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Zakhour R, Tamim H, Faytrouni F, Makki M, Hojeij R, Charafeddine L. Determinants of human papillomavirus vaccine hesitancy among Lebanese parents. PLoS One 2023; 18:e0295644. [PMID: 38091310 PMCID: PMC10718448 DOI: 10.1371/journal.pone.0295644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Accepted: 11/27/2023] [Indexed: 12/18/2023] Open
Abstract
INTRODUCTION Human papillomavirus (HPV) is the most common sexually transmitted infection. HPV is responsible for cancer of cervix uteri. Despite its safety and immunogenicity, HPV vaccine hesitancy is one of the most challenging topics that pediatricians face. METHODS We aimed to describe the impact of knowledge, attitude, and practice towards vaccines in general, on practice related to HPV vaccination in Lebanon. A questionnaire addressed to parents of students (3-18 years of age) was distributed in 2 public and 2 private schools randomly selected from the greater Beirut area during the school year 2017-2018. Questionnaires covered knowledge, attitude, and practices of vaccination in general and HPV vaccine in particular. RESULTS Out of 400 distributed questionnaires, 306 (76.5%) were returned. Of the 185 parents aware of HPV vaccine, 60% hadn't given or were not planning to give the HPV vaccine to their children. Of parents not in favor of HPV vaccine, 7.5 thought that vaccines aren't necessary versus none among those in favor of HPV vaccine(p = 0.02). Thirteen percent of those not in favor of HPV vaccine thought that vaccines are not safe versus 2.7% in the group in favor (p = 0.02). An effect of gender on vaccine acceptance was noted: mothers vs fathers and daughters vs sons. Lack of recommendation by pediatricians and the thought that too little is known about the vaccine were the most selected reasons for parents not wanting to vaccinate their children against HPV, whereas cost and religious and cultural beliefs seemed to have no impact. CONCLUSION Most parents in our study did not vaccinate or weren't willing to vaccinate their children against HPV even when they were in favor of vaccines in general. Physician recommendation was shown to be one of the most important predictors of vaccination. Effort should be put into educating parents about the importance of the vaccine and its well-established safety and efficacy regardless of gender. Lebanese physicians should also be educated and empowered to recommend HPV vaccine more strongly and consistently.
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Affiliation(s)
- Ramia Zakhour
- Division of Pediatric Infectious Diseases, McGovern Medical School Houston, University of Texas, Austin, Texas, United States of America
| | - Hani Tamim
- Department of Internal Medicine, Clinical Research Institute, American University of Beirut Medical Center, Beirut, Lebanon
- College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | - Farah Faytrouni
- Department of Pediatrics, Medcare Medical Centers, Dr Sulaiman Al Habib Medical Group, United Arab Emirates
| | - Maha Makki
- Clinical Research Institute, American University of Beirut Medical Center, Beirut, Lebanon
| | - Rayan Hojeij
- Division of Pediatric Infectious Diseases, McGovern Medical School Houston, University of Texas, Austin, Texas, United States of America
| | - Lama Charafeddine
- Division of Pediatric Infectious Diseases, McGovern Medical School Houston, University of Texas, Austin, Texas, United States of America
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McMann T, Wenzel C, Le N, Li Z, Xu Q, Cuomo RE, Mackey T. Detection and Characterization of Web-Based Pediatric COVID-19 Vaccine Discussions and Racial and Ethnic Minority Topics: Retrospective Analysis of Twitter Data. JMIR Pediatr Parent 2023; 6:e48004. [PMID: 38038663 DOI: 10.2196/48004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 09/20/2023] [Accepted: 09/21/2023] [Indexed: 12/02/2023] Open
Abstract
Background Despite pediatric populations representing a smaller proportion of COVID-19 cases and having a less severe prognosis, those belonging to racial and ethnic minority groups are at an increased risk of developing more severe COVID-19-related outcomes. Vaccine coverage is crucial to pandemic mitigation efforts, yet since the start of the COVID-19 pandemic, vaccine hesitancy has increased and routine pediatric immunizations have decreased. Limited research exists on how vaccine hesitancy may contribute to low pediatric COVID-19 vaccine uptake among racial and ethnic minority populations. Objective This study aimed to characterize COVID-19 vaccine-related discussion and sentiment among Twitter users, particularly among racial and ethnic minority users. Methods We used the Twitter application programming interface to collect tweets and replies. Tweets were selected by filtering for keywords associated with COVID-19 vaccines and pediatric-related terms. From this corpus of tweets, we used the Biterm Topic Model to output topics and examined the top 200 retweeted tweets that were coded for pediatric COVID-19 vaccine relevance. Relevant tweets were analyzed using an inductive coding approach to characterize pediatric COVID-19 vaccine-related themes. Replies to relevant tweets were collected and coded. User metadata were assessed for self-reporting of race or ethnic group affiliation and verified account status. Results A total of 863,007 tweets were collected from October 2020 to October 2021. After outputting Biterm Topic Model topics and reviewing the 200 most retweeted tweets, 208,666 tweets and 3905 replies were identified as being pediatric COVID-19 vaccine related. The majority (150,262/208,666, 72.01%) of tweets expressed vaccine-related concerns. Among tweets discussing vaccine confidence, user replies expressing agreement were significantly outweighed by those expressing disagreement (1016/3106, 32.71% vs 2090/3106, 67.29%; P<.001). The main themes identified in the Twitter interactions were conversations regarding vaccine-related concerns including adverse side effects, concerns that the vaccine is experimental or needs more testing and should not be tested on pediatric populations, the perception that the vaccine is unnecessary given the perceived low risk of pediatric infection, and conversations associated with vaccine-related confidence (ie, the vaccine is protective). Among signal tweets and replies, we identified 418 users who self-identified as a racial minority individual and 40 who self-identified as an ethnic minority individual. Among the subcodes identified in this study, the vaccine being protective was the most discussed topic by racial and ethnic minority groups (305/444, 68.7%). Conclusions Vaccine-related concerns can have negative consequences on vaccine uptake and participation in vaccine-related clinical trials. This can impact the uptake and development of safe and effective vaccines, especially among racial and ethnic minority populations.
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Affiliation(s)
- Tiana McMann
- Global Health Program, Department of Anthropology, University of California, San Diego, La Jolla, CA, United States
- Global Health Policy and Data Institute, San Diego, CA, United States
- S-3 Research, San Diego, CA, United States
| | | | - Nicolette Le
- Global Health Program, Department of Anthropology, University of California, San Diego, La Jolla, CA, United States
- Global Health Policy and Data Institute, San Diego, CA, United States
| | - Zhuoran Li
- Global Health Policy and Data Institute, San Diego, CA, United States
- S-3 Research, San Diego, CA, United States
| | - Qing Xu
- Global Health Policy and Data Institute, San Diego, CA, United States
- S-3 Research, San Diego, CA, United States
| | - Raphael E Cuomo
- Global Health Policy and Data Institute, San Diego, CA, United States
- Department of Anesthesiology, School of Medicine, University of California, San Diego, San Diego, CA, United States
| | - Tim Mackey
- Global Health Program, Department of Anthropology, University of California, San Diego, La Jolla, CA, United States
- Global Health Policy and Data Institute, San Diego, CA, United States
- S-3 Research, San Diego, CA, United States
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Salmanizadeh F, Jannati N, Ahmadian L, Jahani Y, Balouchi M, Khajouei R. The preferred IT sources and tools of Iranian people for accessing health information. BMC Public Health 2023; 23:1986. [PMID: 37828483 PMCID: PMC10568770 DOI: 10.1186/s12889-023-16334-y] [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: 03/09/2023] [Accepted: 07/18/2023] [Indexed: 10/14/2023] Open
Abstract
INTRODUCTION People need health information to maintain their health. Despite the variety of sources and tools for providing health information, there is little evidence about Iranian people's preferences in using these sources and tools. The objective of this study was to identify the preferred health information sources, tools, and methods for presenting health information in these tools. METHODS This national survey was conducted among a sample of 4000 Iranian people between April and September 2021. The data was collected using a valid and reliable questionnaire (α = 0.86) consisting of four sections: participants' demographic information, current sources of obtaining health information, preferred information technology (IT) tools for accessing health information, and the method of presenting this information. Linear regression was used to investigate the relationship between demographic factors and other questions. RESULTS The participants received health information mostly from the "Internet" (3.62), "family or friends" (3.43), "social networks" (3.41), "specific websites" (3.41), and "mobile apps" (3.27). "Social networks" (3.67), Internet "websites" (3.56), and "mobile apps" (3.50) were the most suitable tools for receiving health information. The participants preferred the presentation of health information in the form of "Images" (3.85), "educational videos" (3.69), and "texts" (3.53). Age, education, and marital status had a significant relationship with most of the preferred information sources, tools, and information presentation methods (p < 0.05). CONCLUSION The results of this study showed that Iranian people are more active information seekers than passive ones compared to a decade ago. The preferred sources and tools identified in this research can be used by healthcare planners and policy-makers in Iran and other developing countries to design and develop IT interventions that meet people's needs. Improving access to the Internet, social networks, and mobile apps and providing health information via images, educational videos, and texts on these platforms enhance access to the information people need.
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Affiliation(s)
- Farzad Salmanizadeh
- Department of Health Information Sciences, Faculty of Management and Medical Information Science, Kerman University of Medical Sciences, Kerman, Iran
| | - Nazanin Jannati
- Department of Health Information Sciences, Faculty of Management and Medical Information Science, Kerman University of Medical Sciences, Kerman, Iran
| | - Leila Ahmadian
- Department of Health Information Sciences, Faculty of Management and Medical Information Science, Kerman University of Medical Sciences, Kerman, Iran
| | - Yunes Jahani
- Modeling in Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Mohsen Balouchi
- Department of Health Information Sciences, Faculty of Management and Medical Information Science, Kerman University of Medical Sciences, Kerman, Iran
| | - Reza Khajouei
- Department of Health Information Sciences, Faculty of Management and Medical Information Science, Kerman University of Medical Sciences, Kerman, Iran.
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Association Between Influenza Vaccination During Pregnancy and Infant Influenza Vaccination. Obstet Gynecol 2023; 141:563-569. [PMID: 36728080 DOI: 10.1097/aog.0000000000005101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 12/22/2022] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To examine the association between influenza vaccination during pregnancy and infant influenza vaccination. METHODS We conducted a retrospective analysis of individuals aged 15-49 years who were continually privately insured from August 2017 to May 2019 and had singleton live births between September 2017 and February 2018 and their infants. Influenza vaccination coverage was assessed for pregnant people during the 2017-2018 influenza season and for their infants during the 2018-2019 season using the 2017-2019 MarketScan data. Multivariate log-binomial regressions were conducted to examine the association between influenza vaccination during pregnancy and infant influenza vaccination. RESULTS Of the 34,919 pregnant people in this analysis, 14,168 (40.6%) received influenza vaccination during pregnancy. Of the infants born to people vaccinated during pregnancy, 90.0% received at least one dose of influenza vaccine during the 2018-2019 season and 75.5% received at least two doses. Of the infants born to those not vaccinated during pregnancy, 66.3% received at least one dose of influenza vaccine and 51.8% received at least two doses. At-least-one-dose coverage was 35.7% higher (adjusted risk ratio [aRR] 1.34, 95% CI 1.33-1.36) and at-least-two-dose coverage was 45.8% higher (aRR 1.43, 95% CI 1.41-1.46) for infants born to people who received influenza vaccination during pregnancy compared with infants born to people who did not. CONCLUSION Our results show a positive and statistically significant relationship between influenza vaccination during pregnancy and infant influenza vaccination status in their first season eligible for vaccination. Interventions to increase influenza vaccination coverage among pregnant people may also increase infant influenza vaccination coverage, offering greater protection against serious complications of influenza in both vulnerable populations.
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Salazar TL, Pollard DL, Pina-Thomas DM, Benton MJ. Parental vaccine hesitancy and concerns regarding the COVID-19 virus. J Pediatr Nurs 2022; 65:10-15. [PMID: 35367855 PMCID: PMC8970879 DOI: 10.1016/j.pedn.2022.03.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 02/11/2022] [Accepted: 03/23/2022] [Indexed: 01/29/2023]
Abstract
PURPOSE This study assessed parental vaccine hesitancy in a metropolitan area of the United States. The study aimed to determine what characteristics and contributing factors influenced parental vaccine hesitancy and concerns regarding COVID-19. DESIGN AND METHODS An online survey was used to recruit 93 parents to answer demographic and vaccine hesitancy information. Vaccine hesitancy was measured using the Parent Attitudes about Childhood Vaccines survey. The study was conducted between June 2020 and September 2020 during the COVID-19 pandemic. RESULTS The rate of vaccine hesitancy was 15%. One hundred percent of vaccine hesitant parents were mothers, at least 30 years of age, married, and had completed at least some college. When characteristics of vaccine hesitant parents were compared to non-hesitant parents, the hesitant parents reported having more children, with 93% reporting two or more children compared to only 74% of non-hesitant parents (p = 0.046). Fifty percent of hesitant parents reported no concerns regarding COVID-19 compared to only 20% of non-hesitant parents (p = 0.006), and significantly less hesitant parents reported willingness to have their children receive a safe, effective COVID-19 vaccine if it were available compared to non-hesitant parents (p < 0.001). CONCLUSIONS Our findings indicate that older mothers with two or more children are more likely to be vaccine hesitant and this hesitancy extends to the current COVID-19 pandemic. PRACTICE IMPLICATIONS Healthcare providers can use the results of this study to identify parents at risk for vaccine hesitancy and initiate individualized education to promote on-time childhood vaccination.
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Affiliation(s)
- Teresa L Salazar
- Helen & Arthur E. Johnson Beth-El College of Nursing & Health Sciences, University of Colorado Colorado Springs, United States of America; Hampden Medical Group, Englewood, CO, United States of America
| | - Deborah L Pollard
- Helen & Arthur E. Johnson Beth-El College of Nursing & Health Sciences, University of Colorado Colorado Springs, United States of America
| | - Deborah M Pina-Thomas
- Helen & Arthur E. Johnson Beth-El College of Nursing & Health Sciences, University of Colorado Colorado Springs, United States of America
| | - Melissa J Benton
- Helen & Arthur E. Johnson Beth-El College of Nursing & Health Sciences, University of Colorado Colorado Springs, United States of America.
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The Need for Health Education and Vaccination-Importance of Teacher Training and Family Involvement. Healthcare (Basel) 2022; 10:healthcare10010110. [PMID: 35052274 PMCID: PMC8775884 DOI: 10.3390/healthcare10010110] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 12/29/2021] [Accepted: 01/05/2022] [Indexed: 02/04/2023] Open
Abstract
The health emergency due to COVID-19 has highlighted the importance of vaccination and its impact on social welfare. Inequalities have surfaced that affect the most vulnerable and those millions of children do not receive the necessary vaccines. Health education becomes a fundamental resource for citizens to access universal rights. One thousand people from 76 countries on five continents participated in this research in 2019–2020, from the health, education, and economic sectors. A descriptive cross-sectional study with a quantitative design was used. The instrument used was a correctly validated questionnaire: VACUNASEDUCA. The objectives were to reflect on the adequacy of teacher training and their awareness for the proper use of vaccines and to analyze the knowledge of parents about the consequences of vaccination. The results demonstrate the importance of teacher training and health education, with positive involvement of the family. The most favorable group is female, under 30 years, from the European continent, with a very high Human Development Index (HDI), and from the education sector. In conclusion, it is noted that, within the framework of the fourth industrial revolution, education must be configured with innovative approaches and tools, making it necessary to intervene in the context considering their cultural characteristics and promoting healthy lifestyle habits.
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Giannakou K, Kyprianidou M, Hadjikou A, Fakonti G, Photiou G, Tzira E, Heraclides A. Knowledge of mothers regarding children's vaccinations in Greece: an online cross-sectional study. BMC Public Health 2021; 21:2119. [PMID: 34794423 PMCID: PMC8600348 DOI: 10.1186/s12889-021-12179-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 10/29/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND One of the main reasons that influence parental choice to postpone or avoid children's vaccination is insufficient knowledge. Mothers' knowledge can be considered as an important factor when determining childcare, as they are often the primary decision maker for their children's healthcare issues. This study aimed to assess the level of mothers' knowledge and practice on certain aspects of vaccination for their child/children in Greece. METHODS This was an online cross-sectional survey, which collected information about mother's socio-demographic characteristics, vaccination-related information, and vaccine knowledge using a self-administered questionnaire. The survey was conducted between April 2020 and June 2020 and the study population included mothers over 18 years old with at least one child (< 18 years old), living in four broad geographical areas of Greece (Attica, Central Greece, North Greece, and Crete/Aegean Islands). RESULTS A total of 1885 Greek mothers participated in the study. The majority stated that they vaccined their child/children (98%), and the most popular source of information about vaccination was their child's pediatrician (89%). About half of participants (52%) have delayed their child/children vaccination with their pediatrician's suggestion being the main driver. The median knowledge score was 11 which indicates a high knowledge level for childhood vaccination among Greek mothers. Multiple linear regression analysis identified an inverse association between education and knowledge score, characterized by higher knowledge scores among individuals with secondary and even higher among those with higher education. Multiple logistic regression analysis showed that the strict adherence to the prescribed dosage as indicated by the local recommendations for each vaccine, was associated with most of the knowledge items included in the study. CONCLUSIONS Our findings show that the vast majority of mothers in Greece did vaccinate their child/children, while pediatricians appear to have a very influential role in mothers' decision making. High knowledge around vaccination was associated with mothers' educational attainment, being particularly high among those who completed higher education. Considerable attention is required from public health authorities to promote vaccination through educational programs and campaigns, particularly aimed at people with lower educational attainment. Additionally, improving communication between pediatricians and mothers to reach those women who have not decided to vaccinate or delayed vaccination for their children, may prove to be very beneficial.
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Affiliation(s)
- Konstantinos Giannakou
- Department of Health Sciences, School of Sciences, European University Cyprus, 6 Diogenes Str. Engomi, 2404, P.O. Box: 22006, 1516, Nicosia, Cyprus.
| | - Maria Kyprianidou
- Department of Health Sciences, School of Sciences, European University Cyprus, 6 Diogenes Str. Engomi, 2404, P.O. Box: 22006, 1516, Nicosia, Cyprus.,Cyprus International Institute for Environmental and Public Health, Cyprus University of Technology, Limassol, Cyprus
| | - Andria Hadjikou
- Department of Health Sciences, School of Sciences, European University Cyprus, 6 Diogenes Str. Engomi, 2404, P.O. Box: 22006, 1516, Nicosia, Cyprus
| | - Georgia Fakonti
- Department of Health Sciences, School of Sciences, European University Cyprus, 6 Diogenes Str. Engomi, 2404, P.O. Box: 22006, 1516, Nicosia, Cyprus.,Faculty of Medicine, Department of Infectious Diseases, Imperial College London, London, UK
| | - Galatia Photiou
- Cyprus International Institute for Environmental and Public Health, Cyprus University of Technology, Limassol, Cyprus
| | - Eleana Tzira
- Department of Health Sciences, School of Sciences, European University Cyprus, 6 Diogenes Str. Engomi, 2404, P.O. Box: 22006, 1516, Nicosia, Cyprus
| | - Alexandros Heraclides
- Department of Health Sciences, School of Sciences, European University Cyprus, 6 Diogenes Str. Engomi, 2404, P.O. Box: 22006, 1516, Nicosia, Cyprus
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Lee M, You M. Direct and Indirect Associations of Media Use with COVID-19 Vaccine Hesitancy: Cross-sectional Web-Based Survey in South Korea. J Med Internet Res 2021; 24:e32329. [PMID: 34870605 PMCID: PMC8734608 DOI: 10.2196/32329] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 10/03/2021] [Accepted: 11/18/2021] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Background: The battle against the 2019 novel coronavirus (COVID-19) has not concluded. Although vaccines are available, the high prevalence of vaccine hesitancy represents a significant challenge to public health and raising vaccine acceptance among the public is critical. While media has become an increasingly popular source of COVID-19 vaccine-related information, the question of whether and how media use is related to the public's vaccine hesitancy warrants exploration. OBJECTIVE This study aimed to (1) examine the level of COVID-19 vaccine hesitancy, (2) identify factors associated with COVID-19 vaccine hesitancy, and (3) explore the direct and indirect relationship between media use and vaccine hesitancy through psychological factors. METHODS A cross-sectional online survey took place over six days (January 20-25, 2021), a month ago before COVID-19 vaccination was initiated in South Korea. This study included 1016 subjects, and a logit model for regression analyzed associations between socio-demographic factors, health-related factors, psychological factors, and media use toward one's COVID-19 vaccine hesitancy. Additionally, path analysis to examine the indirect effects of media use on vaccine hesitancy via psychological factors (i.e., perceived risk of COVID-19 infection, perceived benefits, and perceived barriers of COVID-19 vaccination) were conducted. RESULTS Among the respondents (n=1,016), 53.3% hesitated COVID-19 vaccination, while 46.7% of the respondents would accept the vaccine. Out of the socio-demographic factors, female (OR, 1.967; 95% CI, 1.36-2.86; P < .001), age in 50s (OR, .47; 95% CI, .23-.96; P= .004), and over 60s (OR, .49; 95% CI, .24 - 0.99; P= .04) were significant individual predictors of COVID-19 vaccine hesitancy. Perceived susceptibility of infection (OR, .69; 95% CI, .52 - .91; P= .01) and perceived benefits of vaccination (OR, .69; 95% CI, .52 - .91; P= .01) were associated with lower vaccine hesitancy. Perceived barriers of vaccination (OR, 1.63; 95% CI, 1.29 - 2.07; P < .001) and lower trust in government (OR, .72; 95% CI, .53 - 0.98; P= .04) were related to vaccine hesitancy. The use of offline and online media was associated with vaccine hesitancy through perceived benefits of vaccination, resulting in a lower vaccine hesitancy. Moreover, perceived susceptibility of the disease and perceived barriers of vaccination mediated the association between social media use and vaccine hesitancy. CONCLUSIONS Findings revealed a considerable level of COVID-19 vaccine hesitancy in South Korea. Gender-based and generation-based public health policies and communication are recommended. Efforts to lower the perceived risk of vaccine side effects and heighten perceived benefits of the vaccine are required. While the use of media has a positive or negative effect on the population's vaccine hesitancy, efforts should be made to disseminate reliable and timely information on media while confront misinformation or disinformation for successive implementation of vaccine programs during pandemics. CLINICALTRIAL
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Affiliation(s)
- Minjung Lee
- Institute of Health and Environment, Seoul National University, Seoul, KR.,Office of Dental Education, School of Dentistry, Seoul National University, Seoul
| | - Myoungsoon You
- Department of Public Health Sciences, Graduate School of Public Health, Seoul National University, Department of Public Health Sciences, Graduate School of Public Health Seoul National University Gwanak-ro 1, Gwanak-gu Seoul, 08826, Seoul, KR.,Institute of Health and Environment, Seoul National University, Seoul, KR
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Lee HS, Smith CA. A comparative mixed methods study on health information seeking among US‐born/US‐dwelling, Korean‐born/US‐dwelling, and Korean‐born/Korean‐dwelling mothers. J Assoc Inf Sci Technol 2021. [DOI: 10.1002/asi.24601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Knowledge, attitude and practice of influenza vaccination among Lebanese parents: A cross-sectional survey from a developing country. PLoS One 2021; 16:e0258258. [PMID: 34648535 PMCID: PMC8516244 DOI: 10.1371/journal.pone.0258258] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 09/22/2021] [Indexed: 12/01/2022] Open
Abstract
Background A growing number of parents refuse vaccination due to concerns about side effects. Influenza vaccine is no exception and remains one of the most controversial vaccines. Data regarding influenza vaccine uptake and parental knowledge, attitude and practice towards vaccination in the Lebanese population is lacking. The aim of this study was to assess the rate of vaccination refusal and potential associated factors among Lebanese parents of school-aged children, in general and with a focus on influenza vaccine. Methods A parent questionnaire was distributed in randomly selected 2 public and 2 private schools from the greater Beirut area during the school year 2017–2018. Questionnaires covered knowledge, attitude (including themes of efficacy, hesitancy and trust), and practice of vaccination in general and influenza vaccine in particular. Results The response rate was 76.5% (306/400). Overall, 29.4% parents reported vaccinating their children against influenza (62.2% in private and 37.7% in public schools). Younger age, paternal employment and higher household income were associated with higher vaccination rates (p = 0.01, 0.02 and <0.0001 respectively). Lack of vaccine recommendation by the physician was the most common reason for not taking it (47%). Parents who accepted influenza vaccination had higher scores in efficacy, hesitancy and trust and were more compliant with other vaccinations. Conclusion One third of parents of school aged children in the greater Beirut area vaccinate their children against influenza. This rate is likely lower in rural remote areas. Physician’s recommendation is the single most important predictor of such vaccination. Future studies tackling physicians’ attitude and practice are needed to help improve influenza vaccination rates in the Lebanese population.
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Kyprianidou M, Tzira E, Galanis P, Giannakou K. Knowledge of mothers regarding children's vaccinations in Cyprus: A cross-sectional study. PLoS One 2021; 16:e0257590. [PMID: 34543326 PMCID: PMC8452034 DOI: 10.1371/journal.pone.0257590] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 09/03/2021] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Vaccine hesitancy is identified as one of the top threats to global health. A significant drop of childhood vaccine coverage is reported worldwide. One of the key reasons that influenced mothers' choice to postpone, or avoid children's vaccination, is knowledge. This study aimed to assess the level of Cypriot mothers' knowledge on certain aspects of vaccination of their children, examine the association between vaccination knowledge and selected socio-demographic factors, and lastly assess the association of mothers' knowledge about vaccination with vaccination coverage and delay, compliance to the recommended schedules, vaccination during pregnancy and mother-pediatrician relationship. METHODS An online-based cross-sectional study conducted to collect information about socio-demographic characteristics, child's characteristics, vaccination, and vaccine knowledge, using a self-administered questionnaire. The survey was conducted between April 2020 and June 2020 and the study population included mothers over 18 years old with at least one child (<18 years old) living in Cyprus. RESULTS A total of 703 Cypriot mothers participated in the study. Most of the participants stated that they vaccined their children (97%) and the most popular source of information about vaccination was their pediatrician (90%). More than half of the participants (57%) have delayed their child/children vaccination with their pediatrician's suggestion being the main reason. 36% of mothers had low knowledge while the overall correct rate was 13.6% and the median (IQR) knowledge score was 11 (9-12). Having a medium knowledge about vaccination was associated with having a medium or high income, whilst high knowledge compared to low knowledge was associated with completed a higher education and having a high income. Our analysis showed that the correct knowledge by mothers with regards to vaccination increases the probability of vaccinating their children, following the local recommendations for vaccine dosages, and acquiring and trusting vaccination-related information from their children's pediatrician. CONCLUSION Our findings show that the majority of mothers in Cyprus had positives perceptions regarding childhood vaccination, as reflected with the high vaccination rate, however, some aspects of mothers' knowledge of vaccination need to be improved. Public health strategies to promote vaccination, education programs as well as improved communication tools between pediatricians and mothers need to be considered to achieve favorable vaccination attitudes and practices for all mothers in Cyprus.
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Affiliation(s)
- Maria Kyprianidou
- Department of Health Sciences, School of Sciences, European University Cyprus, Nicosia, Cyprus
- Cyprus International Institute for Environmental and Public Health, Cyprus University of Technology, Limassol, Cyprus
| | - Eleana Tzira
- Department of Health Sciences, School of Sciences, European University Cyprus, Nicosia, Cyprus
| | - Petros Galanis
- Faculty of Nursing, Centre for Health Services Management and Evaluation, National and Kapodistrian University of Athens, Athens, Greece
| | - Konstantinos Giannakou
- Department of Health Sciences, School of Sciences, European University Cyprus, Nicosia, Cyprus
- * E-mail:
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Chutiyami M, Wyver S, Amin J. Parent engagement with the New South Wales child health home-based record: A cross-sectional survey and a retrospective chart review. Child Care Health Dev 2021; 47:635-644. [PMID: 33871874 DOI: 10.1111/cch.12871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Revised: 02/22/2021] [Accepted: 04/12/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND In 2018, World Health Organization endorsed universal use of home-based records to improve care for mothers, pregnant women, newborns and children. New South Wales (NSW), Australia has had universal use of a child health home-based record since 1988, with the first major update in 2013. Since the update, limitedbelief is sufficient for constituting evidence has been collected about factors influencing parent use of the record. This study aims to examine parent engagement with the record and whether it is influenced by child's first-born status and Parent Evaluation of Development Status (PEDS) outcome. METHOD A survey of 202 parent-child pairs and a review of 20 record books were conducted in NSW, Australia. Odds ratio (OR) at 95% confidence interval (CI) and .05 level of significance, bivariate and multivariate logistic regressions were conducted to examine the influence of first-born status, child's PEDS outcome and other parent-child characteristics on parent engagement with the record. RESULTS Parents engaged with the home-based record by taking it for routine checks (80.7%), writing (74.8%) or reading (75.8%) information. Parents of first-born children were more than three times likely to take the record book for routine checks compared with parent of later-born children (adjusted OR [AOR] = 3.70, 95% CI 1.12-12.20). Similarly, parents of children with low PEDS level of risk were significantly less likely to read information in the record book compared with parents of children with high risk (AOR = 0.28, 95% CI 0.08-0.98). Parent record input through direct observation significantly decreased from 85% at 1-month to 60% at 12-month postnatal. Data about at least one vaccination event were recorded in all the record books examined, while 85% had all recommended vaccinations recorded. CONCLUSION Parents valued/engaged regularly with a child health home-based record, and the record may be a useful tool for early detection and monitoring of child developmental concerns. Therefore, continued promotion of the use of child health home-based record appears to play an important role in improving child health and development.
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Affiliation(s)
- Muhammad Chutiyami
- Faculty of Human Sciences, Macquarie University, Sydney, New South Wales, Australia
| | - Shirley Wyver
- Faculty of Human Sciences, Macquarie University, Sydney, New South Wales, Australia
| | - Janaki Amin
- Faculty of Medicine and Health Sciences, Macquarie University, Sydney, New South Wales, Australia
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13
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Dudley MZ, Limaye RJ, Salmon DA, Omer SB, O'Leary ST, Ellingson MK, Spina CI, Brewer SE, Bednarczyk RA, Malik F, Frew PM, Chamberlain AT. Racial/Ethnic Disparities in Maternal Vaccine Knowledge, Attitudes, and Intentions. Public Health Rep 2021; 136:699-709. [PMID: 33508208 DOI: 10.1177/0033354920974660] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES Although disparities in maternal vaccine acceptance among racial/ethnic groups are well documented, the reasons for these disparities are unclear. The objective of this study was to describe differences in pregnant women's knowledge, attitudes, beliefs, intentions, and trust regarding maternal and infant vaccines by race/ethnicity. METHODS We collected survey data from 1862 pregnant women from diverse prenatal care practices in Georgia and Colorado from June 2017 through July 2018. We performed multiple logistic regressions to determine differences in intentions, knowledge, attitudes, beliefs, and trust by race/ethnicity and calculated odds ratios (ORs) and 95% CIs. RESULTS Compared with White women, Black and Hispanic women were less confident in vaccine safety and efficacy and less likely to perceive risk of acquiring vaccine-preventable diseases, report provaccine social norms, indicate having enough vaccine knowledge, and trust vaccine information from health care providers and public health authorities. Black women were the least confident in the safety of the maternal influenza vaccine (OR = 0.37; 95% CI, 0.27-0.49); maternal tetanus, diphtheria, and acellular pertussis vaccine (OR = 0.37; 95% CI, 0.27-0.52); and infant vaccines overall (OR = 0.40; 95% CI, 0.28-0.58), and were least likely to intend to receive both maternal vaccines (OR = 0.35; 95% CI, 0.27-0.47) or all infant vaccines on time (OR = 0.45; 95% CI, 0.34-0.61) as compared with White women. CONCLUSIONS Understanding differences in behavioral constructs integral to vaccine decision making among women of different races/ethnicities can lead to tailored interventions to improve vaccine acceptance.
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Affiliation(s)
- Matthew Z Dudley
- 25802 Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA.,1466 Institute for Vaccine Safety, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Rupali J Limaye
- 25802 Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA.,1466 Institute for Vaccine Safety, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA.,Department of Health, Behavior and Society, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA.,Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA.,International Vaccine Access Center, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Daniel A Salmon
- 25802 Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA.,1466 Institute for Vaccine Safety, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA.,Department of Health, Behavior and Society, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Saad B Omer
- 12228 Yale Institute for Global Health, Yale School of Medicine, New Haven, CT, USA.,Department of 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.,Department of Health Policy and Management, Yale School of Public Health, New Haven, CT, USA
| | - Sean T O'Leary
- 129263 Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus and Children's Hospital Colorado, Aurora, CO, USA.,Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Mallory K Ellingson
- Department of Infectious Diseases, Yale School of Medicine, New Haven, CT, USA
| | - Christine I Spina
- 129263 Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus and Children's Hospital Colorado, Aurora, CO, USA
| | - Sarah E Brewer
- 129263 Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus and Children's Hospital Colorado, Aurora, CO, USA.,Department of Family Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Robert A Bednarczyk
- 25798 Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA.,1371 Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA.,Emory Vaccine Center, Emory University, Atlanta, GA, USA
| | - Fauzia Malik
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA
| | - Paula M Frew
- 14722 School of Community Health Sciences and Office of Research and Economic Development, University of Nevada, Las Vegas, NV, USA.,Population Health & Health Equity Initiative, University of Nevada, Las Vegas, NV, USA
| | - Allison T Chamberlain
- 1371 Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
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14
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Marotta S, McNally VV. Increasing Vaccine Confidence Through Parent Education and Empowerment Using Clear and Comprehensible Communication. Acad Pediatr 2021; 21:S30-S31. [PMID: 33958088 PMCID: PMC8090594 DOI: 10.1016/j.acap.2021.01.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 01/15/2021] [Accepted: 01/29/2021] [Indexed: 01/04/2023]
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15
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Fisher A, Mbaeyi S, Cohn A. Addressing Vaccine Hesitancy in the Age of COVID-19. Acad Pediatr 2021; 21:S3-S4. [PMID: 33753285 PMCID: PMC7977007 DOI: 10.1016/j.acap.2021.03.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 03/04/2021] [Accepted: 03/05/2021] [Indexed: 12/18/2022]
Affiliation(s)
- Allison Fisher
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Ga.
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16
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Abstract
Although vaccine acceptance and uptake are overall high among children in the United States, vaccine delays or refusals are a growing concern. Vaccine hesitancy is a challenge for the pediatric provider, given the diverse factors associated with hesitancy and the limited evidence on effective strategies for addressing vaccine hesitancy in the provider office. In this article, we review available evidence and approaches for vaccine communication, including the importance of using a whole-team approach, building trust, starting the conversation early, using a presumptive approach for vaccine recommendations, motivational interviewing with parents who have concerns for vaccines, and additional techniques for responding to parent questions. We also review organizational strategies to help create a culture of immunization in the practice, including evidence-based approaches for increasing vaccine uptake and efficiency. Although these communication approaches and organizational strategies are intended to reassure parents who are vaccine hesitant that all routine, universally recommended vaccines are safe and effective, they likely will take on increased significance as the development, implementation, and evaluation of coronavirus disease 2019 vaccines continue to unfold. [Pediatr Ann. 2020;49(12):e523-e531.].
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17
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Lazarus JV, Wyka K, Rauh L, Rabin K, Ratzan S, Gostin LO, Larson HJ, El-Mohandes A. Hesitant or Not? The Association of Age, Gender, and Education with Potential Acceptance of a COVID-19 Vaccine: A Country-level Analysis. JOURNAL OF HEALTH COMMUNICATION 2020; 25:799-807. [PMID: 33719881 DOI: 10.1080/10810730.2020.1868630] [Citation(s) in RCA: 140] [Impact Index Per Article: 35.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
In December 2020, the first COVID-19 vaccines were approved. Despite more than 85 million reported cases and 1.8 million known deaths, millions worldwide say they may not accept it. This study assesses the associations of age, gender, and level of education with vaccine acceptance, from a random sample of 13,426 participants selected from 19 high-COVID-19 burden countries in June 2020. Based on univariable and multivariable logistic regression, several noteworthy trends emerged: women in France, Germany, Russia, and Sweden were significantly more likely to accept a vaccine than men in these countries. Older (≥50) people in Canada, Poland, France, Germany, Sweden, and the UK were significantly more favorably disposed to vaccination than younger respondents, but the reverse trend held in China. Highly educated individuals in Ecuador, France, Germany, India, and the US reported that they will accept a vaccine, but higher education levels were associated with lower vaccination acceptance in Canada, Spain, and the UK. Heterogeneity by demographic factors in the respondents' willingness to accept a vaccine if recommended by employers were substantial when comparing responses from Brazil, Ecuador, France, India, Italy, Mexico, Poland, Russia, South Africa, South Korea, Sweden, and the US. This information should help public health authorities target vaccine promotion messages more effectively.
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Affiliation(s)
- Jeffrey V Lazarus
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic, University of Barcelona, Barcelona Spain
| | - Katarzyna Wyka
- Graduate School of Public Health & Health Policy, City University of New York (CUNY), New York, USA
| | - Lauren Rauh
- Graduate School of Public Health & Health Policy, City University of New York (CUNY), New York, USA
| | - Kenneth Rabin
- Graduate School of Public Health & Health Policy, City University of New York (CUNY), New York, USA
| | - Scott Ratzan
- Graduate School of Public Health & Health Policy, City University of New York (CUNY), New York, USA
| | | | - Heidi J Larson
- The Vaccine Confidence Project, Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - Ayman El-Mohandes
- Graduate School of Public Health & Health Policy, City University of New York (CUNY), New York, USA
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18
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Is parent engagement with a child health home-based record influenced by early child development and first-born status? hypotheses from a high-income countries’ perspective. Med Hypotheses 2020; 137:109605. [DOI: 10.1016/j.mehy.2020.109605] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Accepted: 01/24/2020] [Indexed: 11/20/2022]
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19
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Yacoob Z, Cook C, Kotovicz F, Kram JJ, Klumph M, Stanley M, Hunter P, Baumgardner DJ. Enhancing Immunization Rates in Two Urban Academic Primary Care Clinics: A Before and After Assessment. J Patient Cent Res Rev 2020; 7:47-56. [PMID: 32002447 PMCID: PMC6988711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023] Open
Abstract
PURPOSE Immunization rates in many cities in the United States remain suboptimal compared to Healthy People 2020 Goals and are lower than national averages. This study aimed to determine whether a lecture-based educational intervention targeted at nurses and medical assistants would improve vaccination rates. METHODS We conducted a quality improvement study in two urban academic family medicine clinics serving a predominantly Medicaid patient population as well as a sizable proportion of refugees. The intervention consisted of 3 lectures that were delivered to clinic nurses and medical assistants. Vaccinations in 1689 patients - 872 in the 3-month preintervention period, 817 in the 3-month postintervention period - were analyzed. RESULTS Following the educational intervention, a statistically significant increase was seen only in human papillomavirus vaccine immunization rates for 13-18-year-olds (from 90.7% [n=54] to 100% [n=45]; P=0.036). When the results were stratified by clinic, only 1 site showed statistically significant increases in: pneumococcal polysaccharide vaccine (23-valent) for high-risk 19-to-64-year-olds (from 36.4% [n=154] to 47.8% [n=136]; P=0.049); Haemophilus influenzae type B vaccine for 2-month-to-5-year-olds (from 91.1% [n=112] to 97.3% [n=111]; P=0.048); and meningococcal conjugate vaccine (quadrivalent) for 13-18-year olds (from 85.2% [n=27] to 100% [n=26]; P=0.042). No increases were seen for our study's refugee patient population (n=171), and a significant decrease of the second-dose measles, mumps, and rubella vaccine (P=0.036) occurred in this subcohort. CONCLUSIONS Ultimately, this quality improvement study demonstrated that educational interventions alone have a limited impact on increasing immunization rates.
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Affiliation(s)
- Zeeshan Yacoob
- University of Wisconsin School of Medicine and Public Health, Madison, WI
- Department of Family Medicine, Aurora UW Medical Group, Aurora Health Care, Milwaukee, WI
| | - Christopher Cook
- Department of Family Medicine, Aurora UW Medical Group, Aurora Health Care, Milwaukee, WI
| | - Fabiana Kotovicz
- University of Wisconsin School of Medicine and Public Health, Madison, WI
- Department of Family Medicine, Aurora UW Medical Group, Aurora Health Care, Milwaukee, WI
| | - Jessica J.F. Kram
- University of Wisconsin School of Medicine and Public Health, Madison, WI
- Department of Family Medicine, Aurora UW Medical Group, Aurora Health Care, Milwaukee, WI
- Center for Urban Population Health, Milwaukee, WI
| | - Marianne Klumph
- Department of Family Medicine, Aurora UW Medical Group, Aurora Health Care, Milwaukee, WI
- Center for Urban Population Health, Milwaukee, WI
| | - Marisa Stanley
- Eau Claire City-County Health Department, Eau Claire, WI
| | - Paul Hunter
- University of Wisconsin School of Medicine and Public Health, Madison, WI
- City of Milwaukee Health Department, Milwaukee, WI
| | - Dennis J. Baumgardner
- University of Wisconsin School of Medicine and Public Health, Madison, WI
- Department of Family Medicine, Aurora UW Medical Group, Aurora Health Care, Milwaukee, WI
- Center for Urban Population Health, Milwaukee, WI
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20
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Kowalska M, Gajda M, Barański K, Braczkowska B. Sources of parental knowledge about the safety of vaccinations in Poland. Health Promot Int 2019; 34:1191-1199. [PMID: 30476112 DOI: 10.1093/heapro/day096] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
There has been a recent increase in the number of parents refusing vaccination for their children in many European countries, including Poland. This observation necessitates the need to understand parental knowledge in regard to mandatory vaccination of children in these countries. A cross-sectional survey was conducted in 2016 on 1239 parents or legal guardians of preschool and school children in the Silesian Voivodship (Poland) to evaluate their hesitancy in acquiescing to their children mandatory immunization and the relation to this habit in regard to the use of informational sources on children vaccination system in Poland. Medical doctors often provide the basic source of information about vaccination to parents. About one-third (29%) of the respondents from the survey deemed the qualification system for vaccination as either inadequate or bad. 16.9% of the respondents surveyed declared that information received from physicians regarding vaccinations were either incomplete or unconvincing. Results of multivariable analyses confirmed that respondents are less likely to seek information about mandatory vaccinations from medical professionals and more often to misjudged vaccination's qualification system. Participants who used less informative sources (e.g. leaflets) and those with a lower level of education were more likely to avoid vaccination. Greater emphasis on the quality of information provided by medical professionals is crucial in order to avoid doubts about vaccination and to create proper attitudes and adherence to vaccination schedules.
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Affiliation(s)
- Małgorzata Kowalska
- Department of Epidemiology, School of Medicine in Katowice, Medical University of Silesia, Medyków 18 Str., Katowice 40-752, Poland
| | - Maksymilian Gajda
- Department of Epidemiology, School of Medicine in Katowice, Medical University of Silesia, Medyków 18 Str., Katowice 40-752, Poland
| | - Kamil Barański
- Department of Epidemiology, School of Medicine in Katowice, Medical University of Silesia, Medyków 18 Str., Katowice 40-752, Poland
| | - Bogumiła Braczkowska
- Department of Epidemiology, School of Medicine in Katowice, Medical University of Silesia, Medyków 18 Str., Katowice 40-752, Poland
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21
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Bert F, Olivero E, Rossello P, Gualano MR, Castaldi S, Damiani G, D’Errico MM, Di Giovanni P, Fantini MP, Fabiani L, Gabutti G, Loperto I, Marranzano M, Masanotti G, Nante N, Rosso A, Squeri R, Signorelli C, Siliquini R. Knowledge and beliefs on vaccines among a sample of Italian pregnant women: results from the NAVIDAD study. Eur J Public Health 2019; 30:286-292. [DOI: 10.1093/eurpub/ckz209] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Vaccine hesitancy is an emerging phenomenon in European countries and leads to decreasing trends in infant vaccine coverage. The aim of this study was to analyze the level of confidence and correct awareness about immunizations, which are crucial for the success of vaccination programmes.
Methods
As part of the NAVIDAD multicentre study, we examined vaccination confidence and complacency among a sample of 1820 pregnant women from 14 Italian cities. The questionnaire assessed the interviewee's knowledge, beliefs and misconceptions, as well as their socioeconomic status, information sources about vaccines and confidence in the Italian National Healthcare Service.
Results
Only 9% of women completely believed to the efficacy, necessity and safety of vaccinations. Almost 20% of them had misconceptions on most of the themes. There was a significant difference in the level of knowledge considering educational level: women with a high educational level have less probability of obtaining a low knowledge score (odds ratio (OR) 0.43 [95% confidence interval (CI) 0.34–0.54]). The level of knowledge was also influenced by the sources of information: women who received information from their general practitioner (GP) and from institutional websites had a significantly lower chance of having misconceptions (OR 0.74 [95% CI 0.58–0.96]; OR 0.59 [95% CI 0.46–0.74]). Finally, the results underlined the influence of trust in healthcare professional information on the likelihood of having misconceptions (OR 0.49 [95% CI 0.27–0.89]).
Conclusions
The data suggest the efficacy of GPs and institutional websites as a source of information to contrast misconceptions and underline the importance of confidence in the healthcare system to increase complacency and confidence in vaccines.
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Affiliation(s)
- Fabrizio Bert
- Department of Public Health, University of Torino, Torino, Italy
| | - Elena Olivero
- Department of Public Health, University of Torino, Torino, Italy
| | - Paola Rossello
- Department of Public Health, University of Torino, Torino, Italy
| | - Maria R Gualano
- Department of Public Health, University of Torino, Torino, Italy
| | - Silvana Castaldi
- Department of Biomedical Sciences for Health, University of Milan, Milano, Italy
- Fondazione IRCCS Cà Granda OMP, Milano, Italy
| | - Gianfranco Damiani
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
- Institute of Public Health, Hygiene Section, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Marcello M D’Errico
- Department of Biomedical Sciences and Public Health, Università Politecnica delle Marche, Ancona, Italy
| | - Pamela Di Giovanni
- Department of Pharmacy, Università degli Studi “G. D’Annunzio” of Chieti-Pescara, Chieti, Italy
| | - Maria P Fantini
- Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, Bologna, Italy
| | - Leila Fabiani
- Department of Life, Health and Environmental Sciences, University of L’Aquila, L’Aquila, Italy
| | - Giovanni Gabutti
- Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Ilaria Loperto
- Department of Public Health, University of Naples “Federico II”, Napoli, Italy
| | - Marina Marranzano
- Department of Medical and Surgical Sciences and Advanced Technologies “G.F. Ingrassia”, Section of Hygiene and Preventive Medicine, University of Catania, Catania, Italy
| | - Giuseppe Masanotti
- Public Health Section, Department of Experimental Medicine, University of Perugia, Perugia, Italy
| | - Nicola Nante
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
| | - Annalisa Rosso
- Department of Public Health and Infectious Diseases, Sapienza University of Roma, Roma, Italy
| | - Raffaele Squeri
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
| | - Carlo Signorelli
- Department of Medicine and Surgery, University of Parma, Parma, Italy
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22
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Hadisuyatmana S, Krisnana I, Sipahutar MA. Factors Influencing Mothers’ Intention to Immunize Children Younger than Five Years of Age in West Borneo: a Cross-Sectional Study. JURNAL NERS 2019. [DOI: 10.20473/jn.v14i1.9406] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Introduction: Immunisations for BCG, DTP, Poliomyelitis, Hepatitis, and MMR are compulsory for children under 5 years old in Indonesia and government-provided free services. However, the available records indicated that adherence to the program remains a challenge. This study aimed to investigate factors associated with mothers’ intention to comply with the immunization program, particularly among those who had children of younger than one year old.Methods: The study was conducted through a cross-sectional analysis. Fourty-six mothers self-registered them selves as participants of this study. The data were collected through check-listed interviews, to investigate the correlations between social factors, information factors, attitude toward behaviour, subjective norm, perceived behavioural control, and intention to adhere to the compulsory immunization program. The data were then analysed using logistic regression and spearman rank test with significance level of α=0.05.Results: Mothers’ attitude, subjective norm, perceived behavioral control, and knowledge have significant correlations with the intention in completing the immunisation program for their children (respectively p = 0.009; 0.014; 0.025; 0.038). Their intention positively correlated with adherence to complete the program (p=0,002). However, other factors studied did not correlate either with mothers’ intention to adherence to the program.Conclusion: This study suggests that mothers’ intention is influenced by family members suggestions, indicating that their capacity in decision making was limited and relying to other member. Further investigation is required to unveil the underlying reasons of being non-adherence.
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23
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Clarke RM, Sirota M, Paterson P. Do previously held vaccine attitudes dictate the extent and influence of vaccine information-seeking behavior during pregnancy? Hum Vaccin Immunother 2019; 15:2081-2089. [PMID: 31291160 PMCID: PMC6773393 DOI: 10.1080/21645515.2019.1638203] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Pregnancy represents a high information need state, where uncertainty around medical intervention is common. As such, the pertussis vaccination given during pregnancy presents a unique opportunity to study the interaction between vaccine attitudes and vaccine information-seeking behavior. We surveyed a sample of pregnant women (N = 182) during early pregnancy and again during late pregnancy. The variables of vaccine confidence and risk perception of vaccination during pregnancy were measured across two questionnaires. Additional variables of decision conflict and intention to vaccinate were recorded during early pregnancy, while vaccine information-seeking behavior and vaccine uptake were recorded during late pregnancy. 88.8% of participants reported seeking additional information about the pertussis vaccine during pregnancy. Women that had a lower confidence in vaccination (p = .004) and those that saw the risk of pertussis disease as high compared to the risk of side effects from the pertussis vaccination during pregnancy (p = .004) spent significantly more time seeking information about the pertussis vaccination. Women’s perception of risk related to vaccination during pregnancy significantly changed throughout the pregnancy (t(182) = 4.685 p< .001), with women perceiving the risk of pertussis disease higher as compared to the risk of side effects from the vaccine as the pregnancy progresses. The strength and influence of information found through seeking was predicted by intention to vaccinate (p = .011). As such, we suggest that intention to vaccinate during early pregnancy plays a role in whether the information found through seeking influences women towards or away from vaccination.
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Affiliation(s)
- Richard M Clarke
- Department of Epidemiology and Population Health, The London School of Hygiene and Tropical Medicine , London , UK
| | - Miroslav Sirota
- Department of Psychology, University of Essex , Colchester , UK
| | - Pauline Paterson
- Department of Epidemiology and Population Health, The London School of Hygiene and Tropical Medicine , London , UK
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24
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Determinants of satisfaction with information and additional information-seeking behaviour for the pertussis vaccination given during pregnancy. Vaccine 2019; 37:2712-2720. [DOI: 10.1016/j.vaccine.2019.04.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Revised: 04/02/2019] [Accepted: 04/04/2019] [Indexed: 11/21/2022]
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25
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Cacciatore MA, Nowak GJ, Evans NJ. It's Complicated: The 2014-2015 U.S. Measles Outbreak and Parents' Vaccination Beliefs, Confidence, and Intentions. RISK ANALYSIS : AN OFFICIAL PUBLICATION OF THE SOCIETY FOR RISK ANALYSIS 2018; 38:2178-2192. [PMID: 29874395 DOI: 10.1111/risa.13120] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/08/2017] [Revised: 02/21/2018] [Accepted: 05/14/2018] [Indexed: 06/08/2023]
Abstract
While it seems intuitive that highly visible vaccine-preventable disease outbreaks should impact perceptions of disease risk and facilitate vaccination, few empirical studies exist to confirm or dispel these beliefs. This study investigates the impact of the 2014-2015 Disneyland measles outbreak on parents' vaccination attitudes and future vaccination intentions. The analysis relies on a pair of public opinion surveys of American parents with at least one child under the age of six (N = 1,000 across each survey). Controlling for basic demographics, we found higher levels of reported confidence in the safety and efficacy of childhood vaccinations in our follow-up data collection. However, this confidence was also accompanied by elevated levels of concern toward childhood vaccines among American parents. We then examined how different subgroups in the population scored on these measures before and after the outbreak. We found that parents with high levels of interest in the topic of vaccines and a child who is not fully upto date with the recommended vaccination schedule reported more supportive attitudes toward vaccines. However, future intentions to follow the recommended vaccination schedule were not positively impacted by the outbreak. Possible explanations for these results and implications for vaccination outreach are discussed.
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Affiliation(s)
- Michael A Cacciatore
- Center for Health and Risk Communication, Grady College, University of Georgia, Athens, GA, USA
| | - Glen J Nowak
- Center for Health and Risk Communication, Grady College, University of Georgia, Athens, GA, USA
| | - Nathaniel J Evans
- Center for Health and Risk Communication, Grady College, University of Georgia, Athens, GA, USA
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Gualano MR, Bert F, Voglino G, Buttinelli E, D'Errico MM, De Waure C, Di Giovanni P, Fantini MP, Giuliani AR, Marranzano M, Masanotti G, Massimi A, Nante N, Pennino F, Squeri R, Stefanati A, Signorelli C, Siliquini R. Attitudes towards compulsory vaccination in Italy: Results from the NAVIDAD multicentre study. Vaccine 2018; 36:3368-3374. [PMID: 29729995 DOI: 10.1016/j.vaccine.2018.04.029] [Citation(s) in RCA: 61] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Revised: 03/26/2018] [Accepted: 04/11/2018] [Indexed: 11/29/2022]
Abstract
BACKGROUND Vaccine hesitancy is a considerable issue in European countries and leads to low coverage rates. After a long debate, Italy has made vaccination mandatory for admission to its schools. METHODS In the NAVIDAD study (a cross-sectional multicentre study), a 63-item questionnaire was administered to 1820 pregnant women from 15 Italian cities. The questionnaire assessed the interviewee's opinion on mandatory vaccines, as well as their socioeconomic status, sources of information about vaccines, confidence in the Italian National Healthcare Service (NHS), and intention to vaccinate their newborn. RESULTS Information sources play a key role in determining the opinion on restoration of mandatory vaccines; in particular, women who obtained information from anti-vaccination movements are less likely to accept the vaccines (OR: 0.35, 95% CI: 0.21-0.58, p < 0.001). Women who had confidence in healthcare professional information agreed more on mandatory vaccination than did the other women (OR: 2.66, 95% CI: 1.62-4.36, p < 0.001); those who perceived that healthcare professionals have economic interest in child immunization and who declared that healthcare providers inform only on vaccinations benefits not on risks were less likely to agree on compulsory vaccination (OR: 0.66, CI 95%: 0.46-0.96, p = 0.03; OR: 0.66, CI 95%: 0.46-0.95, p = 0.03, respectively). CONCLUSION Information sources and confidence towards health professionals are the main determinants of acceptance of mandatory vaccine restoration. To increase the acceptability of the restoration and reduce vaccine hesitancy, these aspects need to be strengthened.
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Affiliation(s)
- M R Gualano
- Department of Public Health, University of Torino, Italy
| | - F Bert
- Department of Public Health, University of Torino, Italy
| | - G Voglino
- Department of Public Health, University of Torino, Italy.
| | - E Buttinelli
- Postgraduate School of Public Health, Department of Biomedical Sciences for Health, University of Milan, Italy
| | - M M D'Errico
- Department of Biomedical Sciences and Public Health, Università Politecnica delle Marche, Ancona, Italy
| | - C De Waure
- Institute of Public Health, Section of Hygiene, Catholic University of the Sacred Heart, Rome, Italy
| | - P Di Giovanni
- Department of Pharmacy, Università degli Studi "G. D'Annunzio" of Chieti-Pescara, Italy
| | - M P Fantini
- Department of Biomedical and Neuromotor Sciences (DIBINEM) University of Bologna, Bologna, Italy
| | - A R Giuliani
- Department of Life, Health and Environmental Sciences, University of L'Aquila, Italy
| | - M Marranzano
- Department of Medical and Surgical Sciences and Advanced Technologies "G.F. Ingrassia", Section of Hygiene and Preventive Medicine, University of Catania, Catania, Italy
| | - G Masanotti
- Public Health Section, Department of Experimental Medicine, University of Perugia, Perugia, Italy
| | - A Massimi
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - N Nante
- Post Graduate School of Public Health, University of Siena, Siena, Italy
| | - F Pennino
- Department of Public Health, University of Naples "Federico II", Italy
| | | | - A Stefanati
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - C Signorelli
- Department of Morphology, Surgery and Experimental Medicine, Section of Obstetrics and Gynecology, University of Ferrara, Ferrara, Italy
| | - R Siliquini
- Department of Public Health, University of Torino, Italy
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What is 'confidence' and what could affect it?: A qualitative study of mothers who are hesitant about vaccines. Vaccine 2017; 36:6464-6472. [PMID: 28899629 DOI: 10.1016/j.vaccine.2017.09.007] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Revised: 06/21/2017] [Accepted: 09/01/2017] [Indexed: 11/20/2022]
Abstract
BACKGROUND Public confidence in immunization is critical to maintaining high vaccine-coverage rates needed to protect individuals and communities from vaccine-preventable diseases. Recent attention has been placed on factors influencing confidence in vaccination in the US and globally, but comprehensive understanding of what drives or hinders confidence in childhood vaccination is yet to be reached. As such, assessing parents' confidence in childhood vaccination and the ways in which educational materials affect confidence is needed. OBJECTIVE We sought to (1) learn how mothers who are hesitant about vaccination characterize confidence in health-related products for young children, including the recommended vaccines; (2) gain insights on what influences vaccine confidence beliefs; and (3) assess whether short, education materials affect parental confidence in childhood vaccinations. METHODS Eight moderator-lead focus groups (n=61), stratified by socioeconomic status, were undertaken with mothers of children 5years of age of less who are hesitant about vaccines. Four of the groups were held in the Philadelphia, PA area and four were held in the San Francisco/Oakland, CA area. Three educational material pairs, each consisting of a 2-3min video and an infographic poster about an immunization-related topic, were reviewed and assessed for influence on confidence. RESULTS Qualitative data analysis was used to identify overarching themes across the focus groups. Themes, insights, and illustrative quotes were identified and provided for each of the major discussion areas: primary health concerns for young children; confidence beliefs and perceptions, including for recommended vaccines; facilitators and barriers to confidence; and reactions to the educational materials. CONCLUSIONS Results provide helpful insights into how mothers who are hesitant about vaccines perceive confidence in childhood vaccines and health-related products, suggestions for how to improve confidence, and support for the value and use of short videos as part of vaccination education efforts. Findings can aid those developing vaccination education materials and resources designed to foster vaccine confidence.
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Lieu TA, Zikmund-Fisher BJ, Chou C, Ray GT, Wittenberg E. Parents' Perspectives on How to Improve the Childhood Vaccination Process. Clin Pediatr (Phila) 2017; 56:238-246. [PMID: 27162178 DOI: 10.1177/0009922816649001] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Few national studies have asked parents how to improve the childhood vaccination process. We surveyed a nationally representative online panel of parents on how to improve this process, rationales for nonstandard approaches, and alternatives to the standard schedule. Twelve percent of the 1222 respondents reported using nonstandard approaches: 3.2% used a specific schedule, 6.0% had no specific schedule, and 2.5% declined all vaccinations. The most common rationales were that too many vaccines are given at once, and discomfort with vaccine ingredients. Regarding how to improve the process, parents using the standard schedule most often said nothing could be improved (51%), or better vaccine information (22%). Those using nonstandard approaches most often would have liked more choice (40%) or better vaccine information (26%). Parents' experiences with the vaccination process could be improved by offering information prior to visits, giving more information about side effects, and allowing more flexibility about vaccine scheduling.
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Affiliation(s)
- Tracy A Lieu
- 1 Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - Brian J Zikmund-Fisher
- 2 Deaprtment of Health Behavior and Health Education, Department of Medicine, and Center for Bioethics and Social Sciences in Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Cathy Chou
- 1 Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - G Thomas Ray
- 1 Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - Eve Wittenberg
- 3 Center for Health Decision Science, Harvard T.H. Chan School of Public Health, Boston, MA
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Nowak GJ, Cacciatore MA. Parents' confidence in recommended childhood vaccinations: Extending the assessment, expanding the context. Hum Vaccin Immunother 2016; 13:687-700. [PMID: 27682979 DOI: 10.1080/21645515.2016.1236881] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
There has been significant and growing interest in vaccine hesitancy and confidence in the United States as well as across the globe. While studies have used confidence measures, few studies have provided in-depth assessments and no studies have assessed parents' confidence in vaccines in relationship to other frequently recommended health-related products for young children. This study used a nationally representative sample of 1000 US parents to identify confidence levels for recommended vaccinations, antibiotics, over-the-counter (OTC) medicines, and vitamins for children. The analyses examined associations between confidence ratings, vaccination behaviors and intentions, and trust in healthcare provider, along with associations between confidence ratings and use of the other health-related products. Parents' confidence in vaccines was relatively high and high relative to antibiotics, OTC medicines and vitamins. For all 4 health-related products examined, past product experience and knowledge of bad or adverse outcomes negatively impacted parents' confidence levels. Confidence levels were associated with both trust in advice from their child's healthcare provider and acceptance of healthcare provider recommendations. Parents in some groups, such as those with lower income and education levels, were more likely to have less confidence not just in vaccines, but also in antibiotics and OTC medicines for children. Overall, the findings extend understanding of vaccine confidence, including by placing it into a broader context.
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Affiliation(s)
- Glen J Nowak
- a Grady College Center for Health & Risk Communication, Grady College of Journalism and Mass Communication, University of Georgia , Athens , GA , USA
| | - Michael A Cacciatore
- b Grady College of Journalism and Mass Communication, University of Georgia , Athens , GA , USA
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Affiliation(s)
- Andrew W Artenstein
- Department of Medicine, Baystate Health and Tufts University School of Medicine, Springfield, MA, United States.
| | - Neal A Halsey
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Glen J Nowak
- Center for Health and Risk Communication, Grady College of Journalism and Mass Communication, University of Georgia, Athens, GA, United States
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Fostering further successes in vaccinology. Vaccine 2015; 33 Suppl 4:D1-3. [DOI: 10.1016/j.vaccine.2015.07.053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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