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Huang Y, Feng S, Zhao Y, Wang H, Jiang H. Preferences for COVID-19 Vaccines: Systematic Literature Review of Discrete Choice Experiments. JMIR Public Health Surveill 2024; 10:e56546. [PMID: 39073875 PMCID: PMC11319885 DOI: 10.2196/56546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Revised: 05/01/2024] [Accepted: 05/26/2024] [Indexed: 07/30/2024] Open
Abstract
BACKGROUND Vaccination can be viewed as comprising the most important defensive barriers to protect susceptible groups from infection. However, vaccine hesitancy for COVID-19 is widespread worldwide. OBJECTIVE We aimed to systematically review studies eliciting the COVID-19 vaccine preference using discrete choice experiments. METHODS A literature search was conducted in PubMed, Embase, Web of Science, Scopus, and CINAHL Plus platforms in April 2023. Search terms included discrete choice experiments, COVID-19, and vaccines and related synonyms. Descriptive statistics were used to summarize the study characteristics. Subgroup analyses were performed by factors such as high-income countries and low- and middle-income countries and study period (before, during, and after the pandemic wave). Quality appraisal was performed using the 5-item Purpose, Respondents, Explanation, Findings, and Significance checklist. RESULTS The search yield a total of 623 records, and 47 studies with 53 data points were finally included. Attributes were grouped into 4 categories: outcome, process, cost, and others. The vaccine effectiveness (21/53, 40%) and safety (7/53, 13%) were the most frequently reported and important attributes. Subgroup analyses showed that vaccine effectiveness was the most important attribute, although the preference varied by subgroups. Compared to high-income countries (3/29, 10%), a higher proportion of low- and middle-income countries (4/24, 17%) prioritized safety. As the pandemic progressed, the duration of protection (2/24, 8%) during the pandemic wave and COVID-19 mortality risk (5/25, 20%) after the pandemic wave emerged as 2 of the most important attributes. CONCLUSIONS Our review revealed the critical role of vaccine effectiveness and safety in COVID-19 vaccine preference. However, it should be noticed that preference heterogeneity was observed across subpopulations and may change over time. TRIAL REGISTRATION PROSPERO CRD42023422720; https://tinyurl.com/2etf7ny7.
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Affiliation(s)
- Yiting Huang
- Department of Epidemiology and Biostatistics, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China
- Department of Medical Statistics, School of Basic Medicine and Public Health, Jinan University, Guangzhou, China
| | - Shuaixin Feng
- Outpatient department of Baogang, the First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou, China
| | - Yuyan Zhao
- Department of Epidemiology and Biostatistics, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China
| | - Haode Wang
- School of Health and Related Research, University of Sheffield, Sheffield, United Kingdom
| | - Hongbo Jiang
- Department of Epidemiology and Biostatistics, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China
- Institute for Global Health, University College London, London, United Kingdom
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Limbu YB, Huhmann BA. Message Effectiveness of Fear Appeals in Vaccination Communication Campaigns: A Systematic Review. Vaccines (Basel) 2024; 12:653. [PMID: 38932382 PMCID: PMC11209406 DOI: 10.3390/vaccines12060653] [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: 05/06/2024] [Revised: 06/08/2024] [Accepted: 06/09/2024] [Indexed: 06/28/2024] Open
Abstract
This systematic review of 54 cross-disciplinary peer-reviewed causal empirical studies helps public health officials, researchers, and healthcare professionals better comprehend the effects of fear appeals in vaccine promotional campaigns on message processing, persuasion, vaccination attitudes, and vaccination intentions. This review documents inconsistent findings across studies, which it attempts to clarify by considering differences in research designs, sample populations, and outcomes measured. In general, we find that fear appeals increase risk perceptions, message involvement, and vaccination attitudes. However, fear appeals have less influence on vaccination intentions, especially among female and general adult populations or populations from the U.S. and other Western cultures. On the other hand, the effect of fear appeals on vaccination intentions is stronger among student populations and those from China (People's Republic of China and Hong Kong) and other non-Western cultures. Also, fear appeals are less persuasive when promoting COVID-19 vaccines and boosters than they are for other vaccines (e.g., HPV, influenza, MMR). Future research should compare fear appeal effectiveness in messages across vaccines or when combined with other executional elements, such as the endorser or type of evidence provided. Finally, future studies should explore other methodological approaches and measure underexplored message outcomes, such as vaccine uptake behavior, in more naturalistic settings.
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Affiliation(s)
- Yam B. Limbu
- Department of Marketing, Montclair State University, Montclair, NJ 07043, USA
| | - Bruce A. Huhmann
- Department of Marketing, Virginia Commonwealth University, Richmond, VA 23284, USA;
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Sarbazi E, Masoudi N, Mehri A, Esfanjani RM, Azizi H, Soleimanpour M, Pouraghaei M, Soleimanpour H. Trust in primary health care and COVID-19 vaccine uptake among Iranian pediatric: a web-based cross-sectional survey. BMC Pediatr 2024; 24:356. [PMID: 38778272 PMCID: PMC11110261 DOI: 10.1186/s12887-024-04816-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 05/08/2024] [Indexed: 05/25/2024] Open
Abstract
BACKGROUND Children are the most vulnerable group to diseases. Thus, it's critical to evaluate parents' or guardians' willingness to vaccinate their children. This study aims to investigate the prevalence and predictors of pediatric COVID-19 vaccination in Iran and its relationship with trust in the Primary Health Care (PHC) system. METHOD A cross-sectional online survey of 549 Iranian parents was conducted between January and March 2023. This study collected data from all provinces of Iran using a questionnaire shared on Google Forms and various social media platforms. After considering various background factors, we used a multivariable logistic regression model. This model explored how trust in the PHC system and parent-related and child-related factors were related to parents' vaccine uptake for their children. RESULTS Of 549 parents aged between 19 and 67 years (median = 38 years), 65.2% (358) were female. The prevalence of vaccine uptake among parents was 46.8%. After adjusting for background features, child's age (adjusted odds ratio [AOR] 0.81, 95% CI 0.71-0.91), vaccine doses (1-dose: AOR 14.72, 95% CI 6.44-33.65, 2-dose: AOR 32.54, 95% CI 15.22-69.57), child's disease (AOR 5.31, 95% CI 2.19-12.85), and trust in PHC (AOR 1.01, 95% CI 1.00-1.02) were associated with parental uptake of the COVID-19 vaccine. CONCLUSIONS The findings of this study suggest that the child's age, vaccine doses received, diseases, and trust in PHC are significant predictors of parental uptake of the COVID-19 vaccine for children in Iran. The results can be used in service planning regarding children's COVID-19 vaccination.
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Affiliation(s)
- Ehsan Sarbazi
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
- Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Nazanin Masoudi
- Department of Statistics and Epidemiology, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ahmad Mehri
- Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Hosein Azizi
- Women's Reproductive Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Maryam Soleimanpour
- Clinical Research Development Unit of Tabriz Valiasr Hospital, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mahboub Pouraghaei
- Emergency and Trauma Care Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hassan Soleimanpour
- Medical Philosophy and History Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
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Limbu YB, McKinley C. Communication Strategies to Promote COVID-19 Vaccination Intention: How Effective are Source, Appeal, Framing, and Evidence Type Approaches? HEALTH COMMUNICATION 2024:1-16. [PMID: 38706043 DOI: 10.1080/10410236.2024.2346959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2024]
Abstract
This systematic review analyzed the effectiveness of key persuasive strategies - source, appeal, framing, and evidence (SAFE) - on COVID-19 vaccination intention. Quantitative studies were searched in Web of Science, Scopus, and PubMed following the PRISMA guidelines. From the 61 studies that met inclusion criteria, source and framing are the most commonly applied SAFE strategies. However, source characteristics are a more consistent influence on vaccine intentions than message framing strategies, with expert sources and general practitioners emerging as the key sources contributing to greater vaccine intentions. In addition, a range of mediators and moderators influence the process through which SAFE message strategies impact vaccine intentions. Framing effects, in particular, are moderated by political identity, source characteristics, and vaccine perceptions. Tests of mediating processes highlight how health behavior judgments (e.g. perceived vaccine benefits, risks, trust in vaccination, perceived severity) and message response/perceptions (e.g. counterarguing, perceived similarity/empathy) operate as key intervening factors between SAFE message strategies and vaccine intentions. Overall, when practitioners apply various structural approaches (narrative elements, fear appeals, framing cues) to vaccine promotion campaigns, they should be cognizant of who is providing that appeal. Targeted populations may benefit most from different structural elements if they are integrated with sources that resonate with the audience.
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Affiliation(s)
- Yam B Limbu
- Department of Marketing, Feliciano School of Business, Montclair State University
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Tan H, Liu J, Zhang Y. Effects of COVID-19 vaccine safety framing on parental reactions. PLoS One 2024; 19:e0302233. [PMID: 38626128 PMCID: PMC11020397 DOI: 10.1371/journal.pone.0302233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 03/29/2024] [Indexed: 04/18/2024] Open
Abstract
As a major concern shared by parents globally, COVID-19 vaccine safety is typically being messaged to the public in a negative frame in many countries. However, whether the COVID-19 vaccine safety framing have an effect on parents when vaccinating their children is unclear. Here we implement an online survey with a convenience sample of 3,861 parents living in mainland China, all over 18 years old and with at least one child under 18. The parents were randomly assigned to receive information about COVID-19 vaccine safety in either a negative frame (incidence of side effects) or a positive frame (the inverse incidence of side effects), to compare parental reactions to a range of questions about communication, risk perception, trust, involvement and behavioral intention. We found that parents were more likely to regard vaccine safety as relevant to policy support and as a higher priority for government when receiving positively framed information (p = 0.002). For some specific subgroups, parents in positive framing group showed lower risk perception and higher trust (p<0.05). This suggests that positive framing of COVID-19 vaccine safety messages show more effective performance than negative framing in terms of involvement, as well as trust and risk perception in specific subgroups, which may lead to a reflection on whether to adjust the current widespread use of negative framing. Our findings inform how governments and health care workers strategically choose the framing design of COVID-19 vaccine safety information, and have important implications for promoting COVID-19 vaccination in children in the future.
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Affiliation(s)
- Hao Tan
- Lushan Lab, Hunan University, Changsha, China
- School of Design, Hunan University, Changsha, China
| | - Jiayan Liu
- Lushan Lab, Hunan University, Changsha, China
- School of Design, Hunan University, Changsha, China
| | - Yingli Zhang
- Lushan Lab, Hunan University, Changsha, China
- School of Design, Hunan University, Changsha, China
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Bergenfeld I. What can public health communicators learn from Reddit? A perspective for the next pandemic. Front Public Health 2024; 12:1348095. [PMID: 38651132 PMCID: PMC11033353 DOI: 10.3389/fpubh.2024.1348095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 03/22/2024] [Indexed: 04/25/2024] Open
Affiliation(s)
- Irina Bergenfeld
- Hubert Department of Global Health, Emory University, Atlanta, GA, United States
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Gupta D, Rudisill C. Timing of preventive behavior in the case of a new and evolving health risk: the case of COVID-19 vaccination. HEALTH ECONOMICS REVIEW 2024; 14:16. [PMID: 38411764 PMCID: PMC11344437 DOI: 10.1186/s13561-024-00484-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Accepted: 02/01/2024] [Indexed: 02/28/2024]
Abstract
BACKGROUND Time preferences for preventive behavior under novel risks and uncertain contexts may differ from timing preferences related to familiar risks. Therefore, it is crucial to examine drivers of preventative health behavior timing in light of new health risks. Using the case of COVID-19, we examine factors affecting vaccination timing plans when vaccines were widely available in the European Union (EU). METHODS We use data from the Flash Eurobarometer 494 survey (May 21-26, 2021), which collected information on EU residents' attitudes towards COVID-19 vaccinations. We also use the 'Our World in Data' vaccination database for country-level COVID-19 vaccination rates. Probit regressions were conducted to determine how local vaccination rates, trust in information sources, social norms, vaccine safety beliefs, and risk understanding affected the probability of COVID-19 vaccination delay. RESULTS Of total participants (n = 26,106), 9,063 (34.7%) were vaccinated, 7,114 (27.3%) wanted to get vaccinated as soon as possible, 5,168 (19.8%) wanted to delay vaccination and 2,962 (11.4%) resisted vaccination. Participants were more likely to delay COVID-19 vaccination if they lived in a country with lower vaccination prevalence, trusted online social networks, family, friends, and colleagues for vaccination information, were eager to follow vaccination-related social norms, expressed vaccine safety concerns, and understood the risk of catching COVID-19 without a vaccine to be lower. CONCLUSIONS Results from the study contribute to understanding important factors that predict timing of vaccination plans. These findings can also contribute to the wider knowledge base about timing of preventive behavior uptake in novel risk contexts.
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Affiliation(s)
- Deeksha Gupta
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA.
| | - Caroline Rudisill
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA
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Wang B, McDonough J, Chen G, Ong JJ, Marshall H. Sociodemographic factors and attitudes associated with Australian parental acceptance of paediatric COVID-19 vaccination. Vaccine 2023; 41:7608-7617. [PMID: 37996291 DOI: 10.1016/j.vaccine.2023.11.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 10/29/2023] [Accepted: 11/11/2023] [Indexed: 11/25/2023]
Abstract
INTRODUCTION The COVID-19 vaccine coverage among children in countries where COVID-19 vaccines are recommended has been suboptimal. Conflicting information in the media leads to parental anxiety and confusion around COVID-19 vaccination in children. The scepticism expressed by certain experts regarding the importance of COVID-19 vaccines in children has also had a negative impact on parental attitudes towards COVID-19 vaccination. This study aimed to understand parental concerns and preferences for paediatric COVID-19 vaccination, and identify potential vaccination promotion ("nudge") interventions to optimise paediatric COVID-19 vaccine uptake. METHODS Mixed methods including Focus Group Discussions and a Discrete Choice Experiment survey were used. The Discrete Choice Experiment survey design was based on a literature review and the findings of Focus Group Discussions. The study was conducted on a nationally representative sample of parents in Australia. RESULTS In total, 1039 parents participated in the study. Parents showed strong preferences for a COVID-19 vaccine with lower risk of serious side effects and longer protection duration, followed by higher vaccine effectiveness and delivery via oral tablets. Promotion strategies were similarly preferred by parents. Latent class logit analysis identified three groups, interpretable as COVID-19 vaccine "accepters (35.3%)", "deliberators (31.7%)", and "rejecters (33.1%)". The "deliberators" composed of more parents, residing in metropolitan areas, having concerns about vaccine effectiveness, and believing that disease risks outweigh vaccine benefits than the "accepters". The "rejecters" were more likely to not be vaccinated themselves, and generally have less trust in vaccines than the "accepters". The "deliberators" and "rejecters" were less likely to be parents aged ≥25 years and complete final year of high school than the "accepters". CONCLUSIONS Parents' sociodemographic factors and vaccine perceptions were associated with different levels of acceptance toward paediatric COVID-19 vaccination, which may help to better understand how to "nudge" vaccine hesitancy.
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Affiliation(s)
- Bing Wang
- Vaccinology and Immunology Research Trials Unit, Women's and Children's Health Network, Adelaide, South Australia, Australia; Robinson Research Institute and Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia.
| | - Joshua McDonough
- Vaccinology and Immunology Research Trials Unit, Women's and Children's Health Network, Adelaide, South Australia, Australia; Robinson Research Institute and Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia
| | - Gang Chen
- Centre for Health Economics, Monash University, Melbourne, Victoria, Australia
| | - Jason J Ong
- Central Clinical School, Monash University, Melbourne, Victoria, Australia; Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Helen Marshall
- Vaccinology and Immunology Research Trials Unit, Women's and Children's Health Network, Adelaide, South Australia, Australia; Robinson Research Institute and Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia
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Lan Z, Yan J, Yang Y, Tang Z, Guo X, Wu Z, Jin Q. Effectiveness of COVID-19 vaccines among children and adolescents against SARS-CoV-2 variants: a meta-analysis. Eur J Pediatr 2023; 182:5235-5244. [PMID: 37768334 DOI: 10.1007/s00431-023-05216-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 09/11/2023] [Accepted: 09/15/2023] [Indexed: 09/29/2023]
Abstract
This systematic review and meta-analysis aimed to evaluate the effectiveness of COVID-19 vaccines among children and adolescents against SARS-CoV-2 variants. We searched PubMed, Embase, Web of Science, the Cochrane Library, and ClinicalTrials.gov for studies published on or before June 20, 2023. Studies evaluating the effectiveness of COVID-19 vaccines in children and adolescents (≤ 18 years of age) were included. Data extraction, quality assessment, and analysis were conducted following PRISMA guidelines. Ten studies were included, comprising five cohort studies (527,778 participants) and four case-control studies (1,477,422 participants). The overall vaccine effectiveness (VE) against SARS-CoV-2 variants was 68% (95% CI = 60-74%). In terms of age, the VE was higher in adolescents aged 12-18 years [69%(95% CI = 61-75%)] than in children aged 5-11 years [44%(95% CI = 1-68%)]. "Fully vaccinated" may offer greater protection than "partially vaccinated," with a VE of 71% (95%CI = 59-79%) and 66% (95%CI = 51-76%), respectively. Conclusion: This meta-analysis presents moderate-quality evidence that the COVID-19 vaccine is effective in safeguarding children and adolescents from the SARS-CoV-2 variant. Being fully vaccinated may offer greater protection than being partially vaccinated. Nevertheless, additional high-quality controlled trials are required to verify this finding. What is Known: • The COVID-19 pandemic has led to the rapid development and deployment of vaccines worldwide. Children and adolescents are a unique population for vaccination, and the effectiveness of vaccines against SARS-CoV-2 variants in this age group is of concern. What is New: • The COVID-19 vaccine is effective in protecting children and adolescents against the SARS-CoV-2 variant. Being fully vaccinated may offer greater protection than being partially vaccinated.
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Affiliation(s)
- Zhibin Lan
- Ningxia Medical University, The General Hospital of Ningxia Medical University, 804 Shengli South Street, Ningxia Hui Autonomous Region, 750004, Yinchuan, China
- Institute of Medical Sciences, General Hospital of Ningxia Medical University, Yinchuan, Ningxia, 750004, China
| | - Jiangbo Yan
- Ningxia Medical University, The General Hospital of Ningxia Medical University, 804 Shengli South Street, Ningxia Hui Autonomous Region, 750004, Yinchuan, China
- Institute of Medical Sciences, General Hospital of Ningxia Medical University, Yinchuan, Ningxia, 750004, China
| | - Yang Yang
- Ningxia Medical University, The General Hospital of Ningxia Medical University, 804 Shengli South Street, Ningxia Hui Autonomous Region, 750004, Yinchuan, China
- Institute of Medical Sciences, General Hospital of Ningxia Medical University, Yinchuan, Ningxia, 750004, China
| | - Zhiqun Tang
- Ningxia Medical University, The General Hospital of Ningxia Medical University, 804 Shengli South Street, Ningxia Hui Autonomous Region, 750004, Yinchuan, China
| | - Xuefang Guo
- Quanzhou Orthopedic-Traumatological Hospital, Quanzhou, China
| | - Zhiqiang Wu
- Quanzhou Orthopedic-Traumatological Hospital, Quanzhou, China
| | - Qunhua Jin
- Ningxia Medical University, The General Hospital of Ningxia Medical University, 804 Shengli South Street, Ningxia Hui Autonomous Region, 750004, Yinchuan, China.
- Institute of Medical Sciences, General Hospital of Ningxia Medical University, Yinchuan, Ningxia, 750004, China.
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Patient-Guided Talking Points to Address COVID-19 and General Vaccine Hesitancy. PHARMACY 2022; 10:pharmacy10050137. [PMID: 36287458 PMCID: PMC9611272 DOI: 10.3390/pharmacy10050137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 10/10/2022] [Accepted: 10/13/2022] [Indexed: 11/25/2022] Open
Abstract
Vaccination remains one of the most effective ways to limit spread of disease. Waning public confidence in COVID-19 vaccines has resulted in reduced vaccination rates. In fact, despite vaccine availability, many individuals choose to delay COVID-19 vaccination resulting in suboptimal herd immunity and increased viral mutations. A number of qualitative and quantitative studies have been conducted to identify, understand, and address modifiable barriers and factors contributing to COVID-19 vaccine hesitancy among individuals with access to vaccine. Vaccine confidence may be improved through targeted patient–provider discussion. More patients are turning to pharmacists to receive their vaccinations across the lifespan. The primary goal of this commentary is to share evidence-based, patient talking points, tailored by practicing pharmacists, to better communicate and address factors contributing to vaccine hesitancy and reduced vaccine confidence.
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