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Gonzalez H, Patel MS, Pehlivanova M, Burke RV. Assessing Trust in Physician and Vaccine Hesitancy Among Hispanic/Latinx Parents. HISPANIC HEALTH CARE INTERNATIONAL 2024; 22:74-82. [PMID: 37438967 DOI: 10.1177/15404153231187379] [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] [Indexed: 07/14/2023]
Abstract
Introduction: Representing the USA's largest ethnic/racial group, Hispanic/Latinx (HL) experience health challenges of proportional magnitude. This study investigates the prevalence of vaccine hesitancy among HL adults and trust in their child's pediatrician. Methods: HL parents of children who receive medical care at one of the largest Federally Qualified Health Centers in the United States completed a survey examining associations between physician trust, vaccine hesitancy, and demographics. Data were subjected to ANOVA via SAS9 version 9.0 (Cary, NC) and SPSS version 27 (Chicago, IL) software. Results: With a total of 500 surveys completed (51% response rate; 81% completion rate), the prevalence of vaccine hesitancy amounted to 15.4% (n = 77). Parents with university-level education displayed higher levels of trust and perceptions in favor of routine vaccination practices (p < .01). When medical visits were conducted in Spanish, parents exhibited lower levels of trust and were more vaccine-hesitant (p < .01). Conclusions: Vaccine literacy must be prioritized in early education to reach parents who may not achieve college degrees. Ensuring language concordance within patient-physician dyads may maximize the potential for vaccine uptake and physician trust.
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Affiliation(s)
- Hector Gonzalez
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Mona S Patel
- Department of General Pediatrics, Children's Hospital of Los Angeles, Los Angeles, CA, USA
| | - Marieta Pehlivanova
- Department of Psychiatry and Neurobehavioral Sciences, University of Virginia School of Medicine, Charlottesville, VA, USA
| | - Rita V Burke
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
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2
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Datta BK, Coughlin SS, Majeed B. Inequities in routine preventive care utilization among persons with overweight/obesity in the United States: An analysis of nativity, racial and ethnic identity, and socioeconomic status. DIALOGUES IN HEALTH 2023; 2:100125. [PMID: 37377782 PMCID: PMC10292657 DOI: 10.1016/j.dialog.2023.100125] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 03/06/2023] [Accepted: 03/10/2023] [Indexed: 06/29/2023]
Abstract
Extant literature documented various health disparities among immigrants and racial and ethnically marginalized individuals in the United States. However, health disparities in the intersection of nativity and race are generally less visited. This cross-sectional study assessed utilization of routine preventive care among adults with overweight/obesity at the junction of their nativity, racial/ethnic identity, and socioeconomic status (i.e., income and education). Pooling data on 120,184 adults with overweight/obesity from the 2013-2018 waves of the National Health Interview Survey (NHIS), we estimated modified Poisson regressions with robust standard errors to obtain adjusted prevalence rates of preventive care visit, receiving flu shot, and having blood pressure, cholesterol and blood glucose screened. We found that immigrant adults with overweight/obesity had lower rates of utilization of all five preventive care services. However, these patterns varied by racial and ethnic sub-populations. While White immigrants had comparable rates of cholesterol and blood glucose screening, they had 2.7%, 2.9%, and 14.5% lower rates of preventive care visit, blood pressure screening, and getting a flu shot respectively, compared to native-born Whites. These patterns were similar for Asian immigrants as well. Black immigrants, on the other hand, had comparable rates of getting a flu shot and blood glucose screening, and had 5.2%, 4.9%, and 4.9% lower rates of preventive care visit, blood pressure screening, and cholesterol screening respectively. Lastly, the rates of utilization among Hispanic immigrants were significantly lower (ranging from 9.2% to 20%) than those of their native-born counterparts for all five preventive care services. These rates further varied by education, income, and length of stay in the US, within the racial and ethnic subgroups. Our findings thus suggest a complex relationship between nativity and racial/ethnic identity in relation to preventive care utilization among adults with overweight/obesity.
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Affiliation(s)
- Biplab Kumar Datta
- Institute of Public and Preventive Health, Augusta University, Augusta, GA, USA
- Department of Population Health Sciences, Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - Steven S. Coughlin
- Institute of Public and Preventive Health, Augusta University, Augusta, GA, USA
- Department of Population Health Sciences, Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - Ban Majeed
- Institute of Public and Preventive Health, Augusta University, Augusta, GA, USA
- Department of Population Health Sciences, Medical College of Georgia, Augusta University, Augusta, GA, USA
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3
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Zimmerman M, Zapata LP, Bachiller K, Devera JL, Hall TA, Casey SM, Pierre-Joseph N, Perkins RB. Comparison of attitudes toward routine maternal vaccines and COVID-19 vaccines among pregnant patients in an urban safety-net setting. J Natl Med Assoc 2023; 115:362-376. [PMID: 37210252 PMCID: PMC10194813 DOI: 10.1016/j.jnma.2023.04.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Accepted: 04/18/2023] [Indexed: 05/22/2023]
Abstract
OBJECTIVE To explore attitudes toward tetanus-diphtheria-acellular pertussis (Tdap), influenza, and COVID vaccines among English- and Spanish- speaking pregnant individuals in a safety net setting. METHODS Pregnant people aged 18 years or older were recruited from outpatient clinics between August 2020 and June 2021. Interviews were conducted via phone in English or Spanish, recorded, transcribed, and translated verbatim. Data were qualitatively analyzed using modified grounded theory and content analysis. RESULTS 42 patients participated (22 English-speaking, 20 Spanish-speaking). Most participants expressed positive attitudes towards both routine prenatal vaccinations and COVID-19 vaccines, endorsing the belief that vaccines promote health and considering vaccines a social norm. Positive attitudes were similar for the three vaccines, and among Spanish- and English-speaking individuals. Participants trusted their healthcare provider's recommendations and felt comfortable receiving booster doses of vaccines they had received successfully in the past. Vaccine concerns differed by each vaccine. Despite limited knowledge, few participants expressed concerns about Tdap vaccines. Concerns around influenza vaccines often stemmed from personal experience and centered around ineffectiveness and increased risk of flu-like illnesses. Participants expressed the most concerns related to COVID vaccinations, including misinformation about serious side effects and distrust around accelerated approval of the vaccines. Many participants wished to know more about the side effects and safety of vaccinating during pregnancy, especially regarding the fetus's health. CONCLUSIONS Most participants supported routine prenatal vaccinations, including COVID vaccines. Clinicians are trusted information sources and can help reinforce positive attitudes and social norms of receiving vaccinations in pregnancy while addressing vaccine-specific concerns. FUNDING This work was supported by Suzanne Cutler Vaccination Education & Research Fund at the Boston University Chobanian and Avedisian School of Medicine for funding and support.
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Affiliation(s)
- Margaux Zimmerman
- Boston University Chobanian and Avedisian School of Medicine, Boston, MA, United States
| | - Lesly P Zapata
- Boston University School of Public Health, Boston, MA, United States
| | - Karla Bachiller
- Boston University Chobanian and Avedisian School of Medicine, Boston, MA, United States
| | - Jean L Devera
- Boston University Chobanian and Avedisian School of Medicine, Boston, MA, United States
| | - Taylor A Hall
- Graduate of Medical Sciences, Boston University School of Medicine, Boston, MA, United States
| | - Sharon M Casey
- Boston University School of Public Health, Boston, MA, United States
| | - Natalie Pierre-Joseph
- Department of Pediatrics, Boston University Chobanian and Avedisian School of Medicine and Boston Medical Center, Boston, MA, United States
| | - Rebecca B Perkins
- Department of Obstetrics and Gynecology, Boston University Chobanian and Avedisian School of Medicine and Boston Medical Center, 775 Albany St, Dowling Buidling, Boston, MA 02118, United States.
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4
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Tsui J, Martinez B, Shin MB, Allee-Munoz A, Rodriguez I, Navarro J, Thomas-Barrios KR, Kast WM, Baezconde-Garbanati L. Understanding medical mistrust and HPV vaccine hesitancy among multiethnic parents in Los Angeles. J Behav Med 2023; 46:100-115. [PMID: 35107656 PMCID: PMC8808279 DOI: 10.1007/s10865-022-00283-9] [Citation(s) in RCA: 23] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 01/03/2022] [Indexed: 01/26/2023]
Abstract
Determinants of parental HPV vaccine hesitancy, including medical mistrust and exposure to negative vaccine information, are understudied in racial/ethnic minority communities where vaccine uptake is low. We conducted a cross-sectional survey (March 2021) among parents of adolescents, ages 9-17 years, from an academic enrichment program serving low-income, first-generation, underrepresented minority families in Los Angeles to understand determinants of parental HPV vaccine hesitancy. Parents completed self-administered surveys, including a 9-item HPV vaccine hesitancy scale, in either English, Spanish, or Chinese. Logistic regression was used to identify individual and interpersonal factors associated with parental hesitancy and adolescent HPV vaccination. One-fifth of parents (n = 357) reported high HPV vaccine hesitancy and > 50% reported concerns about safety or side effects. High medical mistrust was associated with high parental HPV vaccine hesitancy (adjusted-OR 1.69, 95% CI: 1.13, 2.37). Community-tailored and multilevel strategies to increase vaccine confidence are needed to improve HPV and other adolescent vaccinations.
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Affiliation(s)
- Jennifer Tsui
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
| | - Bibiana Martinez
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Michelle B Shin
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Alec Allee-Munoz
- Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Ivonne Rodriguez
- Leslie and William McMorrow Neighborhood Academic Initiative, University of Southern California, Los Angeles, CA, USA
| | - Jazmin Navarro
- Leslie and William McMorrow Neighborhood Academic Initiative, University of Southern California, Los Angeles, CA, USA
| | - Kim R Thomas-Barrios
- Leslie and William McMorrow Neighborhood Academic Initiative, University of Southern California, Los Angeles, CA, USA
| | - W Martin Kast
- Department of Molecular Microbiology and Immunology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Lourdes Baezconde-Garbanati
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
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5
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Shin MB, Sloan KE, Martinez B, Soto C, Baezconde-Garbanati L, Unger JB, Kast WM, Cockburn M, Tsui J. Examining multilevel influences on parental HPV vaccine hesitancy among multiethnic communities in Los Angeles: a qualitative analysis. BMC Public Health 2023; 23:545. [PMID: 36949438 PMCID: PMC10031192 DOI: 10.1186/s12889-023-15318-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 02/24/2023] [Indexed: 03/24/2023] Open
Abstract
BACKGROUND Human papillomavirus (HPV) vaccine hesitancy is a growing concern in the United States, yet understudied among racial/ethnic minority parents. We conducted qualitative research to understand parental HPV vaccine hesitancy and inform community-specific, multilevel approaches to improve HPV vaccination among diverse populations in Los Angeles. METHODS We recruited American Indian/Alaska Native (AI/AN), Hispanic/Latino/a (HL) and Chinese parents of unvaccinated children (9-17 years) from low-HPV vaccine uptake regions in Los Angeles for virtual focus groups (FGs). FGs were conducted in English (2), Mandarin (1), and Spanish (1) between June-August 2021. One English FG was with AI/AN-identifying parents. FGs prompted discussions about vaccine knowledge, sources of information/hesitancy, logistical barriers and interpersonal, healthcare and community interactions regarding HPV vaccination. Guided by the social-ecological model, we identified multilevel emergent themes related to HPV vaccination. RESULTS Parents (n = 20) in all FGs reported exposure to HPV vaccine information from the internet and other sources, including in-language media (Mandarin) and health care providers (Spanish). All FGs expressed confusion around the vaccine and had encountered HPV vaccine misinformation. FGs experienced challenges navigating relationships with children, providers, and friends/family for HPV vaccine decision-making. At the community-level, historical events contributed to mistrust (e.g., forced community displacement [AI/AN]). At the societal-level, transportation, and work schedules (Spanish, AI/AN) were barriers to vaccination. Medical mistrust contributed to HPV vaccine hesitancy across the analysis levels. CONCLUSION Our findings highlight the importance of multilevel influences on parental HPV vaccine hesitancy and decision-making and the need for community-specific messaging to combat medical mistrust and other barriers to HPV vaccination among racial/ethnic minority communities.
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Affiliation(s)
- Michelle B Shin
- Department of Child, Family, and Population Health Nursing, School of Nursing, University of Washington, Seattle, WA, United States
| | - Kylie E Sloan
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Bibiana Martinez
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Claradina Soto
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Lourdes Baezconde-Garbanati
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Jennifer B Unger
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - W Martin Kast
- Department of Molecular Microbiology & Immunology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Myles Cockburn
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Jennifer Tsui
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
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6
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Fisher C, Bragard E, Madhivanan P. COVID-19 Vaccine Hesitancy among Economically Marginalized Hispanic Parents of Children under Five Years in the United States. Vaccines (Basel) 2023; 11:599. [PMID: 36992183 PMCID: PMC10052092 DOI: 10.3390/vaccines11030599] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 03/01/2023] [Accepted: 03/03/2023] [Indexed: 03/08/2023] Open
Abstract
Hispanic children in the US have high rates of COVID-19-related hospitalizations and deaths. Following FDA emergency approval, COVID-19 vaccination rates for young children under five years have been alarmingly low, especially in border states with significant Hispanic populations. This study identified social and cultural determinants of COVID-19 vaccine hesitancy among economically marginalized Hispanic parents of children under five. In 2022, following FDA approval, 309 Hispanic female guardians in US border states responded to an online survey assessing parental intent to vaccinate their child, demographic characteristics, COVID-19 health and vaccine beliefs, trust in traditional sources of health information, physician and community support, and acculturation to Anglo American norms. The majority (45.6%) did not intend to vaccinate their child or were unsure (22.0%). Kendall's tau-b indicated vaccine acceptance was negatively associated with COVID-19 specific and general vaccine distrust, belief the vaccine was unnecessary, time living in the U.S., and language acculturation (range tb = -0.13 to -0.44; p = 0.05-0.001) and positively related to trust in traditional resources, doctor's recommendation, child's age, household income and parent education (range tb = 0.11 to 0.37; p = 0.05-0.001). This research highlights the importance of COVID-19 vaccination public health strategies that draw on Hispanic cultural values, community partnerships and enhanced pediatrician communication regarding routine and COVID-19-specific vaccinations.
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Affiliation(s)
- Celia Fisher
- Department of Psychology, Fordham University, Bronx, New York, NY 10458, USA
| | - Elise Bragard
- Department of Psychology, Fordham University, Bronx, New York, NY 10458, USA
| | - Purnima Madhivanan
- Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ 85721, USA
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7
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Scheiber A, Prinster TB, Stecko H, Wang T, Scott S, Shah SH, Wyne K. COVID-19 Vaccination Rates and Vaccine Hesitancy Among Spanish-Speaking Free Clinic Patients. J Community Health 2023; 48:127-135. [PMID: 36315301 PMCID: PMC9619016 DOI: 10.1007/s10900-022-01150-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/12/2022] [Indexed: 11/06/2022]
Abstract
We sought to assess COVID-19 vaccination rates, as well as attitudes and beliefs towards the vaccine, of patients in a Spanish-speaking student-run free clinic in Columbus, Ohio. A cross-sectional study was performed. Surveys were distributed to all individuals over 18 years who presented to La Clínica Latina between July, 2022 and September, 2022. A convenience sample was used: patients in the waiting room and their accompanying family members or friends were invited to participate. Subjects were excluded if under the age of 18 or over the age of 75, or if non-Spanish speaking. Of the 158 individuals who agreed to participate in our study, 146 responded to the question regarding vaccination status, revealing 90.4% of respondents had received a COVID-19 vaccination. Most respondents learned about the vaccine from social media (26.4%) or television (22.7%). The majority of participants sought answers to questions surrounding the vaccine by asking their doctor (49.1%). The most common reason among unvaccinated participants for not undergoing vaccination was fear of an adverse reaction to the vaccine (n = 11). We found that a large proportion (90.4%) of individuals seeking care at a Spanish-speaking free clinic were vaccinated against COVID-19. Our study also provides perspective on the means of health knowledge acquisition and behaviors in this predominantly Latinx patient population in central Ohio. We can utilize our results to optimize and tailor clinic services and initiatives for COVID-19 boosters to meet the needs of this community.
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Affiliation(s)
- Alexandra Scheiber
- The Ohio State University College of Medicine, 370 W 9th Ave, Columbus, OH, 43210, USA.
| | - Teresa B. Prinster
- The Ohio State University College of Medicine, 370 W 9th Ave, Columbus, OH 43210 USA
| | - Hunter Stecko
- The Ohio State University College of Medicine, 370 W 9th Ave, Columbus, OH 43210 USA
| | - Tina Wang
- The Ohio State University College of Medicine, 370 W 9th Ave, Columbus, OH 43210 USA
| | - Sara Scott
- Contra Costa Regional Medical Center, Martinez, CA USA
| | - Summit H. Shah
- Department of Radiology, Nationwide Children’s Hospital, Columbus, OH USA
| | - Kathleen Wyne
- Division of Endocrinology, Diabetes, and Metabolism, The Ohio State University Wexner Medical Center, Columbus, OH USA
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8
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Liu PL, Zhao X, Wan B. COVID-19 information exposure and vaccine hesitancy: The influence of trust in government and vaccine confidence. PSYCHOL HEALTH MED 2023; 28:27-36. [PMID: 34875950 DOI: 10.1080/13548506.2021.2014910] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
As the novel coronavirus (COVID-19) continues to spread, vaccine hesitancy increasingly threats public health worldwide. Health information from traditional, online and social media may influence vaccine hesitancy. The purpose of this study was to explore the influence of exposure to COVID-19 information from various media on vaccine hesitancy, as well as the mediating roles of public trust in government and vaccine confidence. With a sample of 438 online participants (mean age = 30.69 years) responding to an anonymous questionnaire, the study tested a mediation model using bias-corrected bootstrap. The results indicated that exposure to COVID-19 information from online news media and traditional media can reduce vaccine hesitancy indirectly. Whereas a positive and indirect relationship between COVID-19 information exposure on social media and vaccine hesitancy was revealed. Trust in government and vaccine confidence were found to be salient mediators between exposure to COVID-19 information from various media and vaccine hesitancy. Findings from this study offer implications for strategies to address vaccine hesitancy.
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Affiliation(s)
| | - Xinshu Zhao
- Department of Communication, University of Macau, Macao, Macao
| | - Bo Wan
- Institute of Neurology, University College London, London
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Daniels D, Imdad A, Buscemi-Kimmins T, Vitale D, Rani U, Darabaner E, Shaw A, Shaw J. Vaccine hesitancy in the refugee, immigrant, and migrant population in the United States: A systematic review and meta-analysis. Hum Vaccin Immunother 2022; 18:2131168. [PMID: 36332155 PMCID: PMC9746503 DOI: 10.1080/21645515.2022.2131168] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Refugees, immigrants, and migrants (RIM) in the United States (US) have been identified as an underimmunized population prior to the COVID-19 pandemic. Vaccine acceptance is critical to combat the public health threat incited by COVID-19 and other vaccine-preventable disease. To better understand escalating vaccine hesitancy among US RIM, a comprehensive evaluation of the problem and solutions is necessary. In this systematic review, we included 57 studies to describe vaccination rates, barriers, and interventions addressing vaccine hesitancy over the past decade. Meta-analysis was performed among 22 studies, concluding that RIM represent an underimmunized population compared to the general US population. Narrative synthesis and qualitative methods were used to identify critical barriers, including gaps in knowledge, poor access to medical care, and heightened distrust of the medical system. Our results demonstrate the need for effective, evidence-based interventions to increase vaccination rates among diverse RIM populations.
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Affiliation(s)
- Danielle Daniels
- Department of Pediatrics, Division of Infectious Diseases, Upstate Golisano Children’s Hospital, SUNY Upstate Medical University, Syracuse, NY, USA,CONTACT Danielle Daniels 750 East Adams St. Room 5400, Syracuse, NY13210, USA
| | - Aamer Imdad
- Department of Pediatrics, Karjoo Family Center for Pediatric Gastroenterology, SUNY Upstate Medical University, Syracuse, NY, USA
| | | | - Danielle Vitale
- Norton College of Medicine, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Uzma Rani
- Department of Pediatrics, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Ellen Darabaner
- Hunter-Rice Health Sciences Library, Samaritan Medical Center, Watertown, NY, USA
| | - Andrea Shaw
- Department of Pediatrics, Department of Internal Medicine, Institute for Global Health and Translational Science, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Jana Shaw
- Department of Pediatrics, Division of Infectious Diseases, Upstate Golisano Children’s Hospital, SUNY Upstate Medical University, Syracuse, NY, USA
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10
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Siena LM, Isonne C, Sciurti A, De Blasiis MR, Migliara G, Marzuillo C, De Vito C, Villari P, Baccolini V. The Association of Health Literacy with Intention to Vaccinate and Vaccination Status: A Systematic Review. Vaccines (Basel) 2022; 10:1832. [PMID: 36366341 PMCID: PMC9692286 DOI: 10.3390/vaccines10111832] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 10/23/2022] [Accepted: 10/27/2022] [Indexed: 08/29/2023] Open
Abstract
Despite health literacy (HL) being recognized as a driver of health-promoting behavior, its influence on the vaccination decision-making process remains unclear. This study summarized current evidence on the association between HL and both intention to vaccinate and vaccination status. We searched PubMed, Scopus, and Web of Science, retrieving observational studies published until January 2022 that used HL-validated tools to investigate the above associations for any vaccine. Quality was assessed using the Newcastle-Ottawa scale. Twenty-one articles were included; of these, six investigated the intention to vaccinate and the remainder vaccination status. Articles on intention looked at SARS-CoV-2 vaccination using heterogeneous HL tools and were of high/fair quality. Vaccination status, mainly for influenza or pneumococcal vaccines, was explored using various HL tools; the quality was generally high. We found inconsistent results across and within vaccine types, with no clear conclusion for either vaccination intention or status. A weak but positive association was reported between a high HL level and influenza vaccination uptake for individuals aged more than 65 years. HL did not seem to significantly influence behavior towards vaccination. Differences in the methods used might explain these results. Further research is needed to investigate the role of HL in the vaccination decision-making process.
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Affiliation(s)
| | - Claudia Isonne
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
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11
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Frisco ML, Van Hook J, Thomas KJA. Racial/ethnic and nativity disparities in U.S. Covid-19 vaccination hesitancy during vaccine rollout and factors that explain them. Soc Sci Med 2022; 307:115183. [PMID: 35843179 PMCID: PMC9242888 DOI: 10.1016/j.socscimed.2022.115183] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 06/24/2022] [Accepted: 06/26/2022] [Indexed: 01/26/2023]
Abstract
While research has begun to investigate disparities in Covid-19 vaccine hesitancy between White, Black and Hispanic adults, no nationally representative studies to date have accounted for Hispanic immigrants as a unique group or fully investigated the reasons behind racial/ethnic and nativity disparities. We make these contributions by substantively drawing from what is known about the ways that immigrant fear and structural racism create conditions that produce countervailing forces that are likely to contribute to racial/ethnic and nativity disparities in vaccine hesitancy. We use OLS regression and decomposition techniques to analyze data from 1936 18-65 year-old United States (U.S.) adults who participated in the COVID-19 and its Implications for American Communities (CIAC) study during February and March 2021, a period of time that coincides with early stages of the U.S. vaccine roll-out effort that pre-dated universal adult eligibility for Covid-19 vaccination. Results indicate that U.S.-born Black adults are more vaccine hesitant than U.S.-born White adults. This disparity is largely due to differences in anti-vaccine beliefs. U.S.-born Hispanic adults are less vaccine hesitant than U.S.-born White adults in adjusted OLS regression models and personal experiences with Covid-19 drive this difference. There were not significant differences between foreign-born Hispanic and U.S.-born White adults in vaccine hesitancy. These findings suggest that foreign-born Hispanic adults did not drive early disparities in vaccine hesitancy and that alleviating concerns about anti-vaccine beliefs and utilizing personal stories have important roles in preventing future racial/ethnic disparities in Covid-19 vaccine hesitancy as new Covid-19 vaccines and booster shots are rolled out. Study findings may also have implications for reducing racial/ethnic disparities in the uptake of other new vaccines.
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Affiliation(s)
- Michelle L Frisco
- Penn State University Department of Sociology & Criminology and Population Research Institute, 211 Oswald Tower, University Park, PA, 16802, United States.
| | - Jennifer Van Hook
- Penn State University Department of Sociology & Criminology and Population Research Institute, 211 Oswald Tower, University Park, PA, 16802, United States
| | - Kevin J A Thomas
- University of Texas-Austin Department of African and African Diaspora Studies and Population Research Center, 116 Inner Campus Dr. Stop G6000, Austin, TX, 181712, United States
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12
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Ortiz AC, Akgün KM, Bazan IS. Embracing the Diversity of Latinx Communities to Promote Vaccinations. THE YALE JOURNAL OF BIOLOGY AND MEDICINE 2022; 95:257-263. [PMID: 35782479 PMCID: PMC9235259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
While vaccine hesitancy is well documented in the literature among the Latinx community, little attention or effort is given to the nuances among the members of individual communities, such as country of origin, immigration status, generational status, primary language, race, age, sex, gender, or rural residence and how these complexities affect vaccine messaging and uptake. We have evidence that this heterogeneity causes differences in access to healthcare, attitudes towards vaccines, and degree of health disparities. In this review we will describe their impact on vaccination rates in the Latinx community, highlighting missed opportunities for public health outreach, and how targeted messaging could improve vaccine uptake.
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Affiliation(s)
- Alexander C. Ortiz
- Department of Medicine, Yale School of Medicine, New
Haven, CT, USA,To whom all correspondence should be addressed:
Alexander Ortiz, MD, MS, Department of Internal Medicine, Yale University School
of Medicine;
| | - Kathleen M. Akgün
- Pulmonary, Critical Care and Sleep Medicine, VA
Connecticut Healthcare System, West Haven, CT, USA,Section of Pulmonary, Critical Care, & Sleep
Medicine, Yale University School of Medicine, New Haven, CT, USA
| | - Isabel S. Bazan
- Section of Pulmonary, Critical Care, & Sleep
Medicine, Yale University School of Medicine, New Haven, CT, USA
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13
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Moussaoui S, Combes S, Ibanez G, Gautier A, Relyea B, Vignier N. Are immigrants living in France more reluctant to receive vaccines than native-born French citizens? findings from the national health Barometer study. Vaccine 2022; 40:3869-3883. [DOI: 10.1016/j.vaccine.2022.05.041] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 04/12/2022] [Accepted: 05/14/2022] [Indexed: 01/04/2023]
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14
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Factors associated with COVID-19 vaccine intent among Latino SNAP participants in Southern California. BMC Public Health 2022; 22:653. [PMID: 35382803 PMCID: PMC8981200 DOI: 10.1186/s12889-022-13027-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 03/18/2022] [Indexed: 01/04/2023] Open
Abstract
Background COVID-19 is significantly impacting the health and well-being of the country, particularly for ethnic minority populations and low-income groups. Our goal was to determine COVID-19 vaccination intent in a low-income, Latino population receiving aid from the Supplemental Nutrition Assistance Program (SNAP) in Southern California, and identify contributing factors and concerns. Methods A cross-sectional, mixed-methods survey was conducted among participants in the Southern California Nutrition Incentives Program (¡Más Fresco! More Fresh). Only Latino respondents were included in this analysis. Primary outcome was vaccine intent trichotomized into: “definitely/likely yes”, “not sure/don’t know”, and “definitely/likely not.” Results The majority of participants (n = 486) were female (93%), Spanish speaking (74%), with a median age of 40 years (IQR = 13). Approximately half (48%) reported they would get a COVID-19 vaccine, 39% were unsure, and 13% reported “definitely/likely not”. In the multivariable multinomial logistic regression model, participants with a household member with a COVID-19 health risk factor were more likely to be unsure about getting the vaccine. Participants who were primarily English speaking, did not receive the influenza vaccine last season, and reported not reading or talking about COVID-19 were more likely to report not intending to receive the vaccine. Many respondents were concerned about “side effects and ingredients”, and did not trust the vaccine development process, particularly with how fast it happened. Conclusion Low-income Latinos in Southern California were generally hesitant to get a COVID-19 vaccine. Culturally sensitive vaccine promotion campaigns need to address the concerns of minority populations who experience increased morbidity and mortality from COVID-19. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13027-w.
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15
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Heintzman J, Hwang J, Quiñones AR, Guzman CEV, Bailey SR, Lucas J, Giebultowicz S, Chan B, Marino M. Influenza and pneumococcal vaccination delivery in older Hispanic populations in the United States. J Am Geriatr Soc 2022; 70:854-861. [PMID: 34854478 PMCID: PMC9904430 DOI: 10.1111/jgs.17589] [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: 07/14/2021] [Revised: 09/29/2021] [Accepted: 10/24/2021] [Indexed: 11/29/2022]
Abstract
INTRODUCTION National reports suggest that Hispanic patients may underutilize influenza and pneumococcal vaccination, although studies sometimes conflict on this point. A clearer picture of adult immunization utilization in older Hispanic patients is necessary to ensure equity in adult vaccinations. METHODS Using electronic health records from 648 community health centers (CHCs) across 21 states, we compared English-preferring Hispanic patients, Spanish-preferring Hispanic patients, and Non-Hispanic White (NHW) adults aged ≥50 years across five outcomes between 2012-2017: (1) Odds of ever receiving pneumococcal vaccination after age 65, (2) Odds of ever receiving ≥2 pneumococcal vaccinations for those ≥65, (3) odds of vaccination between the ages of 50 and 64 for those with diabetes or heart disease, (4) odds of influenza vaccine, and (5) annual rate of influenza vaccination. RESULTS Of our total study sample (N = 143,869), 85,562 were age 50-64 during the entire study period, and 65,977 were ≥65 at some point during the study period. In patients aged 50-64, Spanish-preferring Hispanic patients were more likely to have ever had an influenza vaccination (covariate-adjusted odds ratio [aOR] = 1.33, 95% CI = 1.29-1.37), had higher rates of annual influenza vaccination (covariate-adjusted rate ratio [aRR] = 1.41, 95% CI = 1.38-1.44), and higher odds of pneumococcal vaccination (aOR = 1.87, 95% CI = 1.76-1.98) than NHW patients. These findings were similar in Spanish-preferring Hispanic patients ≥65. English-preferring Hispanics ≥65 were less likely than NHW patients to ever have an influenza vaccination (aOR = 0.91, 95% CI = 0.85-0.98) and to have ever received at least one (aOR = 0.92, 95% CI = 0.86-0.99) or two (aOR = 0.86, 95% CI = 0.77-0.95) pneumococcal vaccine doses. CONCLUSIONS In a multistate CHC network, Spanish-preferring Hispanic patients were more likely to receive influenza and pneumococcal vaccinations than NHW patients; older English-preferring Hispanic patients were often less likely than NHW patients to receive these vaccinations. In vaccine initiatives, English-preferring Hispanic patients may be at higher risk of vaccination inequity.
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Affiliation(s)
- John Heintzman
- Associate Professor, Department of Family Medicine, Oregon Health and Science University (OHSU), 3381 Sw Sam Jackson Park Road, Portland, OR 97239
| | - Jun Hwang
- Oregon Health & Science University, Department of Family Medicine, Portland OR
| | - Ana R. Quiñones
- Oregon Health & Science University, Department of Family Medicine, Portland OR
| | | | - Steffani R Bailey
- Oregon Health & Science University, Department of Family Medicine, Portland OR
| | - Jennifer Lucas
- Oregon Health & Science University, Department of Family Medicine, Portland OR
| | | | - Brian Chan
- Oregon Health & Science University, Department of General Internal Medicine
| | - Miguel Marino
- Oregon Health & Science University, Department of Family Medicine, Portland OR
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16
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Sanders-Jackson A, Gonzalez M, Adams RB, Rhodes N. Social determinants of flu vaccine uptake among racial/ethnic minorities in the United States. Prev Med Rep 2021; 24:101516. [PMID: 34976601 PMCID: PMC8683944 DOI: 10.1016/j.pmedr.2021.101516] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 08/06/2021] [Accepted: 08/08/2021] [Indexed: 12/25/2022] Open
Abstract
Research on the social determinants of vaccine uptake often occur between racial/ethnic groups and not within groups. Though minoritized individuals face inequalities across the board, these are also not evenly distributed amongst minoritized individuals within groups. Using the National Health Interview Survey data, we examined disparities in flu vaccine uptake across racial/ethnic groups in the United States (US). We examined (a) NH (non-Hispanic) White (n = 32,655), (b) NH Asian (n = 2335), (c) NH African American (n = 5137), and (d) Hispanic (n = 5718) respondents who lived in the United States using the combined 2017 and 2018. We used multivariable logistic regression to predict flu vaccination (yes/no) both in models comparing racial/ethnic groups and within groups. Less than 50% of any of the four major racial/ethnic groups in the US received a flu vaccination in 2017–18. Flu vaccine uptake varied within racial and ethnic groups. These results suggest that increasing vaccination may require a complex, multi-faceted perspective that considers subgroups more directly.
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Affiliation(s)
- Ashley Sanders-Jackson
- Dept. of Advertising and Public Relations, Michigan State University, 404 Wilson Road, East Lansing, MI 48823, USA
| | - Mariaelena Gonzalez
- Department of Public Health, University of California, Merced, 5200 Lake Road, Merced, CA 95343, USA.,Health Science Research Institute, University of California, Merced, 5200 Lake Road, Merced, CA 95343, USA
| | - Robyn B Adams
- Dept. of Advertising and Public Relations, Michigan State University, 404 Wilson Road, East Lansing, MI 48823, USA
| | - Nancy Rhodes
- Dept. of Advertising and Public Relations, Michigan State University, 404 Wilson Road, East Lansing, MI 48823, USA
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17
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Cuellar NG, Lacey M, Remuzgo Artezano A, Zegers C, Mariñas Acevedo O, Williams JSJ, Mendigure J, Moran Parades GI. COVID-19 Behaviors and Beliefs Toward Immunizations among College Students in Lima, Peru. HISPANIC HEALTH CARE INTERNATIONAL 2021; 19:246-253. [PMID: 34693796 DOI: 10.1177/15404153211051091] [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: 11/16/2022]
Abstract
Introduction: Peru has experienced one of the highest rates of COVID-19 with only 27% of the population vaccinated. College students must make decisions on vaccination based on their belief and knowledge about immunizations. The purpose of this study was to describe COVID-19 behaviors and beliefs toward immunization among college students in Lima, Peru. Methods: Undergraduate students from Universidad Maria Auxiliadora (UMA) participated in this descriptive study. The CDC National 2009 H1N1 Flu Survey was adapted to measure behaviors and beliefs about immunizations of COVID-19. Results: 818 students participated in the study during the 2020 academic year. Significant differences were identified about taking vaccine when it was available by age (p = .02), gender (p < .001), marital status (p = .004), and income (p = .002). Significant associations were found between participants' ethnicity and location of last vaccination (p < .001) and race and reason to not receive the COVID-19 vaccine (p < .001). Conclusions: Peruvian students under the age of 32 are not eligible for the COVID-19 at this time. Findings can prepare academic institutions to promote education about the vaccine in this age group who have unique barriers in receiving health care and vaccinations.
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Affiliation(s)
| | - Micayla Lacey
- Nursing, 8059University of Alabama System, Tuscaloosa, USA
| | | | - Carli Zegers
- School of Nursing, 21638University of Kansas Medical Center, Kansas City, USA
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18
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Valdez RB, Romero KS. Improving Adult Vaccination Status in the United States. Healthcare (Basel) 2021; 9:healthcare9111411. [PMID: 34828459 PMCID: PMC8620051 DOI: 10.3390/healthcare9111411] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 10/09/2021] [Accepted: 10/13/2021] [Indexed: 11/16/2022] Open
Abstract
Adult immunization practices leave much to be desired. Misinformation has increased mistrust. As a result, Latino and African American populations have low rates of annual flu vaccinations and, during the COVID-19 pandemic, lag behind for COVID-19 vaccination. Historically, healthcare staff have failed to adhere to adult immunization guidelines contributing to patient infections. Healthcare staff, both clinical and non-clinical, must lead by example by making “prevention primary”. Most adults may not realize they need immunizations. We recommend the following steps to increase immunization uptake: Make adult immunization a standard of patient care as we do for children. Assess immunization status at every clinical opportunity. Strongly recommend vaccinations needed. Administer needed vaccinations, multiple if warranted. Document vaccines received by your patient. Participate in your state’s immunization registry and work with community organizations that can help make adult immunization the norm.
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Affiliation(s)
- R. Burciaga Valdez
- Department of Family & Community Medicine and Economics, University of New Mexico, Albuquerque, NM 87131-0001, USA
- Correspondence: or
| | - Korazon S. Romero
- School of Medicine, University of New Mexico, Albuquerque, NM 87131-0001, USA;
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19
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García-Grimshaw M, Ceballos-Liceaga SE, Hernández-Vanegas LE, Núñez I, Hernández-Valdivia N, Carrillo-García DA, Michel-Chávez A, Galnares-Olalde JA, Carbajal-Sandoval G, Del Mar Saniger-Alba M, Carrillo-Mezo RA, Fragoso-Saavedra S, Espino-Ojeda A, Blaisdell-Vidal C, Mosqueda-Gómez JL, Sierra-Madero J, Pérez-Padilla R, Alomía-Zegarra JL, López-Gatell H, Díaz-Ortega JL, Reyes-Terán G, Arauz A, Valdés-Ferrer SI. Neurologic adverse events among 704,003 first-dose recipients of the BNT162b2 mRNA COVID-19 vaccine in Mexico: A nationwide descriptive study. Clin Immunol 2021; 229:108786. [PMID: 34147649 PMCID: PMC8213977 DOI: 10.1016/j.clim.2021.108786] [Citation(s) in RCA: 74] [Impact Index Per Article: 24.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 06/10/2021] [Accepted: 06/15/2021] [Indexed: 12/29/2022]
Abstract
mRNA vaccines against SARS-CoV-2 are remarkably effective. Limited information exists about the incidence of adverse events following immunization (AEFI) with their use. We conducted a prospective observational study including data from 704,003 first-doses recipients; 6536 AEFI were reported, of whom 65.1% had at least one neurologic AEFI (non-serious 99.6%). Thirty-three serious events were reported; 17 (51.5%) were neurologic (observed frequency, 2.4/100,000 doses). At the time of writing this report, 16/17 cases had been discharged without deaths. Our data suggest that the BNT162b2 mRNA COVID-19 vaccine is safe; its individual and societal benefits outweigh the low percentage of serious neurologic AEFI. This information should help to dissipate hesitancy towards this new vaccine platform.
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Affiliation(s)
- Miguel García-Grimshaw
- Department of Neurology and Psychiatry, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | | | - Laura E Hernández-Vanegas
- Department of Neurology, Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez, Mexico City, Mexico
| | - Isaac Núñez
- Department of Internal Medicine, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | | | | | - Anaclara Michel-Chávez
- Department of Neurology and Psychiatry, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | | | | | - María Del Mar Saniger-Alba
- Department of Neurology and Psychiatry, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Roger A Carrillo-Mezo
- Department of Neuroradiology, Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez, Mexico City, Mexico
| | - Sergio Fragoso-Saavedra
- Department of Neurology and Psychiatry, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico; Programa de Estudios Combinados en Medicina (MD/PhD program), Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | | | | | | | - Juan Sierra-Madero
- Department of Infectious Diseases, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Rogelio Pérez-Padilla
- Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Mexico City, Mexico
| | | | | | | | - Gustavo Reyes-Terán
- Comisión Coordinadora de Institutos Nacionales de Salud y Hospitales de Alta Especialidad, Mexico City, Mexico
| | | | - Sergio Iván Valdés-Ferrer
- Department of Neurology and Psychiatry, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico; Secretaría de Salud, Gobierno de México, Mexico; Department of Infectious Diseases, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico; Feinstein Institutes for Medical Research, Manhasset, NY, USA.
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20
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Long A, Mathew S, Alvarez KS, Smartt J, Shah M, Madden C, Perl TM, Cerise FP, Bhavan KP. Co-Created Messaging for Influenza Vaccination in a High-Risk Hispanic Community Provides Groundwork for COVID-19 Vaccine. Health Equity 2021; 5:345-352. [PMID: 34084986 PMCID: PMC8170719 DOI: 10.1089/heq.2020.0132] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/14/2021] [Indexed: 01/07/2023] Open
Abstract
Purpose: Influenza/pneumonia is the eighth leading cause of death in the United States. The 2020-2021 influenza season is predicted to be further impacted by COVID-19 infections. Historical data reflect disproportionate morbidity and mortality rates in the Hispanic population for influenza and COVID-19. Influenza vaccination rates remain low in the Hispanic community. We aim to improve vaccination through a community-led event, partnering with the Cristo Rey School Dallas, located in a zip code with a higher age-adjusted influenza/pneumonia mortality rate. A survey was administered to adults attending the Influenza vaccine event to understand attitudes and perceptions about influenza, vaccination, and effective messaging strategies for the campaign. Methods: Messaging was cocreated with student health ambassadors to promote immunization and delivered through trusted sources. The health department administered vaccines to individuals >age 3 at no cost. Adults were asked to complete a 19-question survey postvaccination offered in both English and Spanish. Results: Two hundred and forty-one of 394 (61.2%) participants completed the survey. Ninety-eight percent identified as Hispanic/Latino, and the majority of surveys were administered in Spanish. Among Spanish language participants, the church bulletins (57.3%) and Spanish language radio (30.5%) were reported to be most effective modes of messaging versus word of mouth (32.9%) and social media (26.3%) for English-speaking participants. Sixteen percent of participants surveyed had never received an influenza vaccine before this event. Conclusion: Cocreated messaging delivered by trusted sources in the Hispanic community led to a successful Influenza vaccine drive with the Dallas County health department.
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Affiliation(s)
- Apple Long
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Sheryl Mathew
- Center for Innovation and Value, Parkland Health and Hospital System, Dallas, Texas, USA
| | - Kristin S Alvarez
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA.,Center for Innovation and Value, Parkland Health and Hospital System, Dallas, Texas, USA
| | - Jillian Smartt
- Center for Innovation and Value, Parkland Health and Hospital System, Dallas, Texas, USA
| | - Monal Shah
- Center for Innovation and Value, Parkland Health and Hospital System, Dallas, Texas, USA
| | - Christopher Madden
- Health Systems Operations Administration, UT Southwestern Medical Center, Dallas, Texas, USA
| | - Trish M Perl
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Fred P Cerise
- Center for Innovation and Value, Parkland Health and Hospital System, Dallas, Texas, USA
| | - Kavita P Bhavan
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA.,Center for Innovation and Value, Parkland Health and Hospital System, Dallas, Texas, USA
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21
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Dorman C, Perera A, Condon C, Chau C, Qian J, Kalk K, DiazDeleon D. Factors Associated with Willingness to be Vaccinated Against COVID-19 in a Large Convenience Sample. J Community Health 2021; 46:1013-1019. [PMID: 33835369 PMCID: PMC8033546 DOI: 10.1007/s10900-021-00987-0] [Citation(s) in RCA: 50] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/29/2021] [Indexed: 12/02/2022]
Abstract
Willingness and reasons to be vaccinated against COVID-19 were examined among 26,324 respondents who completed a survey on willingness and questions related to Confidence in vaccine safety, Complacency about the disease, Convenience of vaccination, tendency to Calculate risks versus benefits, and Concern for protecting others. Willingness to be vaccinated differed by age (p < 0.001), by race and ethnicity (p < 0.001) and by level of education (p < 0.001). Willingness generally increased with age and education. Asians were most willing to be vaccinated, followed by non-Hispanic Whites, Hispanics, and non-Hispanic Blacks (p < 0.001). Occupational groups differed in willingness (p < 0.001). Retired and students were more willing than all others (p < 0.001) followed by disabled or unemployed, healthcare workers, and educators. First Responders were least willing to be vaccinated (p < 0.001) followed by construction, maintenance and landscaping, homemakers, housekeeping, cleaning and janitorial workers, and retail and food service. The strongest predictor of willingness was confidence with the safety of the vaccine (r = 0.723, p < 0.001), followed by concern with protecting others by being vaccinated (r = 0.574, p < 0.001), and believing COVID-19 was serious enough to merit vaccination (r = 0.478, p < 0.00). Using multiple regression, confidence in safety was the strongest predictor for all groups. Protecting others was strongest for 13 of 15 demographic groups and 8 of 11 occupational groups. College educated, non-Hispanic Whites, first responders, construction, maintenance and landscape workers, housekeeping, cleaning and janitorial workers all gave greater weight to complacency about the disease. These results can help in designing programs to combat vaccine hesitancy.
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Affiliation(s)
- Casey Dorman
- Orange County Health Care Agency, Santa Ana, CA, 92660, USA.
| | - Anthony Perera
- Orange County Health Care Agency, Santa Ana, CA, 92660, USA
| | - Curt Condon
- Orange County Health Care Agency, Santa Ana, CA, 92660, USA
| | - Clayton Chau
- Orange County Health Care Agency, Santa Ana, CA, 92660, USA
| | - Jenny Qian
- Orange County Health Care Agency, Santa Ana, CA, 92660, USA
| | - Karin Kalk
- Orange County Health Care Agency, Santa Ana, CA, 92660, USA
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22
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Chan CP, Lee SS, Wong NS. Adherence of nurses to annual seasonal influenza vaccination over a 5-year period. J Hosp Infect 2021; 112:6-15. [PMID: 33640372 DOI: 10.1016/j.jhin.2021.02.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 02/10/2021] [Accepted: 02/18/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND Healthcare workers (HCWs) are at risk of influenza infection with associated nosocomial transmission. Sustained adherence to seasonal influenza vaccination uptake each year is important in epidemic control. AIM To assess the adherence of nurses to seasonal influenza vaccination over 5 years and its associated factors. METHODS A cross-sectional study was conducted among nurses after the winter influenza season in Hong Kong in March 2019. Based on influenza vaccine uptake rates in the 2014/15-2018/19 seasons, respondents were stratified into three groups: 'full adherence' (vaccine uptake in five seasons), 'partial adherence' (vaccine uptake in one to four seasons) and 'non-adherence' (no vaccine uptake). Stepwise multi-variable logistic regression was performed to determine the associations between adherence to annual influenza vaccination, respondents' characteristics and considerations for vaccination. FINDINGS Of 1306 nurses recruited, the majority were female (88%) with a median age of 36 years (interquartile range 30-46 years). The influenza vaccination uptake rate increased from 36% in the 2014/15 season to 47% in the 2018/19 season. After stratification, 39%, 40% and 21% of respondents were non-adherers, partial adherers and full adherers, respectively. Full adherence was significantly associated with female gender [adjusted odds ratio (aOR) 0.60], age ≥40 years (aOR 2.92), long-term care facility nurse (aOR 0.56), uptake during studentship (aOR 3.83), local prevalence of seasonal influenza (aOR 0.51) and expert opinion (aOR 4.04). CONCLUSIONS A limited proportion of nurses were fully adherent to seasonal influenza vaccination. Monitoring adherence, improving access to vaccines, and interventions targeting less-adherent HCWs are crucial.
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Affiliation(s)
- C P Chan
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - S S Lee
- Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - N S Wong
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong; Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Shatin, Hong Kong.
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23
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Murillo-Zamora E, Mendoza-Cano O, Delgado-Enciso I, Guzmán-Esquivel J. National retrospective cohort study to identify risk factors for in-hospital 30-day lethality in laboratory-confirmed cases of influenza. Rev Clin Esp 2021; 221:76-85. [PMID: 32674849 DOI: 10.1016/j.rce.2020.05.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 05/11/2020] [Accepted: 05/15/2020] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To identify factors associated with the risk of death in adolescent and adult inpatients with laboratory-positive (reverse-transcription polymerase chain reaction) influenza in Mexico during consecutive influenza seasons (2018-2020). PATIENTS AND METHODS A retrospective cohort study used national surveillance system data, enrolling 3422 individuals. The association between various risk factors and 30-day in-hospital lethality were evaluated through risk ratios (RR) and 95% confidence intervals (CI). RESULTS The lethality rate was 18.1%. Flu vaccination history (RR = 0.56, 95% CI 0.42-0.78), early antiviral drug administration (≤ two days from symptom onset [reference ≥ 5 days], RR = 0.68, 95% CI 0.58-0.81), and a history of asthma (RR = 0.66, 95% CI 0.47-0.95) showed protective effects against influenza-attributable death. Mechanical ventilator support produced the highest increase in death risk (RR = 3.31, 95% CI 2.89-3.79). Male sex, older age, AH1N1 subtype, and other chronic diseases were also associated with fatal in-hospital influenza-related outcomes. CONCLUSIONS Our findings highlight the major relevance of promoting immunization in high-risk individuals, together with ensuring early and effective antiviral management in suspected influenza cases.
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Affiliation(s)
- E Murillo-Zamora
- Departamento de Epidemiología, Unidad de Medicina Familiar No. 19, Instituto Mexicano del Seguro Social, Colima, México
| | - O Mendoza-Cano
- Facultad de Ingeniería Civil, Universidad de Colima, Colima, México
| | | | - J Guzmán-Esquivel
- Facultad de Medicina, Universidad de Colima, Colima, México; Unidad de Investigación en Epidemiología Clínica, Instituto Mexicano del Seguro Social, Colima, México.
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24
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Jiang LC, Chu TH, Sun M. Characterization of Vaccine Tweets During the Early Stage of the COVID-19 Outbreak in the United States: Topic Modeling Analysis. JMIR INFODEMIOLOGY 2021; 1:e25636. [PMID: 34604707 PMCID: PMC8448459 DOI: 10.2196/25636] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 12/30/2020] [Accepted: 06/21/2021] [Indexed: 04/28/2023]
Abstract
BACKGROUND During the early stages of the COVID-19 pandemic, developing safe and effective coronavirus vaccines was considered critical to arresting the spread of the disease. News and social media discussions have extensively covered the issue of coronavirus vaccines, with a mixture of vaccine advocacies, concerns, and oppositions. OBJECTIVE This study aimed to uncover the emerging themes in Twitter users' perceptions and attitudes toward vaccines during the early stages of the COVID-19 outbreak. METHODS This study employed topic modeling to analyze tweets related to coronavirus vaccines at the start of the COVID-19 outbreak in the United States (February 21 to March 20, 2020). We created a predefined query (eg, "COVID" AND "vaccine") to extract the tweet text and metadata (number of followers of the Twitter account and engagement metrics based on likes, comments, and retweeting) from the Meltwater database. After preprocessing the data, we tested Latent Dirichlet Allocation models to identify topics associated with these tweets. The model specifying 20 topics provided the best overall coherence, and each topic was interpreted based on its top associated terms. RESULTS In total, we analyzed 100,209 tweets containing keywords related to coronavirus and vaccines. The 20 topics were further collapsed based on shared similarities, thereby generating 7 major themes. Our analysis characterized 26.3% (26,234/100,209) of the tweets as News Related to Coronavirus and Vaccine Development, 25.4% (25,425/100,209) as General Discussion and Seeking of Information on Coronavirus, 12.9% (12,882/100,209) as Financial Concerns, 12.7% (12,696/100,209) as Venting Negative Emotions, 9.9% (9908/100,209) as Prayers and Calls for Positivity, 8.1% (8155/100,209) as Efficacy of Vaccine and Treatment, and 4.9% (4909/100,209) as Conspiracies about Coronavirus and Its Vaccines. Different themes demonstrated some changes over time, mostly in close association with news or events related to vaccine developments. Twitter users who discussed conspiracy theories, the efficacy of vaccines and treatments, and financial concerns had more followers than those focused on other vaccine themes. The engagement level-the extent to which a tweet being retweeted, quoted, liked, or replied by other users-was similar among different themes, but tweets venting negative emotions yielded the lowest engagement. CONCLUSIONS This study enriches our understanding of public concerns over new vaccines or vaccine development at early stages of the outbreak, bearing implications for influencing vaccine attitudes and guiding public health efforts to cope with infectious disease outbreaks in the future. This study concluded that public concerns centered on general policy issues related to coronavirus vaccines and that the discussions were considerably mixed with political views when vaccines were not made available. Only a small proportion of tweets focused on conspiracy theories, but these tweets demonstrated high engagement levels and were often contributed by Twitter users with more influence.
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Affiliation(s)
- Li Crystal Jiang
- Department of Media and Communication City University of Hong Kong Hong Kong Hong Kong
| | - Tsz Hang Chu
- Department of Media and Communication City University of Hong Kong Hong Kong Hong Kong
| | - Mengru Sun
- College of Media and International Culture Zhejiang University Hangzhou China
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Murillo-Zamora E, Mendoza-Cano O, Delgado-Enciso I, Guzmán-Esquivel J. National retrospective cohort study to identify risk factors for in-hospital 30-day lethality in laboratory-confirmed cases of influenza. Rev Clin Esp 2020; 221:76-85. [PMID: 33998492 DOI: 10.1016/j.rceng.2020.05.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 05/15/2020] [Indexed: 01/01/2023]
Abstract
OBJECTIVE To identify factors associated with the risk of death in adolescent and adult inpatients with laboratory-positive (reverse-transcription polymerase chain reaction) influenza in Mexico during consecutive influenza seasons (2018-2020). METHODS A retrospective cohort study used national surveillance system data, enrolling 3.422 individuals. The association between various risk factors and 30-day in-hospital lethality were evaluated through risk ratios (RRs) and 95% confidence intervals (CIs). RESULTS The lethality rate was 18.1%. Flu vaccination history (RR=0.56, 95% CI 0.42-0.78), early antiviral drug administration (≤2 days from symptom onset [reference ≥5 days], RR=0.68, 95% CI 0.58-0.81), and a history of asthma (RR=0.66, 95% CI 0.47-0.95) showed protective effects against influenza-attributable death. Mechanical ventilator support produced the highest increase in death risk (RR=3.31, 95% CI 2.89-3.79). Male sex, older age, AH1N1 subtype, and other chronic diseases were also associated with fatal in-hospital influenza-related outcomes. CONCLUSIONS Our findings highlight the major relevance of promoting immunization in high-risk individuals, together with ensuring early and effective antiviral management in suspected influenza cases.
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Affiliation(s)
- E Murillo-Zamora
- Departamento de Epidemiología, Unidad de Medicina Familiar No. 19, Instituto Mexicano del Seguro, Colima, Colima, Mexico
| | - O Mendoza-Cano
- Facultad de Ingeniería Civil, Universidad de Colima, km. 9 carretera Colima-Coquimatlán, Colima, Mexico
| | - I Delgado-Enciso
- Facultad de Medicina, Universidad de Colima, Av. Universidad 333, Colima, Mexico
| | - J Guzmán-Esquivel
- Facultad de Medicina, Universidad de Colima, Av. Universidad 333, Colima, Mexico; Unidad de Investigación en Epidemiología Clínica, Instituto Mexicano del Seguro Social, Colima, Mexico.
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The Acceptance of Key Public Health Interventions by the Polish Population Is Related to Health Literacy, But Not eHealth Literacy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17155459. [PMID: 32751180 PMCID: PMC7432801 DOI: 10.3390/ijerph17155459] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 07/25/2020] [Accepted: 07/27/2020] [Indexed: 12/16/2022]
Abstract
Background: Public health and health promotion rely on many different interventions, which range from health education and communication, through community mobilisation and changes to environmental conditions, to legal and fiscal actions. The introduction of the increased tax on sugar-sweetened beverages (SSB), popularly called sugar tax (ST), and a mandatory programme of vaccinations are the strategies inciting the most vivid discussions in Polish society. The study was intended to assess the determinants of the attitudes of Polish society regarding the ST and to vaccinations. Methods: For the analysis, the data originating from the survey of a representative adult sample of Polish society (n = 1000) was used. The survey was based on computer-assisted telephone interviewing (CATI). The assessment of the relationships between the selected variables and the opinions about the introduction of the ST and the safety and effectiveness of vaccinations were carried out using the chi2 test and univariate logistic regression models. Results: The acceptance of the ST and vaccination showed a significant relationship to the level of health literacy (HL) but not to eHealth literacy (eHL). Respondents having a higher rather than lower HL; older rather than younger; married rather than singles; retired, or on a disability pension, rather than vocationally active and nonusers of the Internet rather than users were more likely to show an acceptance for both interventions. Those more frequently using health care services and those with chronic diseases showed a greater belief in the safety and effectiveness of vaccinations. Conclusions: The relationship between the opinions of the two public health interventions analysed and the sociodemographic variables demonstrated similar patterns. Interestingly, the opinions were associated only with HL and not with eHL and users of the Internet were more sceptical about the interventions.
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Guclu OA, Demirci H, Ocakoglu G, Guclu Y, Uzaslan E, Karadag M. Relationship of pneumococcal and influenza vaccination frequency with health literacy in the rural population in Turkey. Vaccine 2019; 37:6617-6623. [PMID: 31542263 DOI: 10.1016/j.vaccine.2019.09.049] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Revised: 09/11/2019] [Accepted: 09/12/2019] [Indexed: 10/26/2022]
Abstract
INTRODUCTION Vaccines have been shown to prevent illness, disability and death from vaccine-preventable diseases. The purpose of our study was to analyze the influenza and pneumococcal vaccination status of patients, the factors that influence the uptake of influenza/pneumococcal vaccination and the effects of health literacy (HL) on vaccination. MATERIALS AND METHODS In this cross-sectional study, demographic characteristics, comorbid diseases and the pneumococcal and influenza vaccination status in previous years were recorded for each patient. The Turkish version of the European Health Literacy Survey Questionnaire (HLS-EU-Q47) was used to assess HL. RESULTS A total of 350 patients were enrolled in the study. A total of 6.3% of patients had received both vaccines. 20% of subjects were vaccinated with influenza vaccine and 11.1% of the subjects were vaccinated with pneumococcal vaccine. Overall HL was insufficient for 70.9%, problematic for 20.6%, sufficient for 7.1% and excellent for 14.2% of patients. Patients who had pneumococcal and influenza vaccination had higher disease prevention HL scores (p = 0.013, p = 0.001; respectively). DISCUSSION An insufficient HL level was found to be much higher than previous studies. It was observed that an increase in disease prevention HL was associated with a rise in the rate of pneumococcal and influenza vaccination.
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Affiliation(s)
- Ozge Aydin Guclu
- Boyabat 75th Year State Hospital, Department of Pulmonary Diseases, Sinop, Turkey
| | - Hakan Demirci
- University of Health Sciences Bursa Yuksek İhtisas Training and Research Hospital, Department of Family Medicine, Bursa, Turkey.
| | - Gokhan Ocakoglu
- Uludag University Faculty of Medicine, Department of Biostatistics, Bursa, Turkey
| | - Yasin Guclu
- Boyabat Community Health Center, Department of Family Medicine, Sinop, Turkey
| | - Esra Uzaslan
- Uludag University, Faculty of Medicine, Department of Pulmonary Diseases, Bursa, Turkey
| | - Mehmet Karadag
- Uludag University, Faculty of Medicine, Department of Pulmonary Diseases, Bursa, Turkey
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MacCarthy S, Burkhart Q, Haviland AM, Dembosky JW, Wilson-Frederick S, Saliba D, Gaillot S, Elliott MN. Exploring Disparities in Influenza Immunization for Older Women. J Am Geriatr Soc 2019; 67:1268-1272. [PMID: 30990226 DOI: 10.1111/jgs.15887] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Revised: 01/23/2019] [Accepted: 02/26/2019] [Indexed: 01/03/2023]
Abstract
OBJECTIVES While women obtain most recommended preventive health interventions more often than men, evidence is mixed regarding influenza vaccination for older adults. Therefore, we evaluated sex differences in influenza vaccination among older adults. DESIGN Nationally representative cross-sectional survey. SETTING United States. PARTICIPANTS A total of 1 252 705 adults, aged 65 years and older, responding to 2013 to 2017 Medicare Consumer Assessment of Healthcare Providers and Systems surveys. MEASUREMENTS The dependent variable was Healthcare Effectiveness Data and Information Set self-reported influenza immunization. The primary predictor was sex. Covariates included general health status, education, race/ethnicity, and Medicare Advantage (MA; managed care) vs Fee-for-Service (FFS) coverage. RESULTS After adjusting for health status and other sociodemographic factors, women's immunization was 2% lower than men's immunization in MA, with no significant overall sex difference in FFS. Women were immunized less often than men in 95% of MA health plans, with the largest gaps in low-immunizing plans. Further analyses revealed variation in sex differences by health status, education, and race/ethnicity in both MA and FFS. Notably in MA, women in poor health were immunized less often than men in similar health (-4%; P < .001). Black women were immunized much less often than black men in both MA and FFS (-5%; P < .001 for each). Hispanic women were immunized less often than Hispanic men in MA (-4%; P < .001) but not within FFS. CONCLUSION Women in MA experience small disparities overall in influenza immunization, with larger disparities for black and Hispanic women. Providers and MA plans should increase efforts to recommend and monitor immunization for older women, especially black and Hispanic women and those in poor health. Given the potential to reduce morbidity and mortality, equitable access to a critical preventive health service, such as influenza immunization, is crucial for all older adults.
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Affiliation(s)
| | - Q Burkhart
- RAND Corporation, Santa Monica, California
| | - Amelia M Haviland
- Heinz College, Carnegie Mellon University, Pittsburgh, Pennsylvania.,RAND Corporation, Pittsburgh, Pennsylvania
| | | | | | - Debra Saliba
- RAND Corporation, Santa Monica, California.,Borun Center, University of California, Los Angeles.,Veterans Affairs Geriatric Research Education and Clinical Center, Los Angeles, California
| | - Sarah Gaillot
- Office of Minority Health, Centers for Medicare and Medicaid Services, Baltimore, Maryland.,Center for Medicare, Centers for Medicare and Medicaid Services, Baltimore, Maryland
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Ramírez AS, Arellano Carmona K. Beyond fatalism: Information overload as a mechanism to understand health disparities. Soc Sci Med 2018; 219:11-18. [PMID: 30342382 PMCID: PMC6240483 DOI: 10.1016/j.socscimed.2018.10.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2018] [Revised: 10/03/2018] [Accepted: 10/12/2018] [Indexed: 12/19/2022]
Abstract
BACKGROUND Fatalism - beliefs about the causes and controllability of disease - has been negatively associated with prevention behaviors. Fatalism has been suggested as a mechanism for health disparities because ethnic minorities are especially likely to hold fatalistic beliefs. However, the construct has been criticized: Fatalism fails to account for structural barriers to health faced by vulnerable populations that also score highly on measures of fatalism. Another critique suggests that operationalizations of fatalism expose communication failures: "Fatalism" rather reflects information overload from an environment riddled with misinformation and contradictions. This study aimed to expand understanding of one mechanism through which communication may contribute to disparities by considering the context of nutrition among bicultural Latinas, who face increased risk from dietary acculturation. METHOD Mixed-methods (semi-structured in-depth interview, survey) with Mexican-American women ages 18-29 (n = 24) in rural California. RESULTS Contrary to previous studies, the majority of this sample of Mexican-American women did not endorse fatalistic beliefs; most demonstrated clear understanding of the link between diet and risk of diseases: Diabetes and heart disease were understood to result from behaviors within one's control. Yet despite articulating links between diet and disease, participants felt overloaded and confused about conflicting information from public and interpersonal sources. Moreover, despite reporting feeling inundated with information, participants noted critical information gaps, distinguishing between information available and information needed. CONCLUSIONS We found minimal support for fatalistic beliefs among a sample of Mexican-American women, but considerable information overload and confusion, together with a desire for specific knowledge and skills. Results extend understanding of how communication may influence disparities: Information overload may be conflated with fatalism, challenging the notion that fatalism is a cultural belief. Moreover, inequalities in access to and ability to process information compound overload effects. We discuss opportunities to improve the clarity of communication about nutrition science and dietary recommendations.
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Affiliation(s)
- A Susana Ramírez
- School of Social Sciences, Humanities, and Arts, University of California, Merced 5200 North Lake Road, Merced, CA, 95343, USA.
| | - Kimberly Arellano Carmona
- School of Social Sciences, Humanities, and Arts, University of California, Merced 5200 North Lake Road, Merced, CA, 95343, USA.
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Nowak GJ, Cacciatore MA, Len-Ríos ME. Understanding and Increasing Influenza Vaccination Acceptance: Insights from a 2016 National Survey of U.S. Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15040711. [PMID: 29642624 PMCID: PMC5923753 DOI: 10.3390/ijerph15040711] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Revised: 04/05/2018] [Accepted: 04/07/2018] [Indexed: 11/16/2022]
Abstract
Background: The percentage of adults in the U.S. getting seasonal influenza vaccination has not changed significantly since 2013 and remains far below the federal government's 70% target. Objective: This study assessed and identified characteristics, experiences, and beliefs associated with influenza vaccination using a nationally representative survey of 1005 U.S. adults 19 years old and older. Methods: The sample was drawn from the National Opinion Research Center's AmeriSpeak Panel, a probability-based panel designed to be representative of the U.S. household population. Results: Overall, 42.3% received an influenza vaccination in the past 12 months, with rates highest for non-Hispanic Whites and Blacks and those 65 years old and older. Hispanic respondents and those under 64 years old were much less likely to get an influenza vaccination. They were also less aware of the recommendation, less informed about influenza and the benefits of vaccination, and least confident in the vaccine. Conclusions: Increasing influenza vaccination coverage in the U.S. requires a greater focus on 19-64 year-olds, particularly those 50 to 64, Hispanics and continued focus on those with diabetes and asthma. Efforts need to increase awareness of influenza vaccination recommendations, foster a sense of being well informed about influenza vaccination benefits and the risks associated with non-vaccination, and increase confidence that there are meaningful benefits from receiving an influenza vaccination.
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Affiliation(s)
- Glen J Nowak
- Center for Health and Risk Communication, Grady College of Journalism & Mass Communication, University of Georgia, 120 Hooper Street, Athens, GA 30602, USA.
| | - Michael A Cacciatore
- Center for Health and Risk Communication, Grady College of Journalism & Mass Communication, University of Georgia, 120 Hooper Street, Athens, GA 30602, USA.
| | - María E Len-Ríos
- Center for Health and Risk Communication, Grady College of Journalism & Mass Communication, University of Georgia, 120 Hooper Street, Athens, GA 30602, USA.
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Lorini C, Santomauro F, Donzellini M, Capecchi L, Bechini A, Boccalini S, Bonanni P, Bonaccorsi G. Health literacy and vaccination: A systematic review. Hum Vaccin Immunother 2017; 14:478-488. [PMID: 29048987 PMCID: PMC5806657 DOI: 10.1080/21645515.2017.1392423] [Citation(s) in RCA: 129] [Impact Index Per Article: 18.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
This systematic review describes the current relationship between health literacy (HL) and vaccination (including attitude to vaccines, intention to vaccinate, and vaccine uptake). The aim is to comprehend the role of HL as a determinant of vaccine hesitancy. For this purpose, the following databases were explored from 1 January 2007 to 15 January 2017: PubMed, Embase, PsycINFO, ERIC, Health Evidence, Centre for Reviews and Dissemination, Scopus, Web of Science, and Cochrane Library. Nine studies were included in the final synthesis. The role of HL in predicting vaccine hesitancy or acceptance seems to be influenced by a few key factors. These include country, age, and type of vaccine. However, the relationship between HL and vaccination remains unclear. New research studies are needed-particularly longitudinal ones that use multiple measurement tools. This would facilitate a better understanding of the role of HL in predicting vaccine uptake.
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Affiliation(s)
- Chiara Lorini
- a Department of Health Science , University of Florence , Florence , Italy
| | | | - Martina Donzellini
- b School of Specialization on Hygiene and Preventive Medicine, University of Florence , Florence , Italy
| | - Leonardo Capecchi
- b School of Specialization on Hygiene and Preventive Medicine, University of Florence , Florence , Italy
| | - Angela Bechini
- a Department of Health Science , University of Florence , Florence , Italy
| | - Sara Boccalini
- a Department of Health Science , University of Florence , Florence , Italy
| | - Paolo Bonanni
- a Department of Health Science , University of Florence , Florence , Italy
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Lorini C, Santomauro F, Grazzini M, Mantwill S, Vettori V, Lastrucci V, Bechini A, Boccalini S, Bussotti A, Bonaccorsi G. Health literacy in Italy: a cross-sectional study protocol to assess the health literacy level in a population-based sample, and to validate health literacy measures in the Italian language. BMJ Open 2017; 7:e017812. [PMID: 29138204 PMCID: PMC5695375 DOI: 10.1136/bmjopen-2017-017812] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION Health literacy (HL) concerns the knowledge and competences necessary for people to meet complex health demands. The aims of this study are to assess the level of HL in a sample using the Italian version of the Newest Vital Sign and the association of HL and selected antecedents with health outcomes, and to develop and validate the Italian version of the three Brief Health Literacy Screeners, two subjective numeracy items and the short form and the short-short form of the European Health Literacy Survey Questionnaire. METHODS AND ANALYSIS The study adopts a cross-sectional design and is being conducted in Florence, with information collected through telephone interviews. The population-based sample has been randomly selected using the registries of eight general practitioners (GPs). Based on a power calculation, 480 subjects will be included. Participants have been randomly offered two different questionnaires, each containing different HL measures. Data on sociodemographics and important antecedents and consequences of HL will be collected and the distribution of HL levels calculated. The mediating role of HL will be assessed using Preacher and Hayes' model. To assess the concurrent validity of the HL scales, correlation and receiver operating characteristic analyses will be performed. ETHICS AND DISSEMINATION The study protocol has been approved by the Ethics Committee of the Area Vasta Centro. Results will be disseminated via scientific journals and conference presentations, and individual data made available to the GPs.
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Affiliation(s)
- Chiara Lorini
- Departement of Health Science, University of Florence, Florence, Italy
| | | | - Maddalena Grazzini
- School of Specialization in Hygiene and Preventive Medicine, University of Florence, Florence, Italy
| | - Sarah Mantwill
- Department of Health Sciences & Health Policy, University of Lucerne, Lucerne, Switzerland
| | - Virginia Vettori
- Departement of Health Science, University of Florence, Florence, Italy
| | - Vieri Lastrucci
- Departement of Health Science, University of Florence, Florence, Italy
| | - Angela Bechini
- Departement of Health Science, University of Florence, Florence, Italy
| | - Sara Boccalini
- Departement of Health Science, University of Florence, Florence, Italy
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