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Jäckle S, Timmis JK. Esoteric beliefs and CAM impact SARS-CoV-2 immunization drivers, uptake and pediatric immunization views in Germany. NPJ Vaccines 2024; 9:137. [PMID: 39097580 PMCID: PMC11297982 DOI: 10.1038/s41541-024-00928-7] [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: 07/05/2023] [Accepted: 07/17/2024] [Indexed: 08/05/2024] Open
Abstract
Recent studies demonstrate that sociopolitical attitudes partially explain variance in (SARS-CoV-2) vaccine hesitancy and uptake. Other attitudes, such as those towards esoteric beliefs, complementary and alternative medicine (CAM), and religion, have also been proposed. However, pertinent studies provide limited direction for public health efforts, as the impact of such attitudes has been tested in isolation or on different outcomes. Moreover, related associations between SARS-CoV-2 immunization drivers as well as views towards other modes of immunization (e.g., routine pediatric immunization), remain unclear. Based on a sample of ~7400 survey participants (Germany), where esoteric belief systems and CAM (Waldorf, homeopathy) are rather prevalent, and controlling for other sociological factors, we found that (i) individuals with positive attitudes towards Waldorf education and homeopathy are significantly less likely to have received a (further) dose of SARS-CoV-2 vaccine compared to those with positive views of mainstream medicine; (ii) for the former, immunization decisions are primarily driven by external pressures, and for the latter overwhelmingly by voluntary considerations; (iii) attitudes influencing adult SARS-CoV-2 vaccine uptake similarly influence views towards routine pediatric immunization. Our findings provide significant evidence informing a more nuanced design of public health and communication campaigns, and pertinent policies.
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Affiliation(s)
- Sebastian Jäckle
- Department of Political Science, University of Freiburg, Freiburg, 79085, Germany.
| | - James K Timmis
- Department of Political Science, University of Freiburg, Freiburg, 79085, Germany
- Athena Institute for Research on Innovation and Communication in Health and Life Sciences, Vrije Universiteit Amsterdam, Amsterdam, 1081 HV, The Netherlands
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2
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Higgins DM, O’Leary ST. A World without Measles and Rubella: Addressing the Challenge of Vaccine Hesitancy. Vaccines (Basel) 2024; 12:694. [PMID: 38932423 PMCID: PMC11209163 DOI: 10.3390/vaccines12060694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2024] [Revised: 05/28/2024] [Accepted: 05/30/2024] [Indexed: 06/28/2024] Open
Abstract
The worldwide elimination of measles and rubella is feasible, but not without overcoming the substantial challenge of vaccine hesitancy. This challenge is complicated by the spread of misinformation and disinformation fueled by rapidly progressing technologies and evolving forms of online communication. The recent COVID-19 pandemic has only added further complexity to this challenge. However, considerable progress has been made in understanding the scope of the problem and the complex factors that influence vaccine hesitancy. Our understanding of evidence-based strategies for addressing vaccine hesitancy has grown significantly, including evidence for effective communication and behavioral interventions. In this article, we review measles and rubella vaccines and vaccine hesitancy. We then provide an overview of evidence-based strategies for addressing vaccine hesitancy, including communication strategies and behavioral interventions. This article is relevant to healthcare professionals, health system leaders, public health professionals, policymakers, community leaders, and any individuals who have a role in addressing vaccine hesitancy in their communities. Finally, we review future directions and major areas of research need.
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Affiliation(s)
| | - Sean T. O’Leary
- Adult and Child Center for Outcomes Research and Delivery Science (ACCORDS), Children’s Hospital Colorado, University of Colorado School of Medicine, Aurora, CO 80045, USA;
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3
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Baumer-Mouradian SH, Hofstetter AM, O'Leary ST, Opel DJ. Vaccine Confidence as Critical to Pandemic Preparedness and Response. Pediatr Clin North Am 2024; 71:499-513. [PMID: 38754938 DOI: 10.1016/j.pcl.2024.01.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/18/2024]
Abstract
Vaccine confidence is a belief that vaccines work, are safe, and are part of a trustworthy medical system. The COVID-19 pandemic exposed the fragility of the public's confidence in vaccines and the vaccine enterprise, limiting the public health impact of vaccination. In this review, we examine the critical nature of vaccine confidence to pandemic preparedness and response.
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Affiliation(s)
- Shannon H Baumer-Mouradian
- Department of Pediatrics, Medical College of Wisconsin, 9000 W. Wisconsin Avenue, Milwaukee, WI 53226, USA
| | - Annika M Hofstetter
- Department of Pediatrics, University of Washington School of Medicine and Center for Clinical and Translational Research, Seattle Children's Research Institute, M/S CURE-4, PO Box 5371, Seattle, WA 98145, USA
| | - Sean T O'Leary
- Department of Pediatrics and Adult and Child Center for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus, 1890 North Revere Court, Aurora, CO 80045, USA
| | - Douglas J Opel
- Department of Pediatrics, University of Washington School of Medicine and Treuman Katz Center for Pediatric Bioethics and Palliative Care, Center for Clinical and Translational Research, Seattle Children's Research Institute, M/S: JMB-6; 1900 Ninth Avenue, Seattle, WA 98101, USA.
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4
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Rand CM, Stephens-Shields AJ, Kelly MK, Localio R, Hannan C, Grundmeier RW, Shone LP, Steffes J, Davis K, Albertin C, Humiston SG, McFarland G, Abney DE, Szilagyi PG, Fiks AG. Clinician Prompts for Human Papillomavirus Vaccination: A Cluster Randomized Trial. Acad Pediatr 2024; 24:579-586. [PMID: 37925070 PMCID: PMC11056302 DOI: 10.1016/j.acap.2023.10.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 10/24/2023] [Accepted: 10/27/2023] [Indexed: 11/06/2023]
Abstract
OBJECTIVE We assessed the impact of an online intervention using clinician prompts for human papillomavirus (HPV) vaccination with a cluster randomized controlled trial. METHODS The randomized trial occurred July 2021-January 2022 in 48 primary care pediatric practices (24 intervention, 24 control) across the US. We trained clinicians via two online learning modules, plus weekly ''quick tips'' delivered via text or email. The training taught practices to implement a staff prompt to the clinician (e.g., printed reminders placed on the keyboard) plus electronic health record (EHR) prompts (if not already done) at well and acute/chronic visits for initial and subsequent HPV vaccination. We assessed missed opportunities for HPV vaccination using logistic regression models accounting for clustering by practice on an intent to treat basis. Surveys assessed facilitators and barriers to using prompts. RESULTS During the 6-month intervention, missed opportunities for HPV vaccination increased (worsened) in both intervention and control groups. However, at well child care visits, missed opportunities for the initial HPV vaccine increased by 4.5 (95% CI: -9.0%, -0.1%) percentage points less in intervention versus control practices. Change in missed opportunities for subsequent doses at well child care and non-well child care visits did not differ between trial groups. An end-of trial survey found understaffing as a common challenge. CONCLUSIONS Clinician prompts reduced missed opportunities for HPV vaccination at well child care visits. Understaffing related to the COVID-19 pandemic may have led to worsening missed opportunities for both groups and likely impeded practices in fully implementing changes.
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Affiliation(s)
- Cynthia M Rand
- Department of Pediatrics (CM Rand), University of Rochester School of Medicine and Dentistry, Rochester, NY.
| | - Alisa J Stephens-Shields
- Department of Biostatistics (AJ Stephens-Shields, R Localio, C Hannan, and RW Grundmeier), Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pa
| | - Mary K Kelly
- Clinical Futures (MK Kelly and AG Fiks), Children's Hospital of Philadelphia, Philadelphia, Pa
| | - Russell Localio
- Department of Biostatistics (AJ Stephens-Shields, R Localio, C Hannan, and RW Grundmeier), Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pa
| | - Chloe Hannan
- Department of Biostatistics (AJ Stephens-Shields, R Localio, C Hannan, and RW Grundmeier), Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pa
| | - Robert W Grundmeier
- Department of Biostatistics (AJ Stephens-Shields, R Localio, C Hannan, and RW Grundmeier), Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pa; Department of Biomedical and Health Informatics (RW Grundmeier and AG Fiks), Children's Hospital of Philadelphia, Philadelphia, Pa
| | | | - Jennifer Steffes
- Pediatric Research in Office Settings (J Steffes, K Davis, G McFarland, DE Abney, and AG Fiks), American Academy of Pediatrics, Itasca, Ill; Primary Care Research (J Steffes and K Davis), American Academy of Pediatrics, Itasca, Ill
| | - Kristin Davis
- Pediatric Research in Office Settings (J Steffes, K Davis, G McFarland, DE Abney, and AG Fiks), American Academy of Pediatrics, Itasca, Ill; Primary Care Research (J Steffes and K Davis), American Academy of Pediatrics, Itasca, Ill
| | - Christina Albertin
- Department of Pediatrics (C Albertin), University of California at Los Angeles, Mattel Children's Hospital, Los Angeles, Calif
| | - Sharon G Humiston
- Department of Pediatrics, Mattel Children's Hospital, UCLA, Los Angeles, CA, USA
| | - Greta McFarland
- Pediatric Research in Office Settings (J Steffes, K Davis, G McFarland, DE Abney, and AG Fiks), American Academy of Pediatrics, Itasca, Ill
| | - Dianna E Abney
- Pediatric Research in Office Settings (J Steffes, K Davis, G McFarland, DE Abney, and AG Fiks), American Academy of Pediatrics, Itasca, Ill
| | - Peter G Szilagyi
- Department of Pediatrics, Mattel Children's Hospital, UCLA, Los Angeles, CA, USA
| | - Alexander G Fiks
- Clinical Futures (MK Kelly and AG Fiks), Children's Hospital of Philadelphia, Philadelphia, Pa; Department of Biomedical and Health Informatics (RW Grundmeier and AG Fiks), Children's Hospital of Philadelphia, Philadelphia, Pa; Pediatric Research in Office Settings (J Steffes, K Davis, G McFarland, DE Abney, and AG Fiks), American Academy of Pediatrics, Itasca, Ill
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5
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Abu-Farha RK, Khabour OF, Gharaibeh L, Elrahal YM, Alzoubi KH, Nassar R, Harahsheh MM, Binsaleh AY, Shilbayeh SA. Navigating parental attitudes on childhood vaccination in Jordan: a cross-sectional study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2024:1-13. [PMID: 38620051 DOI: 10.1080/09603123.2024.2342018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Accepted: 04/07/2024] [Indexed: 04/17/2024]
Abstract
This study investigated parental attitudes toward childhood vaccination in Jordan, focusing on acceptance, concerns, and perceptions. A cross-sectional survey conducted from January to February 2024 included 939 parents. Findings indicated that 85.4% (n = 802) of respondents received the COVID-19 vaccine, while only 25% (n = 229) vaccinated their children. Concerns regarding vaccine safety and efficacy were prevalent, with 63.9% (n = 600) expressing worries about side effects and 46.9% (n = 440) trusting immunization programs. Post-pandemic, 34% (n = 319) reported a more negative attitude. Logistic regression showed parents not vaccinating their children against COVID-19 were significantly less likely to exhibit positive attitudes toward childhood vaccination (OR = 0.412, p < 0.001). Older participants were more inclined toward negativity post-pandemic (OR = 1.031, p = 0.007). In conclusion, parental attitudes shifted post-COVID-19, reflecting hesitancy and decreased trust. Addressing concerns and restoring confidence are crucial, especially for children's health. Education through healthcare providers and dispelling social media misinformation are essential. Implementing strategies to enhance post-pandemic vaccine acceptance is imperative for preventing outbreaks of vaccine-preventable diseases.
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Affiliation(s)
- Rana K Abu-Farha
- Clinical Pharmacy and Therapeutics Department, Faculty of Pharmacy, Applied Science Private University, Amman, Jordan
| | - Omar F Khabour
- Department of Medical Laboratory Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Lobna Gharaibeh
- Biopharmaceutics and Clinical Pharmacy Department, Faculty of Pharmacy, Al-Ahliyya Amman University, Amman, Jordan
| | - Yusra M Elrahal
- Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Karem H Alzoubi
- Department of Pharmacy Practice and Pharmacotherapeutics, University of Sharjah, Sharjah, UAE
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Razan Nassar
- Department of Clinical Pharmacy and Therapeutics, Faculty of Pharmacy, Applied Science Private University, Amman, Jordan
| | - Meaad M Harahsheh
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Ammena Y Binsaleh
- Department of Pharmacy Practice, College of Pharmacy, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Sireen A Shilbayeh
- Department of Pharmacy Practice, College of Pharmacy, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
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O'Leary ST, Opel DJ, Cataldi JR, Hackell JM. Strategies for Improving Vaccine Communication and Uptake. Pediatrics 2024; 153:e2023065483. [PMID: 38404211 DOI: 10.1542/peds.2023-065483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/19/2023] [Indexed: 02/27/2024] Open
Abstract
Vaccines have led to a significant decrease in rates of vaccine-preventable diseases and have made a significant impact on the health of children. However, some parents express concerns about vaccine safety and the necessity of vaccines. The concerns of parents range from hesitancy about some immunizations to refusal of all vaccines. This clinical report provides information about the scope and impact of the problem, the facts surrounding common vaccination concerns, and the latest evidence regarding effective communication techniques for the vaccine conversation. After reading this clinical report, readers can expect to: Understand concepts and underlying determinants of vaccine uptake and vaccine hesitancy.Understand the relationship between vaccine hesitancy and costs of preventable medical care.Recognize and address specific concerns (eg, vaccine safety) with caregivers when hesitancy is present.
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Affiliation(s)
- Sean T O'Leary
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado; Adult and Child Center for Outcomes Research and Delivery Science (ACCORDS), University of Colorado School of Medicine/Children's Hospital Colorado, Aurora, Colorado
| | - Douglas J Opel
- Treuman Katz Center for Pediatric Bioethics and Palliative Care, Seattle Children's Research Institute; Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington
| | - Jessica R Cataldi
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado; Adult and Child Center for Outcomes Research and Delivery Science (ACCORDS), University of Colorado School of Medicine/Children's Hospital Colorado, Aurora, Colorado
| | - Jesse M Hackell
- Department of Pediatrics, New York Medical College, Valhalla, New York
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7
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Knijff M, van Lier A, Boer M, de Vries M, Hament JM, de Melker HE. Parental intention, attitudes, beliefs, trust and deliberation towards childhood vaccination in the Netherlands in 2022: Indications of change compared to 2013. Vaccine 2024; 42:801-811. [PMID: 38216441 DOI: 10.1016/j.vaccine.2023.12.080] [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: 08/10/2023] [Revised: 12/21/2023] [Accepted: 12/27/2023] [Indexed: 01/14/2024]
Abstract
BACKGROUND Vaccine uptake within the Dutch National Immunisation Programme (NIP) has slightly declined since the COVID-19 pandemic. We studied psychosocial factors of vaccine uptake, namely parental intention, attitudes, beliefs, trust and deliberation (i.e., self-evidence), before (2013) and two years into the pandemic (2022). METHODS In 2022 and 2013, parents with a young child (aged < 3.5 years) participated in online surveys on vaccination (n = 1000 and 800, (estimated) response = 12.2 % and 37.2 %, respectively). Psychosocial factors were measured on 7-point Likert scales. Multivariate logistic regression analysis was used to study differences between parents in 2022 and 2013 in 'negative' scores (≤2) of psychosocial factors. RESULTS In both 2022 and 2013, most parents with a young child expressed positive intention (2022 = 83.1 %, 2013 = 87.0 %), attitudes (3 items: 2022 = 66.7 %-70.9 %, 2013 = 62.1 %-69.8 %) and trust (2022 = 51.8 %, 2013 = 52.0 %) towards the NIP and considered vaccinating their child as self-evident (2022 = 57.2 %, 2013 = 67.3 %). Compared to parents in 2013, parents in 2022 had significantly higher odds of reporting negative attitudes towards vaccination (3 items combined: OR = 2.84, 95 % CI = 1.09, 7.37), believing that vaccinations offer insufficient protection (OR = 4.89, 95 % CI = 3.19, 7.51), that the NIP is not beneficial for the protection of their child's health (OR = 2.23, 95 % CI = 1.15, 4.35), that vaccinating their child does not necessarily protect the health of other children (OR = 2.24, 95 % CI = 1.16, 4.33) or adults (OR = 2.22, 95 % CI = 1.32, 3.75) and that vaccinations could cause severe side effects (OR = 2.20, 95 % CI = 1.35, 3.58), preferring natural infection over vaccination (OR = 3.18, 95 % CI = 2.24, 4.51) and reporting low trust towards the NIP (OR = 1.73, 95 % CI = 1.08, 2.79). CONCLUSIONS Although most parents had positive intention, attitudes and trust towards vaccination and perceived vaccinating their child as self-evident, proportions of parents with negative scores were slightly larger in 2022 compared to 2013. Monitoring these determinants of vaccine uptake and developing appropriate interventions could contribute to sustaining high vaccine uptake.
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Affiliation(s)
- Marthe Knijff
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), P.O. Box 1, 3720 BA Bilthoven, the Netherlands.
| | - Alies van Lier
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), P.O. Box 1, 3720 BA Bilthoven, the Netherlands
| | - Maartje Boer
- Statistics, Data Science, and Modelling, National Institute for Public Health and the Environment (RIVM), P.O. Box 1, 3720 BA Bilthoven, the Netherlands
| | - Marion de Vries
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), P.O. Box 1, 3720 BA Bilthoven, the Netherlands
| | - Jeanne-Marie Hament
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), P.O. Box 1, 3720 BA Bilthoven, the Netherlands
| | - Hester E de Melker
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), P.O. Box 1, 3720 BA Bilthoven, the Netherlands
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Dudley MZ, Schuh HB, Goryn M, Shaw J, Salmon DA. Attitudes toward COVID-19 and Other Vaccines: Comparing Parents to Other Adults, September 2022. Vaccines (Basel) 2023; 11:1735. [PMID: 38140140 PMCID: PMC10748314 DOI: 10.3390/vaccines11121735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 11/08/2023] [Accepted: 11/18/2023] [Indexed: 12/24/2023] Open
Abstract
Few analyses of COVID-19 vaccine attitudes also cover routine vaccines or focus on parents. In this cross-sectional study, we surveyed US adults in September 2022, immediately following the authorization of updated bivalent COVID-19 boosters for adults but before their authorization for children. The vaccine attitudes of parents were compared to other adults. Fewer parents were up-to-date on COVID-19 vaccines than other adults (54% vs. 67%), even after adjusting for age, education, and race/ethnicity (Adjusted Odds Ratio: 0.58; 95% Confidence Interval: 0.45-0.76). More parents had concerns about COVID-19 vaccines' safety in children (67% vs. 58%; aOR: 1.59; 95%CI: 1.23-2.06) and vaccine ingredients (52% vs. 45%; aOR: 1.41; 95%CI: 1.09-1.81), and more parents perceived COVID-19 in children to be no worse than a cold or the flu (51% vs. 38%; aOR: 1.56; 95%CI: 1.22-2.01). Fewer parents supported COVID-19 vaccine school requirements (52% vs. 57%; aOR: 0.75; 95%CI: 0.58-0.97) and perceived high vaccine coverage among their friends (51% vs. 61%; aOR: 0.60; 95%CI: 0.46-0.78). However, three-quarters of parents intended their child to receive all routinely recommended vaccines, whereas only half of adults intended to receive all routinely recommended vaccines themselves. To improve parental informed vaccine decision-making, public health must ensure pediatric providers have updated resources to support their discussions of vaccine risks and benefits with their patients' parents.
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Affiliation(s)
- Matthew Z. Dudley
- Institute for Vaccine Safety, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD 21205, USA; (H.B.S.); (M.G.); (D.A.S.)
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Holly B. Schuh
- Institute for Vaccine Safety, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD 21205, USA; (H.B.S.); (M.G.); (D.A.S.)
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Michelle Goryn
- Institute for Vaccine Safety, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD 21205, USA; (H.B.S.); (M.G.); (D.A.S.)
| | - Jana Shaw
- Department of Pediatrics, SUNY Upstate Medical University, Syracuse, NY 13210, USA;
| | - Daniel A. Salmon
- Institute for Vaccine Safety, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD 21205, USA; (H.B.S.); (M.G.); (D.A.S.)
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
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Wagner AL, Lacombe-Duncan A, Boulton ML. Acceptance of a Future Gonorrhea Vaccine in a Post-Coronavirus Disease 2019 World: Impact of Type of Recommendation and Changing Levels of Trust in Health Institutions and Authorities. Med Clin North Am 2023; 107:e19-e37. [PMID: 38609279 PMCID: PMC10261718 DOI: 10.1016/j.mcna.2023.06.010] [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: 04/14/2024]
Abstract
Widespread uptake of a future gonorrhea vaccine could decrease the burden of disease and limit the spread of antibiotic resistance. However, gonorrhea vaccination will occur in the backdrop of the roll-out of the coronavirus disease 2019 (COVID-19) vaccine, which could have influenced parental perceptions about other, non-COVID-19 vaccines. In an internet-based cross-sectional survey, 74% of parents would get a gonorrhea vaccine for their child, and this was higher among those whose trust in pharmaceutical companies increased since the start of the COVID-19 pandemic. About 60% of adults aged 18 to 45 would receive a vaccine for themselves.
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Affiliation(s)
- Abram L Wagner
- Department of Epidemiology, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI 48109, USA.
| | - Ashley Lacombe-Duncan
- School of Social Work, University of Michigan, 1080 South University Avenue, Ann Arbor, MI 48109, USA
| | - Matthew L Boulton
- Department of Epidemiology, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI 48109, USA; Division of Infectious Disease, Department of Internal Medicine, Michigan Medicine, 1500 East Medical Center Drive, Ann Arbor, MI 48109, USA
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10
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Higgins DM, Moss A, Blackwell S, O'Leary ST. The COVID-19 Pandemic and Parental Attitudes Toward Routine Childhood Vaccines. Pediatrics 2023; 152:e2023062927. [PMID: 37867454 DOI: 10.1542/peds.2023-062927] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/23/2023] [Indexed: 10/24/2023] Open
Abstract
BACKGROUND AND OBJECTIVES The coronavirus disease 2019 (COVID-19) pandemic may have impacted parental attitudes toward childhood vaccines. However, few data sources followed attitudes before and after onset of the pandemic. We used data from a parental survey to describe the effect of the pandemic on parental attitudes toward childhood vaccines. METHODS Data were analyzed from the Health eMoms survey which randomly sampled birthing parents in Colorado from 2018 to 2021 on several health topics including vaccine hesitancy. Population weighted multivariable regression was used to measure the association between overall vaccine hesitancy and 5 individual hesitancy questions and different COVID-19 pandemic periods: prepandemic (April 2018-February 2020); pandemic prevaccine (April 2020-December 2020); and pandemic postvaccine (January 2021-August 2021), adjusting for demographic factors. RESULTS Overall, 20.4% (726/3553) of respondents were vaccine hesitant. Vaccine hesitancy during pandemic time periods was not different from the prepandemic period (prevaccine adjusted odds ratio [aOR] = 0.82, 95% confidence interval [CI] = 0.65-1.04; postvaccine aOR = 1.07, 95% CI = 0.85-1.34). In analyses of individual hesitancy questions, parents were more likely to be unsure about trusting vaccine information in the pandemic postvaccine time period compared with the prepandemic period (aOR = 2.14; 95% CI = 1.55-2.96), and less likely to be unsure about their hesitancy toward childhood vaccines (aOR = 0.48; 95% CI = 0.27-0.84). CONCLUSIONS The COVID-19 pandemic was not associated with changes in parental vaccine hesitancy overall, although there were changes in trust about vaccine information and a polarization of vaccination attitudes.
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Affiliation(s)
- David M Higgins
- Adult and Child Center for Outcomes Research and Delivery Science (ACCORDS), University of Colorado/Children's Hospital Colorado, Aurora, Colorado
| | - Angela Moss
- Adult and Child Center for Outcomes Research and Delivery Science (ACCORDS), University of Colorado/Children's Hospital Colorado, Aurora, Colorado
| | - Sarah Blackwell
- Colorado Department of Public Health and Environment, Denver, Colorado
| | - Sean T O'Leary
- Adult and Child Center for Outcomes Research and Delivery Science (ACCORDS), University of Colorado/Children's Hospital Colorado, Aurora, Colorado
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11
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Grills LA, Wagner AL. The impact of the COVID-19 pandemic on parental vaccine hesitancy: A cross-sectional survey. Vaccine 2023; 41:6127-6133. [PMID: 37659897 PMCID: PMC10954085 DOI: 10.1016/j.vaccine.2023.08.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 08/14/2023] [Accepted: 08/16/2023] [Indexed: 09/04/2023]
Abstract
BACKGROUND It is unclear how hesitancy towards pediatric vaccines has changed quantitatively since the onset of the COVID-19 pandemic, and if changes are more readily apparent in clusters of low COVID-19 vaccination. In this study, we assess how clusters of low COVID-19 vaccination correlate with changing parental beliefs about childhood vaccines. METHODS A cross-sectional, opt-in, internet-based survey of parents resident in the U.S. was conducted during August-September 2022. Our survey measured changes in beliefs about childhood vaccine safety, importance, and effectiveness since the start of COVID-19. We also measured parents' perceived vaccination rates in the community, assessing its relationship with changing vaccination perceptions using Rao-Scott chi-square tests, and multinomial logistic regression models. RESULTS Among 310 parents of children 0-17 years old, 11 % (95 % CI: 7 %, 15 %) believed that childhood vaccines are less safe, 12 % (95 % CI: 8 %, 17 %) less important, and 13 % (95 % CI: 9 %, 18 %) less effective since the start of the COVID-19 pandemic. About 9 % (95 % CI: 5 %, 12 %) stated COVID-19 vaccination coverage was low in their community. Among those who stated COVID-19 vaccination coverage was low, 38 % reported believing childhood vaccines were less effective (vs 12 % of those who stated vaccination coverage was high). This corresponds to 4.34 times greater odds of believing childhood vaccines were less effective since the start of the pandemic (95 % CI: 1.38, 13.73) in those who believe COVID-19 vaccination coverage to be low in their community vs high. CONCLUSION Our study demonstrates that parental perceptions about childhood vaccines have been affected by the COVID-19 pandemic through geographic and social clustering of non-vaccination. Beliefs about the COVID-19 vaccine have spillover with beliefs about childhood vaccines, and more negative beliefs may be clustering in areas with low vaccination coverage, which could predispose the area to outbreaks of vaccine-preventable disease.
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Affiliation(s)
- Lily A Grills
- Department of Epidemiology, University of Michigan, Ann Arbor, MI, USA
| | - Abram L Wagner
- Department of Epidemiology, University of Michigan, Ann Arbor, MI, USA.
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12
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Lin CY, Hsiao RC, Chen YM, Yen CF. A Parent Version of the Motors of COVID-19 Vaccination Acceptance Scale for Assessing Parents' Motivation to Have Their Children Vaccinated. Vaccines (Basel) 2023; 11:1192. [PMID: 37515008 PMCID: PMC10385549 DOI: 10.3390/vaccines11071192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 06/16/2023] [Accepted: 06/29/2023] [Indexed: 07/30/2023] Open
Abstract
Parents' motivation to vaccinate their children against coronavirus disease 2019 (COVID-19) plays a crucial role in the uptake of COVID-19 vaccines among children. The Motors of COVID-19 Vaccination Acceptance Scale (MoVac-COVID19S) is a valuable tool for assessing individuals' vaccination-related attitudes and the factors influencing their decision to be vaccinated against COVID-19. This study adapted the MoVac-COVID19S to create a parent version (P-MoVac-COVID19S) and examined the psychometric soundness of two P-MoVac-COVID19S versions (a 9-item version (P-MoVac-COVID19S-9) and a 12-item version (P-MoVac-COVID19S-12)) for assessing parents' motivation to vaccinate their children. A total of 550 parents completed the P-MoVac-COVID19S and a questionnaire assessing the factors that impact parents' intention to allow their children to receive the COVID-19 vaccine using a vaccine acceptance scale. We enquired about the level of parental worry regarding the adverse effects of COVID-19 vaccines on children's health and the number of COVID-19 vaccine doses received by parents. The factor structures of the P-MoVac-COVID19S-9 and P-MoVac-COVID19S-12 were examined using confirmatory factor analysis. The internal consistency, test-retest reliability, and concurrent validity of the P-MoVac-COVID19S were also examined. The results revealed that the P-MoVac-COVID19S-12 has a four-factor structure, which aligns well with the theoretical framework of the cognitive model of empowerment; the P-MoVac-COVID19S-9 has a one-factor structure. Both the P-MoVac-COVID19S-9 and P-MoVac-COVID19S-12 had good internal consistency and test-retest reliability and acceptable concurrent validity. The results of this study demonstrated that the P-MoVac-COVID19S is a reliable and valid instrument for assessing parent's motivation to vaccinate their children against COVID-19.
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Affiliation(s)
- Chung-Ying Lin
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan
- Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan
- Department of Public Health, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan
- Biostatistics Consulting Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan
| | - Ray C Hsiao
- Department of Psychiatry, Seattle Children's, Seattle, WA 98195, USA
- Department of Psychiatry and Behavioral Sciences, School of Medicine, University of Washington, Seattle, WA 98105, USA
| | - Yu-Min Chen
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung 80756, Taiwan
| | - Cheng-Fang Yen
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung 80756, Taiwan
- Department of Psychiatry, School of Medicine College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- College of Professional Studies, National Pingtung University of Science and Technology, Pingtung 91201, Taiwan
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13
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Opel DJ, Brewer NT, Buttenheim AM, Callaghan T, Carpiano RM, Clinton C, Elharake JA, Flowers LC, Galvani AP, Hotez PJ, Schwartz JL, Benjamin RM, Caplan A, DiResta R, Lakshmanan R, Maldonado YA, Mello MM, Parmet WE, Salmon DA, Sharfstein JM, Omer SB. The legacy of the COVID-19 pandemic for childhood vaccination in the USA. Lancet 2023; 401:75-78. [PMID: 36309017 PMCID: PMC9605265 DOI: 10.1016/s0140-6736(22)01693-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 08/12/2022] [Accepted: 08/25/2022] [Indexed: 11/07/2022]
Affiliation(s)
- Douglas J Opel
- Department of Pediatrics, University of Washington School of Medicine, Seattle, WA, USA; Treuman Katz Center for Pediatric Bioethics, Seattle Children's Research Institute, Seattle, WA, USA.
| | - Noel T Brewer
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA; Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA
| | - Alison M Buttenheim
- Department of Family and Community Health, University of Pennsylvania School of Nursing and Center for Health Incentives, University of Pennsylvania, Philadelphia, PA, USA; Behavioral Economics, University of Pennsylvania, Philadelphia, PA, USA
| | - Timothy Callaghan
- Department of Health Law, Policy, and Management, Boston University School of Public Health, Boston, MA, USA
| | | | - Chelsea Clinton
- Clinton Foundation, New York, NY, USA; Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Jad A Elharake
- Yale Institute for Global Health, New Haven, CT, USA; Department of Internal Medicine (Infectious Diseases), Yale School of Medicine, New Haven, CT, USA
| | - Lisa C Flowers
- Department of Obstetrics & Gynecology, Emory University, Atlanta, GA, USA
| | - Alison P Galvani
- Center for Infectious Disease Modeling and Analysis, Yale School of Public Health, New Haven, CT, USA
| | - Peter J Hotez
- Texas Children's Center for Vaccine Development, Baylor College of Medicine, Houston, TX, USA; Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA; Department of Molecular Virology & Microbiology, Baylor College of Medicine, Houston, TX, USA; National School of Tropical Medicine, Baylor College of Medicine, Houston, TX, USA; Department of Biology, Baylor University, Waco, TX, USA; Hagler Institute for Advanced Study, Texas A&M University, College Station, TX, USA; Scowcroft Institute of International Affairs, Bush School of Government and Public Service, Texas A&M University, College Station, TX, USA; James A Baker III Institute for Public Policy, Rice University, Houston, TX, USA
| | - Jason L Schwartz
- Department of Health Policy and Management, Yale School of Public Health, New Haven, CT, USA
| | | | - Arthur Caplan
- New York University Langone School of Medicine, New York University, New York, NY, USA
| | - Renee DiResta
- Stanford Internet Observatory, Stanford University, Stanford, CA, USA
| | | | | | - Michelle M Mello
- Freeman Spogli Institute for International Studies, Stanford University, Stanford, CA, USA; Stanford Law School, Stanford, CA, USA; Department of Health Policy, Stanford University School of Medicine, Stanford, CA, USA
| | - Wendy E Parmet
- Center for Health Policy & Law, Northeastern University, Boston, MA, USA
| | - Daniel A Salmon
- Institute for Vaccine Safety, Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Joshua M Sharfstein
- Department of Health Policy and Management, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Saad B Omer
- Yale Institute for Global Health, New Haven, CT, USA; Department of Internal Medicine (Infectious Diseases), Yale School of Medicine, New Haven, CT, USA; Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA; Yale School of Nursing, Orange, CT, USA
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14
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Parents' Attitudes toward Childhood Vaccines and COVID-19 Vaccines in a Turkish Pediatric Outpatient Population. Vaccines (Basel) 2022; 10:vaccines10111958. [PMID: 36423053 PMCID: PMC9699553 DOI: 10.3390/vaccines10111958] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 11/08/2022] [Accepted: 11/10/2022] [Indexed: 11/19/2022] Open
Abstract
Vaccination hesitancy (VH) is an important public health issue. The determinants of parental decisions on whether to vaccinate their children are multidimensional and need to be carefully considered in the COVID-19 era. Our study aims to investigate the prevalence of VH among parents, parents’ use of social media, and their attitudes toward the COVID-19 vaccine upon vaccine refusal. Materials and methods: Our participants were the parents of children admitted to hospitals in three different cities in Turkey between September 2021 and December 2021. The parents were asked to complete sociodemographic data and their attitudes toward COVID-19 diseases, the Parental Attitudes Toward Childhood Vaccines (PACV) scale, and the Attitudes Toward COVID-19 Vaccine (ATV-COVID-19) scale. Participants were categorized as “non-hesitant”, with a score of <50, and “hesitant”, with a score of ≥50. Results: A total of 1087 parents with a mean age of 33.66 (SD 9.1) years old participated in the study. VH was noted in 102 (9.38%) parents. Age, gender, education, and income levels did not significantly differ from one another, according to the PACV; however, parents who delayed vaccinating their children and indicated that social media had an impact on vaccination decisions were more hesitant. Parents who were male and had a family member diagnosed with COVID-19 showed more positive attitudes in the ATV-COVID-19. Parents who were hesitant about childhood vaccinations had lower positive attitudes toward the COVID-19 vaccine (2.84 ± 0.97) than parents who were not hesitant (3.77 ± 0.9). A total of 761 (70.14%) parents need more information about childhood immunizations. Conclusion: Parents who are hesitant about childhood immunization programs in Turkey have a less positive attitude toward COVID-19 vaccines and are affected by social media. Parents need information about vaccines, and because the controversy surrounding COVID-19 vaccines can diminish parents’ confidence in routine childhood immunizations, understanding the complex causes behind vaccination hesitancy can help public health policy break through barriers and increase immunization rates.
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15
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ElSayed DA, Bou Raad E, Bekhit SA, Sallam M, Ibrahim NM, Soliman S, Abdullah R, Farag S, Ghazy RM. Validation and Cultural Adaptation of the Parent Attitudes about Childhood Vaccines (PACV) Questionnaire in Arabic Language Widely Spoken in a Region with a High Prevalence of COVID-19 Vaccine Hesitancy. Trop Med Infect Dis 2022; 7:234. [PMID: 36136645 PMCID: PMC9504773 DOI: 10.3390/tropicalmed7090234] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Revised: 09/01/2022] [Accepted: 09/06/2022] [Indexed: 11/16/2022] Open
Abstract
The parents’ attitude toward vaccinating children and adolescents against coronavirus disease 2019 (COVID-19) remains inconsistent and needs further elucidation. The high rates of COVID-19 vaccine hesitancy in the Middle East and North Africa (MENA) region require intensive research to understand the determinants of this phenomenon. This study aimed to validate a version of the Parent Attitudes about Childhood Vaccines (PACV) tool in Arabic, the most widely spoken language in the MENA. The study objectives included the investigation of Arab-speaking parents’ views regarding COVID-19 vaccination of their children. Parents living in Egypt with at least one child aged 5−18 years were eligible to participate in the study that was conducted through an online survey with 15 PACV items. The PACV tool was translated into Arabic using forward and backward translation. To assess the psychometric properties of the Arabic version of PACV, Pearson’s correlation coefficient and exploratory and confirmatory factor analysis (EFA and CFA) were performed. A total of 223 parents participated in the study: 59.82% aged 30−39 years, 69.20% were females, 46.19% were university-educated, and 40.63% had one child. The overall Cronbach’s alpha for the Arabic version of PACV was 0.799. The EFA of the 15 items showed that three domains were most conceptually equivalent. All items had a positive significant correlation with the mean score of each subscale except for item 4 (r = 0.016, p = 0.811). Regression analyses results indicated that education, previous COVID-19 infection, vaccine status of parents, and PACV score were significantly associated with the intention of the parents to vaccinate their children against COVID-19. The CFA results showed that most of the factor loadings were statistically significant (p < 0.010) except for items 4 and 7. However, the root mean square error of approximation (RMSEA = 0.080) and the standardized root mean squared residual (SRMR = 0.080) indicated that the model had a reasonable fit, and the three factors were good in reproducing each correlation. Our study results indicated the validity and reliability of the PACV instrument in Arabic language. Consequently, the PACV can be used to assess COVID-19 vaccine hesitancy in a majority of MENA countries for better delineation of this highly prevalent phenomenon in the region.
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Affiliation(s)
- Doaa Ali ElSayed
- Family Health Department, High Institute of Public Health, Alexandria University, Alexandria 21561, Egypt
| | - Etwal Bou Raad
- School of Pharmacy, Lebanese International University, Beirut 961, Lebanon
| | - Salma A. Bekhit
- Environmental Health Department, High Institute of Public Health, Alexandria University, Alexandria 21561, Egypt
| | - Malik Sallam
- Department of Pathology, Microbiology and Forensic Medicine, School of Medicine, The University of Jordan, Amman 11942, Jordan
- Department of Clinical Laboratories and Forensic Medicine, Jordan University Hospital, Amman 11942, Jordan
- Department of Translational Medicine, Faculty of Medicine, Lund University, 22184 Malmö, Sweden
| | - Nada M. Ibrahim
- Nutrition Department, High Institute of Public Health, Alexandria University, Alexandria 21561, Egypt
| | - Sarah Soliman
- Tropical Health Department, High Institute of Public Health, Alexandria University, Alexandria 21561, Egypt
| | - Reham Abdullah
- Infectious Disease Residency Program, Egyptian Ministry of Health and Population, Cairo 71529, Egypt
| | - Shehata Farag
- Biostatistics Department, High Institute of Public Health, Alexandria University, Alexandria 21561, Egypt
- Department of Family and Community Medicine, College of Medicine, King Khalid University, Abha 62529, Saudi Arabia
| | - Ramy Mohamed Ghazy
- Tropical Health Department, High Institute of Public Health, Alexandria University, Alexandria 21561, Egypt
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