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Skrzat-Klapaczyńska A, Kowalska J, Fijołek F, Paciorek M, Bieńkowski C, Krogulec D, Horban A. Vaccination against COVID-19 among healthcare workers as a cocoon strategy for people living with HIV. J Virus Erad 2024; 10:100377. [PMID: 38983868 PMCID: PMC11228949 DOI: 10.1016/j.jve.2024.100377] [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: 03/18/2024] [Revised: 06/01/2024] [Accepted: 06/09/2024] [Indexed: 07/11/2024] Open
Abstract
Introduction Healthcare professionals working in infectious disease units are often engaged in the care of patients with HIV infection. A cocoon vaccination strategy may protect those who are immunocompromised from a severe course of COVID-19. Methods The research was conducted between January 2021 and June 2022. The study participants were 450 healthcare workers (HCWs) from the Hospital for Infectious Diseases in Warsaw who were vaccinated against COVID-19 with the BNT162b2 mRNA vaccine (Pfizer-BioNTech) -, thefirst available type of vaccine in Poland. Sera were collected according to the schedule of the study. Statistical analyses were performed with non-parametric tests: Wilcoxon's test was used to compare dependent numerical variables, and Fisher's exact test and the Chi-squared test to compare categorical variables. A p value of <0.05 was considered statistically significant. Results Among the 450 HCWs working in the Hospital for Infectious Diseases in Warsaw 412 (91,5 %) were vaccinated against COVID-19. In total 170 (41,3 %) vaccinated HCWs were included in the final analysis. Their median age was 51 years [interquartile range (IQR): 41-60 years] and median body mass index (BMI) was 25.10 [IQR: 22.68-29.03]. Most of the cohort consisted of women (n = 137, 80.59 %), with the majority working directly with patients (n = 137, 73.21 %). It was found that as early as 14 days after the second dose of the vaccine, 100 % of the study participants achieved a positive result for SARS CoV-2 S-RBD antibodies. There were 168 subjects who had had a COVID-19 diagnosis before entering study and after vaccination 65 HCWs was diagnosed with COVID-19. Conclusions Due to the fact that people living with HIV with severe immunodeficiency may have an incomplete immune response to COVID vaccination and be at risk of a severe course of the disease, the cocoon strategy of vaccinating medical personnel may be beneficial for these patients.
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Affiliation(s)
- Agata Skrzat-Klapaczyńska
- Department of Adults' Infectious Diseases, Hospital for Infectious Diseases, Medical University of Warsaw, Poland
- Ward 7, Hospital for Infectious Diseases, 01-201, Warsaw, Poland
| | - Justyna Kowalska
- Department of Adults' Infectious Diseases, Hospital for Infectious Diseases, Medical University of Warsaw, Poland
- Ward 7, Hospital for Infectious Diseases, 01-201, Warsaw, Poland
| | - Filip Fijołek
- Ward 7, Hospital for Infectious Diseases, 01-201, Warsaw, Poland
| | - Marcin Paciorek
- Department of Adults' Infectious Diseases, Hospital for Infectious Diseases, Medical University of Warsaw, Poland
- Ward 7, Hospital for Infectious Diseases, 01-201, Warsaw, Poland
| | - Carlo Bieńkowski
- Department of Adults' Infectious Diseases, Hospital for Infectious Diseases, Medical University of Warsaw, Poland
- Ward 7, Hospital for Infectious Diseases, 01-201, Warsaw, Poland
| | - Dominika Krogulec
- Department of Adults' Infectious Diseases, Hospital for Infectious Diseases, Medical University of Warsaw, Poland
- Ward 7, Hospital for Infectious Diseases, 01-201, Warsaw, Poland
| | - Andrzej Horban
- Department of Adults' Infectious Diseases, Hospital for Infectious Diseases, Medical University of Warsaw, Poland
- Ward 7, Hospital for Infectious Diseases, 01-201, Warsaw, Poland
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Gkentzi D, Mpania L, Fouzas S, Sinopidis X, Dimitriou G, Karatza AA. Influenza vaccination among caregivers and household contacts of children with congenital heart disease before and during COVID-19 pandemic. J Paediatr Child Health 2022; 58:468-473. [PMID: 34562323 PMCID: PMC8662015 DOI: 10.1111/jpc.15748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 08/19/2021] [Accepted: 08/27/2021] [Indexed: 02/05/2023]
Abstract
AIM We aimed to investigate the influenza immunisation status of caregivers and household contacts of children with congenital heart disease (CHD) and potential barriers to vaccine uptake. METHODS Prospective questionnaire-based survey over two influenza seasons (2019-2020 and 2020-2021) on 161 children with CHD attending a tertiary paediatric cardiology clinic and their families. Logistic regression and factor analysis were performed to identify factors associated with influenza vaccine uptake. RESULTS Influenza vaccination coverage of children was 65%, whereas that of their fathers and mothers was 34% and 26%, respectively. Children with unvaccinated siblings represented 43% and those with unvaccinated adults in the household 79% of our study population. No statistically significant differences were found before and during COVID-19 pandemic on vaccine uptake. Logistic regression analysis showed that higher education level, understanding the risk of contracting the disease and vaccination status of the child determined the vaccination status of parents, regardless of their age, age of their child, severity of CHD, beliefs about vaccine safety and efficacy and risk of transmission if not vaccinated. Factor analysis revealed distinct groups among unvaccinated parents (76.3% of the variation in the responses). CONCLUSIONS Vaccination coverage of caregivers and household contacts of children with CHD is suboptimal. Influenza vaccination campaigns should take into consideration the specific characteristics of parental groups and target interventions accordingly to increase their vaccine uptake and indirectly protect children with CHD.
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Affiliation(s)
- Despoina Gkentzi
- Department of PaediatricsUniversity of Patras Medical SchoolPatrasGreece
| | - Lamprini Mpania
- Department of PaediatricsUniversity of Patras Medical SchoolPatrasGreece
| | - Sotirios Fouzas
- Department of PaediatricsUniversity of Patras Medical SchoolPatrasGreece
| | - Xenophon Sinopidis
- Department of PaediatricsUniversity of Patras Medical SchoolPatrasGreece
| | - Gabriel Dimitriou
- Department of PaediatricsUniversity of Patras Medical SchoolPatrasGreece
| | - Ageliki A Karatza
- Department of PaediatricsUniversity of Patras Medical SchoolPatrasGreece
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Giatraki V, Dimitriou H, Pappas A, Mamoulakis D, Makris G, Galanakis E, Perdikogianni C. Vaccine coverage in children, adolescents and adults with type 1 diabetes and their close contacts in Crete. Hum Vaccin Immunother 2021; 17:4291-4298. [PMID: 34613871 DOI: 10.1080/21645515.2021.1973882] [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: 10/20/2022] Open
Abstract
BACKGROUND Individuals with type 1 diabetes (T1D) are at increased risk of infections from vaccine-preventable diseases. This study focuses on compliance of T1D patients to the recommended vaccination schedule, vaccination of their close contacts for influenza and on factors potentially contributing to vaccination program deviations. METHODS The study population comprised children, adolescents and adults with T1D under follow-up at the Department of Pediatrics University Hospital and the Diabetic Center General Hospital, Heraklion, Crete-Greece. Data were extracted, following informed consent, from individual's vaccination booklet, medical files and telephone interview. Vaccination records, demographic parameters, glycemic control and influenza vaccination of close contacts were assessed. RESULTS The study included 258 participants (111 children/adolescents, 147 adults). Vaccination coverage for influenza was 76.7% for children, 64.4% for adults, for PCV 90.9% for children, but only 10.8% for the 23-valent, for hepatitis B 99% for children and 78.2% for adults. Youngsters were vaccinated against Hib 91.9%, meningococcus C 98.2%, measles-mumps-rubella 90.3%, chickenpox 86.4%, hepatitis A 76.5% and HPV 42.5%. Less than 65% of all individuals were fully vaccinated for diphtheria-tetanus-pertussis and meningococcus ACWY. Approximately 50% of the 605 close contacts were not vaccinated against influenza. Individuals with better glycemic status seemed to adhere to the recommended schedule and had a better vaccinated family environment. CONCLUSIONS Vaccination coverage for T1D individuals was sufficient regarding the majority of routine childhood vaccines, but less for adolescence and group-specific vaccines. Their family contacts were not sufficiently vaccinated for influenza. Targeted interventions are required in order to increase vaccination rates.
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Affiliation(s)
- Victoria Giatraki
- Department of Pediatrics, University Hospital of Heraklion, Medical School University of Crete, Greece
| | - Helen Dimitriou
- Department of Pediatrics, University Hospital of Heraklion, Medical School University of Crete, Greece
| | - Aggelos Pappas
- Diabetic Centre, Venizeleio General Hospital, Heraklion, Crete, Greece
| | - Dimitris Mamoulakis
- Department of Pediatrics, University Hospital of Heraklion, Medical School University of Crete, Greece
| | - George Makris
- Diabetic Centre, Venizeleio General Hospital, Heraklion, Crete, Greece
| | - Emmanouil Galanakis
- Department of Pediatrics, University Hospital of Heraklion, Medical School University of Crete, Greece
| | - Chrysoula Perdikogianni
- Department of Pediatrics, University Hospital of Heraklion, Medical School University of Crete, Greece
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Adult Caregiver Influenza Vaccination Through Administration in Pediatric Outpatient Clinics: A Cocooning Healthcare Improvement Project. Pediatr Infect Dis J 2018; 37:939-942. [PMID: 29505481 DOI: 10.1097/inf.0000000000001970] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Pediatric exposure to influenza-infected adult caregivers (AC) is a significant risk factor for developing influenza. Poor access to vaccines contributes to low adult vaccination rates. We offered adult vaccination at regularly scheduled pediatric office visits and examined barriers to improve future vaccination rates. METHODS Via a retrospective chart review, we identified ACs who received an influenza vaccination at 1 of 3 pediatric clinics within an academic center from August 2015 to May 2016. We screened for demographics of ACs and their children. Rates of AC vaccination and AC refusal were not measured. RESULTS A total of 297 ACs representing 518 children received their influenza vaccine at their child's pediatric office. The mean age of ACs was 35.9 years (range, 22-70 years) and 68.5% were mothers. Most ACs (n = 294, 99%) receiving the vaccine had private insurance. Almost all ACs received their vaccination on the day of the child's visit (n = 250, 84%). A total of 49.6% of AC's children had high-risk illnesses. Parents of children with Medicaid were under-represented because of high parental copays (n = 3, 1%). The highest clinic vaccine participation was noted at the clinics with lowest Medicaid populations. CONCLUSIONS ACs readily accepted influenza vaccination at their child's pediatric primary care office. Increased vaccination acceptance occurred when ACs were female, had private insurance, if their child had a chronic illness and if the vaccination was offered the same day as their child's appointment. Likely reason for low acceptance in ACs with Medicaid insurance is high cost; thus, staff, well-aware of Medicaid's nonreimbursement, likely offered the vaccine less to these parents.
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Siegel JD, Guzman-Cottrill JA. Pediatric Healthcare Epidemiology. PRINCIPLES AND PRACTICE OF PEDIATRIC INFECTIOUS DISEASES 2018. [PMCID: PMC7152479 DOI: 10.1016/b978-0-323-40181-4.00002-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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DePasse JV, Smith KJ, Raviotta JM, Shim E, Nowalk MP, Zimmerman RK, Brown ST. Does Choice of Influenza Vaccine Type Change Disease Burden and Cost-Effectiveness in the United States? An Agent-Based Modeling Study. Am J Epidemiol 2017; 185:822-831. [PMID: 28402385 DOI: 10.1093/aje/kww229] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2016] [Accepted: 06/30/2016] [Indexed: 12/22/2022] Open
Abstract
Offering a choice of influenza vaccine type may increase vaccine coverage and reduce disease burden, but it is more costly. This study calculated the public health impact and cost-effectiveness of 4 strategies: no choice, pediatric choice, adult choice, or choice for both age groups. Using agent-based modeling, individuals were simulated as they interacted with others, and influenza was tracked as it spread through a population in Washington, DC. Influenza vaccination coverage derived from data from the Centers for Disease Control and Prevention was increased by 6.5% (range, 3.25%-11.25%), reflecting changes due to vaccine choice. With moderate influenza infectivity, the number of cases averaged 1,117,285 for no choice, 1,083,126 for pediatric choice, 1,009,026 for adult choice, and 975,818 for choice for both age groups. Averted cases increased with increased coverage and were highest for the choice-for-both-age-groups strategy; adult choice also reduced cases in children. In cost-effectiveness analysis, choice for both age groups was dominant when choice increased vaccine coverage by ≥3.25%. Offering a choice of influenza vaccines, with reasonable resultant increases in coverage, decreased influenza cases by >100,000 with a favorable cost-effectiveness profile. Clinical trials testing the predictions made based on these simulation results and deliberation of policies and procedures to facilitate choice should be considered.
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Moriarty LF, Omer SB. Infants and the seasonal influenza vaccine. A global perspective on safety, effectiveness, and alternate forms of protection. Hum Vaccin Immunother 2016; 10:2721-8. [PMID: 25483664 DOI: 10.4161/hv.29669] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Seasonal influenza is a substantial cause of severe illness among infants under 6 months of age globally. There are multiple methods of vaccination against influenza, including inactivated and live vaccines that are approved and recommended for children and adults over 6 months of age, but there is no vaccine that protects against seasonal influenza for children <6 months of age. This group is at a high risk of severe illness and is associated with higher rates of hospitalization and mortality during the influenza season. In absence of an available vaccine, approaches protecting young infants from influenza must be taken seriously. These methods include vaccinating pregnant women for influenza as a method of protecting mothers and the fetus as well as vaccinating caregivers and close contacts of individuals in this age group.
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Affiliation(s)
- Leah F Moriarty
- a Hubert Department of Global Health; Rollins School of Public Health ; Emory University ; Atlanta , GA USA
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Shepard JE, Douglas A, Phillipi CA, Guzman-Cottrill JA. Free Vaccines for Parents Program: A Novel (and Successful) Pediatric Resident Advocacy Project. Acad Pediatr 2015; 15:476-9. [PMID: 26344716 DOI: 10.1016/j.acap.2015.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Accepted: 07/14/2015] [Indexed: 10/23/2022]
Affiliation(s)
- Jennifer E Shepard
- Department of Pediatrics, Oregon Health & Science University, Portland, Ore.
| | - Angela Douglas
- Department of Pediatrics, Oregon Health & Science University, Portland, Ore
| | - Carrie A Phillipi
- Department of Pediatrics, Oregon Health & Science University, Portland, Ore
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Berti E, Venturini E, Galli L, de Martino M, Chiappini E. Management and prevention of pertussis infection in neonates. Expert Rev Anti Infect Ther 2014; 12:1515-31. [PMID: 25371322 DOI: 10.1586/14787210.2014.979156] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Despite the fact that universal immunization against pertussis led to a dramatic decrease in the incidence and mortality in high-income countries, it has left a window of vulnerability for newborns. Although specific guidelines concerning management of neonatal whooping cough have not yet been developed, the present review summarizes the main available recommendations on diagnostic work-up and treatment of neonatal pertussis. Additionally, new prevention strategies are explored, including the use of an additional booster dose of vaccine to adolescents and adults, vaccination of healthcare workers, immunization of household contacts and caregivers (cocooning strategy), vaccination of pregnant women and, finally, neonatal immunization with novel vaccines. These strategies are analyzed and discussed in terms of efficacy, safety and cost-effectiveness.
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Affiliation(s)
- Elettra Berti
- Department of Health Sciences, Anna Meyer Children's University Hospital, University of Florence, Viale Pieraccini 24, I-50139, Florence, Italy
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MacDonald NE, McDonald JC. The benefits of influenza vaccine in pregnancy for the fetus and the infant younger than six months of age. Paediatr Child Health 2014. [DOI: 10.1093/pch/19.9.e121] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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MacDonald NE, McDonald JC. Les avantages d’administrer le vaccin antigrippal pendant la grossesse pour le fœtus et le nourrisson de moins de six mois. Paediatr Child Health 2014. [DOI: 10.1093/pch/19.9.e123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Stockwell MS, Westhoff C, Kharbanda EO, Vargas CY, Camargo S, Vawdrey DK, Castaño PM. Influenza vaccine text message reminders for urban, low-income pregnant women: a randomized controlled trial. Am J Public Health 2013; 104 Suppl 1:e7-12. [PMID: 24354839 DOI: 10.2105/ajph.2013.301620] [Citation(s) in RCA: 83] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We evaluated the impact of influenza vaccine text message reminders in a low-income obstetric population. METHODS We conducted a randomized controlled trial that enrolled 1187 obstetric patients from 5 community-based clinics in New York City. The intervention group received 5 weekly text messages regarding influenza vaccination starting mid-September 2011 and 2 text message appointment reminders. Both groups received standard automated telephone appointment reminders. The prespecified endpoints were receipt of either pre- or postpartum influenza vaccination calculated cumulatively at the end of each month (September-December 2011). RESULTS After adjusting for gestational age and number of clinic visits, women who received the intervention were 30% more likely to be vaccinated as of December 2011 (adjusted odds ratio [AOR] = 1.30; 95% confidence interval [CI] = 1.003, 1.69 end of September: AOR = 1.34; 95% CI = 0.98, 1.85; October: AOR = 1.35; 95% CI = 1.05, 1.75; November: AOR = 1.27; 95% CI = 0.98, 1.65). The subgroup of women early in the third trimester at randomization showed the greatest intervention effect (December 31: 61.9% intervention vs 49.0% control; AOR = 1.88; 95% CI = 1.12, 3.15). CONCLUSIONS In this low-income obstetric population, text messaging was associated with increased influenza vaccination, especially in those who received messages early in their third trimester.
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Affiliation(s)
- Melissa S Stockwell
- Melissa S. Stockwell is with the Departments of Pediatrics and Population and Family Health, Columbia University, and New York-Presbyterian Hospital, New York, NY. Carolyn Westhoff is with the Departments of Obstetrics and Gynecology and Epidemiology, Columbia University. Elyse Olshen Kharbanda is with HealthPartners Institute for Education and Research, Minneapolis, MN. Celibell Y. Vargas and Stewin Camargo are with the Department of Pediatrics, Columbia University. David K. Vawdrey is with the Department of Biomedical Informatics, Columbia University, and New York-Presbyterian Hospital. Paula M. Castaño is with the Department of Obstetrics and Gynecology, Columbia University
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Evaluation of several approaches to immunize parents of neonates against B. pertussis. Vaccine 2013; 31:6087-91. [DOI: 10.1016/j.vaccine.2013.09.043] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2013] [Revised: 09/16/2013] [Accepted: 09/23/2013] [Indexed: 11/24/2022]
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Maltezou HC, Fotiou A, Antonakopoulos N, Kallogriopoulou C, Katerelos P, Dimopoulou A, Tsoutsa V, Siahanidou T, Papagaroufalis C, Kostis E, Papantoniou N, Antsaklis A, Theodoridou M. Impact of Postpartum Influenza Vaccination of Mothers and Household Contacts in Preventing Febrile Episodes, Influenza-like Illness, Healthcare Seeking, and Administration of Antibiotics in Young Infants During the 2012-2013 Influenza Season. Clin Infect Dis 2013; 57:1520-6. [DOI: 10.1093/cid/cit599] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Wheelock A, Thomson A, Sevdalis N. Social and psychological factors underlying adult vaccination behavior: lessons from seasonal influenza vaccination in the US and the UK. Expert Rev Vaccines 2013; 12:893-901. [PMID: 23944683 DOI: 10.1586/14760584.2013.814841] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
This article reviews the evidence base on the social and psychological factors that facilitate or hinder vaccination among adults. The authors categorized these factors into eight themes: social influence, disease-related factors, vaccine-related factors, habit, general attitudes toward health and vaccines, awareness and knowledge, practical barriers and motivators and altruism. Although there were many commonalities between both settings, the authors also indentifiedimportant differences. A better understanding of social and psychological aspects of vaccination across contexts and vaccines remains a priority.
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Affiliation(s)
- Ana Wheelock
- Centre for Patient Safety and Service Quality, Imperial College London, Medical School Building, St Mary's Campus, Norfolk Place, London, W2 1PG, UK.
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