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Vashist K, Yankey D, Elam-Evans LD, Mu Y, Valier MR, Pingali C, Hill HA, Santibanez TA, Singleton JA. Changes in vaccine hesitancy among parents of children aged 6 months - 17 Years, National Immunization Surveys, 2019-2022. Vaccine 2024; 42:125989. [PMID: 38806351 DOI: 10.1016/j.vaccine.2024.05.037] [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: 03/20/2024] [Revised: 05/16/2024] [Accepted: 05/16/2024] [Indexed: 05/30/2024]
Abstract
BACKGROUND Vaccine hesitancy (VH) has been a major contributor to large outbreaks of vaccine-preventable diseases globally, including in the United States. METHODS Data from the 2019-2022 National Immunization Surveys were analyzed to assess parental hesitancy toward routine vaccination of their children aged 6 months -17 years. Joinpoint regression was employed to investigate trends in VH from 2019 to 2022 nationally overall and among socio-demographic subgroups. Using logistic regression, the difference between the prevalence of VH before and after the authorization of the COVID-19 vaccine for children aged 6 months-4 years, 5-11 years, and 12-17 years was computed. Both unadjusted and adjusted estimates were reported. VH was also compared within each socio-demographic subgroup with a reference level, at two-time points- before and after the authorization of the COVID-19 vaccine for each age group. RESULTS Overall, VH remained around 19.0 % from Q2 2019 to Q3 2022. Parents of non-Hispanic Black children had the largest average quarterly decrease in VH (β = -0.55; p < 0.05 by test for trend). After the authorization of the COVID-19 vaccine for children aged 6 months to 4 years, the adjusted percentage of children having parents that reported VH decreased by 2.2 (95 % CI: -3.9, -0.6) percentage points (pp) from 21.6 % to 19.4 %. Conversely, for children aged 5-11 years, VH increased by 1.2 (95 % CI: 0.2, 2.3) pp, from 19.8 % to 21.0 %. VH among parents of non-Hispanic Black children decreased after the authorization of the COVID-19 vaccine for adolescents aged 12-17 years but remained significantly higher compared to parents of non-Hispanic White children before and after authorization of the COVID-19 vaccine for all age groups. DISCUSSION About 1 in 5 children had parents reporting VH from 2019 to 2022. Parental VH increased after the authorization of the COVID-19 vaccine for children aged 5-11 years and declined for children aged 6 months-4 years.
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Affiliation(s)
- Kushagra Vashist
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States; Rollins School of Public Health, Emory University, Atlanta, GA, United States.
| | - David Yankey
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Laurie D Elam-Evans
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Yi Mu
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Madeleine R Valier
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Cassandra Pingali
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Holly A Hill
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Tammy A Santibanez
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - James A Singleton
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
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Zaveri PP, Clark S, Kan K, Lee BR, Naik V, Opel DJ, Popovsky E, Ren D, Simpson J, Watts J, White ML, Myers AL. Rapid Development and Testing of a COVID-19 Vaccine Curriculum for Pediatricians. Acad Pediatr 2023; 23:790-799. [PMID: 36122826 PMCID: PMC9479378 DOI: 10.1016/j.acap.2022.09.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 09/07/2022] [Accepted: 09/10/2022] [Indexed: 11/21/2022]
Abstract
BACKGROUND AND OBJECTIVES As the coronavirus disease 2019 (COVID-19) pandemic evolves and vaccines become available to children, pediatricians must navigate vaccination discussions in the setting of rapidly changing vaccine recommendations and approvals. We developed and evaluated an educational curriculum for pediatricians to improve their knowledge about COVID-19 vaccines and confidence in communicating with patients and families about COVID-19 vaccines. METHODS Five institutions collaborated to develop an online educational curriculum. Utilizing the collaboration's multidisciplinary expertise, we developed a 3-module curriculum focused on the SARS-CoV-2 virus and vaccine basics, logistics and administration of COVID-19 vaccine, and COVID-19 vaccine communication principles. Surveys administered to clinician participants before and after completion of the curriculum assessed knowledge and confidence; a follow-up survey 1 month after the post-survey assessed persistence of initial findings. RESULTS A total of 152 pediatric providers participated; 72 completed both pre- and post-surveys. The median knowledge score improved from the pre-survey to the post-survey (79%-93%, P < .001). There was an increase in providers' confidence after completing the curriculum, which persisted in the follow-up survey. In the post-survey, 98% of participants had had the opportunity to discuss the COVID-19 vaccine with patients, and most clinicians reported that the modules decreased apprehension some or significantly. CONCLUSIONS This project demonstrates rapid and feasible deployment of a curriculum providing up-to-date information to front-line clinicians responsible for having complex conversations about COVID-19 vaccine decision-making. Clinicians who completed this curriculum had sustained increased confidence and decreased levels of apprehension when discussing the COVID-19 vaccine.
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Affiliation(s)
- Pavan P Zaveri
- Division of Emergency Medicine (PP Zaveri, D Ren, and J Simpson), Children's National Hospital, Washington, DC; Department of Pediatrics (PP Zaveri, D Ren, and J Simpson), George Washington University, Washington, DC.
| | - Shannon Clark
- Icon Clinical Research (S Clark, AL Myers), South County Business Park, Ireland
| | - Kristin Kan
- Division of Advanced General Pediatrics (K Kan), Northwestern University and Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, Ill
| | - Brian R Lee
- Division of Health Services and Outcomes Research (BR Lee), Overland Park, Kans
| | - Vishal Naik
- Division of Emergency Medicine (V Naik, E Popovsky), Northwestern University and Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, Ill
| | - Douglas J Opel
- Division of General Pediatrics, Department of Pediatrics (DJ Opel), University of Washington School of Medicine, Seattle, Wash
| | - Erica Popovsky
- Division of Emergency Medicine (V Naik, E Popovsky), Northwestern University and Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, Ill
| | - Dennis Ren
- Division of Emergency Medicine (PP Zaveri, D Ren, and J Simpson), Children's National Hospital, Washington, DC; Department of Pediatrics (PP Zaveri, D Ren, and J Simpson), George Washington University, Washington, DC
| | - Joelle Simpson
- Division of Emergency Medicine (PP Zaveri, D Ren, and J Simpson), Children's National Hospital, Washington, DC; Department of Pediatrics (PP Zaveri, D Ren, and J Simpson), George Washington University, Washington, DC
| | - Jennifer Watts
- Children's Mercy Kansas (J Watts, AL Myers), Overland Park, Kans
| | - Marjorie Lee White
- Division of Emergency Medicine, Department of Pediatrics (ML White), Heersink School of Medicine, University of Alabama at Birmingham, Ala
| | - Angela L Myers
- Icon Clinical Research (S Clark, AL Myers), South County Business Park, Ireland; Division of Infectious Diseases (AL Myers), Children's Mercy Hospital Kansas, Overland Park, Kans
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Abstract
Vaccine acceptance by parents and caregivers remains a public health challenge that can potentially be addressed via community-based strategies. Such strategies might augment current vaccine hesitancy interventions occurring within medical homes. This article reviews the key challenges and advantages of evidence-based community strategies for overcoming parent/caregiver vaccine hesitancy, specifically (1) community-participatory vaccine hesitancy measurement, (2) communication approaches, (3) reinforcement techniques (eg, incentives, mandates), and (4) community-engaged partnerships (eg, vaccine champion training, vaccination in community settings). This article also discusses important considerations when vaccinating children and adolescents in non-primary care settings (school-based health centers, pharmacies, community events).
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Affiliation(s)
- Lori E Crosby
- Division of Behavioral Medicine, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, MLC 7039, Cincinnati, OH 45229, USA; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
| | - Francis J Real
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA; Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, MLC 2011, Cincinnati, OH 45229, USA
| | - Jodi Cunnigham
- The Community Builders, Inc., 3635 Reading Road, Cincinnati, OH 45229, USA
| | - Monica Mitchell
- Division of Behavioral Medicine, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, MLC 7039, Cincinnati, OH 45229, USA; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA; Community Relations, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, MLC 7039, Cincinnati, OH 45229, USA
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Rostkowska OM, Raczkiewicz D, Knap-Wielgus W, Zgliczyński WS. Polish Medical Doctors' Opinions on Available Resources and Information Campaigns concerning Antibiotics and Antibiotic Resistance, a Cross-Sectional Study. Antibiotics (Basel) 2022; 11:882. [PMID: 35884136 PMCID: PMC9311609 DOI: 10.3390/antibiotics11070882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 06/26/2022] [Accepted: 06/28/2022] [Indexed: 02/05/2023] Open
Abstract
Background: Antibiotic resistance (ABR) is at the top of global health threats. This paper aims to assess Polish physicians' readiness to impact ABR through prescribing routines. Methods: Surveying Polish physicians participating in specialization courses at the Center for Postgraduate Medical Education in Warsaw, Poland from October 2019 to March 2020. Results: Information was obtained from 504 physicians aged 25-59, mean 32.8 ± 5.9 years, mainly women (65%). Most doctors (78%) prescribed antibiotics at least once a week. Physicians indicated clinical practice guidelines as resources most often consulted in the management of infections (90%). However, clinical experience was also declared a powerful resource. In total, 54% of respondents recalled receiving information about the prudent use of antibiotics within 12 months, which partially translated into changing views (56%) and practice (42%). Physicians disagreed that national campaigns provide good promotion of prudent antibiotics use (75%) or that they are effective (61%). Only 40% of doctors were aware of the national campaign promoting responsible antibiotics use, 24% had heard about the European Antibiotic Awareness Day and 20% knew about the World Antimicrobial Awareness Week. Conclusions: Prescribers most often rely on clinical practice guidelines and their own experience as resources for antibiotics use. Doctors' awareness of available resources and information campaigns concerning antibiotics and antibiotic resistance should be improved.
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Affiliation(s)
- Olga Maria Rostkowska
- Department of Transplantation Medicine, Nephrology and Internal Diseases, Medical University of Warsaw, 02-006 Warsaw, Poland;
| | - Dorota Raczkiewicz
- Department of Medical Statistics, School of Public Health, Center of Postgraduate Medical Education, 01-826 Warsaw, Poland;
| | - Weronika Knap-Wielgus
- Infant Jesus Clinical Hospital, Medical University of Warsaw, 02-091 Warsaw, Poland;
| | - Wojciech Stefan Zgliczyński
- Department of Lifestyle Medicine, School of Public Health, Center of Postgraduate Medical Education, 01-826 Warsaw, Poland
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Stokley S, Kempe A, Stockwell MS, Szilagyi PG. Improving Pediatric Vaccination Coverage in the United States. Acad Pediatr 2021; 21:S1-S2. [PMID: 33958085 PMCID: PMC11334946 DOI: 10.1016/j.acap.2021.03.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 03/10/2021] [Indexed: 12/11/2022]
Affiliation(s)
- Shannon Stokley
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (S Stokley), Atlanta, Ga.
| | - Allison Kempe
- Adult and Child Consortium for Health Outcomes Research and Delivery Science (ACCORDS), University of Colorado Anschutz Medical Center and Children's Hospital Colorado (A Kempe), Aurora, Colo; Department of Pediatrics, University of Colorado Anschutz Medical Center (A Kempe), Aurora, Colo
| | - Melissa S Stockwell
- Division of Child and Adolescent Health, Department of Pediatrics, Columbia University (MS Stockwell), New York, NY; Department of Population and Family Health, Mailman School of Public Health, Columbia University (MS Stockwell), New York, NY; New York - Presbyterian Hospital (MS Stockwell), New York, NY
| | - Peter G Szilagyi
- Department of Pediatrics, University of California at Los Angeles (PG Szilagyi); Mattel Children's Hospital (PG Szilagyi), Los Angeles, Calif
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