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Al-Maghaireh D, Alsaqer K, Kawafha M, Jallad ST, Al Kofahi A. Predictors on parent's attitudes toward the measles-rubella (MR) vaccine in Jordan: An education program. Am J Infect Control 2024:S0196-6553(24)00501-7. [PMID: 38763429 DOI: 10.1016/j.ajic.2024.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Revised: 05/13/2024] [Accepted: 05/14/2024] [Indexed: 05/21/2024]
Abstract
BACKGROUND Vaccine hesitancy is considered 1 of the top 10 threats to global health. This study aims to assess the impact of an education program on parents' attitudes toward the measles-rubella vaccine. METHODS A study was conducted with 250 parents using a randomized controlled trial design. The intervention group (125 parents) received training, education programs, and video, while the control group (125 parents) only received video. The Parent Attitudes about Childhood Vaccines (PACV) scale, including its behavior, safety and efficacy, and trust subscales, was used for pre-post assessment. This allowed for comparison between the groups and measurement of score differences. The PACV scale (range 0-42) identified vaccine hesitancy, with a score below 21 indicating "non-hesitant" and 21 or higher indicating "hesitant." RESULTS The intervention group had a significant decrease in PACV scores after the program (17.54 ± 4.7, P = .001), mainly in behavior, safety, efficacy, and trust (6.4 ± 3.6, 9.8 ± 4.7, 3.9 ± 2; P = .001, .011, .002). The control group showed no changes (23.6 ± 3.5; P = .402). Postintervention PACV score differences were significant (t = 11.562, P = .001). DISCUSSION Findings indicate that the education program had a positive effect on changing vaccine hesitancy. CONCLUSIONS The education programs promoted vaccine acceptance among parents.
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Affiliation(s)
| | - Khitam Alsaqer
- Faculty of Nursing, Irbid National University, Irbid, Jordan.
| | - Mariam Kawafha
- Faculty of Nursing, Philadelphia University, Amman, Jordan
| | - Samar Thabet Jallad
- Department of Nursing, Faculty of Health Professions, Al-Quds University, Jerusalem, Palestine
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2
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Gao BG, Huang LF, Xie P. Effectiveness and safety of a mumps containing vaccine in preventing laboratory-confirmed mumps cases from 2002 to 2017: A meta-analysis. Open Life Sci 2024; 19:20220820. [PMID: 38465337 PMCID: PMC10921504 DOI: 10.1515/biol-2022-0820] [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: 08/10/2023] [Revised: 11/22/2023] [Accepted: 12/05/2023] [Indexed: 03/12/2024] Open
Abstract
Emerging evidence has figured that serum conversion rate of mumps is a crucial link of mumps disease. Nevertheless, a rising number of mumps outbreaks caused our attention and studies examining the serum conversion cases were conducted in small samples previously; this meta-analysis was conducted to assess the immunogenicity and safety of a mumps containing vaccine (MuCV) before 2019. We identified a total of 17 studies from the year of 2002-2017. In the case-control studies, the vaccine effectiveness (VE) of MuCV in preventing laboratory-confirmed mumps was 68% (odds risk: 0.32; 95% confidence interval [CI], 0.14-0.70) while in the cohort studies and randomised control trials, 58% (relative risk [RR]: 0.42; 95% CI, 0.26-0.69). Similar intervals of effectiveness rates were found during non-outbreak periods compared with outbreak periods (VE: 66%; RR: 0.34; 95% CI, 0.18-0.68 versus VE: 49%; RR: 0.51; 95% CI, 0.21-1.27). In addition, the MuCV group with two and three doses did not show enhanced laboratory-confirmed mumps than one dose (VE: 58%; RR: 0.42; 95% CI, 0.20-0.88 versus VE: 65%, RR: 0.35; 95% CI, 0.20-0.61) for the reason of the overlap of 95% CI. MuCV had comparable effectiveness comparing non-outbreak and outbreak period, one dose, and two or three doses. MuCV displayed acceptable adverse event profiles.
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Affiliation(s)
- Bu-Gang Gao
- Rehabilitation Teaching and Research Office, Department of Medicine, ChuZhou City Vocational College, Chuzhou, Anhui Province, China
| | - Ling-feng Huang
- Department of Epidemiology and Biostatistics, School of Public Health, Guangdong Medical University, Zhanjiang, Guangdong, China
- Community Health Service Center in Nantou, Zhongshan, Guangdong Province, China
| | - Ping Xie
- Rehabilitation Teaching and Research Office, Department of Medicine, ChuZhou City Vocational College, Chuzhou, Anhui Province, China
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Liew XW, Tang ZHM, Ong YQC, See KC. Hearing Loss after COVID-19 and Non-COVID-19 Vaccination: A Systematic Review. Vaccines (Basel) 2023; 11:1834. [PMID: 38140238 PMCID: PMC10748333 DOI: 10.3390/vaccines11121834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 12/07/2023] [Accepted: 12/08/2023] [Indexed: 12/24/2023] Open
Abstract
(1) Background: Vaccine safety is an important topic with public health implications on a global scale. The purpose of this study was to systematically review available literature assessing sensorineural hearing loss (SNHL) incidence and severity following both coronavirus disease 2019 (COVID-19) and non-COVID-19 vaccinations, as well as prognosis and outcomes. (2) Methods: This systematic review was performed according to the Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines. Relevant publications evaluating post-vaccination SNHL were selected from PubMed and Embase, searching from inception to July 2023. (3) Results: From 11 observational studies, the incidence of post-vaccination SNHL was low for both COVID-19 and non-COVID-19 vaccines, ranging from 0.6 to 60.77 per 100,000 person-years, comparable to all-cause SNHL. (4) Conclusions: The incidence rates of SNHL following COVID-19 and non-COVID-19 vaccinations remained reassuringly low. Most patients experienced improved hearing function in the weeks to months following vaccination. This study underscores the importance and safety of vaccinations and encourages ongoing surveillance and detailed reporting of hearing loss cases post-vaccination.
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Affiliation(s)
- Xin Wei Liew
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore 169856, Singapore; (X.W.L.); (Z.H.M.T.); (Y.Q.C.O.)
| | - Zer Han Malcolm Tang
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore 169856, Singapore; (X.W.L.); (Z.H.M.T.); (Y.Q.C.O.)
| | - Yan Qing Cherie Ong
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore 169856, Singapore; (X.W.L.); (Z.H.M.T.); (Y.Q.C.O.)
| | - Kay Choong See
- Division of Respiratory and Critical Care Medicine, Department of Medicine, National University Hospital, Singapore 119228, Singapore
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4
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Deng JS, Ying CQ, Lin XQ, Huang CL, Zhang MX, Tung TH, Zhu JS. Impact of household decision makers' hesitancy to vaccinate children against COVID-19 on other household members: A family-based study in Taizhou, China. SSM Popul Health 2023; 24:101517. [PMID: 37767519 PMCID: PMC10520923 DOI: 10.1016/j.ssmph.2023.101517] [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: 06/03/2023] [Revised: 08/13/2023] [Accepted: 09/18/2023] [Indexed: 09/29/2023] Open
Abstract
Background Vaccination is the most effective means of preventing outbreaks of infectious diseases, and family ;decision makers play an important role in decision-making regarding family matters and may influence other family members to take an active role in vaccinating children against COVID-19. Purpose This study examined the influence of family decision makers on the hesitation of other family members to vaccinate their children against COVID-19. Methods A population-based, self-administered online questionnaire was administered in Taizhou, China, from September 1, 2021, to September 15, 2021. The questionnaire included demographic information, knowledge, attitudes, and perceptions about the COVID-19 vaccine as well as hesitation regarding the use of the COVID-19 vaccination in children. In total, 490 respondents were included in this study. Logistic regression was used to assess the factors associated with vaccine hesitancy. Results In total, 490 respondents from 190 households were interviewed. Of the 190 family decision makers, 43.7% (83/190) were hesitant to vaccinate their children against COVID-19. When family decision makers were hesitant to vaccinate children against COVID-19, 65.1% (82/126) of the other family members expressed similar hesitancy regarding vaccination. When family decision makers were not hesitant to vaccinate children, only 21.3% (37/174) of other family members were hesitant to do so. In the regression analysis, family decision makers' hesitation to vaccinate their children was associated with other family members' hesitation (OR=6.264, 95% CI:3.132-12.526). In addition, decision makers' perceptions of the safety of the vaccine (OR=0.422, 95% CI:0.215-0.826) and hesitation to vaccinate themselves (OR=8.967, 95% CI:4.745-16.948) influenced their hesitation to vaccinate their children. Conclusion The present study found that family decision makers' hesitation to vaccinate children against COVID-19 influenced other family members' hesitation to vaccinate children. In addition, family decision makers' perceptions of the safety of the vaccine and their hesitation to vaccinate themselves influenced other family members' hesitation to vaccinate their children.
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Affiliation(s)
- Jing-Shan Deng
- Department of Infectious Diseases, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, Zhejiang, 317000, China
| | - Chen-Qian Ying
- Department of Infectious Diseases, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, Zhejiang, 317000, China
| | - Xiao-Qing Lin
- Department of Infectious Diseases, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, Zhejiang, 317000, China
| | - Chun-Lian Huang
- Department of Infectious Diseases, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, Zhejiang, 317000, China
| | - Mei-Xian Zhang
- Evidence-based Medicine Center, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, Zhejiang, 317000, China
| | - Tao-Hsin Tung
- Evidence-based Medicine Center, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, Zhejiang, 317000, China
| | - Jian-Sheng Zhu
- Department of Infectious Diseases, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, Zhejiang, 317000, China
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Manan A, Wessels T, Finlayson H. Routine immunization experience and practices during the COVID-19 pandemic of caregivers attending a tertiary hospital in Cape Town. FRONTIERS IN HEALTH SERVICES 2023; 3:1242796. [PMID: 38028940 PMCID: PMC10646605 DOI: 10.3389/frhs.2023.1242796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 10/10/2023] [Indexed: 12/01/2023]
Abstract
Introduction Immunizations are successful, cost-effective interventions for the control of infectious diseases and preventing mortality. Lockdown restrictions during the COVID-19 pandemic had adverse effects on child-health including access to immunizations. Our study aimed to document immunization status, describe caregiver experiences around accessing immunizations during the COVID-19 pandemic and identify any significant factors associated with immunization status. Methods Caregivers, with children between the ages of 10 to 33 months, attending Tygerberg Hospital Paediatric Department were invited to complete an anonymous survey from 15th September-15th December 2022. Data was captured using a REDCap questionnaire and analysed using Stata Version 17. Results 171 caregivers completed the survey. Immunizations were up to date in 81%. Most (155, 88%) agreed it was important to immunize their child. A third of caregivers (55) felt it was unsafe to attend the clinic and 37% (62) agreed it was difficult to attend. Caregivers receiving a social grant (p = 0.023) or who felt safe attending clinic (p = 0.053) were more likely to be up to date with immunizations. Three-quarters (128, 78%) were aware of recommendations to continue immunization. These caregivers were more likely to think it was important to immunize on time (p = 0.003) and to receive family encouragement (p = 0.001). Caregivers were more likely to attend clinic if they felt it was important to vaccinate on time (p < 0.001) or felt safe attending clinic (p = 0.036). Conclusion Immunization rates were higher than expected but below global targets. Although caregivers feel immunizations are important, unknowns still instilled fear of attending clinics. Social factors such as family support and social grants improve vaccine seeking behaviour.
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Affiliation(s)
- A. Manan
- Department of Paediatrics and Child Health, Stellenbosch University, Cape Town, South Africa
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6
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Candio P, Violato M, Clarke PM, Duch R, Roope LS. Prevalence, predictors and reasons for COVID-19 vaccine hesitancy: Results of a global online survey. Health Policy 2023; 137:104895. [PMID: 37666080 DOI: 10.1016/j.healthpol.2023.104895] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 07/10/2023] [Accepted: 08/17/2023] [Indexed: 09/06/2023]
Abstract
Vaccine hesitancy has the potential to cripple efforts to end the COVID-19 pandemic. Policy makers need to be informed about the scale, nature and drivers of this problem, both domestically and globally, so that effective interventions can be designed. To this end, we conducted a statistical analysis of data from the CANDOUR survey (n = 15,536), which was carried out in 13 countries representing approximately half of the global population. Both pooled and country-level ordered regression models were estimated to identify predictors of vaccine hesitancy and reasons for not getting vaccinated. We found high levels of hesitancy, particularly in high-income countries. Factors driving moderate hesitancy differed from those driving extreme hesitancy. A lack of trust in health care providers was consistently the underlying driver of more extreme hesitancy. Predictors of moderate hesitancy varied across countries, though being younger and female was typically associated with greater hesitancy. While political ideology played a role in vaccine hesitancy in some countries, this effect was often moderated by income level, particularly in the US. Overall, the results suggest that different interventions such as mass-media campaigns and monetary incentives may be needed to target the moderately versus extremely hesitant. The lack of trust in health care professionals that drives extreme hesitancy may reflect deep societal mistrust in science and institutions and be challenging to overcome.
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Affiliation(s)
- Paolo Candio
- Department of Economics and Management, University of Trento, Trento, Italy; Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom; National Institute for Health Research Oxford Biomedical Research Centre, John Radcliffe Hospital, Oxford, United Kingdom.
| | - Mara Violato
- Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom; National Institute for Health Research Oxford Biomedical Research Centre, John Radcliffe Hospital, Oxford, United Kingdom
| | - Philip M Clarke
- Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom; National Institute for Health Research Oxford Biomedical Research Centre, John Radcliffe Hospital, Oxford, United Kingdom; Centre for Health Policy, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Raymond Duch
- Nuffield College, University of Oxford, Oxford, United Kingdom of Great Britain and Northern Ireland, UK
| | - Laurence Sj Roope
- Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom; National Institute for Health Research Oxford Biomedical Research Centre, John Radcliffe Hospital, Oxford, United Kingdom
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Milionis C, Ilias I, Tselebis A, Pachi A. Psychological and Social Aspects of Vaccination Hesitancy-Implications for Travel Medicine in the Aftermath of the COVID-19 Crisis: A Narrative Review. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1744. [PMID: 37893462 PMCID: PMC10608755 DOI: 10.3390/medicina59101744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 09/23/2023] [Accepted: 09/26/2023] [Indexed: 10/29/2023]
Abstract
Vaccines are an important tool of preventive medicine. Although organized vaccination programs have saved large populations from serious infectious diseases, there is a considerable part of the population who oppose vaccinations. In particular, anti-vaccination perceptions, among travelers to countries with endemic diseases, are a major public health concern. Although hesitancy towards vaccinations is not a novel phenomenon, it came back to the forefront during the fight against the COVID-19 pandemic. This review explores the etiology of anti-vaccination beliefs among travelers and draws conclusions about their impact on public health and society in general. For this purpose, a purposeful search for data on the causative factors of vaccine hesitancy and their impact on people's health was conducted. A descriptive analysis of the findings and conclusions regarding possible implications in health policy and clinical practice are presented. A fear of side effects, lack of credence in the necessity of vaccines, and mistrust of medical authorities are important causative factors. Their interplay shapes hesitancy towards vaccines. However, anti-vaccination beliefs can also be an aspect of a more general unconventional stance of life. Health care professionals and organizations must be ready to tackle vaccine hesitancy by making the necessary interventions. Correcting misconceptions about vaccinations is a prerequisite for ensuring personal and public health, especially in the context of a pandemic or epidemic. Moreover, ensuring the efficacy and safety of vaccines, especially in cases of modern technology applications, is a fundamental factor in addressing people's concerns about vaccines. For this purpose, medical authorities and organizations must provide accurate and clear information on vaccines so as to eliminate misinformation. Furthermore, clinicians should cultivate their communication skills in order to convey the appropriate messages to prospective recipients of vaccinations.
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Affiliation(s)
- Charalampos Milionis
- Department of Endocrinology, Diabetes and Metabolism, Elena Venizelou General and Maternity Hospital, GR-11521 Athens, Greece;
| | - Ioannis Ilias
- Department of Endocrinology, Diabetes and Metabolism, Elena Venizelou General and Maternity Hospital, GR-11521 Athens, Greece;
| | - Athanasios Tselebis
- Department of Psychiatry, Sotiria Thoracic Diseases Hospital of Athens, GR-11527 Athens, Greece; (A.T.); (A.P.)
| | - Argyro Pachi
- Department of Psychiatry, Sotiria Thoracic Diseases Hospital of Athens, GR-11527 Athens, Greece; (A.T.); (A.P.)
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8
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Ilesanmi M, Olujobi B, Ilesanmi O, Umaefulam V. Exploring data trends and providers' insights on measles immunization uptake in south-west Nigeria. Pan Afr Med J 2023; 46:28. [PMID: 38107335 PMCID: PMC10724030 DOI: 10.11604/pamj.2023.46.28.37572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 09/10/2023] [Indexed: 12/19/2023] Open
Abstract
Introduction measles outbreak remains a recurring episode and continues to be responsible for millions of deaths globally every year. This study examines measles immunization coverage and uncovers barriers and enablers to effective provision and uptake of measles immunization services from the supply end and provider´s perspective in a developing nation´s context. Methods the study employed a mixed-method approach to explore trends and patterns of measles immunization uptake in Ekiti State-a state in the southwestern region of Nigeria-utilizing DHIS 2014 - 2019 data of 789,518 under 1-year children and complemented the quantitative study with key informant interviews from appointed Immunization Officers in the state. Using deductive methods, we thematically analyzed the interview data using NVivo version 12 while STATA 16 was used to analyze the quantitative data. Results the annualized measles immunization coverage ranged between 49% and 86% from 2014 to 2019, which is below the WHO set threshold for measles infection prevention. Caregiver, geographical, human, and infrastructural factors were elicited as barriers, while potential enablers include increased public engagement and enhanced media involvement. Conclusion while programmatic efforts are being improved nationally to drive up the uptake, this study provides baseline information for benchmarking the subsequent level of efforts and recommends improved collaboration across contextually similar states to promote program efficiency. The results can inform policy and program development, execution and direct future research on measles immunization to address uptake challenges at both local and central administration levels, especially in the aspect of surveillance and monitoring.
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Affiliation(s)
- Marcus Ilesanmi
- Department of Community Health and Epidemiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
- Ekiti State Primary Health Care Development Agency, Ado Ekiti, Ekiti State, Nigeria
| | - Babatunde Olujobi
- Ekiti State Primary Health Care Development Agency, Ado Ekiti, Ekiti State, Nigeria
| | | | - Valerie Umaefulam
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada
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Moore TP, Bennett JC, Graff K, Rao M, Augusto O, Chu HY, Wagenaar BH, Bell TR. State Policy Removing the Personal Belief Exemption for Measles, Mumps, and Rubella (MMR) School Immunization Requirement, Washington State, 2014-2022. Am J Public Health 2023; 113:795-804. [PMID: 37200605 PMCID: PMC10262239 DOI: 10.2105/ajph.2023.307285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/10/2023] [Indexed: 05/20/2023]
Abstract
Objectives. To assess the impact of Washington State's 2019 Engrossed House Bill (EHB) 1638-which removed measles, mumps, and rubella (MMR) personal belief exemptions-on MMR vaccine series completion and exemption rates in K-12 students. Methods. We used interrupted time-series analyses to examine changes in MMR vaccine series completion rates before and after EHB 1638 was passed and the χ2 test for differences in exemption rates. Results. EHB 1638 implementation was associated with a 5.4% relative increase in kindergarten MMR vaccine series completion rates (95% confidence interval = 3.8%, 7.1%; P ≤ .001), and results were similar with Oregon as a control state (no change observed in Oregon; P = .68). MMR exemptions overall decreased 41% (from 3.1% in 2018-2019 to 1.8% in 2019-2020; P ≤ .001), and religious exemptions increased 367% (from 0.3% to 1.4%; P ≤ .001). Conclusions. EHB 1638 was associated with an increase in MMR vaccine series completion rates and a decrease in any MMR exemption. However, effects were partially offset by an increase in religious exemption rates. Public Health Implications. Removal of personal belief exemptions for the MMR immunization requirement only may be an effective approach to increase MMR vaccine coverage rates statewide and among underimmunized communities. (Am J Public Health. 2023;113(7):795-804. https://doi.org/10.2105/AJPH.2023.307285).
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Affiliation(s)
- Tyler P Moore
- Tyler P. Moore, Katherine Graff, and Teal R. Bell are with the Washington State Department of Health, Tumwater. Julia C. Bennett, Mayuree Rao, Orvalho Augusto, and Bradley H. Wagenaar are with the School of Public Health, University of Washington, Seattle. Helen Y. Chu is with the Department of Medicine, University of Washington, Seattle
| | - Julia C Bennett
- Tyler P. Moore, Katherine Graff, and Teal R. Bell are with the Washington State Department of Health, Tumwater. Julia C. Bennett, Mayuree Rao, Orvalho Augusto, and Bradley H. Wagenaar are with the School of Public Health, University of Washington, Seattle. Helen Y. Chu is with the Department of Medicine, University of Washington, Seattle
| | - Katherine Graff
- Tyler P. Moore, Katherine Graff, and Teal R. Bell are with the Washington State Department of Health, Tumwater. Julia C. Bennett, Mayuree Rao, Orvalho Augusto, and Bradley H. Wagenaar are with the School of Public Health, University of Washington, Seattle. Helen Y. Chu is with the Department of Medicine, University of Washington, Seattle
| | - Mayuree Rao
- Tyler P. Moore, Katherine Graff, and Teal R. Bell are with the Washington State Department of Health, Tumwater. Julia C. Bennett, Mayuree Rao, Orvalho Augusto, and Bradley H. Wagenaar are with the School of Public Health, University of Washington, Seattle. Helen Y. Chu is with the Department of Medicine, University of Washington, Seattle
| | - Orvalho Augusto
- Tyler P. Moore, Katherine Graff, and Teal R. Bell are with the Washington State Department of Health, Tumwater. Julia C. Bennett, Mayuree Rao, Orvalho Augusto, and Bradley H. Wagenaar are with the School of Public Health, University of Washington, Seattle. Helen Y. Chu is with the Department of Medicine, University of Washington, Seattle
| | - Helen Y Chu
- Tyler P. Moore, Katherine Graff, and Teal R. Bell are with the Washington State Department of Health, Tumwater. Julia C. Bennett, Mayuree Rao, Orvalho Augusto, and Bradley H. Wagenaar are with the School of Public Health, University of Washington, Seattle. Helen Y. Chu is with the Department of Medicine, University of Washington, Seattle
| | - Bradley H Wagenaar
- Tyler P. Moore, Katherine Graff, and Teal R. Bell are with the Washington State Department of Health, Tumwater. Julia C. Bennett, Mayuree Rao, Orvalho Augusto, and Bradley H. Wagenaar are with the School of Public Health, University of Washington, Seattle. Helen Y. Chu is with the Department of Medicine, University of Washington, Seattle
| | - Teal R Bell
- Tyler P. Moore, Katherine Graff, and Teal R. Bell are with the Washington State Department of Health, Tumwater. Julia C. Bennett, Mayuree Rao, Orvalho Augusto, and Bradley H. Wagenaar are with the School of Public Health, University of Washington, Seattle. Helen Y. Chu is with the Department of Medicine, University of Washington, Seattle
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10
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Liu S, Chu H. Parents' COVID-19, HPV, and Monkeypox vaccination intention: A multilevel structural equation model of risk, benefit, barrier, and efficacy perceptions and individual characteristics. PATIENT EDUCATION AND COUNSELING 2023; 114:107842. [PMID: 37301013 PMCID: PMC10246936 DOI: 10.1016/j.pec.2023.107842] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 06/03/2023] [Accepted: 06/06/2023] [Indexed: 06/12/2023]
Abstract
OBJECTIVE This study seeks to comparatively examine parents' intention to vaccinate their children for three infectious diseases, including COVID-19, HPV, and monkeypox. METHODS Utilizing a mixed-design survey and multilevel structural equation models, we investigated if perception of the diseases and vaccines explained the variance in parents' vaccine-specific decision-making and population difference in vaccination intention. RESULTS Compared with the COVID-19 vaccine, parents were more willing to get an HPV vaccine for their children due to greater perceived benefit and lower perceived barrier. Concerns about vaccine safety and lower disease risk perception were associated with lower intention to get a monkeypox vaccine. Parents of color, less educated, and lower-income parents were less willing to get vaccines for their children due to low benefit perception and high perceived barriers. CONCLUSION Parents were motivated by different social and psychological factors when deciding whether to get a COVID-19, HPV, and monkeypox vaccine for their children. PRACTICE IMPLICATIONS Vaccine promotion should be tailored to the characteristics of the target population and the vaccines. Underprivileged communities may be better approached with information about vaccine benefit and barriers, and vaccines for unfamiliar diseases may be better communicated with disease risk information.
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Affiliation(s)
- Sixiao Liu
- Annenberg School for Communication, University of Pennsylvania, Philadelphia, USA
| | - Haoran Chu
- Department of Public Relations, University of Florida, Gainesville, USA.
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11
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Chu H, Liu S. Psychological Distance, Construal Level, and Parental Vaccine Hesitancy for COVID-19, HPV, and Monkey Pox Vaccines. SCIENCE COMMUNICATION 2023; 45:279-309. [PMID: 38602977 PMCID: PMC10331124 DOI: 10.1177/10755470231182614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/13/2024]
Abstract
Building on the construal-level theory and the multi-dimensional model of behavioral barriers, this study examined whether psychological distance and construal level explain the association between behavioral intention and behavioral barriers that may lead to parental vaccine hesitancy. Results of multilevel structural equation models show that low vaccination intention, far distance perception, and abstract construal of vaccines led to more global concerns, such as vaccine safety and relevance. Such effects emerged when people considered specific vaccines, such as coronavirus disease 2019 (COVID-19), human papillomavirus (HPV), and monkeypox vaccines, and when they considered multiple vaccines in general.
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Affiliation(s)
| | - Sixiao Liu
- University of Pennsylvania, Philadelphia, USA
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12
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Yap DL, Mandell C, Behar E. The Role of Perceived Risk in the Relationship Between Disgust Sensitivity and COVID-19 Vaccine Hesitancy. COGNITIVE THERAPY AND RESEARCH 2023; 47:1-12. [PMID: 37363746 PMCID: PMC10206364 DOI: 10.1007/s10608-023-10391-8] [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] [Accepted: 05/15/2023] [Indexed: 06/28/2023]
Abstract
Background Despite widespread availability of COVID vaccines and evidence of their efficacy, vaccine hesitancy remains prevalent. Several studies have examined the relationship between disgust sensitivity and vaccine hesitancy. Although results from studies using data collected prior to the COVID pandemic indicate that higher disgust sensitivity is related to greater vaccine hesitancy, results from studies using data collected during the COVID pandemic are equivocal. The present study examined whether perceived risk of contracting COVID moderated the relationship between disgust sensitivity and vaccine hesitancy. Methods Participants (n = 152) completed self-report measures of disgust sensitivity, perceived risk of contracting COVID, and COVID vaccine hesitancy (defined as both vaccine confidence and vaccine complacency). Results Perceived risk of contracting COVID significantly moderated the relationship between disgust sensitivity and vaccine complacency, with the association strengthened at low levels of perceived risk. Perceived risk of contracting COVID also marginally moderated the relationship between disgust sensitivity and vaccine confidence, with the association strengthened at low and average levels of perceived risk. Conclusions Results suggest that individuals with elevated disgust sensitivity who also report low levels of perceived risk of contracting COVID are more likely to express vaccine hesitancy. Implications of these findings are discussed. Supplementary Information The online version contains supplementary material available at 10.1007/s10608-023-10391-8.
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Affiliation(s)
- David L. Yap
- Hunter College, City University of New York, New York, USA
- The Graduate Center, City University of New York, New York, USA
- Department of Psychology, Hunter College of The City University of New York, 695 Park Avenue, 611HN, New York, NY 10065 USA
| | | | - Evelyn Behar
- Hunter College, City University of New York, New York, USA
- The Graduate Center, City University of New York, New York, USA
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Jing S, Milne R, Wang H, Xue L. Vaccine hesitancy promotes emergence of new SARS-CoV-2 variants. J Theor Biol 2023; 570:111522. [PMID: 37210068 DOI: 10.1016/j.jtbi.2023.111522] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 04/30/2023] [Accepted: 05/03/2023] [Indexed: 05/22/2023]
Abstract
The successive emergence of SARS-CoV-2 mutations has led to an unprecedented increase in COVID-19 incidence worldwide. Currently, vaccination is considered to be the best available solution to control the ongoing COVID-19 pandemic. However, public opposition to vaccination persists in many countries, which can lead to increased COVID-19 caseloads and hence greater opportunities for vaccine-evasive mutant strains to arise. To determine the extent that public opinion regarding vaccination can induce or hamper the emergence of new variants, we develop a model that couples a compartmental disease transmission framework featuring two strains of SARS-CoV-2 with game theoretical dynamics on whether or not to vaccinate. We combine semi-stochastic and deterministic simulations to explore the effect of mutation probability, perceived cost of receiving vaccines, and perceived risks of infection on the emergence and spread of mutant SARS-CoV-2 strains. We find that decreasing the perceived costs of being vaccinated and increasing the perceived risks of infection (that is, decreasing vaccine hesitation) will decrease the possibility of vaccine-resistant mutant strains becoming established by about fourfold for intermediate mutation rates. Conversely, we find increasing vaccine hesitation to cause both higher probability of mutant strains emerging and more wild-type cases after the mutant strain has appeared. We also find that once a new variant has emerged, perceived risk of being infected by the original variant plays a much larger role than perceptions of the new variant in determining future outbreak characteristics. Furthermore, we find that rapid vaccination under non-pharmaceutical interventions is a highly effective strategy for preventing new variant emergence, due to interaction effects between non-pharmaceutical interventions and public support for vaccination. Our findings indicate that policies that combine combating vaccine-related misinformation with non-pharmaceutical interventions (such as reducing social contact) will be the most effective for avoiding the establishment of harmful new variants.
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Affiliation(s)
- Shuanglin Jing
- College of Mathematical Sciences, Harbin Engineering University, Harbin, Heilongjiang, 150001, China
| | - Russell Milne
- Department of Mathematical and Statistical Sciences & Interdisciplinary Lab for Mathematical Ecology and Epidemiology, University of Alberta, Edmonton, Alberta T6G 2R3, Canada
| | - Hao Wang
- Department of Mathematical and Statistical Sciences & Interdisciplinary Lab for Mathematical Ecology and Epidemiology, University of Alberta, Edmonton, Alberta T6G 2R3, Canada.
| | - Ling Xue
- College of Mathematical Sciences, Harbin Engineering University, Harbin, Heilongjiang, 150001, China
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14
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Novilla MLB, Goates MC, Redelfs AH, Quenzer M, Novilla LKB, Leffler T, Holt CA, Doria RB, Dang MT, Hewitt M, Lind E, Prickett E, Aldridge K. Why Parents Say No to Having Their Children Vaccinated against Measles: A Systematic Review of the Social Determinants of Parental Perceptions on MMR Vaccine Hesitancy. Vaccines (Basel) 2023; 11:vaccines11050926. [PMID: 37243030 DOI: 10.3390/vaccines11050926] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 04/20/2023] [Accepted: 04/24/2023] [Indexed: 05/28/2023] Open
Abstract
Ongoing outbreaks of measles threaten its elimination status in the United States. Its resurgence points to lower parental vaccine confidence and local pockets of unvaccinated and undervaccinated individuals. The geographic clustering of hesitancy to MMR indicates the presence of social drivers that shape parental perceptions and decisions on immunization. Through a qualitative systematic review of published literature (n = 115 articles; 7 databases), we determined major themes regarding parental reasons for MMR vaccine hesitancy, social context of MMR vaccine hesitancy, and trustworthy vaccine information sources. Fear of autism was the most cited reason for MMR hesitancy. The social drivers of vaccine hesitancy included primary care/healthcare, education, economy, and government/policy factors. Social factors, such as income and education, exerted a bidirectional influence, which facilitated or hindered vaccine compliance depending on how the social determinant was experienced. Fear of autism was the most cited reason for MMR hesitancy. Vaccine hesitancy to MMR and other childhood vaccines clustered in middle- to high-income areas among mothers with a college-level education or higher who preferred internet/social media narratives over physician-based vaccine information. They had low parental trust, low perceived disease susceptibility, and were skeptical of vaccine safety and benefits. Combating MMR vaccine misinformation and hesitancy requires intersectoral and multifaceted approaches at various socioecological levels to address the social drivers of vaccine behavior.
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Affiliation(s)
| | - Michael C Goates
- Harold B. Lee Library, Brigham Young University, Provo, UT 84602, USA
| | - Alisha H Redelfs
- Department of Public Health, Brigham Young University, Provo, UT 84602, USA
| | - Mallory Quenzer
- Department of Public Health, Brigham Young University, Provo, UT 84602, USA
| | | | - Tyler Leffler
- Department of Public Health, Brigham Young University, Provo, UT 84602, USA
| | - Christian A Holt
- Department of Public Health, Brigham Young University, Provo, UT 84602, USA
| | - Russell B Doria
- School of Osteopathic Medicine, Campbell University, Lillington, NC 27546, USA
| | - Michael T Dang
- School of Osteopathic Medicine, Campbell University, Lillington, NC 27546, USA
| | - Melissa Hewitt
- Department of Public Health, Brigham Young University, Provo, UT 84602, USA
| | - Emma Lind
- Department of Public Health, Brigham Young University, Provo, UT 84602, USA
| | - Elizabeth Prickett
- Department of Public Health, Brigham Young University, Provo, UT 84602, USA
| | - Katelyn Aldridge
- Department of Public Health, Brigham Young University, Provo, UT 84602, USA
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15
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AlShurman BA, Butt ZA. Proposing a New Conceptual Syndemic Framework for COVID-19 Vaccine Hesitancy: A Narrative Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1561. [PMID: 36674314 PMCID: PMC9864682 DOI: 10.3390/ijerph20021561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 01/09/2023] [Accepted: 01/12/2023] [Indexed: 06/17/2023]
Abstract
BACKGROUND Discussions regarding syndemics have dominated research in recent years. Vaccine hesitancy has also been propelled to the forefront. In this narrative review, we aim to frame a novel syndemic framework to understand the interaction between vaccine hesitancy, COVID-19, and negative health outcomes. METHODS A non-systematic electronic search was conducted in PubMed and Google Scholar. Search criteria were limited to articles published between November 2019 and June 2022. Articles related to the COVID-19 syndemic and vaccine hesitancy were included. RESULTS Our review revealed that the adherence to COVID-19 regulations-although they were effective in preventing COVID-19 transmission, cases, and deaths-created a dynamically unstable 'vicious cycle' between undesirable health, economic, and social outcomes. The "accumulation" of complex stressors decreased individuals' cognitive flexibility and hindered them from making decisions and getting vaccinated. Furthermore, it increased individuals' risk of acquiring COVID-19, losing their employment, increasing poverty, and decreasing healthcare utilization. We illustrated how the amalgamation of sociodemographic and contextual factors associated with COVID-19 might impact people's vaccine decisions, making them more hesitant toward COVID-19 vaccination. Failing to receive vaccinations increases the chances of COVID-19 transmission, hospitalization, and other negative health outcomes. CONCLUSIONS Understanding the interaction between these factors is essential to provide policymakers with inspiration to set appropriate interventions for promoting COVID-19 vaccination acceptance to decrease the overall burden of pandemics.
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Affiliation(s)
| | - Zahid Ahmad Butt
- School of Public Health Sciences, University of Waterloo, Waterloo, ON N2L 3G1, Canada
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16
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Nguyen KH, Zhao R, Mullins C, Corlin L, Beninger P, Bednarczyk RA. Trends in vaccination schedules and up-to-date status of children 19-35 months, United States, 2015-2020. Vaccine 2023; 41:467-475. [PMID: 36481107 DOI: 10.1016/j.vaccine.2022.11.023] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 11/10/2022] [Accepted: 11/11/2022] [Indexed: 12/12/2022]
Abstract
OBJECTIVES To estimate trends in, and factors associated with, vaccination patterns and up-to-date immunization status of U.S. children by 19 to 35 months of age. METHODS Data from the 2015 to 2020 National Immunization Surveys were used to assess trends in vaccination patterns, up-to-date status, and zero vaccination status of U.S. children by 19-35 months. Vaccination patterns were categorized as: 1) recommended, 2) alternate, or 3) unknown or unclassifiable. Multivariable analyses were conducted to examine factors associated with each vaccination pattern and up-to-date status for all recommended vaccines. RESULTS From 2015 to 2020, the proportion of U.S. children completing the recommended schedule increased from 62.5% to 69.4%, alternative schedule decreased from 21.6% to 16.2%, and unknown or unclassifiable schedules decreased from 15.9% to 14.3%. In addition, being not up-to-date decreased from 39.7% to 35.6%. There was no change in the percentage of children receiving zero vaccinations from 2015 to 2020 (0.9% to 0.9%). Respondents with lower household income or who were uninsured were more likely to follow an alternate or unknown/unclassifiable schedule, or not be up-to-date with vaccines. CONCLUSION Following any schedule other than the recommended schedule was associated with not being up-to-date on immunizations. Increased efforts to catch up on recommended vaccines is important for protecting children's health. Further efforts should be made to improve timely adherence to recommended vaccination schedules, particularly among populations with the largest disparities in coverage through a tailored approach to increase confidence in and access to vaccines.
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Affiliation(s)
- Kimberly H Nguyen
- Department of Public Health & Community Medicine, Tufts University School of Medicine, Boston, MA, USA.
| | - Ruitong Zhao
- Department of Public Health & Community Medicine, Tufts University School of Medicine, Boston, MA, USA
| | - Corey Mullins
- Department of Public Health & Community Medicine, Tufts University School of Medicine, Boston, MA, USA
| | - Laura Corlin
- Department of Public Health & Community Medicine, Tufts University School of Medicine, Boston, MA, USA; Department of Civil and Environmental Engineering, Tufts University School of Engineering, Medford, MA, USA
| | - Paul Beninger
- Department of Public Health & Community Medicine, Tufts University School of Medicine, Boston, MA, USA
| | - Robert A Bednarczyk
- Hubert Department of Global Health, Emory University Rollins School of Public Health, Atlanta, GA, USA; Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, GA, USA; Emory Vaccine Center, Emory University, Atlanta, GA, USA
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17
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Doliński D, Kulesza W, Rędzio AM, Muniak P, Guzek M, Silczuk A, Gujski M. The Effects of Offering Freedom to Comply by Pediatricians and Nurses, Using the But-You-Are-Free (BYAF) Technique, on Vaccination Compliance on 185 Parents of Newborn Babies Conducted in Outpatient Clinics in Poland Between January 2022 and July 2022. Med Sci Monit 2023; 29:e938743. [PMID: 36597299 PMCID: PMC9827711 DOI: 10.12659/msm.938743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND This study aimed to evaluate, in outpatient clinics in Poland between January 2022 and July 2022, the effectiveness of the But-You-Are-Free (BYAF) social influence technique by healthcare professionals during interaction with 185 parents deciding about vaccinating (eg, Hexacima, Prevenor 13, Synflorix, Rotateq, Act Hib, Boostrix, Pentaxim, DTP, Imovax, Priorix, MMR, Tetracim, Adacel, Euvax B, Fuvax, FSME, Varilix, Nimenrix, Bexero vaccines) their babies. MATERIAL AND METHODS During an interaction with pediatricians or nurses, the parents were encouraged to vaccinate their babies. In experimental condition (111 interactions), the BYAF technique was employed, and the phrase "But you are free" was added at the end of the conversation. In the control condition (74 interactions), it was not employed. RESULTS In the experimental condition, 71 (64%) participants declared intention to vaccinate their children. In the control condition, it 61 (84%) participants declared intention to vaccinate (the difference in percentages was significant: P=0.006). The number of parents who actually vaccinated their babies in the experimental condition was 92 (83%) and in the control condition it was 70 (95%; P=0.018). CONCLUSIONS The findings showed that participants who were exposed to the BYAF technique declared lower intentions to vaccinate their babies, and vaccinated them less often than those in the control condition. This result critically highlights that this technique should not be employed in the medical settings of pediatric vaccination.
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Affiliation(s)
- Dariusz Doliński
- Department of Psychology, SWPS University of Social Sciences and Humanities in Wrocław, Wrocław, Poland
| | - Wojciech Kulesza
- Department of Psychology, SWPS University of Social Sciences and Humanities in Warsaw, Warsaw, Poland
| | - Anna Magdalena Rędzio
- Department of Psychology, SWPS University of Social Sciences and Humanities in Warsaw, Warsaw, Poland
| | - Paweł Muniak
- Department of Psychology, SWPS University of Social Sciences and Humanities in Warsaw, Warsaw, Poland
| | - Marika Guzek
- Medical Projects and Patients’ Health, Medical-Diagnostic Center in Siedlce, Siedlce, Poland
| | - Andrzej Silczuk
- Department of Public Health, Medical University of Warsaw, Warsaw, Poland
| | - Mariusz Gujski
- Department of Public Health, Medical University of Warsaw, Warsaw, Poland
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Alatrany SSJ, Falaiyah AM, Zuhairawi RHM, Ogden R, ALi Sayyid ALdrraji H, Alatrany ASS, Al-Jumeily D. A cross-sectional analysis of the predictors of COVID-19 vaccine uptake and vaccine hesitancy in Iraq. PLoS One 2023; 18:e0282523. [PMID: 36893102 PMCID: PMC9997880 DOI: 10.1371/journal.pone.0282523] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 02/16/2023] [Indexed: 03/10/2023] Open
Abstract
BACKGROUND Vaccine hesitancy poses a significant risk to global recovery from COVID-19. To date however, there is little research exploring the psychological factors associated with vaccine acceptability and hesitancy in Iraq. AIM To explore attitudes towards COVID-19 vaccination in Iraq. To establish the predictors of vaccine uptake and vaccine hesitancy in an Iraqi population. METHODS Using a cross-sectional design, 7,778 participants completed an online questionnaire exploring their vaccination status, likelihood of infection, perceived severity infection, benefits of vaccine, barriers to vaccine, anticipated regret, subjective norms, and trust in government. FINDINGS Vaccination rates increased with age and were greater in males, those who were married, divorced or widowed, those with children and those with underlying conditions. Vaccine hesitancy was widespread with 61.40% of unvaccinated individuals reported an unwillingness to receive a COVID-19 vaccine. In unvaccinated groups, vaccine hesitancy was associated with lower trust in the government, more negative social norms, greater perceived barriers to vaccination and reduced perceived benefits. CONCLUSIONS There is significant COVID-19 vaccine hesitancy in Iraq. Public health institutions should be aware of the influence of demographic factors, as well as personal beliefs and social norms, on individuals' decisions to vaccinate. Public health messaging should therefore aim to be tailored to address the concerns of citizens.
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Affiliation(s)
| | - Ashraf Muwafa Falaiyah
- College of Education for Human Sciences, Ibn Reshed, University of Baghdad, Baghdad, Iraq
| | | | - Ruth Ogden
- School of Psychology, Liverpool John Moores University, Liverpool, United Kingdom
- * E-mail:
| | | | - Abbas S. S. Alatrany
- University of Information Technology and Communications, Baghdad, Iraq
- School of Computer Science and Mathematics, Liverpool John Moores University, Liverpool, United Kingdom
| | - Dhiya Al-Jumeily
- School of Computer Science and Mathematics, Liverpool John Moores University, Liverpool, United Kingdom
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19
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Wei Z, Liu Y, Zhang L, Sun X, Jiang Q, Li Z, Wu Y, Fu C. Stages of HPV Vaccine Hesitancy Among Guardians of Female Secondary School Students in China. J Adolesc Health 2023; 72:73-79. [PMID: 36229401 PMCID: PMC9746349 DOI: 10.1016/j.jadohealth.2022.08.027] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Revised: 08/31/2022] [Accepted: 08/31/2022] [Indexed: 11/05/2022]
Abstract
PURPOSE Female secondary school students are the primary recommended population for human papillomavirus (HPV) vaccines. However, vaccine hesitancy may affect uptake. In this study, we assessed the vaccine hesitancy levels among the guardians of female secondary school students in China. METHODS We developed a questionnaire and conducted cross-sectional surveys among guardians of secondary school girls aged 12-19 years in mainland China based on the Increasing Vaccination Model and the Precaution Adoption Process Model. RESULTS We collected 3,225 valid samples. Among the participating guardians, 53.9% were vaccine hesitant, although only 0.9% had refused HPV vaccines. Some individual characteristics of guardians (e.g. sex, education/income level) were associated with understanding HPV vaccines. Better knowledge of HPV vaccines and communication with reliable sources of information were associated with vaccine nonhesitancy. Practical barriers such as vaccine shortage and busy schedules prevented nonhesitant guardians from vaccinating their children. DISCUSSION A substantial proportion of the guardians surveyed were HPV vaccine hesitant. Promoting HPV knowledge and communication with reliable sources (e.g. clinical doctors) could help fight against vaccine hesitancy.
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Affiliation(s)
- Zheng Wei
- Institute of Infectious Disease and Vaccine, School of Public Health, Zhejiang Chinese Medical University, Hangzhou, China
| | - Yang Liu
- Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, Bloomsbury, London, England, UK,Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene and Tropical Medicine, Bloomsbury, London, England, UK
| | - Liuren Zhang
- Institute of Infectious Disease and Vaccine, School of Public Health, Zhejiang Chinese Medical University, Hangzhou, China
| | - Xiu Sun
- Institute of Infectious Disease and Vaccine, School of Public Health, Zhejiang Chinese Medical University, Hangzhou, China
| | - Qijing Jiang
- Institute of Infectious Disease and Vaccine, School of Public Health, Zhejiang Chinese Medical University, Hangzhou, China
| | - Zhenwei Li
- Institute of Infectious Disease and Vaccine, School of Public Health, Zhejiang Chinese Medical University, Hangzhou, China
| | - Yue Wu
- Institute of Infectious Disease and Vaccine, School of Public Health, Zhejiang Chinese Medical University, Hangzhou, China
| | - Chuanxi Fu
- Institute of Infectious Disease and Vaccine, School of Public Health, Zhejiang Chinese Medical University, Hangzhou, China.
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20
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Olbrich Neto J, Olbrich SRLR. Attitudes, hesitancy, concerns, and inconsistencies regarding vaccines reported by parents of preschool children. REVISTA PAULISTA DE PEDIATRIA : ORGAO OFICIAL DA SOCIEDADE DE PEDIATRIA DE SAO PAULO 2023; 41:e2022009. [PMID: 36921172 PMCID: PMC10014028 DOI: 10.1590/1984-0462/2023/41/2022009] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 07/26/2022] [Indexed: 03/16/2023]
Abstract
OBJECTIVE This study aimed to assess attitudes, concerns, information and knowledge about vaccines among parents of preschool children attending kindergartens in a city in the interior of São Paulo, Brazil, using a self-administered questionnaire. METHODS Cross-sectional, questionnaire-based study of knowledge and attitudes regarding vaccination among parents of children aged up to 72 months from public and private schools, between 2018 and 2019. RESULTS Among the 2,528 questionnaires, 1,261 were answered and grouped by respondents' educational level. According to information, 96.6% of the children were up to date with vaccines. The prevalence of vaccine hesitancy was 5.0%. The lower the educational level, the lower was the income, the larger the number of household members, and the greater the lack of knowledge about vaccines. The higher the educational level, the lower was the vaccine hesitancy, and the greater the dissatisfaction with the information received. CONCLUSIONS Generally, parents consider vaccines to be important for preventing diseases and to be safe, with their benefits outweighing the risks. Positive comments were accompanied by doubts, concerns, hesitancy, and inconsistencies. The level of educational attainment makes a difference in the access to information, medical care provided by pediatricians, and the feeling of obligation to vaccinate. Parents have vaccinated and still intend to vaccinate their children, but ensuring adequate levels of vaccination coverage will be a post-pandemic challenge.
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Affiliation(s)
- Jaime Olbrich Neto
- Universidade Estadual Paulista "Júlio de Mesquita Filho", Botucatu, SP, Brazil
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21
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Glassman LW, Szymczak JE. The influence of social class and institutional relationships on the experiences of vaccine-hesitant mothers: a qualitative study. BMC Public Health 2022; 22:2309. [PMID: 36494647 PMCID: PMC9733306 DOI: 10.1186/s12889-022-14420-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 10/21/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Vaccine hesitancy is a growing problem in the United States. However, our understanding of the mechanisms by which socioeconomic status (SES) shapes the experience of vaccine hesitancy and decision-making is incomplete. AIM The aim of this study was to understand how social class influences the experiences and perspectives of vaccine-hesitant mothers. METHODS We conducted semistructured interviews with middle- and working-class vaccine-hesitant mothers. Participants were identified through neighborhood parenthood groups in the Philadelphia area, as well as in-person and online groups whose members express concerns about vaccines. Interviews were audio recorded and inductively analyzed. RESULTS Interviews were conducted with 37 vaccine-hesitant mothers, who described their vaccine decision-making through the lens of interactions with three institutional stakeholders: 1) pediatric clinicians; 2) school administrators; and 3) emergency room staff. In discussing these interactions, middle- and working-class mothers invoked distinct levels of authority in relation to these institutions. Specifically, working-class mothers expressed concerns that medical or school professionals could act as reporters for state intervention, including Child Protective Services, while middle-class mothers did not. These interactions highlighted the ways middle- and working-class mothers in our study felt differently empowered and constrained in their vaccine choices, and ultimately influenced their perceptions of available actions. CONCLUSIONS Our findings indicate that experiences of vaccine hesitancy may be influenced by mothers' social class via their relationships to institutional authorities. These findings have implications for how clinicians communicate with parents from different social backgrounds to best build trust and facilitate vaccine uptake.
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Affiliation(s)
| | - Julia E. Szymczak
- grid.25879.310000 0004 1936 8972Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, 423 Guardian Drive, Philadelphia, PA 19104 USA
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22
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He Q, Fan S, Xue Z, Yuan J, Wang Y, Yang Z, Zhou Z, Zhang Z. Waning of maternal antibody against measles virus in Shufu, China. Hum Vaccin Immunother 2022; 18:2045854. [PMID: 36399713 DOI: 10.1080/21645515.2022.2045854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND As measles vaccination coverage has increased, measles infection has shifted to the population of infants. We conducted a follow-up seroepidemiological study among mothers and their infants to evaluate measles seroprevalence and the persistence of maternal measles antibody in Shufu, Kashgar from 2018 to 2020. METHODS Maternal venous blood and cord blood was obtained among mothers and their infants at 0, 3, 5, 8, 9, and 12 months of age. An enzyme-linked immunosorbent assay was used for quantitative measurement of measles antibodies. We analyzed the correlation between maternal and neonatal measles antibodies, and antibodies persistence after infants were born. RESULTS The overall neonatal maternal ratio was 2.38 (95%CI: 2.05-2.71). The measles antibodies for mothers and newborns were 438.93 IU/mL (95%CI: 409.47-470.51 IU/mL) and 440.10 IU/mL (95%CI: 410.82-471.48 IU/mL), respectively. Neonatal measles antibodies were dropping after birth and then beginning to increase starting at 8 months of age. CONCLUSIONS Infant measles antibody levels progressively declined after birth regardless of maternal measles antibody levels. Efforts should be carried out to eliminate measles.
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Affiliation(s)
- Qing He
- Institute of Public Health, Guangzhou Medical University & Guangzhou Center for Disease Control and Prevention, Guangzhou, China
| | - Shujun Fan
- Institute of Public Health, Guangzhou Medical University & Guangzhou Center for Disease Control and Prevention, Guangzhou, China
| | - Zhenxiang Xue
- Emergency Management department, Shufu Center for Disease Control and Prevention, Kashgar, China
| | - Jun Yuan
- Institute of Public Health, Guangzhou Medical University & Guangzhou Center for Disease Control and Prevention, Guangzhou, China
| | - Yuzhong Wang
- Emergency Management department, Shufu Center for Disease Control and Prevention, Kashgar, China
| | - Zhicong Yang
- Institute of Public Health, Guangzhou Medical University & Guangzhou Center for Disease Control and Prevention, Guangzhou, China
| | - Ziyan Zhou
- Institute of Public Health, Guangzhou Medical University & Guangzhou Center for Disease Control and Prevention, Guangzhou, China
| | - Zhoubin Zhang
- Institute of Public Health, Guangzhou Medical University & Guangzhou Center for Disease Control and Prevention, Guangzhou, China
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23
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Moss E, Patterson NA, Seals BF. An Examination of US COVID-19 Vaccine Distribution in New Jersey, Pennsylvania, and New York. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15629. [PMID: 36497703 PMCID: PMC9738558 DOI: 10.3390/ijerph192315629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 11/18/2022] [Accepted: 11/21/2022] [Indexed: 06/17/2023]
Abstract
COVID-19 quickly spread across the United States (US) while communications and policies at all government levels suffered from inconsistency, misinformation, and lack of coordination. In order to explain the discrepancy between availability and population uptake, a case study was conducted analyzing vaccine rollout plans, social media, and Health Officer/Other Key Informant interviews in New Jersey, New York, and Pennsylvania. Key research questions included, "What were the barriers and facilitators of early COVID vaccine distribution?" and "What mechanisms in the community emerged to alleviate strains in early vaccination?" Findings from this study revealed that pre-existing emergency preparedness infrastructures and plans developed since the 9/11 tragedy were seemingly abandoned. This caused health departments at all levels of government to make impromptu, non-uniform decisions leading to confusion, vaccine hesitancy, and ultimately low uptake. The results indicate that future vaccine rollout best practices must include evidence-based decision-making, coordinated communications, and outreach to high-priority and vulnerable communities.
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Ilesanmi MM, Abonyi S, Pahwa P, Gerdts V, Scwandt M, Neudorf C. Trends, barriers and enablers to measles immunisation coverage in Saskatchewan, Canada: A mixed methods study. PLoS One 2022; 17:e0277876. [PMID: 36417461 PMCID: PMC9683619 DOI: 10.1371/journal.pone.0277876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 11/04/2022] [Indexed: 11/25/2022] Open
Abstract
Many social, cultural, and systemic challenges affect the uptake of measles immunisation services. Prior studies have looked at the caregivers' perspectives, but little is known about the perspectives of the health care providers on the barriers of measles immunisation services in Canada. This study examined measles immunisation coverage trends across the regional health authorities in Saskatchewan and explored the barriers and enablers to measles immunisation coverage from providers' perspectives. The study adopted an explanatory sequential mixed method. We utilized the entire population of 16,582 children under two years of age available in the Saskatchewan Immunisation Management System (SIMS) registry for 2002 and 2013 in aggregate format and interviewed 18 key informants in pre-determined two-stages in 2016 and 2017. The quantitative analysis was done with Joinpoint regression modelling, while the qualitative interview data was analyzed using hybrid inductive and deductive thematic approaches. There was a 16.89%-point increase in measles immunisation coverage in the province from 56.32% to 73.21% between 2002 and 2013. There was also a persistently higher coverage among the affluent (66.95% - 82.37%) than the most deprived individuals (45.79% - 62.60%) in the study period. The annual rate of coverage change was marginally higher among the most deprived (16.81%; and average annual percentage change (AAPC) 2.0, 95% CI 1.7-2.2) than among the affluent group (15.42% and AAPC 3.0; 95% CI 2.0-4.0). While access-related issues, caregivers' fears, hesitancy, anti-vaccination challenges, and resource limitations were barriers to immunisation, improving community engagement, service delivery flexibility, targeted social responses and increasing media role were found useful to address the uptake of measles and other vaccine-preventable diseases immunisation. There is low coverage and inequity in measles immunisation uptake in Saskatchewan from social and institutional barriers. Even though there is evidence of disparity reduction among the different groups, the barriers to increasing measles immunisation coverage have implications for the health of the socio-economically deprived groups, the healthcare system and other vaccination programs. There is a need to improve policy framework for community engagement, targeted programs, and public health discourse.
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Affiliation(s)
- Marcus M. Ilesanmi
- Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
- * E-mail:
| | - Sylvia Abonyi
- Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
- Saskatchewan Population Health and Evaluation Research Unit (SPHERU), University of Saskatchewan, Saskatoon, SK, Canada
| | - Punam Pahwa
- Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, SK, Canada
| | - Volker Gerdts
- Vaccine and Infectious Disease Organization-International Vaccine Centre (VIDO-InterVac), University of Saskatchewan, Saskatoon, SK, Canada
- Department of Veterinary Microbiology, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - Michael Scwandt
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
- Vancouver Coastal Health, Office of the Chief Medical Health Officer, Vancouver, BC, Canada
| | - Cordell Neudorf
- Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
- Health Surveillance & Reporting, Saskatchewan Health Authority (SHA), Saskatoon, SK, Canada
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Ferrara P, Dallagiacoma G, Alberti F, Gentile L, Bertuccio P, Odone A. Prevention, diagnosis and treatment of cervical cancer: A systematic review of the impact of COVID-19 on patient care. Prev Med 2022; 164:107264. [PMID: 36150446 PMCID: PMC9487163 DOI: 10.1016/j.ypmed.2022.107264] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 08/07/2022] [Accepted: 09/17/2022] [Indexed: 11/30/2022]
Abstract
Worldwide, the COVID-19 pandemic disrupted healthcare services, including cervical cancer management, and an increased burden for this condition is expected. This systematic review synthetizes the available evidence on the impact of the pandemic on prevention, diagnosis and treatment of cervical cancer. Searches were performed on PubMed, Embase, and Scopus for relevant studies on these topics with the purpose of comparing service access and care delivery before and during COVID-19 pandemic. Due to the methodological heterogeneity among the studies, findings were narratively discussed. Of the 715 screened titles and abstracts, 33 articles were included, corresponding to 42 reports that covered the outcomes of interest: vaccination against human papillomavirus (HPV) (6 reports), cancer screening (19), diagnosis (8), and treatment (8). Seven studies observed reductions in HPV vaccination uptake and coverage during COVID-19. Reports on cervical screening and cancer diagnosis activities showed a substantial impact of the pandemic on access to screening services and diagnostic procedures. All but one study that investigated cervical cancer treatment reported changes in the number of women with cervical lesions who received treatments, as well as treatment delay and interruption. With a major impact during the first wave in 2020, COVID-19 and restriction measures resulted in a substantial disruption in cervical cancer prevention and management, with declines in screening and delays in treatment. Taken together, findings from this systematic review calls for urgent policy interventions for recovering cervical cancer prevention and care.
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Affiliation(s)
- Pietro Ferrara
- Center for Public Health Research, University of Milan-Bicocca, 20900 Monza, Italy; IRCCS Istituto Auxologico Italiano, 20145 Milan, Italy
| | - Giulia Dallagiacoma
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy
| | - Federica Alberti
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy
| | - Leandro Gentile
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy
| | - Paola Bertuccio
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy
| | - Anna Odone
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy.
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Trends in Vaccine Refusal and Acceptance Using Electronic Health Records from a Large Pediatric Hospital Network, 2013-2020: Strategies for Change. Vaccines (Basel) 2022; 10:vaccines10101688. [PMID: 36298553 PMCID: PMC9610983 DOI: 10.3390/vaccines10101688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 09/27/2022] [Accepted: 10/05/2022] [Indexed: 11/17/2022] Open
Abstract
Understanding trends in vaccine refusal is critical to monitor as small declines in vaccination coverage can lead to outbreaks of vaccine-preventable diseases. Using electronic heath record (EHR) data from the Children’s Hospital of Philadelphia’s 31 outpatient primary care sites, we created a cohort of 403,448 children less than age 20 years who received at least one visit from 1 January 2013 through 31 December 2020. The sample represented 1,449,061 annualized patient and 181,131 annualized preventive vaccination visits per year. We characterized trends in vaccine refusal and acceptance using a repeated cross-sectional observational analysis of electronic health records (EHR) data using a single annual merged observation measure for patients seen multiple times for preventive healthcare within a calendar year. Refusals were identified for 212,900 annualized patient-visit year observations, which represented 14.6% of annualized patient-visit year observations and 25.1% of annualized vaccine patient-year observations. The odds of having a refusal marker were significantly increased in patients seen in suburban practices (aOR [CI]: 2.35 [2.30−2.40, p < 0.001]), in patients with increased age 11−17 years (aOR [CI]: 3.85 [3.79−3.91], p < 0.001), and those eligible for the VFC program (aOR [CI]: 1.10 [1.08−1.11]. Parental refusal (61.0%) and provider decisions (32.0%) were the most common documented in progress notes for not administering vaccines, whereas contraindications (2.5%) and supply issues (1.8%) were the least common. When offered, vaccine acceptance increased for human papillomavirus, hepatitis B, measles-mumps-rubella-containing and varicella-containing vaccines and decreased for hepatitis A and meningococcal vaccines. Repeated offering of vaccines was central to increasing acceptance, in part due to increased opportunities to address specific concerns.
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Simonart T, Lam Hoai XL, de Maertelaer V. Worldwide Evolution of Vaccinable and Nonvaccinable Viral Skin Infections: Google Trends Analysis. JMIR DERMATOLOGY 2022; 5:e35034. [PMID: 37632891 PMCID: PMC10334945 DOI: 10.2196/35034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 08/24/2022] [Accepted: 09/11/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Most common viral skin infections are not reportable conditions. Studying the population dynamics of these viral epidemics using traditional field methods is costly and time-consuming, especially over wide geographical areas. OBJECTIVE This study aimed to explore the evolution, seasonality, and distribution of vaccinable and nonvaccinable viral skin infections through an analysis of Google Trends. METHODS Worldwide search trends from January 2004 through May 2021 for viral skin infections were extracted from Google Trends, quantified, and analyzed. RESULTS Time series decomposition showed that the total search term volume for warts; zoster; roseola; measles; hand, foot, and mouth disease (HFMD); varicella; and rubella increased worldwide over the study period, whereas the interest for Pityriasis rosea and herpes simplex decreased. Internet searches for HFMD, varicella, and measles exhibited the highest seasonal patterns. The interest for measles and rubella was more pronounced in African countries, whereas the interest for HFMD and roseola was more pronounced in East Asia. CONCLUSIONS Harnessing data generated by web searches may increase the efficacy of traditional surveillance systems and strengthens the suspicion that the incidence of some vaccinable viral skin infections such as varicella, measles, and rubella may be globally increasing, whereas the incidence of common nonvaccinable skin infections remains stable.
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Affiliation(s)
- Thierry Simonart
- Department of Dermatology, Delta Hospital, Centre Hospitalier Interrégional Edith Cavell, Université Libre de Bruxelles, Brussels, Belgium
| | - Xuân-Lan Lam Hoai
- Department of Dermatology, St Pierre - Brugmann - Hôpital Universitaire des Enfants Reine Fabiola University Hospitals, Université Libre de Bruxelles, Brussels, Belgium
| | - Viviane de Maertelaer
- Department of Biostatistics, Institut de Recherche Interdisciplinaire en Biologie Humaine et Moléculaire, Université Libre de Bruxelles, Brussels, Belgium
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Thakur M, Zhou R, Mohan M, Marathe A, Chen J, Hoops S, Machi D, Lewis B, Vullikanti A. COVID's collateral damage: likelihood of measles resurgence in the United States. BMC Infect Dis 2022; 22:743. [PMID: 36127637 PMCID: PMC9487857 DOI: 10.1186/s12879-022-07703-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Accepted: 08/25/2022] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Lockdowns imposed throughout the US to control the COVID-19 pandemic led to a decline in all routine immunizations rates, including the MMR (measles, mumps, rubella) vaccine. It is feared that post-lockdown, these reduced MMR rates will lead to a resurgence of measles. METHODS To measure the potential impact of reduced MMR vaccination rates on measles outbreak, this research examines several counterfactual scenarios in pre-COVID-19 and post-COVID-19 era. An agent-based modeling framework is used to simulate the spread of measles on a synthetic yet realistic social network of Virginia. The change in vulnerability of various communities to measles due to reduced MMR rate is analyzed. RESULTS Results show that a decrease in vaccination rate [Formula: see text] has a highly non-linear effect on the number of measles cases and this effect grows exponentially beyond a threshold [Formula: see text]. At low vaccination rates, faster isolation of cases and higher compliance to home-isolation are not enough to control the outbreak. The overall impact on urban and rural counties is proportional to their population size but the younger children, African Americans and American Indians are disproportionately infected and hence are more vulnerable to the reduction in the vaccination rate. CONCLUSIONS At low vaccination rates, broader interventions are needed to control the outbreak. Identifying the cause of the decline in vaccination rates (e.g., low income) can help design targeted interventions which can dampen the disproportional impact on more vulnerable populations and reduce disparities in health. Per capita burden of the potential measles resurgence is equivalent in the rural and the urban communities and hence proportionally equitable public health resources should be allocated to rural regions.
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Affiliation(s)
- Mugdha Thakur
- Biocomplexity Institute, Town Center Four, 994 Research Park Boulevard, Charlottesville, VA, 22904, USA.
| | - Richard Zhou
- Biocomplexity Institute, Town Center Four, 994 Research Park Boulevard, Charlottesville, VA 22904 USA
| | - Mukundan Mohan
- Biocomplexity Institute, Town Center Four, 994 Research Park Boulevard, Charlottesville, VA 22904 USA
| | - Achla Marathe
- Biocomplexity Institute, Town Center Four, 994 Research Park Boulevard, Charlottesville, VA 22904 USA
| | - Jiangzhuo Chen
- Biocomplexity Institute, Town Center Four, 994 Research Park Boulevard, Charlottesville, VA 22904 USA
| | - Stefan Hoops
- Biocomplexity Institute, Town Center Four, 994 Research Park Boulevard, Charlottesville, VA 22904 USA
| | - Dustin Machi
- Biocomplexity Institute, Town Center Four, 994 Research Park Boulevard, Charlottesville, VA 22904 USA
| | - Bryan Lewis
- Biocomplexity Institute, Town Center Four, 994 Research Park Boulevard, Charlottesville, VA 22904 USA
| | - Anil Vullikanti
- Biocomplexity Institute, Town Center Four, 994 Research Park Boulevard, Charlottesville, VA 22904 USA
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Sustainable Development Goals and childhood measles vaccination in Ekiti State, Nigeria: Results from spatial and interrupted time series analyses. Vaccine 2022; 40:3861-3868. [PMID: 35644673 DOI: 10.1016/j.vaccine.2022.05.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 04/27/2022] [Accepted: 05/13/2022] [Indexed: 11/22/2022]
Abstract
Measles remains an important cause of childhood mortality in many resource-limited countries. With Sustainable Development Goals (SDG), there has been increasing emphasis on measles vaccination as a key strategy to remarkably improve child survival. While progress has been made towards measles vaccination coverage due to SDG in some settings, there has been no prior study evaluating its impact in Nigeria. To assess the effectiveness of SDG policy implementation on measles vaccination coverage, we examined the changes in first dose of measles vaccination coverage rates among children aged 9-15 months following the implementation of SDG, and changes in spatial patterns of measles vaccination from 2014 to 2019 in Ekiti State, Southwest Nigeria. Using state and local government area-level District Health Information data from January 2014 to December 2019, we conducted interrupted time series (ITS) and spatiotemporal analyses. The ITS evaluated the immediate and continuous effects of SDG policy implementation on the monthly childhood measles vaccination coverage by comparing longitudinal changes in rates between pre-intervention period (January 2014-December 2015) and during-intervention period (January 2016-December 2019). The low and high coverage clusters across the years were detected with spatial cluster analysis. The average state-level measles vaccination coverage rates from 2014 to 2019 was 70.67%. In 2019, coverage rate was 49%-a 35.53% decline from 76% in 2014 and a state-level gap of 46%. The geographical distribution of measles vaccination varied considerably across the local government areas from 2014 to 2019. There was an initial acceleration of vaccination rates (β^ = 24.07, p-value = 0.012), but a significant decrease in coverage rates after implementation of SDG policy in Ekiti State (β^ = -1.08, p-value < 0.001). No local government area had accelerated monthly coverage rates following SDG-implementation. Evidence suggests immediate acceleration in coverage rates which could not be sustained during SDG-era and calls for a rethink measles immunization coverage strategy in the state and other resource-limited jurisdictions to ensure vaccination scale-up.
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30
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Rawlings L, Looi JCL, Robson SJ. Economic Considerations in COVID-19 Vaccine Hesitancy and Refusal: A Survey of the Literature. THE ECONOMIC RECORD 2022; 98:214-229. [PMID: 35937100 PMCID: PMC9347763 DOI: 10.1111/1475-4932.12667] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Revised: 02/19/2022] [Accepted: 03/21/2022] [Indexed: 06/15/2023]
Abstract
The COVID-19 global pandemic has triggered one of the greatest economic shocks in a century. Effective COVID-19 vaccines have been developed, but a proportion of people either are hesitant or refuse to be vaccinated, facilitated by a global misinformation campaign. If 'herd immunity' cannot be achieved, there is potential not only for ongoing surges in infection, but also for development of new strains of the virus that could evade vaccines and precipitate further health and economic crises. We review the economics of vaccination and of vaccine hesitancy and refusal, and their potential effects on the recovery from the COVID-19 pandemic.
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Affiliation(s)
- Louise Rawlings
- Crawford School of Public PolicyCanberraAustralian Capital TerritoryAustralia
| | - Jeffrey C. L. Looi
- College of Health and MedicineAustralian National UniversityGarranAustralian Capital TerritoryAustralia
| | - Stephen J. Robson
- College of Health and MedicineAustralian National UniversityGarranAustralian Capital TerritoryAustralia
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Hohmeier KC, Renfro C, Loomis B, Alexander CE, Patel U, Cheramie M, Cernasev A, Hagemann T, Chiu CY, Chisholm-Burns MA, Gatwood JD. The Lean Six Sigma Define, Measure, Analyze, Implement, Control (LSS DMAIC) Framework: An Innovative Strategy for Quality Improvement of Pharmacist Vaccine Recommendations in Community Pharmacy. PHARMACY 2022; 10:pharmacy10030049. [PMID: 35645328 PMCID: PMC9149925 DOI: 10.3390/pharmacy10030049] [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: 03/23/2022] [Revised: 04/19/2022] [Accepted: 04/20/2022] [Indexed: 12/10/2022] Open
Abstract
Community pharmacies represent a highly accessible and convenient setting for vaccination. However, setting-specific barriers exist which contribute to suboptimal vaccination rates, particularly for pneumococcal vaccinations. One proven quality improvement framework growing in use within healthcare settings is Lean Six Sigma (LSS). This paper describes the application of the LSS framework in select locations of a national pharmacy chain. The implementation of a training program for improved recommendation techniques to promote higher rates of pneumococcal vaccinations in high-risk adult populations is also addressed. A mixed-methods approach including pre/post quasi-experimental design and in-depth key informant interviews was used.
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Affiliation(s)
- Kenneth C. Hohmeier
- Department of Clinical Pharmacy and Translational Science, College of Pharmacy, University of Tennessee Health Science Center, Nashville, TN 37211, USA; (U.P.); (A.C.); (T.H.); (J.D.G.)
- Correspondence: ; Tel.: +1-615-532-0228
| | - Chelsea Renfro
- Department of Clinical Pharmacy and Translational Science, College of Pharmacy, University of Tennessee Health Science Center, Memphis, TN 38163, USA; (C.R.); (C.E.A.); (M.C.); (C.-Y.C.); (M.A.C.-B.)
| | | | - Connor E. Alexander
- Department of Clinical Pharmacy and Translational Science, College of Pharmacy, University of Tennessee Health Science Center, Memphis, TN 38163, USA; (C.R.); (C.E.A.); (M.C.); (C.-Y.C.); (M.A.C.-B.)
| | - Urvi Patel
- Department of Clinical Pharmacy and Translational Science, College of Pharmacy, University of Tennessee Health Science Center, Nashville, TN 37211, USA; (U.P.); (A.C.); (T.H.); (J.D.G.)
| | - Matthew Cheramie
- Department of Clinical Pharmacy and Translational Science, College of Pharmacy, University of Tennessee Health Science Center, Memphis, TN 38163, USA; (C.R.); (C.E.A.); (M.C.); (C.-Y.C.); (M.A.C.-B.)
| | - Alina Cernasev
- Department of Clinical Pharmacy and Translational Science, College of Pharmacy, University of Tennessee Health Science Center, Nashville, TN 37211, USA; (U.P.); (A.C.); (T.H.); (J.D.G.)
| | - Tracy Hagemann
- Department of Clinical Pharmacy and Translational Science, College of Pharmacy, University of Tennessee Health Science Center, Nashville, TN 37211, USA; (U.P.); (A.C.); (T.H.); (J.D.G.)
| | - Chi-Yang Chiu
- Department of Clinical Pharmacy and Translational Science, College of Pharmacy, University of Tennessee Health Science Center, Memphis, TN 38163, USA; (C.R.); (C.E.A.); (M.C.); (C.-Y.C.); (M.A.C.-B.)
| | - Marie A. Chisholm-Burns
- Department of Clinical Pharmacy and Translational Science, College of Pharmacy, University of Tennessee Health Science Center, Memphis, TN 38163, USA; (C.R.); (C.E.A.); (M.C.); (C.-Y.C.); (M.A.C.-B.)
| | - Justin D. Gatwood
- Department of Clinical Pharmacy and Translational Science, College of Pharmacy, University of Tennessee Health Science Center, Nashville, TN 37211, USA; (U.P.); (A.C.); (T.H.); (J.D.G.)
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Effect of COVID-19 Pandemic on Influenza Vaccination Intention: A Meta-Analysis and Systematic Review. Vaccines (Basel) 2022; 10:vaccines10040606. [PMID: 35455354 PMCID: PMC9026798 DOI: 10.3390/vaccines10040606] [Citation(s) in RCA: 42] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 04/04/2022] [Accepted: 04/11/2022] [Indexed: 12/25/2022] Open
Abstract
Poorer outcomes have been reported with COVID-19 and influenza coinfections. As the COVID-19 pandemic rages on, protection against influenza by vaccination is becoming increasingly important. This study examines how COVID-19 has influenced influenza vaccination intentions from a global perspective. A literature search was conducted on Embase, PubMed, and CNKI from 1 January 2019 to 31 December 2021 for articles reporting rates of influenza vaccination pre-COVID-19 (19/20 season), and intention and/or uptake of influenza vaccination post-COVID-19 (20/21 season). The changes in vaccination intention and reasons for changes were reported. Subgroup analyses were performed by region, gender, age, and occupation. Newcastle Ottawa Scale was used for quality assessment of the articles. Twenty-seven studies with 39,193 participants were included. Among 22 studies reporting intention to vaccinate in 20/21, there was increased intention to vaccinate (RR 1.50, 95% CI 1.32−1.69, p < 0.001) regardless of age, gender, and occupation. The remaining five studies reporting vaccination intention and uptake in 20/21 showed a similar increase (RR 1.68, 95%CI 1.20−2.36). Important determinants include historical vaccine acceptance, and perception of influenza severity and vaccine safety. The COVID-19 pandemic has increased intention to vaccinate against influenza internationally. The pandemic could be a window of opportunity to promote influenza vaccination and decrease vaccine hesitancy.
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Therapist disclosure to combat COVID-19 vaccine hesitancy: a narrative review. J Behav Med 2022; 46:346-355. [PMID: 35355152 PMCID: PMC8967560 DOI: 10.1007/s10865-022-00305-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 02/22/2022] [Indexed: 11/05/2022]
Abstract
With the onset of the COVID-19 pandemic in 2019–2020 and the rapid development of vaccines to prevent this disease came a rise in interest around vaccine hesitancy. Naturally, methods of combatting vaccine hesitancy and increasing vaccination rates are of paramount importance. One such method is building upon the trust and openness of one’s relationship with their healthcare provider. Specifically, this paper examines how psychotherapist self-disclosure could facilitate effective health behaviors in patients, focusing on vaccines. Traditionally, mental health therapists have been encouraged to avoid self-disclosure of personal information due to the possibility of unbalancing or damaging the therapeutic relationship. However, research from medicine and other disciplines suggests that personal recommendation, self-disclosure of vaccination status, and expert encouragement may be effective methods of addressing vaccine hesitancy. In addition, recommendations for therapists in discussing vaccination and in working with vaccine-hesitant patients are provided.
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Bangs AC, Gastañaduy P, Neilan AM, Fiebelkorn AP, Walker AT, Rao SR, Ryan ET, LaRocque RC, Walensky RP, Hyle EP. The Clinical and Economic Impact of Measles-Mumps-Rubella Vaccinations to Prevent Measles Importations From US Pediatric Travelers Returning From Abroad. J Pediatric Infect Dis Soc 2022; 11:257-266. [PMID: 35333347 PMCID: PMC9214784 DOI: 10.1093/jpids/piac011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 02/01/2022] [Indexed: 11/24/2022]
Abstract
BACKGROUND Pediatric international travelers account for nearly half of measles importations in the United States. Over one third of pediatric international travelers depart the United States without the recommended measles-mumps-rubella (MMR) vaccinations: 2 doses for travelers ≥12 months and 1 dose for travelers 6 to <12 months. METHODS We developed a model to compare 2 strategies among a simulated cohort of international travelers (6 months to <6 years): (1) No pretravel health encounter (PHE): travelers depart with baseline MMR vaccination status; (2) PHE: MMR-eligible travelers are offered vaccination. All pediatric travelers experience a destination-specific risk of measles exposure (mean, 30 exposures/million travelers). If exposed to measles, travelers' age and MMR vaccination status determine the risk of infection (range, 3%-90%). We included costs of medical care, contact tracing, and lost wages from the societal perspective. We varied inputs in sensitivity analyses. Model outcomes included projected measles cases, costs, and incremental cost-effectiveness ratios ($/quality-adjusted life year [QALY], cost-effectiveness threshold ≤$100 000/QALY). RESULTS Compared with no PHE, PHE would avert 57 measles cases at $9.2 million/QALY among infant travelers and 7 measles cases at $15.0 million/QALY among preschool-aged travelers. Clinical benefits of PHE would be greatest for infants but cost-effective only for travelers to destinations with higher risk for measles exposure (ie, ≥160 exposures/million travelers) or if more US-acquired cases resulted from an infected traveler, such as in communities with limited MMR coverage. CONCLUSIONS Pretravel MMR vaccination provides the greatest clinical benefit for infant travelers and can be cost-effective before travel to destinations with high risk for measles exposure or from communities with low MMR vaccination coverage.
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Affiliation(s)
- Audrey C Bangs
- Medical Practice Evaluation Center, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Paul Gastañaduy
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Anne M Neilan
- Medical Practice Evaluation Center, Massachusetts General Hospital, Boston, Massachusetts, USA,Division of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts, USA,Division of General Academic Pediatrics, Massachusetts General Hospital, Boston, Massachusetts, USA,Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Amy Parker Fiebelkorn
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Allison Taylor Walker
- Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Sowmya R Rao
- MGH Biostatistics Center, Massachusetts General Hospital, Boston, Massachusetts, USA,Department of Global Health, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Edward T Ryan
- Division of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts, USA,Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA,Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA,Travelers' Advice and Immunization Center, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Regina C LaRocque
- Division of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts, USA,Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA,Travelers' Advice and Immunization Center, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Rochelle P Walensky
- Medical Practice Evaluation Center, Massachusetts General Hospital, Boston, Massachusetts, USA,Division of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts, USA,Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Emily P Hyle
- Corresponding Author: Emily P. Hyle, MD, MSc, Division of Infectious Diseases, Massachusetts General Hospital, 100 Cambridge Street, 16th Floor, Boston, MA 02114, USA. E-mail:
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Ukonaho S, Lummaa V, Briga M. The Long-Term Success of Mandatory Vaccination Laws After Implementing the First Vaccination Campaign in 19th Century Rural Finland. Am J Epidemiol 2022; 191:1180-1189. [PMID: 35292819 PMCID: PMC9440364 DOI: 10.1093/aje/kwac048] [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: 04/21/2021] [Revised: 02/04/2022] [Accepted: 03/08/2022] [Indexed: 01/26/2023] Open
Abstract
In high-income countries, childhood infections are on the rise, a phenomenon attributed in part to persistent hesitancy toward vaccines. To combat vaccine hesitancy, several countries recently made vaccinating children mandatory, but the effect of such vaccination laws on vaccination coverage remains debated, and the long-term consequences are unknown. Here we quantified the consequences of vaccination laws on vaccination coverage, monitoring for a period of 63 years (1837-1899) rural Finland's first vaccination campaign against the highly lethal childhood infection smallpox. We found that annual vaccination campaigns were focused on children up to 1 year old and that their vaccination coverage was low and declined over time until the implementation of the vaccination law, which stopped the declining trend and was associated with an abrupt coverage increase, of 20%, to cover >80% of all children. Our results indicate that vaccination laws can have a long-term beneficial effect of increasing the vaccination coverage and will help public health practitioners to make informed decisions on how to act against vaccine hesitancy and optimize the impact of vaccination programs.
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Affiliation(s)
- Susanna Ukonaho
- Correspondence to Susanna Ukonaho, Department of Biology, University of Turku, Vesilinnantie, 5, Turku 20014, Finland (e-mail: , )
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Gual-Gonzalez L, McCarter MSJ, Dye-Braumuller K, Self S, Ross CH, Rodriguez-Ramos C, Daguise VG, Nolan MS. Determinants of COVID-19 Vaccinations among a State-Wide Year-Long Surveillance Initiative in a Conservative Southern State. Vaccines (Basel) 2022; 10:vaccines10030412. [PMID: 35335044 PMCID: PMC8949372 DOI: 10.3390/vaccines10030412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 03/04/2022] [Accepted: 03/07/2022] [Indexed: 11/30/2022] Open
Abstract
By the end of 2021, the COVID-19 pandemic resulted in over 54 million cases and more than 800,000 deaths in the United States, and over 350 million cases and more than 5 million deaths worldwide. The uniqueness and gravity of this pandemic have been reflected in the public health guidelines poorly received by a growing subset of the United States population. These poorly received guidelines, including vaccine receipt, are a highly complex psychosocial issue, and have impacted the successful prevention of disease spread. Given the intricate nature of this important barrier, any single statistical analysis methodologically fails to address all convolutions. Therefore, this study utilized different analytical approaches to understand vaccine motivations and population-level trends. With 12,975 surveys from a state-wide year-long surveillance initiative, we performed three robust statistical analyses to evaluate COVID-19 vaccine hesitancy: principal component analysis, survival analysis and spatial time series analysis. The analytic goal was to utilize complementary mathematical approaches to identify overlapping themes of vaccine hesitancy and vaccine trust in a highly conservative US state. The results indicate that vaccine receipt is influenced by the source of information and the population’s trust in the science and approval process behind the vaccines. This multifaceted statistical approach allowed for methodologically rigorous results that public health professionals and policy makers can directly use to improve vaccine interventions.
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Affiliation(s)
- Lídia Gual-Gonzalez
- Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, SC 29208, USA; (L.G.-G.); (M.S.J.M.); (K.D.-B.); (S.S.); (C.H.R.); (C.R.-R.); (V.G.D.)
| | - Maggie S. J. McCarter
- Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, SC 29208, USA; (L.G.-G.); (M.S.J.M.); (K.D.-B.); (S.S.); (C.H.R.); (C.R.-R.); (V.G.D.)
| | - Kyndall Dye-Braumuller
- Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, SC 29208, USA; (L.G.-G.); (M.S.J.M.); (K.D.-B.); (S.S.); (C.H.R.); (C.R.-R.); (V.G.D.)
| | - Stella Self
- Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, SC 29208, USA; (L.G.-G.); (M.S.J.M.); (K.D.-B.); (S.S.); (C.H.R.); (C.R.-R.); (V.G.D.)
| | - Connor H. Ross
- Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, SC 29208, USA; (L.G.-G.); (M.S.J.M.); (K.D.-B.); (S.S.); (C.H.R.); (C.R.-R.); (V.G.D.)
| | - Chloe Rodriguez-Ramos
- Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, SC 29208, USA; (L.G.-G.); (M.S.J.M.); (K.D.-B.); (S.S.); (C.H.R.); (C.R.-R.); (V.G.D.)
| | - Virginie G. Daguise
- Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, SC 29208, USA; (L.G.-G.); (M.S.J.M.); (K.D.-B.); (S.S.); (C.H.R.); (C.R.-R.); (V.G.D.)
- South Carolina Department of Health and Environmental Control, Columbia, SC 29201, USA
| | - Melissa S. Nolan
- Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, SC 29208, USA; (L.G.-G.); (M.S.J.M.); (K.D.-B.); (S.S.); (C.H.R.); (C.R.-R.); (V.G.D.)
- Correspondence:
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Moreno-Montoya J, Ballesteros SM, Rojas Sotelo JC, Bocanegra Cervera CL, Barrera-López P, De la Hoz-Valle JA. Impact of the COVID-19 pandemic on routine childhood immunisation in Colombia. Arch Dis Child 2022; 107:e4. [PMID: 34285000 PMCID: PMC8295013 DOI: 10.1136/archdischild-2021-321792] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 06/28/2021] [Indexed: 12/23/2022]
Abstract
OBJECTIVE To assess the impact of the COVID-19 pandemic on routine childhood vaccination coverage in Colombia by age group, rural/urban residence, state and vaccine type. DESIGN Ecological study of official monthly vaccination records. SETTING Vaccination records from the Colombian Ministry of Health (March-October 2019 and 2020). PARTICIPANTS Aggregated data for Colombian children (<12 months, n=676 153; 12-23 months, n=700 319; and 5 years, n=734 295) participating in the Expanded Program on Immunization. MAIN OUTCOME MEASURES Proportion of eligible population receiving vaccination. RESULTS Vaccination coverage showed an overall decline of approximately 14.4% from 2019 to 2020 (2019 coverage=76.0, 2020 coverage=61.6%). The greatest reduction in proportion vaccinated was observed in children <12 months of age for pneumococcal vaccine (second dose) (2019 coverage=81.4%; 2020 coverage=62.2%; 2019-2020 absolute difference, 19.2%; 95% CI 14.8% to 23.7%). For children aged 12-23 months, the proportion vaccinated for yellow fever declined by 16.4% (12.4% to 20.9%) from 78.3% in 2019 to 61.8% in 2020. Among children 5 years of age, the biggest decrease occurred for the oral polio vaccine (second dose), with a difference of 11.4% (7.1% to 15.7%) between 2019 and 2020 (73.1% and 61.7% for 2019 and 2020). We observed a statistically significant effect on vaccine coverage in rural versus urban areas for children <12 months and 5 years of age. CONCLUSIONS Reduced uptake of immunisations during the COVID-19 pandemic poses a serious risk of vaccine-preventable disease outbreaks. Colombia and other middle-income countries need to continue to monitor immunisation programme coverage and disease outbreaks at the national and subnational levels and undertake catch-up vaccination activities.
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Affiliation(s)
- Jose Moreno-Montoya
- Clinical Studies and Clinical Epidemiology Division, Hospital Universitario de la Fundación Santa Fe de Bogotá, Bogota, Colombia
| | - Silvia Marcela Ballesteros
- Clinical Studies and Clinical Epidemiology Division, Hospital Universitario de la Fundación Santa Fe de Bogotá, Bogota, Colombia
| | | | | | - Pedro Barrera-López
- Clinical Studies and Clinical Epidemiology Division, Hospital Universitario de la Fundación Santa Fe de Bogotá, Bogota, Colombia
| | - José A De la Hoz-Valle
- Clinical Studies and Clinical Epidemiology Division, Hospital Universitario de la Fundación Santa Fe de Bogotá, Bogota, Colombia
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Pediatric primary care immunization policies in New York State. Vaccine 2022; 40:1458-1463. [DOI: 10.1016/j.vaccine.2022.01.045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 01/21/2022] [Accepted: 01/23/2022] [Indexed: 11/18/2022]
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van Zyl GU. New Technological Developments in Identification and Monitoring of New and Emerging Infections. ENCYCLOPEDIA OF INFECTION AND IMMUNITY 2022. [PMCID: PMC8291697 DOI: 10.1016/b978-0-12-818731-9.00094-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Patel U, Kumar S. The Use of DMAIC to Improve Quality Vaccination Recommendations in Chain Community Pharmacies. PERSPECTIVES IN HEALTH INFORMATION MANAGEMENT 2022; 19:1d. [PMID: 35440926 PMCID: PMC9013227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Community pharmacies provide the convenience and ease of administrating vaccinations outside traditional settings. Vaccinations are health initiatives that protect communities and improve health outcomes in all populations. Despite their accessibility and supporting clinical data, various influential factors contribute to the current suboptimal rates of vaccine administration. Given the common barriers to vaccine administration, this research narrows down to address a specific barrier and attempts to implement a method that focuses on improving vaccine rates in community pharmacies. This research is a case study that utilizes the Define, Measure, Analyze, Improve, Control (DMAIC) model of Lean Six Sigma and aims to use this quality improvement process to identify, measure, analyze, and implement a training program to facilitate pharmacists in high-quality vaccine recommendations to promote higher rates of pneumococcal vaccinations in community settings.
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Perceptions towards COVID-19 Vaccines and Willingness to Vaccinate in Nepal. Vaccines (Basel) 2021; 9:vaccines9121448. [PMID: 34960194 PMCID: PMC8703692 DOI: 10.3390/vaccines9121448] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 11/21/2021] [Accepted: 11/24/2021] [Indexed: 01/10/2023] Open
Abstract
Vaccination is the most effective preventive measure of COVID-19 available at present, but its success depends on the global accessibility of vaccines and the willingness of people to be vaccinated. As the vaccination rollouts are increasing worldwide, it is important to assess public perception and willingness towards vaccination, so that the aim of mass vaccination will be successful. This study aimed to understand public perception towards COVID-19 vaccines and their willingness to get vaccinated in Nepal. This cross-sectional online survey was conducted among 1196 residents of Nepal in August 2021; most of the participants of this online survey were young adults (18–47 years) with university-level education. A total of 64.5% (771/1196) of the participants perceived COVID-19 vaccines to be safe and risk-free, while 68.6% (820/1196) agreed that vaccination would be efficient in the fight against this pandemic. Most of the participants (841/1196, 70.3%) disagreed that people are getting COVID-19 vaccines easily in Nepal, while they agree with the prioritization of older adults and healthcare workers for vaccination. A total of 61.1% (731/1196) of the participants had received at least one dose of the vaccine. Among the unvaccinated, 93.3% (434/465) were willing to get vaccinated when their turn came. The higher confidence of younger adults in vaccines and the vaccination process is encouraging, as that can help educate others who are hesitant or are not positive towards the idea of receiving vaccines. Dissemination of correct and current information, acquisition of enough doses of vaccines, and equitable distribution of vaccines will be required to achieve successful completion of the COVID-19 vaccination campaign in Nepal.
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Aldakhil H, Albedah N, Alturaiki N, Alajlan R, Abusalih H. Vaccine hesitancy towards childhood immunizations as a predictor of mothers' intention to vaccinate their children against COVID-19 in Saudi Arabia. J Infect Public Health 2021; 14:1497-1504. [PMID: 34481723 PMCID: PMC8390407 DOI: 10.1016/j.jiph.2021.08.028] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 08/23/2021] [Accepted: 08/24/2021] [Indexed: 11/06/2022] Open
Abstract
Background Despite the success of childhood immunization in reducing vaccine-preventable diseases, vaccine hesitancy is now a global health threat to this achievement. The current COVID-19 pandemic may change the picture of vaccine hesitancy toward childhood immunizations, which could influence the mothers’ intention to vaccinate their children against COVID-19. Aim To measure the prevalence and related factors of vaccine hesitancy towards childhood immunization during the era of COVID-19 along with the prevalence of mothers’ intention to vaccinate their children the future COVID-19 and its association with childhood vaccine hesitancy. Methods Cross sectional study was conducted among 270 Saudi mothers attending outpatient clinics at King Abdullah University Hospital (KAAUH) in Riyadh by purposive sampling technique. Data were collected from January to February 2021 using SAGE Group standardized questionnaire. Results Although most mothers strongly agree on the importance of the vaccine (79%), almost one-fourth of mothers were hesitant towards childhood immunization (24.31%). Similar percentage of mothers’ intended to vaccinate their children against COVID-19 in the next 6 months was reported (24%). Vaccine hesitancy was found to be a significant predictor of mothers’ intention. Mothers’ education level was significantly associated with being hesitant towards childhood immunization as well as the intention to accept the future COVID-19 vaccine (p < 0.05). Main reason that was highly significantly associated with being hesitant is the concerns about the side effect (50%). Conclusion The present study reported a considerable percentage of mothers who are hesitant towards childhood immunization which predicts their intension to vaccinate towards COVID19 and is associated with the level of education.
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Affiliation(s)
- Haifa Aldakhil
- College of Health and Rehabilitation Sciences at Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia.
| | - Norah Albedah
- College of Health and Rehabilitation Sciences at Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia.
| | - Nouf Alturaiki
- College of Health and Rehabilitation Sciences at Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia.
| | - Raghad Alajlan
- College of Health and Rehabilitation Sciences at Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia.
| | - Howeida Abusalih
- College of Health and Rehabilitation Sciences at Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia.
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Whelan SO, Moriarty F, Lawlor L, Gorman KM, Beamish J. Vaccine hesitancy and reported non-vaccination in an Irish pediatric outpatient population. Eur J Pediatr 2021; 180:2839-2847. [PMID: 33774718 DOI: 10.1007/s00431-021-04039-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 03/13/2021] [Accepted: 03/19/2021] [Indexed: 12/19/2022]
Abstract
Vaccine hesitancy is defined as a delay in acceptance, or refusal, of vaccines, despite availability. It is a complex and context specific phenomenon and identified as a global health priority. The "Parent Attitudes about Childhood Vaccines" (PACV) questionnaire is a validated tool for identifying vaccine hesitancy. Our aim was to use the PACV to assess vaccine hesitancy and its relationship with reported non-vaccination in an Irish population, for the first time. Our participants were parents or caregivers of children attending general pediatric clinics in a tertiary pediatric hospital in Dublin, Ireland, between September and December 2018. In total, 436 participants completed the questionnaire. 5.5% of our population reported non-vaccination. Human papilloma virus and measles, mumps, rubella vaccines were the most commonly cited vaccines of concern (11.5% and 6.7%, respectively), and autism spectrum disorder was the most commonly side effect of concern (4.3%). Mean PACV score was 26.9 (SD 19.1), with a significant difference between non-vaccinators and vaccinators (53.2 vs 25.3, p<0.001). Safety and efficacy concerns were the major contributor to non-vaccination. 14.4% of our population were vaccine-hesitant using the conventional cut-off score, which increased to 22% when using an optimal cut-off which maximized sensitivity and specificity. The accuracy of the PACV score to identify non-vaccination was good (area under the ROC curve = 0.827), and the optimal cut-off had a high negative predictive value (98.5%).Conclusion: PACV identified reported non-vaccination with high accuracy in our population. It may be useful to screen vaccine-hesitant parents who could benefit from interventions to improve uptake. What is Known: • Vaccine hesitancy is a leading threat to global health, with falls in vaccine uptake associated with disease outbreaks worldwide. • The Parent Attitudes about Childhood Vaccines (PACV) questionnaire is a validated measure of vaccine hesitancy and correlates with non-vaccination in many populations. What is New: • This large study in a pediatric outpatient clinic setting represents the first use of the PACV in a Western European population to assess vaccination hesitancy. • The PACV may be an effective way of screening a pediatric clinic population to identify vaccine-hesitant parents or caregivers for targeted vaccine promotion.
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Affiliation(s)
- Sean Olann Whelan
- Department of General Pediatrics, CHI at Temple Street, Dublin, Ireland. .,Department of Pediatrics, Cork University Hospital, Cork, Ireland.
| | - Frank Moriarty
- School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Lisa Lawlor
- Department of General Pediatrics, CHI at Temple Street, Dublin, Ireland
| | - Kathleen Mary Gorman
- Department of Neurology and Clinical Neurophysiology, CHI at Temple Street, Dublin, Ireland.,School of Medicine and Medical Sciences, University College Dublin, Dublin, Ireland
| | - Joanne Beamish
- Department of General Pediatrics, CHI at Temple Street, Dublin, Ireland
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Oster NV, Williams EC, Unger JM, Newcomb PA, deHart MP, Englund JA, Hofstetter AM. A Risk Prediction Model to Identify Newborns at Risk for Missing Early Childhood Vaccinations. J Pediatric Infect Dis Soc 2021; 10:1080-1086. [PMID: 34402910 PMCID: PMC8719613 DOI: 10.1093/jpids/piab073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 08/02/2021] [Indexed: 11/14/2022]
Abstract
BACKGROUND Approximately 30% of US children aged 24 months have not received all recommended vaccines. This study aimed to develop a prediction model to identify newborns at high risk for missing early childhood vaccines. METHODS A retrospective cohort included 9080 infants born weighing ≥2000 g at an academic medical center between 2008 and 2013. Electronic medical record data were linked to vaccine data from the Washington State Immunization Information System. Risk models were constructed using derivation and validation samples. K-fold cross-validation identified risk factors for model inclusion based on alpha = 0.01. For each patient in the derivation set, the total number of weighted adverse risk factors was calculated and used to establish groups at low, medium, or high risk for undervaccination. Logistic regression evaluated the likelihood of not completing the 7-vaccine series by age 19 months. The final model was tested using the validation sample. RESULTS Overall, 53.6% failed to complete the 7-vaccine series by 19 months. Six risk factors were identified: race/ethnicity, maternal language, insurance status, birth hospitalization length of stay, medical service, and hepatitis B vaccine receipt. Likelihood of non-completion was greater in the high (77.1%; adjusted odds ratio [AOR] 5.6; 99% confidence interval [CI]: 4.2, 7.4) and medium (52.7%; AOR 1.9; 99% CI: 1.6, 2.2) vs low (38.7%) risk groups in the derivation sample. Similar results were observed in the validation sample. CONCLUSIONS Our prediction model using information readily available in birth hospitalization records consistently identified newborns at high risk for undervaccination. Early identification of high-risk families could be useful for initiating timely, tailored vaccine interventions.
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Affiliation(s)
- Natalia V Oster
- Department of Health Systems and Population Health, University of Washington, Seattle, Washington, USA
| | - Emily C Williams
- Department of Health Systems and Population Health, University of Washington, Seattle, Washington, USA,Center of Innovation for Veteran-Centered and Value-Driven Care, Veterans Administration Puget Sound, Seattle, Washington, USA
| | - Joseph M Unger
- Department of Health Systems and Population Health, University of Washington, Seattle, Washington, USA,Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Polly A Newcomb
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA,Department of Epidemiology, University of Washington, Seattle, Washington, USA
| | - M Patricia deHart
- Office of Immunization and Child Profile, Washington State Department of Health, Tumwater, Washington, USA
| | - Janet A Englund
- Department of Pediatrics, University of Washington, Seattle, Washington, USA,Center for Clinical and Translational Research, Seattle Children’s Research Institute, Seattle, Washington, USA
| | - Annika M Hofstetter
- Department of Pediatrics, University of Washington, Seattle, Washington, USA,Center for Clinical and Translational Research, Seattle Children’s Research Institute, Seattle, Washington, USA,Corresponding Author: Annika M. Hofstetter, MD, PhD, MPH, Seattle Children’s Research Institute, M/S CURE-4, PO Box 5371, Seattle, WA 98145-5005, USA.
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Tan CD. Defending 'snake oil': The preservation of contentious knowledge and practices. SOCIAL STUDIES OF SCIENCE 2021; 51:538-563. [PMID: 33618580 DOI: 10.1177/0306312721992543] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
How does belief in controversial ideas persist? I study a community of parents and practitioners who contend that autism spectrum disorder is caused by harmful environmental exposures - notably, early childhood vaccinations - and that there are worthwhile alternative or experimental treatments. Despite objections from dominant experts, these actors maintain their disputed ideas. This study identifies a set of strategies that help maintain internal legitimacy. In particular, actors protect internal legitimacy through professional alignment and contrastive boundary work. Professional alignment mobilizes resemblances to conventional counterparts (i.e. mainstream doctors) to defend unorthodox practices. Meanwhile, contrastive boundary-work performances convey the defining values and strengths that actors associate with their knowledge community and concomitantly, the weaknesses they ascribe to competing groups. Through these activities, actors respond to perceived threats and construct a distinct group identity anchored in shared knowledge, ways of knowing and practice.
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Kricorian K, Civen R, Equils O. COVID-19 vaccine hesitancy: misinformation and perceptions of vaccine safety. Hum Vaccin Immunother 2021; 18:1950504. [PMID: 34325612 PMCID: PMC8920251 DOI: 10.1080/21645515.2021.1950504] [Citation(s) in RCA: 185] [Impact Index Per Article: 61.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Despite COVID-19’s devastating toll, many Americans remain unwilling to receive the COVID-19 vaccine. The authors conducted a US national survey to understand the health literacy of adults regarding the vaccine, as well as their COVID-19 beliefs and experiences. People who believed the COVID-19 vaccine was unsafe were less willing to receive the vaccine, knew less about the virus and were more likely to believe COVID-19 vaccine myths. On average, they were less educated, lower income, and more rural than people who believed the vaccine is safe. The results highlight the importance of developing clear health communications accessible to individuals from varied socioeconomic and educational backgrounds.
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Affiliation(s)
| | - Rachel Civen
- Los Angeles County Department of Public Health, Los Angeles, CA, USA
| | - Ozlem Equils
- MiOra, Encino, CA, USA.,Los Angeles County Department of Public Health, Los Angeles, CA, USA
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Shuvo S, Hagemann T, Hohmeier K, Chiu CY, Ramachandran S, Gatwood J. The role of social determinants in timely herpes zoster vaccination among older American adults. Hum Vaccin Immunother 2021; 17:2043-2049. [PMID: 33517829 DOI: 10.1080/21645515.2020.1856598] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
CDC recommends that U.S. adults ≥50 years receive the herpes zoster (HZ) vaccine; but few are vaccinated at the recommended age. Little is known about how social determinants of health (SDH) influence timely vaccination. This retrospective observational study included U.S. adults aged ≥50 years who were vaccinated against HZ between 2014 and 2016 from IBM MarketScan commercial claims and Medicare supplemental databases. The cohort was classified into three groups based on age of vaccination: earlier (50-59 years), timely (60-64 years), and later (65+ years). Select SDH data from publicly-available sources were linked and included in multinomial logistic regression assessing the impact of SDH on timely vaccination. The final cohort comprised 549,544 individuals, 49.5% of whom were vaccinated at the age of 60-64. Odds of later HZ vaccination increased with higher poverty (OR: 1.035, 95% CI: 1.031-1.038), more democratic voters (OR: 1.011, 95% CI: 1.010-1.012), and lack of Internet access (OR: 1.028, 95% CI: 1.024-1.032), but decreased with higher health literacy (OR: 0.971, 95% CI: 0.970-0.973). Conversely, higher health literacy and lower poverty were associated with higher odds of earlier vaccination. Being male, not receiving a seasonal influenza vaccine, and higher healthcare utilization were associated with later vaccination. Individuals on an EPO/PPO vs. HMO plan, or who resided in regions other than the Northeast were more likely to receive the vaccine earlier. This study demonstrates the influence of SDH on time of HZ vaccination, but further research is needed to fully understand the impact of SDH on vaccination.
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Affiliation(s)
- Sohul Shuvo
- College of Graduate Health Sciences, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Tracy Hagemann
- College of Pharmacy, University of Tennessee, Nashville, TN, USA
| | - Kenneth Hohmeier
- College of Pharmacy, University of Tennessee, Nashville, TN, USA
| | - Chi-Yang Chiu
- College of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN, USA
| | | | - Justin Gatwood
- College of Pharmacy, University of Tennessee, Nashville, TN, USA
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Lin C, Mullen J, Smith D, Kotarba M, Kaplan SJ, Tu P. Healthcare Providers' Vaccine Perceptions, Hesitancy, and Recommendation to Patients: A Systematic Review. Vaccines (Basel) 2021; 9:vaccines9070713. [PMID: 34358132 PMCID: PMC8310254 DOI: 10.3390/vaccines9070713] [Citation(s) in RCA: 54] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 06/09/2021] [Accepted: 06/16/2021] [Indexed: 12/13/2022] Open
Abstract
Despite vaccines' effectiveness in reducing the rate of preventable diseases, vaccine hesitancy has threatened public health and economies worldwide. Healthcare providers' (HCP) communications and behavior strongly influence patient receptivity and uptake. The goal of this review was to examine HCP vaccine perceptions, knowledge, and reservations and how these attitudes affect their recommendations and vaccination practices. Primary research studies published by 16 September 2020 were searched in PubMed, Web of Science, Embase, CINAHL, and PsycINFO. A 14-item scale was developed for survey study and risk of bias appraisal (SSRBA). In total, 96 papers from 34 countries were included, covering 17 vaccines (HPV and influenza vaccines the most studied). Recommendation was positively associated with provider knowledge and experience, beliefs about disease risk, and perceptions of vaccine safety, necessity, and efficacy. HCP vaccination attitudes and practices varied across specialties, vaccines, and countries; demographic impact was inconclusive. Barriers included anticipation of patient/parental concerns or refusal, lacking clear guidelines, time constraints, and cost. For HPV, vaccines were more often recommended to older, female adolescents and by physicians who discussed sexual health. HCPs are vital advocates for patients and the public, but studies indicated a prevalence of provider hesitancy pertaining to inadequate knowledge, low vaccine confidence, and suboptimal uptake themselves. Improving HCP knowledge and assuring their access to information they deem trustworthy are essential to supporting HCPs' role as "trusted messengers" to promote vaccine acceptance.
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Affiliation(s)
- Cheryl Lin
- Policy and Organizational Management Program, Duke University, Durham, NC 27705, USA; (C.L.); (D.S.); (M.K.)
| | - Jewel Mullen
- Dell Medical School, The University of Texas at Austin, Austin, TX 78712, USA;
| | - Danielle Smith
- Policy and Organizational Management Program, Duke University, Durham, NC 27705, USA; (C.L.); (D.S.); (M.K.)
| | - Michaela Kotarba
- Policy and Organizational Management Program, Duke University, Durham, NC 27705, USA; (C.L.); (D.S.); (M.K.)
| | - Samantha J. Kaplan
- Medical Center Library and Archives, Duke University, Durham, NC 27710, USA;
| | - Pikuei Tu
- Policy and Organizational Management Program, Duke University, Durham, NC 27705, USA; (C.L.); (D.S.); (M.K.)
- Correspondence:
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Martin EK, Shearer MP, Trotochaud M, Nuzzo JB. Outbreak response operations during the US measles epidemic, 2017-19. BMC Public Health 2021; 21:620. [PMID: 33845797 PMCID: PMC8042853 DOI: 10.1186/s12889-021-10652-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 03/18/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To understand operational challenges involved with responding to US measles outbreaks in 2017-19 and identify applicable lessons in order to inform preparedness and response operations for future outbreaks, particularly with respect to specific operational barriers and recommendations for outbreak responses among insular communities. METHODS From August 2019 to January 2020, we conducted 11 telephone interviews with 18 participants representing state and local health departments and community health centers that responded to US measles outbreaks in 2017-19, with a focus on outbreaks among insular communities. We conducted qualitative, thematic coding to identify and characterize key operational challenges and lessons identified by the interviewees. RESULTS We categorized principal insights into 5 topic areas: scale of the response, vaccination operations, exclusion policies, community engagement, and countering anti-vaccine efforts. These topics address resource-intensive aspects of these outbreak responses, including personnel demands; guidance needed to support response operations and reduce transmission, such as excluding exposed or at-risk individuals from public spaces; operational challenges and barriers to vaccination and other response activities; and effectively engaging and educating affected populations, particularly with respect to insular and vulnerable communities. CONCLUSIONS Measles outbreak responses are resource intensive, which can quickly overwhelm existing public health capacities. Early and effective coordination with trusted leaders and organizations in affected communities, including to provide vaccination capacity and facilitate community engagement, can promote efficient response operations. The firsthand experiences of public health and healthcare personnel who responded to measles outbreaks, including among insular communities, provide evidence-based operational lessons that can inform future preparedness and response operations for outbreaks of highly transmissible diseases.
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Affiliation(s)
- Elena K Martin
- Johns Hopkins Center for Health Security and Department of Environmental Health and Engineering, Johns Hopkins University Bloomberg School of Public Health, 621 East Pratt Street, Suite, Baltimore, 210, USA.
| | - Matthew P Shearer
- Johns Hopkins Center for Health Security and Department of Environmental Health and Engineering, Johns Hopkins University Bloomberg School of Public Health, 621 East Pratt Street, Suite, Baltimore, 210, USA
| | - Marc Trotochaud
- Johns Hopkins Center for Health Security and Department of Environmental Health and Engineering, Johns Hopkins University Bloomberg School of Public Health, 621 East Pratt Street, Suite, Baltimore, 210, USA
| | - Jennifer B Nuzzo
- Johns Hopkins Center for Health Security and Department of Environmental Health and Engineering, Johns Hopkins University Bloomberg School of Public Health, 621 East Pratt Street, Suite, Baltimore, 210, USA
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Wei Z, Sun X, Yang Y, Zhan S, Fu C. Seasonal influenza vaccine hesitancy profiles and determinants among Chinese children's guardians and the elderly. Expert Rev Vaccines 2021; 20:601-610. [PMID: 33792476 DOI: 10.1080/14760584.2021.1908134] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVES Seasonal influenza vaccine coverage remains low in China due to possible influenza vaccine hesitancy (IVH) and practical issues. We sought to investigate IVH and its determinants among children's guardians and the elderly for a better understanding of the situation and for future intervention. METHODS We performed two cross-sectional studies to identify the profiles and determinants of IVH using stratified cluster random sampling in an eastern China province in 2019. RESULTS Of the 1564 guardians and 522 elders, 43.2% (95%CI: 40.4-46.0%) of guardians and 33.5% of elders (95%CI: 29.5-37.6%) had IVH. 'From rural area' (odds ratio: 1.36), 'don't know government recommendation for flu vaccination' (1.39), 'don't know flu vaccine is vaccinated annually' (1.93), and 'family members (0.22), friends and neighbors had positive attitude toward flu vaccine' (0.58) were related factors of the guardians' IVH. 'Aged 70-79 years' (0.46), 'had flu before' (0.35) and 'once had been vaccinated' (0.42) were related to the elderly's IVH. CONCLUSION Poor awareness of influenza and vaccination, relatives' negative/positive attitude, lack of government recommendations, anxiety about vaccine quality, and practical issues such as short supply are related to IVH in China. Precision education aimed at hesitancy in wider groups is anticipated to increase vaccine confidence and coverage in influenza-vulnerable groups.
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Affiliation(s)
- Zheng Wei
- Department of Epidemiology, School of Public Health, Zhejiang Chinese Medical University, Hangzhou, China
| | - Xiu Sun
- Department of Epidemiology, School of Public Health, Zhejiang Chinese Medical University, Hangzhou, China
| | - Yingying Yang
- Department of Epidemiology, School of Public Health, Zhejiang Chinese Medical University, Hangzhou, China
| | - Siyi Zhan
- Department of Epidemiology, School of Public Health, Zhejiang Chinese Medical University, Hangzhou, China
| | - Chuanxi Fu
- Department of Epidemiology, School of Public Health, Zhejiang Chinese Medical University, Hangzhou, China
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