological, and experiential correlates of SARS-CoV-2 vaccination intentions in a sample of Canadian families. Vaccine X 2021; 8:100091. [PMID: 33778480 PMCID: PMC7983323 DOI: 10.1016/j.jvacx.2021.100091] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 03/10/2021] [Accepted: 03/18/2021] [Indexed: 11/30/2022] Open
Abstract
The COVID-19 pandemic has been ongoing for close to a year, with second waves occurring presently and many viewing vaccine uptake as the most likely way to curb successive waves and promote herd immunity. Reaching herd immunity status likely necessitates that children, as well as their parents, receive a vaccine targeting SARS-CoV-2. In this exploratory study, we investigated the demographic, experiential, and psychological factors associated with the anticipated likelihood and speed of having children receive a SARS-CoV-2 vaccine in a sample of 455 Canadian families (858 children; parents' mean age = 38.2 ± 6.82 years). Using linear mixed-effects and proportional odds logistic regression models, we demonstrated that older parental age, living in the Prairies (relative to Central Canada), more complete child vaccination history, and a greater tendency to prioritise the risks of the disease relative to the risks of side effects (i.e. lower omission bias) were associated with higher likelihoods of intention to vaccinate participants' children, with trend-level associations with lower perceived danger of the vaccine and higher psychological avoidance of the pandemic. Faster speed of intended vaccination was predicted by a similar constellation of variables with an additional predictor of a child in the family having a COVID-19 related health risk being associated with slower intended speed. Results are discussed concerning public health knowledge mobilisation and the unique Canadian health landscape.
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Affiliation(s)
- Christine L. Lackner
- Psychology Department, Mount St. Vincent University, 166 Bedford Highway, Halifax, Nova Scotia B3M2J6, Canada
| | - Charles H. Wang
- Performance and Analytics, Nova Scotia Health Authority (Central Zone), Charter Place Offices Suite 404, 1465 Brenton Street, Halifax, Nova Scotia B3J3T4, Canada
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Fernández-Basanta S, Lagoa-Millarengo M, Movilla-Fernández MJ. Encountering Parents Who Are Hesitant or Reluctant to Vaccinate Their Children: A Meta-Ethnography. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18147584. [PMID: 34300041 PMCID: PMC8306550 DOI: 10.3390/ijerph18147584] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 07/13/2021] [Accepted: 07/15/2021] [Indexed: 11/30/2022]
Abstract
(1) Background: Health professionals play an important role in addressing parents who are hesitant or reluctant to immunise their children. Despite the importance of this topic, gaps remain in the literature about these experiences. This meta-ethnography aimed to synthesise the available body of qualitative work about the care experiences of community and hospital health professionals in encounters with parents hesitant or reluctant to vaccinate their children. The aim is to provide key information for the creation of strategies that address vaccine hesitancy or refusal and ensure public trust in vaccination programs, which are required in a pandemic context such as the current one. (2) Methods: Noblit and Hare’s interpretive meta-ethnography of 12 studies was followed. A line of argument synthesis based on a metaphor was developed. (3) Results: The metaphor “The stone that refuses to be sculpted”, accompanied by three themes, symbolises the care experiences of health professionals in their encounters with parents that hesitate or refuse to vaccinate their children. (4) Conclusions: The creation of clearer communication strategies, the establishment of a therapeutic alliance, health literacy and the empowerment of parents are recommended. The incorporation of health professionals in decision making and the strengthening of multidisciplinary teams interacting with such parents are also included.
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Affiliation(s)
- Sara Fernández-Basanta
- Research Group GRINCAR, Department of Health Sciences, Faculty of Nursing and Podiatry, University of A Coruña, Naturalista López Seoane s/n, 15471 Ferrol, Spain;
- Correspondence: ; Tel.: +34-981-337400-3544
| | - Manuel Lagoa-Millarengo
- Galician Health Service (SERGAS), University Hospital Complex of Ferrol, Av. da Residencia, S/N, 15405 Ferrol, Spain;
| | - María-Jesús Movilla-Fernández
- Research Group GRINCAR, Department of Health Sciences, Faculty of Nursing and Podiatry, University of A Coruña, Naturalista López Seoane s/n, 15471 Ferrol, Spain;
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97
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Cunningham RM, Guffey D, Minard CG, Opel DJ, Boom JA. The effect of screening for vaccine hesitancy on the subsequent development of hesitancy: a randomized controlled trial, Houston, TX. Hum Vaccin Immunother 2021; 17:1994-2000. [PMID: 33499719 DOI: 10.1080/21645515.2020.1859320] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Vaccine hesitancy remains a global health threat. Addressing parental vaccine hesitancy is essential to maintaining high vaccine coverage levels and preventing disease outbreaks; however, it is unknown if administering a vaccine hesitancy screening tool negatively impacts parental vaccine beliefs. We conducted a stratified randomized controlled trial in pediatric primary care practices. English-speaking parents ≥18 years of age seeking routine care for infants <3 months of age were eligible. Participants were randomized to receive 1 of 2 surveys - the Parent Attitudes about Childhood Vaccines (PACV) survey or a placebo survey. Six months after initial enrollment, all participants were asked to complete the PACV, regardless of initial randomization group. Our primary outcome was the proportion of hesitant to non-hesitant parents at 6-months between randomization groups. We examined associations between vaccine hesitancy and participant characteristics. We also evaluated the change in the proportion of vaccine-hesitant parents in the PACV group between baseline and 6-month follow up. We enrolled 1705 parents at baseline. At 6-month follow up, 819 parents completed the PACV (50.2% from PACV group vs. 54.1% from placebo group). The proportion of hesitant parents at 6 months did not differ between PACV and placebo groups (6.6% vs. 6.1%; p = .78) and the odds of hesitancy among PACV group participants was not higher than those in the placebo group (OR = 1.10; 95% CI: 0.63-1.93; p = .743). Race was the only characteristic significantly associated with vaccine hesitancy at 6-month follow up (p = .003). Overall, administration of the PACV did not trigger vaccine hesitancy in this study population.
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Affiliation(s)
| | - Danielle Guffey
- Institute for Clinical and Translational Research, Baylor College of Medicine, Houston, TX, USA
| | - Charles G Minard
- Institute for Clinical and Translational Research, Baylor College of Medicine, Houston, TX, USA
| | - Douglas J Opel
- Seattle Children's Research Institute, University of Washington School of Medicine, Seattle, WA, USA
| | - Julie A Boom
- Immunization Project, Texas Children's Hospital, Houston, TX, USA.,Institute for Clinical and Translational Research, Baylor College of Medicine, Houston, TX, USA
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98
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Differential Demographic and Clinical Characteristics between MMR Vaccinated and Unvaccinated Children in South Korea: A Nationwide Study. Vaccines (Basel) 2021; 9:vaccines9060653. [PMID: 34203834 PMCID: PMC8232726 DOI: 10.3390/vaccines9060653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 06/07/2021] [Accepted: 06/08/2021] [Indexed: 11/24/2022] Open
Abstract
In the context of recent measles outbreaks, substantial factors associated with measles-mumps-rubella (MMR) unvaccination need to be clarified. This study aimed to identify differential demographic and clinical characteristics between MMR vaccinated and unvaccinated groups. We used a large-linked database to identify children born between 2008 and 2016 by combining data from the Korea Immunization Registry Information System and National Health Information database. The MMR vaccination status was ascertained up to the age of 2 to define MMR vaccinated and unvaccinated groups. We conducted a multivariate logistic regression to estimate odds ratios (ORs) with 95% confidence intervals (CIs) to identify factors associated with MMR unvaccination. Of 3,973,253 children, 75,674 (1.9%) did not receive the MMR vaccine. Compared with the MMR vaccinated group, the underutilization of healthcare resources was more notable in the MMR unvaccinated group (number of outpatient visits (5.73 ± 12.1 vs. 25.8 ± 17.06); days hospitalized (1.69 ± 14.5 vs. 2.32 ± 6.90)). Children were less likely to receive the MMR vaccine if they were born with congenital anomaly (OR 2.12; 95% CI 1.90–2.36), were never admitted to an intensive care unit (1.88; 1.78–1.98), or never visited an emergency room (3.57; 3.53–3.72). There were substantial factors associated with MMR unvaccination, underscoring a need to optimize targeted interventions tailored to the subset of children in South Korea.
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99
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Confer SV, Diller JW, Danforth JS. A Behavior-Analytic Approach to Antivaccination Practices. BEHAVIOR AND SOCIAL ISSUES 2021; 30:648-665. [PMID: 38624918 PMCID: PMC8186869 DOI: 10.1007/s42822-021-00051-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/12/2021] [Indexed: 11/07/2022]
Abstract
In recent years, there has been an increase in outbreaks of diseases that are preventable by vaccination. As vaccination involves behavior, behavior analysts are uniquely positioned to contribute solutions to this socially significant problem. The present article explores a behavior-analytic approach to understanding the function of the behavior of both people who have their children vaccinated and those who do not have their children vaccinated, and potential interventions to increase vaccination rates. An introduction to the problem is followed by a brief history of the antivaccination movement. In our analysis, a failure to vaccinate is conceptualized as a noncompliance response (i.e., medical nonadherence), and conditions giving rise to that noncompliance are evaluated. In this process, the roles of avoidance, the functional-altering impact of rule-governed behavior, relational frames, and countercontrol are considered. Potential solutions informed by applied behavior-analytic literature, including contingency management and behavioral safety, are discussed.
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100
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Briko NI, Feldblium IV, Alyeva MK, Mindlina AY, Maslennikova NP, Namazova-Baranova LS, Fedoseenko MV. The concept of risk communications to ensure adherence to vaccination as a necessary component of the strategic development of immunoprophylaxis in Russia. Public Health 2021. [DOI: 10.21045/2782-1676-2021-1-1-32-43] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
It is indicated in the article the importance of vaccine confidence of the population, medical workers, the media, and the bodies of authority. The vaccine confidence is necessary for the implementation of vaccine prevention at the population level for national security. The risk-communication concept to ensure adherence to vaccine prevention of all segments of the population are present. The main directions of activities for the implementation of the concept are given.
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