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Nguyen KH, Zhao R, Chen S, Bednarczyk RA. Exclusive and dual influenza and COVID-19 vaccination among U.S. adults and adolescents in 2021. Ann Med 2023; 55:2196436. [PMID: 37052255 PMCID: PMC10116913 DOI: 10.1080/07853890.2023.2196436] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/14/2023] Open
Abstract
INTRODUCTION Despite recommendations for influenza and COVID-19 vaccines, studies have documented gaps and disparities in vaccination coverage for adults and adolescents. Understanding the proportion and demographics of those unvaccinated against influenza and/or COVID-19 is important for tailoring appropriate messaging and strategies to increase confidence and uptake. METHODS Using the 2021 National Health Interview Survey (NHIS), we assessed the prevalence of four vaccination patterns (exclusive influenza vaccination, exclusive COVID-19 vaccination, dual influenza and COVID-19 vaccination, and neither vaccination) by sociodemographic and other characteristics among adults and adolescents 12-17 years. Adjusted multivariable regression analyses were conducted to examine factors associated with each of the four vaccination categories among adults and adolescents. RESULTS In 2021, 42.5% of adults and 28.3% of adolescents received both influenza and COVID-19 vaccines, while approximately a quarter (22.4%) of adults and a third (34.0%) of adolescents did not receive either vaccine. Among adults and adolescents, 6.0% and 11.4% were exclusively vaccinated against influenza and 29.1% and 26.4% were exclusively vaccinated against COVID-19, respectively. Among adults, exclusive COVID-19 or dual vaccination was more likely to be associated with older age, non-Hispanic multi/other race, and having a college degree compared to their respective counterparts. Exclusive influenza or neither vaccination was more likely to be associated with younger age, having a high school diploma or less, living below the poverty level, and having a previous COVID-19 diagnosis. CONCLUSION During the COVID-19 pandemic, approximately two-thirds of adolescents and three-fourths of adults received exclusive influenza or COVID-19 vaccines or both vaccines in 2021. Vaccination patterns differed by sociodemographic and other characteristics. Promoting confidence in vaccines and reducing barriers to access is needed to protect individuals and families from severe health consequences of vaccine-preventable diseases. Being up-to-date with all recommended vaccinations can prevent a future resurgence of hospitalizations and cases.Key messages42.5% of adults and 28.3% of adolescents received both influenza and COVID-19 vaccines in 2021, while approximately a quarter (22.4%) of adults and a third (34.0%) of adolescents did not receive either vaccine; 6.0% of adults and 11.4% of adolescents were exclusively vaccinated against influenza and 29.1% of adults and 26.4% of adolescents were exclusively vaccinated against COVID-19.Among adults, exclusive COVID-19 vaccination or dual vaccination was more likely to be associated with older age, non-Hispanic multi/other race, and having a college degree or higher compared to their respective counterparts; exclusive influenza vaccination or neither vaccination was more likely to be associated with younger age, having a high school diploma or less, living below poverty level, and having a previous COVID-19 diagnosis compared to their respective counterparts.Promoting confidence in vaccines and reducing barriers to access is needed to protect individuals and families from severe health consequences of vaccine-preventable diseases. Being up-to-date with all recommended vaccinations can prevent a future resurgence of hospitalizations and cases, especially as new variants emerge.
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Affiliation(s)
- Kimberly H Nguyen
- Department of Public Health & Community Medicine, Tufts University School of Medicine, Boston, MA, USA
| | - Ruitong Zhao
- Department of Public Health & Community Medicine, Tufts University School of Medicine, Boston, MA, USA
| | - Siyu Chen
- Department of Public Health & Community Medicine, Tufts University School of Medicine, Boston, MA, USA
| | - Robert A Bednarczyk
- Hubert Department of Global Health, Emory University Rollins School of Public Health, Atlanta, GA, USA
- Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, GA, USA
- Emory Vaccine Center, Emory University, Atlanta, GA, USA
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Carmona N, Trujillo M. Developing Vaccine Literacy for Urban Health Science Students, the Future Health Workforce. JOURNAL OF MICROBIOLOGY & BIOLOGY EDUCATION 2023; 24:e00038-23. [PMID: 37614881 PMCID: PMC10443395 DOI: 10.1128/jmbe.00038-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 04/20/2023] [Indexed: 08/25/2023]
Abstract
The 2019 coronavirus disease pandemic underlined a shift in attitudes against vaccines and a rise in hesitancy among some members of the population, despite the overwhelming evidence that vaccinations are one of the most successful and safe health interventions. Research has shown that vaccine hesitancy is complex and can result from an intersectionality of multiple factors. Research has also shown that to tackle vaccine hesitancy in the community, health care workers play a pivotal role, as they are trusted sources who can provide reliable information and can address vaccination concerns for the public. Unfortunately, health care workers are also susceptible to vaccine hesitancy. Thus, to curb these negative attitudes and doubts against vaccinations, we propose to improve vaccine competency among health science students, who are the future health workforce. Here, we propose a comprehensive pedagogical approach that aims to improve the vaccine literacy in this student population in two urban community colleges. The approach includes the use of high-impact pedagogical interventions to achieve three main objectives: (i) to teach students the nature and process of science to have them become "competent outsiders"; (ii) to enhance students' knowledge of the complex science behind emerging infectious diseases and vaccine action, adopting a learner-centered and concept-focused instructional design, and (iii) to address the social, cultural, and historical aspects of vaccine development and the historical and present inequities that characterize this health intervention.
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Affiliation(s)
- Naydu Carmona
- Biological Sciences and Geology Department, Queensborough Community College, City University of New York, Queens, New York, USA
| | - Monica Trujillo
- Biological Sciences and Geology Department, Queensborough Community College, City University of New York, Queens, New York, USA
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3
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Choi J, Ryu JG. COVID-19 vaccination intention among nursing, medical, and dental students: A systematic review and meta-regression analysis. Hum Vaccin Immunother 2023; 19:2253600. [PMID: 37732552 PMCID: PMC10515672 DOI: 10.1080/21645515.2023.2253600] [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: 06/08/2023] [Accepted: 08/28/2023] [Indexed: 09/22/2023] Open
Abstract
The introduction of the COVID-19 vaccine amidst the pandemic has heralded a paradigm shift. Healthcare students in nursing, medicine, and dentistry must have positive attitudes owing to their future role in vaccine recommendations to the public and patients. This meta-regression analysis assessed the differences in COVID-19 vaccination intention (VI) of nursing, medical, and dental students. Medline/PubMed, EMBASE, CINAHL, Cochrane Library, and Korean MBASE were searched for eligible studies. Quality was assessed by the Joanna Briggs Institute's quality appraisal. Forty-one studies were included in the final analysis, and the estimation of pooled prevalence (68%) and relevant factors were assessed. Dental students were found to have the lowest VI (57%), which significantly (p = .018) differed from that of nursing students (64%). Countries in South-East Asia and those with high income levels were found to have high VI. Therefore, global vaccine programs for healthcare students should be prepared considering their geographical and economic status.
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Affiliation(s)
- Jongrim Choi
- College of Nursing, Keimyung University, Daegu, Republic of Korea
| | - Jae Geum Ryu
- College of Nursing, Chodang University, Muan, Republic of Korea
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Soorapanth S, Cheung R, Zhang X, Mokdad AH, Mensah GA. Rural-Urban Differences in Vaccination and Hesitancy Rates and Trust: US COVID-19 Trends and Impact Survey on a Social Media Platform, May 2021-April 2022. Am J Public Health 2023; 113:680-688. [PMID: 37053528 DOI: 10.2105/ajph.2023.307274] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/15/2023]
Abstract
Objectives. To analyze rural-urban differences in COVID-19 vaccination uptake, hesitancy, and trust in information sources in the United States. Methods. We used data from a large survey of Facebook users. We computed the vaccination, hesitancy, and decline rates and the trust proportions among individuals hesitant toward COVID-19 information sources for rural and urban regions in each state from May 2021 to April 2022. Results. In 48 states with adequate data, on average, two thirds of states showed statistically significant differences in monthly vaccination rates between rural and urban regions, with rural regions having a lower vaccination rate at all times. Far fewer states showed statistically significant differences when comparing monthly hesitancy and decline rates for urban versus rural regions. Doctors and health professionals received the highest level of trust. Friends and family were also among the most trusted sources in rural areas where the vaccination uptake was low. Conclusions. Rural-urban difference in hesitancy rates among those still unvaccinated was much smaller than the rural-urban difference in vaccination rates, suggesting that access to vaccines may be another contributor to the lower vaccination rates in rural areas. (Am J Public Health. Published online ahead of print April 13, 2023:e1-e9. https://doi.org/10.2105/AJPH.2023.307274).
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Affiliation(s)
- Sada Soorapanth
- Sada Soorapanth and Rex Cheung are with the Department of Decision Sciences, Lam Family College of Business, San Francisco State University, San Francisco, CA. Xinzhi Zhang and George A. Mensah are with the Center for Translation Research and Implementation Science, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD. Ali H. Mokdad is with the Institute for Health Metrics and Evaluation and the Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle
| | - Rex Cheung
- Sada Soorapanth and Rex Cheung are with the Department of Decision Sciences, Lam Family College of Business, San Francisco State University, San Francisco, CA. Xinzhi Zhang and George A. Mensah are with the Center for Translation Research and Implementation Science, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD. Ali H. Mokdad is with the Institute for Health Metrics and Evaluation and the Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle
| | - Xinzhi Zhang
- Sada Soorapanth and Rex Cheung are with the Department of Decision Sciences, Lam Family College of Business, San Francisco State University, San Francisco, CA. Xinzhi Zhang and George A. Mensah are with the Center for Translation Research and Implementation Science, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD. Ali H. Mokdad is with the Institute for Health Metrics and Evaluation and the Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle
| | - Ali H Mokdad
- Sada Soorapanth and Rex Cheung are with the Department of Decision Sciences, Lam Family College of Business, San Francisco State University, San Francisco, CA. Xinzhi Zhang and George A. Mensah are with the Center for Translation Research and Implementation Science, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD. Ali H. Mokdad is with the Institute for Health Metrics and Evaluation and the Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle
| | - George A Mensah
- Sada Soorapanth and Rex Cheung are with the Department of Decision Sciences, Lam Family College of Business, San Francisco State University, San Francisco, CA. Xinzhi Zhang and George A. Mensah are with the Center for Translation Research and Implementation Science, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD. Ali H. Mokdad is with the Institute for Health Metrics and Evaluation and the Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle
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Agaku IT, Dimaggio A, Fishelov A, Brathwaite A, Ahmed S, Malinowski M, Long T. SARS-CoV-2 infections and attitudes towards COVID-19 vaccines among healthcare workers in the New York Metropolitan area, USA. Fam Med Community Health 2022; 10:e001692. [PMID: 35896283 PMCID: PMC9334692 DOI: 10.1136/fmch-2022-001692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
OBJECTIVE Because of their increased interaction with patients, healthcare workers (HCWs) face greater vulnerability to COVID-19 exposure than the general population. We examined prevalence and correlates of ever COVID-19 diagnosis and vaccine uncertainty among HCWs. DESIGN Cross-sectional data from the Household Pulse Survey (HPS) conducted during July to October 2021. SETTING HPS is designed to yield representative estimates of the US population aged ≥18 years nationally, by state and across selected metropolitan areas. PARTICIPANTS Our primary analytical sample was adult HCWs in the New York Metropolitan area (n=555), with HCWs defined as individuals who reported working in a 'Hospital'; 'Nursing and residential healthcare facility'; 'Pharmacy' or 'Ambulatory healthcare setting'. In the entire national sample, n=25 909 HCWs completed the survey. Descriptive analyses were performed with HCW data from the New York Metropolitan area, the original epicentre of the pandemic. Multivariable logistic regression analyses were performed on pooled national HCW data to explore how HCW COVID-19-related experiences, perceptions and behaviours varied as a function of broader geographic, clinical and sociodemographic characteristics. RESULTS Of HCWs surveyed in the New York Metropolitan area, 92.3% reported being fully vaccinated, and 20.9% had ever been diagnosed of COVID-19. Of the subset of HCWs in the New York Metropolitan area not yet fully vaccinated, 41.8% were vaccine unsure, 4.5% planned to get vaccinated for the first time soon, 1.6% had got their first dose but were not planning to receive the remaining dose, while 52.1% had got their first dose and planned to receive the remaining dose. Within pooled multivariable analysis of the national HCW sample, personnel in nursing/residential facilities were less likely to be fully vaccinated (adjusted OR, AOR 0.79, 95% CI 0.63 to 0.98) and more likely to report ever COVID-19 diagnosis (AOR 1.35, 95% CI 1.13 to 1.62), than those working in hospitals. Of HCWs not yet vaccinated nationally, vaccine-unsure individuals were more likely to be White and work in pharmacies, whereas vaccine-accepting individuals were more likely to be employed by non-profit organisations and work in ambulatory care facilities. Virtually no HCW was outrightly vaccine-averse, only unsure. CONCLUSIONS Differences in vaccination coverage existed by individual HCW characteristics and healthcare operational settings. Targeted efforts are needed to increase vaccination coverage.
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Affiliation(s)
- Israel T Agaku
- Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Boston, Massachusetts, USA
- COVID-19 Test and Trace Corps, New York, New York, USA
| | | | | | | | - Saief Ahmed
- COVID-19 Test and Trace Corps, New York, New York, USA
| | | | - Theodore Long
- COVID-19 Test and Trace Corps, New York, New York, USA
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6
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Larson HJ, Lin L, Goble R. Vaccines and the social amplification of risk. RISK ANALYSIS : AN OFFICIAL PUBLICATION OF THE SOCIETY FOR RISK ANALYSIS 2022; 42:1409-1422. [PMID: 35568963 PMCID: PMC9347756 DOI: 10.1111/risa.13942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 01/20/2022] [Accepted: 03/06/2022] [Indexed: 05/13/2023]
Abstract
In 2019, the World Health Organization (WHO) named "Vaccine Hesitancy" one of the top 10 threats to global health. Shortly afterward, the COVID-19 pandemic emerged as the world's predominant health concern. COVID-19 vaccines of several types have been developed, tested, and partially deployed with remarkable speed; vaccines are now the primary control measure and hope for a return to normalcy. However, hesitancy concerning these vaccines, along with resistance to masking and other control measures, remains a substantial obstacle. The previous waves of vaccine hesitancy that led to the WHO threat designation, together with recent COVID-19 experience, provide a window for viewing new forms of social amplification of risk (SAR). Not surprisingly, vaccines provide fertile ground for questions, anxieties, concerns, and rumors. These appear in new globalized hyperconnected communications landscapes and in the context of complex human (social, economic, and political) systems that exhibit evolving concerns about vaccines and authorities. We look at drivers, impacts, and implications for vaccine initiatives in several recent historical examples and in the current efforts with COVID-19 vaccination. Findings and insights were drawn from the Vaccine Confidence Project's decade long monitoring of media and social media and its related research efforts. The trends in vaccine confidence and resistance have implications for updating the social amplification of risk framework (SARF); in turn, SARF has practical implications for guiding efforts to alleviate vaccine hesitancy and to mitigate harms from intentional and unintentional vaccine scares.
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Affiliation(s)
- Heidi J. Larson
- Department of Infectious Disease EpidemiologyLondon School of Hygiene & Tropical MedicineLondonUK
- Deparment of Health Metrics SciencesUniversity of WashingtonSeattleWashingtonUSA
| | - Leesa Lin
- Department of Infectious Disease EpidemiologyLondon School of Hygiene & Tropical MedicineLondonUK
- Laboratory of Data Discovery for Health Limited (D24H)Hong Kong Science Park, Hong Kong Special Administrative Region, China
- School of Public HealthThe University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Rob Goble
- George Perkins Marsh InstituteClark UniversityWorcesterMassachusettsUSA
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Buttenheim AM, Thirumurthy H. Pay-for-performance incentives for health worker vaccination: looking under the hood. BMJ Qual Saf 2022; 31:623-626. [PMID: 35149601 DOI: 10.1136/bmjqs-2021-014269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/25/2022] [Indexed: 11/04/2022]
Affiliation(s)
- Alison M Buttenheim
- Department of Family and Community Health, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA .,Center for Health Incentives and Behavioral Economics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Harsha Thirumurthy
- Center for Health Incentives and Behavioral Economics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Department of Medical Ethics and Health Policy, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, Pennsylvania
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