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Pérez-Martín JJ, Iofrío de Arce A, Zornoza-Moreno M. The Attitudes of Healthcare Professionals in an Autonomous Community in Spain towards Paediatric Influenza Vaccination. Vaccines (Basel) 2024; 12:599. [PMID: 38932329 PMCID: PMC11209165 DOI: 10.3390/vaccines12060599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2024] [Revised: 05/21/2024] [Accepted: 05/29/2024] [Indexed: 06/28/2024] Open
Abstract
In the 2022-2023 influenza season, three autonomous communities anticipated the document approved by the Public Health Commission recommending influenza vaccination for all children aged 6 to 59 months. The primary objective of this study was to evaluate the attitude of healthcare professionals towards the first universal vaccination campaign in our region, as well as the acceptability of the vaccines used and their attitude towards pilot school vaccination. This was a cross-sectional, survey-based, descriptive study. All healthcare professionals involved in the campaign were invited to participate. Overall, 91.9% of surveyed professionals thought that influenza vaccination from 6 to 59 months was important or very important, and 89.8% had previous experience regarding the intramuscular vaccine. Healthcare professionals rated the intranasal vaccine significantly more positively, but there were no differences when asking about each vaccine without comparison. The inhaled vaccine was preferred by 97.5% for the following campaign. Pilot school vaccination had a 75% acceptance rate. The inhaled vaccine was preferred by most professionals, and pilot school vaccination was highly accepted and independently associated with the importance of vaccination as considered by physicians, being a medical doctor, and participation in the pilot programme.
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Affiliation(s)
- Jaime J. Pérez-Martín
- Prevention and Health Protection Service, Regional Ministry of Health, Ronda de Levante, 11, 30008 Murcia, Spain;
| | - Antonio Iofrío de Arce
- Murcia-El Ranero Primary Care Centre, Murcia Health Service, Paseo Duques de Lugo, 30009 Murcia, Spain;
| | - Matilde Zornoza-Moreno
- Prevention and Health Protection Service, Regional Ministry of Health, Ronda de Levante, 11, 30008 Murcia, Spain;
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Kainth MK, Sembajwe GN, Ahn H, Qian M, Carrington M, Armellino D, Jan S. Despite mandated primary series, health care personnel still hesitant about COVID-19 vaccine and immunizing children. Vaccine 2024; 42:3122-3133. [PMID: 38604909 DOI: 10.1016/j.vaccine.2024.04.028] [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: 11/08/2023] [Revised: 04/05/2024] [Accepted: 04/06/2024] [Indexed: 04/13/2024]
Abstract
IMPORTANCE Healthcare personnel (HCP) are important messengers for promoting vaccines, for both adults and children. Our investigation describes perceptions of fully vaccinated HCP about COVID-19 vaccine for themselves and primary series for their children. OBJECTIVE To determine associations between sociodemographic, employment characteristics and perceptions of COVID-19 vaccines among HCP overall and the subset of HCP with children, who were all mandated to receive a COVID-19 vaccine, in a large US metropolitan region. DESIGN Cross-sectional survey of fully vaccinated HCP from a large integrated health system. SETTING Participants were electronically enrolled within a multi-site NYS healthcare system from December 21, 2021, to January 21, 2022. PARTICIPANTS Of 78,000 employees, approximately one-third accessed promotional emails; 6,537 employees started surveys and 4165 completed them. Immunocompromised HCP (self-reported) were excluded. EXPOSURE(S) (FOR OBSERVATIONAL STUDIES) We conducted a survey with measures including demographic variables, employment history, booster status, child vaccination status; vaccine recommendation, confidence, and knowledge. MAIN OUTCOME(S) AND MEASURES The primary outcome was COVID-19 vaccine hesitancy for all dose types - primary series or booster doses - among HCP. RESULTS Findings from 4,165 completed surveys indicated that almost 17.2 % of all HCP, including administrative and clinical staff, were hesitant or unsure about receiving a COVID-19 vaccine booster, despite the NYS recommendation to do so. Depending on age group, between 20 % and 40 % of HCP were hesitant about having their children vaccinated for COVID-19, regardless of clinical versus non-clinical duties. In multivariable regression analyses, lack of booster dose, unvaccinated children, females, income less than $50,000, and residence in Manhattan remained significantly associated with vaccine hesitancy. CONCLUSIONS AND RELEVANCE Despite mandated COVID-19 vaccination, a substantial proportion of HCP remained vaccine hesitant towards adult booster doses and pediatric COVID-19 vaccination. While provider recommendation has been the mainstay of combatting COVID-19 vaccine hesitancy, a gap exists between HCP-despite clinical or administrative status-and the ability to communicate the need for vaccination in a healthcare setting. While previous studies describe the HCP vaccine mandate as a positive force to overcome vaccine hesitancy, we have found that despite a mandate, there is still substantial COVID-19 vaccine hesitancy, misinformation, and reluctance to vaccinate children.
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Affiliation(s)
- Mundeep K Kainth
- Northwell, New Hyde Park, NY, USA; Department of Pediatrics, Cohen Children's Medical Center, New Hyde Park, NY, USA; Department of Molecular Medicine, Feinstein Institutes of Medical Research, Manhasset, NY, USA; Donald and Barbara Zucker School of Medicine at Hofstra/Northwell Health, Hempstead, NY, USA.
| | - Grace N Sembajwe
- Northwell, New Hyde Park, NY, USA; Institute of Health System Science, Feinstein Institutes of Medical Research, Manhasset, NY, USA; Department of Occupational Medicine, Epidemiology, and Prevention, Northwell Health, New York, NY, USA
| | - Heejoon Ahn
- Institute of Health System Science, Feinstein Institutes of Medical Research, Manhasset, NY, USA
| | - Min Qian
- Department of Biostatistics, Mailman School of Public Health, Columbia University Medical Center, New York, NY, USA
| | - Maxine Carrington
- Center for Learning & Innovation, Human Resources, Northwell Health, USA
| | | | - Sophia Jan
- Northwell, New Hyde Park, NY, USA; Department of Pediatrics, Cohen Children's Medical Center, New Hyde Park, NY, USA; Donald and Barbara Zucker School of Medicine at Hofstra/Northwell Health, Hempstead, NY, USA
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Binte Hossain F, Muscatello D, Jayasinghe S, Jonnagaddala J, Liu B. Uptake of pneumococcal vaccines in older Australian adults before and after universal public funding of PCV13. Vaccine 2024; 42:3084-3090. [PMID: 38584056 DOI: 10.1016/j.vaccine.2024.04.012] [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: 09/24/2023] [Revised: 03/25/2024] [Accepted: 04/04/2024] [Indexed: 04/09/2024]
Abstract
BACKGROUND In 2020 Australia changed the funded universal older adult pneumococcal vaccination program from use of the 23-valent pneumococcal polysaccharide vaccine (PPV23) at age 65 to the 13-valent pneumococcal conjugate vaccine (PCV13) at age 70 years. We investigated uptake of both PCV13 and PPV23 in older adults before and after the program change. METHODS We analysed a national dataset of records of patients attending general practices (GPs). We included regular attendees aged 65 or above in 2020. Cumulative uptake of PCV13 and monthly uptake of PPV23 was compared for the two periods before (January 2019 to June 2020) and after (July 2020 to May 2021) the program change on 1 July 2020, by age groups and presence of comorbid conditions. RESULTS Our study included data from 192,508 patients (mean age in 2020: 75.1 years, 54.2 % female, 46.1 % with at least one comorbidity). Before July 2020, for all adults regardless of underlying comorbidities, the cumulative uptake of PCV13 was < 1 % but by May 2021, eleven months after the program changes, cumulative uptake of PCV13 had increased among those aged 70-79 years (without comorbidity: 16.3 %; with comorbidity: 21.1 %) and 80 + years (without comorbidity: 13.5 %; with comorbidity: 17.7 %), but not among those aged 65-69 years (without comorbidity: 1.3 %; with comorbidity: 3 %). Monthly uptake of PPV23 dropped following the program change across all age groups. CONCLUSIONS Changes in uptake of PCV13 and PPV23 among those aged 70 + years were consistent with program changes. However, PCV13 uptake was still substantially lower in individuals aged 65-69 years overall and in those with comorbidities.
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Affiliation(s)
- Fariha Binte Hossain
- School of Population Health, UNSW, Sydney, Samuels Building, F25, Samuel Terry Ave, Kensington, NSW 2033, Australia.
| | - David Muscatello
- School of Population Health, UNSW, Sydney, Samuels Building, F25, Samuel Terry Ave, Kensington, NSW 2033, Australia
| | - Sanjay Jayasinghe
- National Centre for Immunisation Research and Surveillance (NCIRS), Kids Research, Sydney Children's Hospitals Network, Cnr Hawkesbury Rd & Hainsworth St, Westmead, NSW 2145, Australia; Children's Hospital at Westmead Clinical School, The University of Sydney, Sydney 2145, Australia
| | - Jitendra Jonnagaddala
- School of Population Health, UNSW, Sydney, Samuels Building, F25, Samuel Terry Ave, Kensington, NSW 2033, Australia
| | - Bette Liu
- School of Population Health, UNSW, Sydney, Samuels Building, F25, Samuel Terry Ave, Kensington, NSW 2033, Australia; National Centre for Immunisation Research and Surveillance (NCIRS), Kids Research, Sydney Children's Hospitals Network, Cnr Hawkesbury Rd & Hainsworth St, Westmead, NSW 2145, Australia
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Dimitrova V, Stoitsova S, Rangelov V, Raycheva R, Martinova M, Nenova G, Iakimova M, Georgieva I, Georgiev I, Krumova S, Minkova A, Vladimirova N, Nikolaeva-Glomb L. High vaccine confidence and strong approval of the mandatory immunization schedule among Bulgarian general practitioners in 2022. Hum Vaccin Immunother 2023; 19:2265640. [PMID: 37846744 PMCID: PMC10583620 DOI: 10.1080/21645515.2023.2265640] [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: 07/18/2023] [Accepted: 09/28/2023] [Indexed: 10/18/2023] Open
Abstract
In a context of recently decreasing childhood immunization coverage and low uptake of COVID-19 vaccines in Bulgaria, this study measures vaccine hesitancy among general practitioners (GPs) in the country, as they are central to forming patients' attitudes. In 2022, a face-to-face survey was conducted through a simple random sample from an exhaustive national database of Bulgarian GPs. This study measured attitudes on vaccine importance, safety, and effectiveness, and attitudes toward the Bulgarian immunization schedule. Information was collected on demographic and GP practice characteristics and possible predictors of vaccine confidence in order to test for associations with attitudes toward immunization. GP attitudes toward vaccines and the immunization schedule in Bulgaria were generally positive. Among 358 respondents, 351 (98%,95%CI96-99%) strongly agreed/agreed that vaccines are important, 352 (98%,95%CI96-99%) that vaccines are effective, and 341 (95%,95%CI93-97%) that vaccines are safe. 347 respondents (97%,95%CI95-98%) affirmed that "it's good that vaccines from the children's immunization schedule are mandatory", and 331 (92%,95%CI89-95%) agreed with the statement "Bulgaria's childhood immunization has my approval". Trust in information from official institutions was among the strongest predictors of vaccine confidence. Respondents' vaccine confidence levels are within the ranges reported by GPs in other European countries and above those reported within the general Bulgarian population. GPs' vaccine confidence is highly associated with trust in official institutions. It is important to maintain trust in official institutions and to support GPs in communicating vaccine knowledge with patients so that vaccine hesitancy in the general population is countered.
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Affiliation(s)
- Veronika Dimitrova
- Department of Sociology, Sofia University “St. Kliment Ohridski”, Sofia, Bulgaria
| | - Savina Stoitsova
- Department of Epidemiology, National Center of Infectious and Parasitic Diseases, Sofia, Bulgaria
| | - Vanya Rangelov
- Department of Epidemiology, National Center of Infectious and Parasitic Diseases, Sofia, Bulgaria
- Department of Epidemiology and Disaster Medicine, Medical University Plovdiv, Plovdiv, Bulgaria
| | - Ralitsa Raycheva
- Department of Social Medicine and Public Health, Medical University Plovdiv, Plovdiv, Bulgaria
| | - Maria Martinova
- Communities and Identities Department, Bulgarian Academy of Sciences, Sofia, Bulgaria
| | - Gergana Nenova
- Department of Sociology, Sofia University “St. Kliment Ohridski”, Sofia, Bulgaria
| | - Milena Iakimova
- Department of Sociology, Sofia University “St. Kliment Ohridski”, Sofia, Bulgaria
| | - Irina Georgieva
- Department of Virology, National Center for Infectious and Parasitic Diseases, Sofia, Bulgaria
| | - Ivo Georgiev
- Department of Epidemiology, National Center of Infectious and Parasitic Diseases, Sofia, Bulgaria
| | - Stefka Krumova
- Department of Virology, National Center for Infectious and Parasitic Diseases, Sofia, Bulgaria
| | - Antoaneta Minkova
- Department of Epidemiology, National Center of Infectious and Parasitic Diseases, Sofia, Bulgaria
| | - Nadezhda Vladimirova
- Department of Epidemiology, National Center of Infectious and Parasitic Diseases, Sofia, Bulgaria
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Kaur M, Coppeta L, Olesen OF. Vaccine Hesitancy among Healthcare Workers in Europe: A Systematic Review. Vaccines (Basel) 2023; 11:1657. [PMID: 38005989 PMCID: PMC10675787 DOI: 10.3390/vaccines11111657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 10/17/2023] [Accepted: 10/25/2023] [Indexed: 11/26/2023] Open
Abstract
This study analyzes vaccine hesitancy (VH) among healthcare workers (HCWs) in 15 European countries. We have undertaken a systematic review by synthesizing data from 46 articles (between 2015 and 2022) encompassing 55,612 subjects. Despite the heterogeneity of the methods in the various studies, we found that physicians had consistently higher vaccination rates than nurses across different countries and different vaccines. Physicians' average vaccination rate was 79% across a selection of vaccines, while that of nurses was 62%. Concerns regarding vaccine safety, information gaps, and the responsibility of healthcare authorities in managing VH are highlighted by qualitative insights. This research contributes to our comprehension of the ways in which VH among HCWs is impacted by healthcare roles, vaccine types, and regional disparities. The insights gleaned from this analysis can serve as a guide for targeted interventions aimed at increasing vaccine acceptance and coverage in Europe, ultimately strengthening public health.
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Affiliation(s)
- Mandeep Kaur
- European Vaccine Initiative, Universitätsklinikum Heidelberg (Heidelberg University Hospital), Voßstraße 2, 69115 Heidelberg, Germany;
| | - Luca Coppeta
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy;
| | - Ole F. Olesen
- European Vaccine Initiative, Universitätsklinikum Heidelberg (Heidelberg University Hospital), Voßstraße 2, 69115 Heidelberg, Germany;
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Dimitrova V, Stoitsova S, Nenova G, Martinova M, Yakimova M, Rangelova V, Georgieva I, Georgiev I, Krumova S, Minkova A, Vladimirova N, Nikolaeva-Glomb L. Bulgarian General Practitioners' Communication Styles about Child Vaccinations, Mainly Focused on Parental Decision Making in the Context of a Mandatory Immunization Schedule. Healthcare (Basel) 2023; 11:2566. [PMID: 37761763 PMCID: PMC10531209 DOI: 10.3390/healthcare11182566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 09/14/2023] [Accepted: 09/15/2023] [Indexed: 09/29/2023] Open
Abstract
The communication practices of general practitioners in relation with vaccines have not been a topic of wide scientific interest. In this article, we outline them in the context of Bulgaria. A representative, cross-sectional, quantitative, face-to-face survey was conducted among 358 Bulgarian general practitioners in 2022 using simple random sampling. We conducted an exploratory factor analysis using questions about the role of the GPs, which measure models of communication. Based on the factor analysis, we distinguished four communication styles. They were called: active communicator, restrictive communicator, informing communicator, and strained communicator. One-way ANOVA and the T-test were carried out to explore the connections between factor scores (communication styles) and other variables. One of the most important results in the study was that the informing physician (emphasizing the choice of the parents) was the most common model in Bulgaria. This is somewhat contradictory, because of the mandatory status of most vaccines. We found connections between the communication styles and other variables-such as the type of settlement, having a hesitant parent in the practice, recommendations of non-mandatory vaccines, and experience with vaccine-preventable diseases. On the basis of the factor analysis and analysis of relationships with other variables, we reached the conclusion that in Bulgaria, hesitant parents are not sufficiently involved in active, effective communication about vaccines by GPs.
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Affiliation(s)
- Veronika Dimitrova
- Department of Sociology, Sofia University, 1000 Sofia, Bulgaria; (G.N.); (M.Y.)
| | - Savina Stoitsova
- Department of Epidemiology, National Centre of Infectious and Parasitic Diseases, 1504 Sofia, Bulgaria; (S.S.); (I.G.); (A.M.); (N.V.)
| | - Gergana Nenova
- Department of Sociology, Sofia University, 1000 Sofia, Bulgaria; (G.N.); (M.Y.)
| | - Maria Martinova
- Communities and Identities Department, Institute of Sociology and Philosophy at the Bulgarian Academy of Sciences, 1000 Sofia, Bulgaria;
| | - Milena Yakimova
- Department of Sociology, Sofia University, 1000 Sofia, Bulgaria; (G.N.); (M.Y.)
| | - Vanya Rangelova
- Department of Epidemiology and Disaster Medicine, Medical University of Plovdiv, 4002 Plovdiv, Bulgaria;
| | - Irina Georgieva
- Department of Virology, National Centre of Infectious and Parasitic Diseases, 1504 Sofia, Bulgaria; (I.G.); (S.K.); (L.N.-G.)
| | - Ivo Georgiev
- Department of Epidemiology, National Centre of Infectious and Parasitic Diseases, 1504 Sofia, Bulgaria; (S.S.); (I.G.); (A.M.); (N.V.)
| | - Stefka Krumova
- Department of Virology, National Centre of Infectious and Parasitic Diseases, 1504 Sofia, Bulgaria; (I.G.); (S.K.); (L.N.-G.)
| | - Antoaneta Minkova
- Department of Epidemiology, National Centre of Infectious and Parasitic Diseases, 1504 Sofia, Bulgaria; (S.S.); (I.G.); (A.M.); (N.V.)
| | - Nadezhda Vladimirova
- Department of Epidemiology, National Centre of Infectious and Parasitic Diseases, 1504 Sofia, Bulgaria; (S.S.); (I.G.); (A.M.); (N.V.)
| | - Lubomira Nikolaeva-Glomb
- Department of Virology, National Centre of Infectious and Parasitic Diseases, 1504 Sofia, Bulgaria; (I.G.); (S.K.); (L.N.-G.)
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Garrison A, Karlsson L, Fressard L, Fasce A, Rodrigues F, Schmid P, Taubert F, Holford D, Lewandowsky S, Nynäs P, Anderson EC, Gagneur A, Dubé E, Soveri A, Verger P. International adaptation and validation of the Pro-VC-Be: measuring the psychosocial determinants of vaccine confidence in healthcare professionals in European countries. Expert Rev Vaccines 2023; 22:726-737. [PMID: 37507356 DOI: 10.1080/14760584.2023.2242479] [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: 02/18/2023] [Revised: 06/29/2023] [Accepted: 07/26/2023] [Indexed: 07/30/2023]
Abstract
BACKGROUND Healthcare professionals (HCPs) play an important role in vaccination; those with low confidence in vaccines are less likely to recommend them to their patients and to be vaccinated themselves. The study's purpose was to adapt and validate long- and short-form versions of the International Professionals' Vaccine Confidence and Behaviors (I-Pro-VC-Be) questionnaire to measure psychosocial determinants of HCPs' vaccine confidence and their associations with vaccination behaviors in European countries. RESEARCH DESIGN AND METHODS After the original French-language Pro-VC-Be was culturally adapted and translated, HCPs involved in vaccination (mainly GPs and pediatricians) across Germany, Finland, France, and Portugal completed a cross-sectional online survey in 2022. A 10-factor multigroup confirmatory factor analysis (MG-CFA) of the long-form (10 factors comprising 34 items) tested for measurement invariance across countries. Modified multiple Poisson regressions tested the criterion validity of both versions. RESULTS 2,748 HCPs participated. The 10-factor structure fit was acceptable to good everywhere. The final MG-CFA model confirmed strong factorial invariance and showed very good fit. The long- and short-form I-Pro-VC-Be had good criterion validity with vaccination behaviors. CONCLUSION This study validates the I-Pro-VC-Be among HCPs in four European countries; including long- and short-form tools for use in research and public health.
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Affiliation(s)
- Amanda Garrison
- Faculté des Sciences Médicales Et Paramédicales, Southeastern Health Regional Observatory (Observatoire Régional de la Santé, ORS) PACA, Marseille, France
| | - Linda Karlsson
- Institute of Clinical Medicine, University of Turku, Turku, Finland
| | - Lisa Fressard
- Faculté des Sciences Médicales Et Paramédicales, Southeastern Health Regional Observatory (Observatoire Régional de la Santé, ORS) PACA, Marseille, France
| | - Angelo Fasce
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | | | - Philipp Schmid
- Institute for Planetary Health Behaviour, University of Erfurt, Erfurt, Germany
- Health Communication, Department of Implementation Research, Bernhard-Nocht-Institute for Tropical Medicine, Hamburg, Germany
| | - Frederike Taubert
- Institute for Planetary Health Behaviour, University of Erfurt, Erfurt, Germany
- Health Communication, Department of Implementation Research, Bernhard-Nocht-Institute for Tropical Medicine, Hamburg, Germany
| | - Dawn Holford
- School of Psychological Science, University of Bristol, Bristol, UK
| | - Stephan Lewandowsky
- School of Psychological Science, University of Bristol, Bristol, UK
- Department of Psychology, University of Potsdam, Potsdam, Germany
- School of Psychological Science, University of Western Australia, Crawley, WA, Australia
| | - Peter Nynäs
- Faculty of Arts, Psychology and Theology, Abo Akademi University, Turku, Finland
| | | | - Arnaud Gagneur
- Department of Pediatrics, University of Sherbrooke, Sherbrooke, Québec, Canada
| | - Eve Dubé
- Département d'anthropologie, Faculté des Sciences Sociales, Université Laval, Laval, Canada
| | - Anna Soveri
- Institute of Clinical Medicine, University of Turku, Turku, Finland
| | - Pierre Verger
- Faculté des Sciences Médicales Et Paramédicales, Southeastern Health Regional Observatory (Observatoire Régional de la Santé, ORS) PACA, Marseille, France
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Perception of COVID-19 and Vaccine Acceptance among Healthcare Workers. Int J Microbiol 2022; 2022:1607441. [PMID: 36505344 PMCID: PMC9733994 DOI: 10.1155/2022/1607441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 10/16/2022] [Accepted: 11/15/2022] [Indexed: 12/04/2022] Open
Abstract
Background COVID-19 infection is more likely to be acquired and transmitted by healthcare workers (HCWs). Furthermore, they serve as role models for communities in terms of COVID-19 vaccination attitudes. As a result, HCWs' reluctance to vaccinate could have a significant impact on pandemic containment efforts. Aim To characterize the current COVID-19 vaccine approval situation among healthcare workers and to determine the most likely reason for agreement or disagreement with COVID-19 vaccination. Methods This cross-sectional design included 451 HCWs from COVID-19 treatment institutions, with COVID-19 exposure risk changing depending on job function and working location. Results The study recruited 156 physicians and 295 nurses, of whom 58.1% were female and 41.9% were male. Physicians had a significantly higher rate of participation in COVID-19 pandemic prevention and control, with a rate of 69.9% versus 55.3% of nurses. Acceptance of COVID-19 vaccination was reported by 40.8% of HCWs. The rate of acceptance was significantly higher among physicians (55.1%) than among nurses (33.2%) (p < 0.001). Most HCWs (67.8%) believed the vaccine was not effective. Physicians showed more significant trust in the effectiveness of the vaccine than nurses (41% and 27.5, respectively) (p=0.003). Concerning vaccine safety, only 32.8% of HCWs believed it was safe. This was significantly higher in physicians (41.7%) than in nurses (28.1%) (p=0.004). Conclusion Vaccination uncertainty is common among healthcare personnel in Egypt, and this could be a significant barrier to vaccine uptake among the public. Campaigns to raise vaccine knowledge are critically needed.
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Bianchi FP, Stefanizzi P, Trerotoli P, Tafuri S. Sex and age as determinants of the seroprevalence of anti-measles IgG among European healthcare workers: A systematic review and meta-analysis. Vaccine 2022; 40:3127-3141. [PMID: 35491343 DOI: 10.1016/j.vaccine.2022.04.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 03/14/2022] [Accepted: 04/04/2022] [Indexed: 12/25/2022]
Abstract
INTRODUCTION The international literature shows good evidence of a significant rate of measles susceptibility among healthcare workers (HCWs). As such, they are an important public health issue. METHODS We conducted a systematic review and meta-analysis to estimate the prevalence of susceptible HCWs in EU/EEA countries and in the UK and to explore the characteristics (sex and age differences) and management of those found to be susceptible. RESULTS Nineteen studies were included in the meta-analysis. The prevalence of measles-susceptible HCWs was 13.3% (95 %CI: 10.0-17.0%). In a comparison of serosusceptible female vs. male HCWs, the RR was 0.92 (95 %CI = 0.83-1.03), and in a comparison of age classes (born after vs. before 1980) the RR was 2.78 (95 %CI = 2.20-3.50). The most recent studies proposed the mandatory vaccination of HCWs. DISCUSSION According to our meta-analysis, the prevalence of serosusceptible European HCWs is 13%; HCWs born in the post-vaccination era seem to be at higher risk. Healthcare professionals susceptible to measles are a serious epidemiological concern. Greater efforts should therefore be made to identify those who have yet to be vaccinated and actively encourage their vaccination.
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Affiliation(s)
| | - Pasquale Stefanizzi
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari, Italy
| | - Paolo Trerotoli
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari, Italy
| | - Silvio Tafuri
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari, Italy.
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Verger P, Botelho-Nevers E, Garrison A, Gagnon D, Gagneur A, Gagneux-Brunon A, Dubé E. Vaccine hesitancy in health-care providers in Western countries: a narrative review. Expert Rev Vaccines 2022; 21:909-927. [PMID: 35315308 DOI: 10.1080/14760584.2022.2056026] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
INTRODUCTION Vaccine hesitancy (VH) is a leading cause of suboptimal vaccine uptake rates worldwide. The interaction between patients and health-care providers (HCPs) is the keystone in addressing VH. However, significant proportions of HCPs, including those who administer vaccines, are personally and professionally vaccine-hesitant. AREAS COVERED This narrative review sought to characterize the nature, extent, correlates, and consequences of VH among HCPs. We included 39 quantitative and qualitative studies conducted in Western countries, published since 2015, that assessed VH among HCPs in general, for several vaccines. Studies were reviewed using the WHO 3Cs model - (lack of) confidence, complacency, and (lack of) convenience. EXPERT OPINION Despite the lack of validated tools and substantial heterogeneity in the methods used to measure VH among HCPs, this review confirms its presence in this population, at frequencies that vary by country, profession type, setting, and level of medical education. Lack of knowledge and mistrust in health authorities/pharmaceutical industry/experts were among its principal drivers. Improving the content about vaccination in HCPs' training programs, facilitating access to reliable information for use during consultations, and developing and validating instruments to measure HCPs' VH and its determinants are key to addressing VH among HCPs.
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Affiliation(s)
- Pierre Verger
- ORS Paca, Southeastern Health Regional Observatory, Marseille, France.,Faculty of Medicine, Aix-Marseille University, Marseille, France
| | - Elisabeth Botelho-Nevers
- Department of Infectious Diseases, University Hospital of Saint-Etienne, Saint-Etienne, France.,CIRI - Centre International de Recherche en Infectiologie, Lyon, France.,Univ Lyon, Jean Monnet University, Saint-Etienne, France.,Chair PreVacCi, Presage Institut, Jean Monnet University, Saint-Etienne, France
| | - Amanda Garrison
- ORS Paca, Southeastern Health Regional Observatory, Marseille, France.,Faculty of Medicine, Aix-Marseille University, Marseille, France
| | - Dominique Gagnon
- Direction des risques biologiques et de la santé au travail, Institut national de santé publique du Québec, Quebec, Canada
| | - Arnaud Gagneur
- Department of Pediatrics, Centre de Recherche du CHUS, Quebec, Canada.,Faculté de médecine et des sciences de la santé, Département de pédiatrie, Université de Sherbrooke-Campus de la Santé, Quebec, Canada
| | - Amandine Gagneux-Brunon
- Department of Infectious Diseases, University Hospital of Saint-Etienne, Saint-Etienne, France.,CIRI - Centre International de Recherche en Infectiologie, Lyon, France.,Univ Lyon, Jean Monnet University, Saint-Etienne, France.,Chair PreVacCi, Presage Institut, Jean Monnet University, Saint-Etienne, France.,CIC INSERM Vaccinology, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - Eve Dubé
- Deptartment of Anthropology, Laval University, Quebec, Canada
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11
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Pope S, Rader A, Stansifer S. Assessing Vaccine Hesitancy Among Pediatric Healthcare Providers. J Dr Nurs Pract 2022; 15:65-71. [DOI: 10.1891/jdnp-2021-0033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BackgroundVaccine compliance has fallen short of national and international targets, generating preventable disease outbreaks. While vaccine hesitancy in the general public is a factor in under-vaccination, vaccine hesitancy among healthcare providers remains an underrecognized obstacle to pediatric vaccine completion.ObjectiveThe aim of this quality improvement study was to assess provider attitudes and practices regarding vaccine efficacy, safety, adverse effects, and recommendations.MethodsTo assess for changes in their vaccine confidence, a convenience sample of three physicians and seven advanced practice registered nurses (APRNs) from a pediatric primary care clinic anonymously completed a self-administered survey, participated in an educational intervention, and then completed another survey.ResultsAll eight providers denied personal vaccine hesitancy. However, one APRN did not fully vaccinate their child due to a medical exemption and another APRN reported concerns about influenza vaccine efficacy. While the mean confidence score for educating vaccine-hesitant parents increased from pre (8.75) to post intervention (9.13), the increase was not statistically significant.ConclusionThe pre-intervention survey affirmed the presence of parental vaccine hesitancy, but not provider vaccine hesitancy.Nursing ImplicationsFurther study is needed to identify and address provider vaccine hesitancy to improve their vaccine confidence and, ultimately, pediatric vaccine completion.
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12
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Ayele AD, Ayenew NT, Tenaw LA, Kassa BG, Yehuala ED, Aychew EW, Mihretie GN, Belay HG. Acceptance of COVID-19 vaccine and associated factors among health professionals working in Hospitals of South Gondar Zone, Northwest Ethiopia. Hum Vaccin Immunother 2021; 17:4925-4933. [PMID: 35119353 PMCID: PMC8903926 DOI: 10.1080/21645515.2021.2013082] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Health-care professions are among the highly exposed group of population affected by COVID-19 pandemic and identified as the target population to get vaccination against the spread of the infection. However, vaccine reluctance is still high, which may negatively affect the efforts to prevent the spread of the infection. Hence, this study was aimed to assess acceptance of COVID-19 vaccine and associated factors among health professionals working in Hospitals of South Gondar Zone, Northwest Ethiopia. METHODS Institutional-based cross-sectional study was performed among 422 health professionals working in Hospitals of South Gondar Zone, Northwest Ethiopia, from March 1 to 30, 2021. Study participants were selected through simple random sampling techniques. Data were collected through a self-administered questionnaire. Multivariable logistic regression analysis was performed to identified factors associated with acceptance of COVID-19 vaccine with a p-value < 0.05 at 95% CI considered as statistically significant. RESULT Overall, 45.3% of health professionals accepted COVID-19 vaccine. Age (AOR: 2.55; 95% CI: 1.32-4.92), being male (AOR: 1.729; 95% CI: 1.32-2.34), had higher risk of COVID-19 (AOR: 1.74, 95% CI: 1.00-3.02), and positive attitude (AOR: 3.26, 95% CI: 2.14-4.96) were found to be statistically significant with the acceptance of COVID-19 vaccine. CONCLUSION The acceptance of COVID-19 vaccine among health professionals was significantly low. Participant's age, sex, high risk of COVID-19, and attitude toward COVID-19 vaccine were significantly associated with vaccine acceptance. Therefore, the government with respective stakeholders should emphasize addressing the concern of the health professionals and increase attitudes regarding COVID-19 vaccine to scale up vaccine acceptance.
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Affiliation(s)
- Alemu Degu Ayele
- College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia,CONTACT Alemu Degu Ayele College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | | | - Lebeza Alemu Tenaw
- School of Public Health, College of Health Sciences, Woldia University, Woldia, Ethiopia
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13
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Mohamed Hussein AAR, Galal I, Makhlouf NA, Makhlouf HA, Abd-Elaal HK, Kholief KMS, Saad MM, Attay DAE, Tawab DAA. Acceptance of COVID-19 vaccines among medical teams in Egypt. Arab J Gastroenterol 2021; 22:323-324. [PMID: 34561160 DOI: 10.1101/2021.01.11.21249324] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 09/08/2021] [Indexed: 05/27/2023]
Abstract
AbstractBackgroundSince the start of COVID-19 outbreak investigators are competing to develop and exam vaccines against COVID-19. It would be valuable to protect the population especially health care employees from COVID-19 infection. The success of COVID-19 vaccination programs will rely heavily on public willingness to accept the vaccine.AimsThis study aimed to describe the existing COVID-19 vaccine approval landscape among the health care providers and to identify the most probable cause of agreement or disagreement of COVID-19 vaccine.MethodsA cross-sectional online survey was done.ResultsThe present study included 496 health care employees, 55% were at age group from 18-45 years old. History of chronic diseases was recorded in 40.4%, and definite history of drug/food allergy in 10.1%. Only 13.5% totally agree to receive the vaccine, 32.4% somewhat agree and 40.9% disagreed to take the vaccine. Causes of disagreement were none safety, fear of genetic mutation and recent techniques and believe that the vaccine is not effective (57%, 20.2%, 17.7% and 16.6% respectively). The most trusted vaccine was the mRNA based vaccine. The age of health care employees and the presence of comorbidities or chronic diseases were the main factors related to COVID-19 acceptance (P<0.001 and 0.02 respectively).ConclusionVaccine hesitancy is not uncommon in healthcare employees in Egypt and this may be an alarming barrier of vaccine acceptance in the rest of population. There is an urgent need to start campaigns to increase the awareness of the vaccine importance.
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Affiliation(s)
| | | | - Nahed A Makhlouf
- Department of Tropical Medicine and Gastroenterology, Faculty of Medicine, Assiut University, Assiut 71515, Egypt.
| | - Hoda A Makhlouf
- Chest Department, Assiut University Hospitals, Assiut 71515, Egypt; Faculty of Medicine, Assiut University, Assiut 71515, Egypt.
| | - Howaida K Abd-Elaal
- Internal Medicine and Surgery (adults), Faculty of Nursing, Assiut University, Egypt.
| | - Karima M S Kholief
- Public Health and Community Medicine Department, Assiut Faculty of Medicine, Egypt.
| | - Mahmoud M Saad
- Undergraduate House Officer, Assiut Faculty of Medicine, Assiut University, Assiut, Egypt.
| | - Dina A E Attay
- Undergraduate House Officer, Faculty of Medicine, Assiut University, Egypt.
| | - Doaa A Abdel Tawab
- Tropical Medicine and Gastroenterology, Faculty of Medicine, Assiut University, Egypt.
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14
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Abdul Kadir A, Noor NM, Mukhtar AF. Development and validation of the knowledge and attitude regarding childhood vaccination (KACV) questionnaire among healthcare workers: the Malay version. Hum Vaccin Immunother 2021; 17:5196-5204. [PMID: 34714713 DOI: 10.1080/21645515.2021.1989915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
Health care workers play an important role in supporting childhood vaccination as they are the most trusted source of vaccine-related information for parents. However, there is limited validated tools to measure their knowledge and attitude on childhood vaccination. This study aims to develop and validate knowledge and attitude regarding childhood vaccination (KACV) questionnaire among healthcare workers. The questionnaire was developed based on literature reviews and underwent a sequential validation process, including content, face validity and exploratory factor analysis. However, the attitude section is unidimensional and has undergone reliability analysis only. The preliminary knowledge questionnaire contains 33 items and the attitude questionnaire consists of 17 items. The preliminary KACV showed a high item Content Validity Index and Face Validity Index. The final questionnaire consists of 10 items for knowledge and 15 items for attitude. The Cronbach alpha for the knowledge and attitude section were 0.896 and 0.861, respectively. KACV is a valid and reliable tool to measure healthcare workers' knowledge and attitude on childhood vaccination.
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Affiliation(s)
- Azidah Abdul Kadir
- Department of Family Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia.,Department of Family Medicine, Hospital Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Norhayati Mohd Noor
- Department of Family Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia.,Department of Family Medicine, Hospital Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Ahmad Faiq Mukhtar
- Department of Family Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia.,Department of Family Medicine, Hospital Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
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15
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Raftopoulos V, Iordanou S, Katsapi A, Dedoukou X, Maltezou HC. A comparative online survey on the intention to get COVID-19 vaccine between Greek and Cypriot healthcare personnel: is the country a predictor? Hum Vaccin Immunother 2021; 17:2397-2404. [PMID: 33754953 PMCID: PMC8475582 DOI: 10.1080/21645515.2021.1896907] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2021] [Revised: 02/05/2021] [Accepted: 02/22/2021] [Indexed: 12/18/2022] Open
Abstract
Vaccine hesitancy amongst healthcare personnel (HCP) is a critical issue. The aim was to explore the factors that determine the intention to opt for COVID-19 vaccine among HCP from two southern European countries. An anonymous online self-administered survey using Google Forms has been conducted between December 1st to December 15th, 2020 among the HCP in Greece and the Republic of Cyprus. A total of 2,238 HCPs participated in the study (1,220/54.5% from Republic of Cyprus and 1,018 from Greece). Overall 1,082 (48.3%) stressed their intention to get vaccinated (64.4% for Greece and 34.9% for Republic of Cyprus). The main reasons for those who intend to get the COVID-19 vaccine include self (94.2%), family (98.7%), and patients protection (95.2%) as well as mitigation of COVID-19 pandemic (95.4%). The multivariate logistic regression that was performed for the total sample revealed that the following variables were significantly associated with an increased probability to get vaccinated against COVID-19: being a physician, a member of the nursing personnel, paramedical staff, working in Greece, age, the belief that influenza vaccination should be mandatory for HCP, and the rating of the overall management of COVID-19 pandemic in the country and from the public hospitals. Physicians were more likely to get vaccinated against COVID-19 than other HCP. The age was a predictor of COVID-19 uptake intention in the Republic of Cyprus. The belief that there was a successful management of the COVID-19 pandemic contributed to the intention to COVID-19 vaccination uptake.
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Affiliation(s)
- Vasilios Raftopoulos
- Epidemiological Surveillance of HIV/AIDS Division, National Public Health Organization, Athens, Greece
| | - Stelios Iordanou
- Intensive Care Unit, Limassol General Hospital, Limassol, Cyprus
| | - Angeliki Katsapi
- Euro-Mediterranean Institute for Quality and Safety in Health Services Avedis Donabedian, Athens, Greece
| | | | - Helena C. Maltezou
- Directorate of Research, Studies and Documentation, National Public Health Organization, Athens, Greece
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16
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Zahumensky J, Psenkova P, Melnikova L, Drabiscakova P, Nadzamova A, Kacerovsky M, Simetka O, Dosedla E. Religion Affects Future Female Doctors' Approach to HPV Vaccination in Czech and Slovak Republics. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2021; 36:880-891. [PMID: 33791949 DOI: 10.1007/s13187-021-01995-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/09/2021] [Indexed: 06/12/2023]
Abstract
The objective of this study is to summarize the factors, including religion, affecting an individual's decision to get vaccinated or reject vaccination. Anonymous questionnaire-based electronic study is conducted in all faculties of medicine in Czech and Slovak republics. One thousand four hundred and six (1406) questionnaires were analyzed. Responders not practicing any religion received vaccination more often and would recommend vaccination more often. Catholic religion was the most important demographic factor affecting the rate of vaccination. In the group of Catholic female students, 21.9% were vaccinated. In the group of non-Catholic female students, 55.5% were vaccinated. In conclusion, female medical students' approach to vaccination depends, among other factors, on their individual beliefs.
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Affiliation(s)
- Jozef Zahumensky
- 2nd Department of Gynecology and Obstetrics, University Hospital Bratislava and Comenius University, Ruzinovska 6, 82606, Bratislava, Slovakia
| | - Petra Psenkova
- 2nd Department of Gynecology and Obstetrics, University Hospital Bratislava and Comenius University, Ruzinovska 6, 82606, Bratislava, Slovakia.
| | - Livia Melnikova
- 2nd Department of Gynecology and Obstetrics, University Hospital Bratislava and Comenius University, Ruzinovska 6, 82606, Bratislava, Slovakia
| | - Paula Drabiscakova
- 2nd Department of Gynecology and Obstetrics, University Hospital Bratislava and Comenius University, Ruzinovska 6, 82606, Bratislava, Slovakia
| | - Alexandra Nadzamova
- 2nd Department of Gynecology and Obstetrics, University Hospital Bratislava and Comenius University, Ruzinovska 6, 82606, Bratislava, Slovakia
| | - Marian Kacerovsky
- Department of Obstetrics and Gynecology, University Hospital Hradec Kralove, Sokolska 581, 50005, Hradec Kralove, Czech Republic
| | - Ondrej Simetka
- Department of Gynecology and Obstetrics, University Hospital Ostrava, 17. listopadu 1790/5, 70852, Ostrava, Czech Republic
| | - Erik Dosedla
- Department of Obstetrics and Gynecology, Pavel Jozef Safarik University, 1st Private Hospital Kosice-Saca Inc., Trieda SNP 1, 04011, Kosice-Saca, Slovakia
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17
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Gobert C, Semaille P, Van der Schueren T, Verger P, Dauby N. Prevalence and Determinants of Vaccine Hesitancy and Vaccines Recommendation Discrepancies among General Practitioners in French-Speaking Parts of Belgium. Vaccines (Basel) 2021; 9:vaccines9070771. [PMID: 34358187 PMCID: PMC8310255 DOI: 10.3390/vaccines9070771] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 07/01/2021] [Accepted: 07/06/2021] [Indexed: 12/11/2022] Open
Abstract
General practitioners (GPs) play a critical role in patient acceptance of vaccination. Vaccine hesitancy (VH) is a growing phenomenon in the general population but also affects GPs. Few data exist on VH among GPs. The objectives of this analysis of a population of GPs in the Belgian Wallonia-Brussels Federation (WBF) were to: (1) determine the prevalence and the features of VH, (2) identify the correlates, and (3) estimate the discrepancy in vaccination’s behaviors between the GPs’ children and the recommendations made to their patients. An online survey was carried out among the population of general practitioners practicing in the WBF between 7 January and 18 March 2020. A hierarchical cluster analysis was carried out based on various dimensions of vaccine hesitancy: perception of the risks and the usefulness of vaccines as well as vaccine recommendations for their patients. A total of 251 GPs answered the survey. The average percentage of moderate to high vaccine hesitancy was 50.6%. Three factors were independently associated with increased risk of vaccine hesitancy: an age <50 years old, having no children, and having no contact with selected vaccine-preventable disease (measles, complicated influenza, chronic hepatitis B (HBV), bacterial meningitis, or cervical cancer) in the past 5 years. VH was associated with controversies on vaccines’ safety. GPs who had vaccinated their children against six diseases (MMR, meningococcus C (MenC), HBV, and HPV) tended not to recommend the same vaccines to their patients. Among GPs with all children vaccinated against HBV, only 37.5% recommended catch-up HBV immunization to their patients. In this small cohort of GP, moderate to high VH was associated with controversies on vaccines’ safety and with specific personal characteristics (age <50, no children, and no recent experience with a serious VPD). As previously reported, GPs have different vaccine prescription attitude toward their patients and children. These findings should be confirmed in larger cohorts.
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Affiliation(s)
- Cathy Gobert
- Department of Infectious Diseases, CHU Saint-Pierre, Université Libre de Bruxelles (ULB), 1000 Bruxelles, Belgium;
| | - Pascal Semaille
- Department of General Medicine, Université Libre de Bruxelles (ULB), 1070 Bruxelles, Belgium;
| | | | - Pierre Verger
- Southeastern Health Regional Observatory (ORS PACA), 13005 Marseille, France;
| | - Nicolas Dauby
- Department of Infectious Diseases, CHU Saint-Pierre, Université Libre de Bruxelles (ULB), 1000 Bruxelles, Belgium;
- School of Public Health, Université Libre de Bruxelles (ULB), 1070 Bruxelles, Belgium
- Institute for Medical Immunology, Université Libre de Bruxelles (ULB), 1070 Bruxelles, Belgium
- Correspondence:
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18
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Lin C, Mullen J, Smith D, Kotarba M, Kaplan SJ, Tu P. Healthcare Providers' Vaccine Perceptions, Hesitancy, and Recommendation to Patients: A Systematic Review. Vaccines (Basel) 2021; 9:vaccines9070713. [PMID: 34358132 PMCID: PMC8310254 DOI: 10.3390/vaccines9070713] [Citation(s) in RCA: 54] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 06/09/2021] [Accepted: 06/16/2021] [Indexed: 12/13/2022] Open
Abstract
Despite vaccines' effectiveness in reducing the rate of preventable diseases, vaccine hesitancy has threatened public health and economies worldwide. Healthcare providers' (HCP) communications and behavior strongly influence patient receptivity and uptake. The goal of this review was to examine HCP vaccine perceptions, knowledge, and reservations and how these attitudes affect their recommendations and vaccination practices. Primary research studies published by 16 September 2020 were searched in PubMed, Web of Science, Embase, CINAHL, and PsycINFO. A 14-item scale was developed for survey study and risk of bias appraisal (SSRBA). In total, 96 papers from 34 countries were included, covering 17 vaccines (HPV and influenza vaccines the most studied). Recommendation was positively associated with provider knowledge and experience, beliefs about disease risk, and perceptions of vaccine safety, necessity, and efficacy. HCP vaccination attitudes and practices varied across specialties, vaccines, and countries; demographic impact was inconclusive. Barriers included anticipation of patient/parental concerns or refusal, lacking clear guidelines, time constraints, and cost. For HPV, vaccines were more often recommended to older, female adolescents and by physicians who discussed sexual health. HCPs are vital advocates for patients and the public, but studies indicated a prevalence of provider hesitancy pertaining to inadequate knowledge, low vaccine confidence, and suboptimal uptake themselves. Improving HCP knowledge and assuring their access to information they deem trustworthy are essential to supporting HCPs' role as "trusted messengers" to promote vaccine acceptance.
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Affiliation(s)
- Cheryl Lin
- Policy and Organizational Management Program, Duke University, Durham, NC 27705, USA; (C.L.); (D.S.); (M.K.)
| | - Jewel Mullen
- Dell Medical School, The University of Texas at Austin, Austin, TX 78712, USA;
| | - Danielle Smith
- Policy and Organizational Management Program, Duke University, Durham, NC 27705, USA; (C.L.); (D.S.); (M.K.)
| | - Michaela Kotarba
- Policy and Organizational Management Program, Duke University, Durham, NC 27705, USA; (C.L.); (D.S.); (M.K.)
| | - Samantha J. Kaplan
- Medical Center Library and Archives, Duke University, Durham, NC 27710, USA;
| | - Pikuei Tu
- Policy and Organizational Management Program, Duke University, Durham, NC 27705, USA; (C.L.); (D.S.); (M.K.)
- Correspondence:
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19
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Elizondo-Alzola U, G. Carrasco M, Pinós L, Picchio CA, Rius C, Diez E. Vaccine hesitancy among paediatric nurses: Prevalence and associated factors. PLoS One 2021; 16:e0251735. [PMID: 34010321 PMCID: PMC8133484 DOI: 10.1371/journal.pone.0251735] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 04/30/2021] [Indexed: 11/18/2022] Open
Abstract
Objective This study describes the prevalence of vaccine hesitancy associated with the Catalan systematic childhood vaccination calendar and some related psychosocial determinants among paediatric primary care nurses in Barcelona (Spain). Methods Cross-sectional descriptive study. In 2017 we invited the paediatric nurses (N = 165) working in Barcelona public primary health centres with paediatric departments (N = 41) to participate. They answered a questionnaire with sociodemographic and behavioural variables: severity and perceived probability of contracting the diseases of the vaccines in the vaccination schedule; safety and protection offered by each vaccine; and beliefs, social norms, and knowledge about vaccines. Outcome variable was vaccine hesitancy, dichotomized into not hesitant (nurses who would vaccinate their own offspring), and hesitant (including those who would not vaccinate them, those who had doubts and those who would delay the administration of one or more vaccines). We performed bivariate analysis and adjusted logistic regression models. Results 83% of paediatric nurses (N = 137) agreed to participate. 67.9% had the intention to vaccinate their children of all the vaccines in the systematic schedule. 32.1% of nurses experienced vaccine hesitancy, especially about the HPV (21.9%) and varicella (17.5%) vaccines. The multivariate analysis suggests associations between hesitancy and low perception of the severity of whooping cough (aOR: 3.88; 95%CI:1.32–11.4), low perception of safety of the HPV vaccine (aOR:8.5;95%CI:1.24–57.8), the belief that vaccines are administered too early (aOR:6.09;95%CI:1.98–18.8), and not having children (aOR:4.05;95%CI:1.22–13.3). Conclusions Although most paediatric nurses had the intention to vaccinate their own children, almost one-third reported some kind of vaccine hesitancy, mainly related to doubts about HPV and varicella vaccines, as well as some misconceptions. These factors should be addressed to enhance nurses’ fundamental role in promoting vaccination to families.
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Affiliation(s)
- Usue Elizondo-Alzola
- Barcelona Public Health Agency, Barcelona, Spain
- Pompeu Fabra University, Barcelona, Spain
- Autonomous University of Barcelona, Barcelona, Spain
- * E-mail:
| | - Mireia G. Carrasco
- Barcelona Public Health Agency, Barcelona, Spain
- Autonomous University of Barcelona, Barcelona, Spain
| | - Laia Pinós
- Preventive Medicine and Epidemiology Department, Vall d’Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Camila Andrea Picchio
- Barcelona Public Health Agency, Barcelona, Spain
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Cristina Rius
- Barcelona Public Health Agency, Barcelona, Spain
- Autonomous University of Barcelona, Barcelona, Spain
- Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain
- CIBER Epidemiology and Public Health (CIBERESP), Carlos III Institute, Madrid, Spain
| | - Elia Diez
- Barcelona Public Health Agency, Barcelona, Spain
- Autonomous University of Barcelona, Barcelona, Spain
- Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain
- CIBER Epidemiology and Public Health (CIBERESP), Carlos III Institute, Madrid, Spain
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Verger P, Dualé C, Scronias D, Lenzi N, Pulcini C, Launay O. Attitudes of hospital physicians toward childhood mandatory vaccines in France: A cross-sectional survey. Hum Vaccin Immunother 2021; 18:1870393. [PMID: 33616464 PMCID: PMC8920152 DOI: 10.1080/21645515.2020.1870393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background Due to a decades-long crisis of confidence in vaccination, in 2017 France extended the number of mandatory early childhood vaccines from 3 to 11. Aims To describe the opinions of hospital staff physicians (HSPs) regarding this measure, quantify the proportion who would have preferred measures based on education, and study the factors associated with the latter opinion. Methods Cross-sectional nationwide survey with a standardized questionnaire in 2018–2019 among HSPs in 14 French public hospitals. The factors associated with HSPs’ preference for education and persuasion over mandatory vaccination were analyzed with simple and multiple Poisson regressions. Results The analyses included 1,795 HSPs (participation rate of 86%). Among them, 84% considered the extension of mandatory childhood vaccination essential given the epidemiological context at the time; in a later question, 40% would have preferred education and persuasion. Multiple regressions showed that the latter tended to be younger and less trustful of sources of information about vaccination. They were more likely to think that information on the rationale behind the national vaccination policy lacked clarity and that the extension of mandatory vaccines was not essential, even in the current epidemiologic situation. Conclusion Although most HSPs agreed that the extension of mandatory childhood vaccines was essential, some were ambivalent about its coercive philosophy. Further research is necessary to better understand the reasons of this ambivalence. A fraction did not understand the French vaccination strategy well. Efforts to explain its details to HSPs and an overhaul of their initial training on vaccination are still needed.
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Affiliation(s)
- Pierre Verger
- Research Department, Southeastern Health Regional Observatory (Observatoire Régional De La Santé Paca), Marseille, France.,INSERM, F-CRIN, Innovative Clinical Research Network in VACcinology (I-REIVAC), Paris, France
| | - Christian Dualé
- INSERM, F-CRIN, Innovative Clinical Research Network in VACcinology (I-REIVAC), Paris, France.,Centre Hospitalo-universitaire, Clermont-Ferrand, Centre d'Investigation Clinique, INSERM, Clermont-Ferrand, France
| | - Dimitri Scronias
- Faculté de Médecine Paris Descartes, Université de Paris, Paris, France.,INSERM, Assistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, France
| | - Nezha Lenzi
- INSERM, F-CRIN, Innovative Clinical Research Network in VACcinology (I-REIVAC), Paris, France.,Faculté de Médecine Paris Descartes, Université de Paris, Paris, France.,INSERM, Assistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, France
| | - Céline Pulcini
- PEMAC, équipe MICS, Université de Lorraine, Nancy, France.,Infectious Diseases Department, Université de Lorraine, CHRU-Nancy, Nancy, France
| | - Odile Launay
- INSERM, F-CRIN, Innovative Clinical Research Network in VACcinology (I-REIVAC), Paris, France.,Faculté de Médecine Paris Descartes, Université de Paris, Paris, France.,INSERM, Assistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, France
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21
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Escriva-Boulley G, Mandrik O, Préau M, Herrero R, Villain P. Cognitions and behaviours of general practitioners in France regarding HPV vaccination: A theory-based systematic review. Prev Med 2021; 143:106323. [PMID: 33171178 PMCID: PMC7840585 DOI: 10.1016/j.ypmed.2020.106323] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 11/04/2020] [Accepted: 11/05/2020] [Indexed: 01/11/2023]
Abstract
Human papillomavirus (HPV) vaccination is safe and efficacious to prevent persistent HPV infection, precancerous anogenital lesions and cervical cancer. However, in countries where vaccination programmes are implemented outside of schools, such as France, reaching high HPV vaccination coverage of the target population is challenging. Many studies have been performed in France to assess cognitions of general practitioners (GPs) regarding HPV vaccination. However, the evidence is not consistent about which cognitions are key. To provide a comprehensive overview, we performed a systematic review of studies conducted in France on GPs' cognitions regarding HPV vaccination and used the reasoned action approach to extract and synthesize data. The systematic search was performed up to July 2020 in Medline via PubMed, PsycINFO, PsycARTICLES, Embase, CINAHL Plus, Web of Science, Pascal and Francis databases. Grey literature was searched for in the French Public Health Database, Cairn. Info, yahoo.fr, and Google Scholar. Twenty-five scientific publications were selected based on eligibility criteria and assessed for quality. Our qualitative synthesis highlights that although 73% of GPs report recommending HPV vaccination, up to 50% would not recommend it because of concerns, including changes in patients' health behaviours and doubts about safety and/or efficacy. GPs' injunctive norms, i.e. trust in institutional information, were shown to be associated positively with GPs' willingness to recommend HPV vaccination. Parents' fears, girls' age, and potential connection with sexuality do not seem to affect GPs' recommendations. These results will inform the development of a professional educational intervention targeting GPs in France.
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Affiliation(s)
| | - Olena Mandrik
- The University of Sheffield, School of Health and Related Research (ScHARR), Health Economic and Decision Science (HEDS), Sheffield S1 4DA, United Kingdom
| | - Marie Préau
- Laboratoire GRePS (EA 4163), Université Lyon 2, 69676 Bron, France
| | - Rolando Herrero
- Agencia Costarricense de Investigaciones, Biomédicas, San Jose, Costa Rica
| | - Patricia Villain
- Screening Group, Early Detection and Prevention Section, International Agency for Research on Cancer, World Health Organization (IARC - WHO), 69372 Lyon, France.
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22
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Gagneux-Brunon A, Detoc M, Bruel S, Tardy B, Rozaire O, Frappe P, Botelho-Nevers E. Intention to get vaccinations against COVID-19 in French healthcare workers during the first pandemic wave: a cross-sectional survey. J Hosp Infect 2020; 108:168-173. [PMID: 33259883 PMCID: PMC7699157 DOI: 10.1016/j.jhin.2020.11.020] [Citation(s) in RCA: 358] [Impact Index Per Article: 89.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 11/24/2020] [Accepted: 11/25/2020] [Indexed: 01/07/2023]
Abstract
Background Healthcare workers (HCWs) are at the frontline of the COVID-19 pandemic and identified as a priority target group for COVID-19 vaccines. We aimed to determine COVID-19 vaccine acceptance rate in HCWs in France. Methods We conducted an anonymous survey from 26th March to 2nd July 2020. The primary endpoint was the intention to get vaccinated against COVID-19 if a vaccine was available. Results Two-thousand and forty-seven HCWs answered the survey; women accounted for 74% of respondents. Among respondents, 1.554 (76.9%, 95% confidence interval 75.1–78.9) would accept a COVID-19 vaccine. Older age, male gender, fear about COVID-19, individual perceived risk and flu vaccination during previous season were associated with hypothetical COVID-19 vaccine acceptance. Nurses and assistant nurses were less prone to accept vaccination against COVID-19 than physicians. Vaccine hesitancy was associated with a decrease in COVID-19 vaccine acceptance. Flu vaccine rate was 57.3% during the previous season, and 54.6% of the respondents had the intention to get a flu vaccine during the next season. Conclusions Intention to get vaccinated against COVID-19 reached 75% in HCWs with discrepancies between occupational categories. COVID-19 pandemic had no positive effect on flu vaccine acceptance rate.
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Affiliation(s)
- A Gagneux-Brunon
- Department of Infectious and Tropical Diseases, University Hospital of Saint-Etienne, Saint-Etienne, France; Centre d'investigation Clinique 1408-INSERM, University Hospital of Saint-Etienne, Saint-Etienne, France; Groupe Immunité des Muqueuses et Agents Pathogènes EA3064, University Jean Monnet, Université de Lyon, Saint-Etienne, France; Institut PRESAGE, Chaire Prevention Vaccination et Contrôle de L'Infection, University Jean Monnet, Université de Lyon, Saint-Etienne, France.
| | - M Detoc
- Department of Infectious and Tropical Diseases, University Hospital of Saint-Etienne, Saint-Etienne, France; Centre d'investigation Clinique 1408-INSERM, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - S Bruel
- Department of General Medicine, Faculté de Médecine Jacques Lisfranc, University Jean Monnet, Université de Lyon, Saint-Etienne, France
| | - B Tardy
- Centre d'investigation Clinique 1408-INSERM, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - O Rozaire
- Union Régionale des Professionnels de Santé Pharmaciens, Auvergne Rhône Alpes, France
| | - P Frappe
- Centre d'investigation Clinique 1408-INSERM, University Hospital of Saint-Etienne, Saint-Etienne, France; Department of General Medicine, Faculté de Médecine Jacques Lisfranc, University Jean Monnet, Université de Lyon, Saint-Etienne, France
| | - E Botelho-Nevers
- Department of Infectious and Tropical Diseases, University Hospital of Saint-Etienne, Saint-Etienne, France; Centre d'investigation Clinique 1408-INSERM, University Hospital of Saint-Etienne, Saint-Etienne, France; Groupe Immunité des Muqueuses et Agents Pathogènes EA3064, University Jean Monnet, Université de Lyon, Saint-Etienne, France; Institut PRESAGE, Chaire Prevention Vaccination et Contrôle de L'Infection, University Jean Monnet, Université de Lyon, Saint-Etienne, France
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Labetoulle R, Detoc M, Gagnaire J, Berthelot P, Pelissier C, Fontana L, Botelho-Nevers E, Gagneux-Brunon A. COVID-19 in health-care workers: lessons from SARS and MERS epidemics and perspectives for chemoprophylaxis and vaccines. Expert Rev Vaccines 2020; 19:937-947. [PMID: 33107353 DOI: 10.1080/14760584.2020.1843432] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Introduction: The world is now facing the COVID-19 pandemic. Experience with SARS-CoV and MERS-CoV, and early reports about SARS-CoV-2 infection suggest that health-care settings and health-care workers (HCWs) are vulnerable in the context of the emergence of a new coronavirus. Areas covered: To highlight the need for prophylactic strategies particularly for HCWs, we identified SARS-CoV, MERS-CoV, and SARS-CoV-2 outbreaks in health-care settings and the incidence of infections in HCWs by a search on MEDLINE and MEDxRIV (for SARS-Cov-2). To identify prophylactic strategies against, we conducted a search on MEDLINE and clinicaltrials.gov about studies involving SARS-CoV, MERS-CoV, and SARS-CoV-2. Expert opinion: HCWs account for a great part of SARS, MERS, and SARS-CoV-2 infections, they may also contribute to the spread of the disease, particularly in health-care settings, and contribute to nosocomial outbreaks. Some preventive strategies were evaluated in previous emerging coronavirus epidemics, particularly in MERS-CoV. For COVID-19 prevention, different chemoprophylaxis with drug repositioning and new agents are under evaluation, and different vaccine candidates entered clinical development, with clinical trials. HCWs are a crucial target population for pre-exposure and post-exposure prophylaxis.
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Affiliation(s)
- Rémi Labetoulle
- Department of Microbiology, University Hospital of Saint-Etienne , Saint-Etienne, France
| | - Maëlle Detoc
- Department of Infectious Diseases and Infection Control, University Hospital of Saint-Etienne , Saint-Etienne, France.,CIC-1408 Vaccinologie INSERM, University Hospital of Saint-Etienne , Saint-Etienne, France
| | - Julie Gagnaire
- Department of Infectious Diseases and Infection Control, University Hospital of Saint-Etienne , Saint-Etienne, France
| | - Philippe Berthelot
- Department of Infectious Diseases and Infection Control, University Hospital of Saint-Etienne , Saint-Etienne, France.,Groupe Immunité des Muqueuses et Agents Pathogènes, GIMAP EA 3064 Université Jean Monnet, Université De Lyon , Saint-Etienne, France.,Chaire Prévention, Vaccination et Contrôle de l'Infection, PRESAGE Institute, PREVACCI department, Université De Lyon , Saint-Etienne, France
| | - Carole Pelissier
- Department of Occupational Medicine, University Hospital of Saint-Etienne , France
| | - Luc Fontana
- Department of Occupational Medicine, University Hospital of Saint-Etienne , France
| | - Elisabeth Botelho-Nevers
- Department of Infectious Diseases and Infection Control, University Hospital of Saint-Etienne , Saint-Etienne, France.,CIC-1408 Vaccinologie INSERM, University Hospital of Saint-Etienne , Saint-Etienne, France.,Groupe Immunité des Muqueuses et Agents Pathogènes, GIMAP EA 3064 Université Jean Monnet, Université De Lyon , Saint-Etienne, France.,Chaire Prévention, Vaccination et Contrôle de l'Infection, PRESAGE Institute, PREVACCI department, Université De Lyon , Saint-Etienne, France
| | - Amandine Gagneux-Brunon
- Department of Infectious Diseases and Infection Control, University Hospital of Saint-Etienne , Saint-Etienne, France.,CIC-1408 Vaccinologie INSERM, University Hospital of Saint-Etienne , Saint-Etienne, France.,Groupe Immunité des Muqueuses et Agents Pathogènes, GIMAP EA 3064 Université Jean Monnet, Université De Lyon , Saint-Etienne, France.,Chaire Prévention, Vaccination et Contrôle de l'Infection, PRESAGE Institute, PREVACCI department, Université De Lyon , Saint-Etienne, France
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24
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Detoc M, Bruel S, Frappe P, Tardy B, Botelho-Nevers E, Gagneux-Brunon A. Intention to participate in a COVID-19 vaccine clinical trial and to get vaccinated against COVID-19 in France during the pandemic. Vaccine 2020; 38:7002-7006. [PMID: 32988688 PMCID: PMC7498238 DOI: 10.1016/j.vaccine.2020.09.041] [Citation(s) in RCA: 417] [Impact Index Per Article: 104.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 09/07/2020] [Accepted: 09/14/2020] [Indexed: 02/07/2023]
Abstract
INTRODUCTION The world is facing the COVID-19 pandemic. The development of a vaccine is challenging. We aimed to determine the proportion of people who intend to get vaccinated against COVID-19 in France or to participate in a vaccine clinical trial. METHODS We conducted an anonymous on-line survey from the 26th of March to the 20th of April 2020. Primary endpoints were the intention to get vaccinated against COVID-19 if a vaccine was available or participate in a vaccine clinical trial. RESULTS Three thousand two hundred and fifty nine individuals answered the survey; women accounted for 67.4% of the respondents. According to their statements, 2.512 participants (77.6%, 95% CI 76.2-79%) will certainly or probably agree to get vaccinated against COVID-19. Older age, male gender, fear about COVID-19, being a healthcare worker and individual perceived risk were associated with COVID-19 vaccine acceptance. Vaccine hesitancy was associated with a decrease in COVID-19 vaccine acceptance. One thousand and five hundred and fifty respondents (47.6% 95% CI 45.9-49.3%) will certainly or probably agree to participate in a COVID-19 vaccine clinical trial. Older age, male gender, being a healthcare worker and individual perceived risk were associated with potential acceptance to participate in a COVID-19 vaccine clinical trial. Vaccine hesitancy was associated with refusal for participation in a COVID-19 vaccine clinical trial. CONCLUSIONS Nearly 75% and 48% of the survey respondents were respectively likely to accept vaccination or participation in a clinical trial against COVID-19. Vaccine hesitancy will be the major barrier to COVID-19 vaccine uptake.
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Affiliation(s)
- Maëlle Detoc
- Centre d'investigation clinique-INSERM 1408, University Hospital of Saint-Etienne, France
| | - Sébastien Bruel
- Centre d'investigation clinique-INSERM 1408, University Hospital of Saint-Etienne, France; Department of General Practice, Faculté de Médecine Jacques Lisfranc, Université Jean Monnet, Université de Lyon, Saint-Etienne, France; PRESAGE Insitute, Université de Lyon, Saint-Etienne, France
| | - Paul Frappe
- Centre d'investigation clinique-INSERM 1408, University Hospital of Saint-Etienne, France; Department of General Practice, Faculté de Médecine Jacques Lisfranc, Université Jean Monnet, Université de Lyon, Saint-Etienne, France; PRESAGE Insitute, Université de Lyon, Saint-Etienne, France
| | - Bernard Tardy
- Centre d'investigation clinique-INSERM 1408, University Hospital of Saint-Etienne, France
| | - Elisabeth Botelho-Nevers
- Centre d'investigation clinique-INSERM 1408, University Hospital of Saint-Etienne, France; Groupe Immunité des Muqueuses et Agents Pathogènes, Université Jean Monnet, Université de Lyon, Saint-Etienne, France; PRESAGE Insitute, Université de Lyon, Saint-Etienne, France
| | - Amandine Gagneux-Brunon
- Centre d'investigation clinique-INSERM 1408, University Hospital of Saint-Etienne, France; Groupe Immunité des Muqueuses et Agents Pathogènes, Université Jean Monnet, Université de Lyon, Saint-Etienne, France; PRESAGE Insitute, Université de Lyon, Saint-Etienne, France.
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25
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Perceptions of French healthcare students of vaccines and the impact of conducting an intervention in health promotion. Vaccine 2020; 38:6794-6799. [PMID: 32896467 DOI: 10.1016/j.vaccine.2020.08.036] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 08/10/2020] [Accepted: 08/14/2020] [Indexed: 01/13/2023]
Abstract
BACKGROUND The perceptions of healthcare students of vaccines have been poorly explored and appropriate training strategies to address possible confidence gaps concerning vaccination for these future professionals is still a subject of debate. METHODS A questionnaire to assess the perceptions of vaccination and the feeling of preparedness to address patient concerns was submitted to 874 multidisciplinary healthcare students enrolled in the French program "Service Sanitaire des Etudiants en Santé" (SSES). The evolution of their perceptions during the year and the impact of having performed a primary prevention intervention in the context of the SSES program were assessed. RESULTS In total, 530 students of nursing (42.5%), medicine (31.5%), physiotherapy (11.3%), pharmacy (10.9%), and midwifery (3.8%) completed the questionnaires. Among them, 7.0% carried out an intervention within the topic "vaccination and hygiene" and 93.0% within another topic ("nutrition and physical activity" or "addiction"). A portion of the students showed traits of vaccine hesitancy, including specific concerns about side effects (61.5%) or the number of vaccines in the vaccination schedule (30.0%). They felt ill prepared to address vaccine-hesitant patients, with poor confidence of their knowledge about vaccines (52.5%), their ability to inform patients about the side effects (42.5%), the benefit/risk of adjuvants (51.7%), and the rules for introducing a new vaccine (51.9%). They showed significant differences in perception depending on their curriculum. Misconceptions and hesitancy concerning vaccines were significantly improved after the students had performed the primary prevention intervention, regardless of the topic. CONCLUSIONS A portion of French healthcare students show traits of vaccine hesitancy, with significant differences depending on the courses attended. Programs of health promotion, such as the French SSES program, which includes a primary prevention intervention conducted by multidisciplinary groups of students, may improve the global confidence of healthcare students concerning vaccination.
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Rey D, Fressard L, Cortaredona S, Bocquier A, Gautier A, Peretti-Watel P, Verger P, On Behalf Of The Baromètre Santé Group. Vaccine hesitancy in the French population in 2016, and its association with vaccine uptake and perceived vaccine risk-benefit balance. ACTA ACUST UNITED AC 2019; 23. [PMID: 29717693 PMCID: PMC5930729 DOI: 10.2807/1560-7917.es.2018.23.17.17-00816] [Citation(s) in RCA: 85] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Vaccine hesitancy (VH) is prominent in France. Objectives: This study aimed to estimate the prevalence and socio-demographic correlates of VH in sub-groups of the French population and to investigate the association of VH with both vaccine uptake and perceived risk–benefit balance (RBB) for four vaccines. Methods: During the 2016 Health Barometer – a national cross-sectional telephone survey in a representative sample of the French population – parents of 1–15 year-old children, parents of 11–15 year-old girls and elderly people aged 65–75 years were asked about VH (using three questions adapted from the World Health Organization definition), vaccine uptake and perceived RBB for measles and hepatitis B (children’s parents), human papillomavirus (girls’ parents) and seasonal influenza (elderly people) vaccines. Results: A total of 3,938 parents including 959 girls' parents – and 2,418 elderly people were interviewed. VH prevalence estimates were 46% (95% confidence interval (CI): 44–48) among parents, 48% (95%CI: 45–51) among girls’ parents and 35% (95% CI: 33–36) among elderly people, with higher estimates associated with high education level, children’s age (10–15 years), and, for the elderly, poor perception of health status. VH was associated with uncertainty about and/or an unfavourable perception of vaccines’ RBB for the four vaccines and with lower self-reported vaccine uptake, except for human papillomavirus vaccine in girls. Results were confirmed by multivariable analysis. Conclusion: Further research is needed to study the association between VH and vaccine uptake for other vaccines, and to design and validate measurement tools to monitor VH over time.
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Affiliation(s)
- Dominique Rey
- ORS PACA, Southeastern Health Regional Observatory, Marseille, France
| | - Lisa Fressard
- Aix-Marseille University, IRD, UMR-S912, Marseille, France.,INSERM, UMR S912, « Economics and Social Sciences Applied to Health & Analysis of Medical Information » (SESSTIM), Marseille, France.,ORS PACA, Southeastern Health Regional Observatory, Marseille, France
| | - Sébastien Cortaredona
- IRD, AP-HM, VITROME, IHU-Méditerranée Infection, Aix-Marseille University, Marseille, France
| | - Aurélie Bocquier
- IRD, AP-HM, VITROME, IHU-Méditerranée Infection, Aix-Marseille University, Marseille, France.,ORS PACA, Southeastern Health Regional Observatory, Marseille, France
| | - Arnaud Gautier
- Santé Publique France, French National Public Health Agency, Saint-Maurice, France
| | - Patrick Peretti-Watel
- IRD, AP-HM, VITROME, IHU-Méditerranée Infection, Aix-Marseille University, Marseille, France.,ORS PACA, Southeastern Health Regional Observatory, Marseille, France
| | - Pierre Verger
- IRD, AP-HM, VITROME, IHU-Méditerranée Infection, Aix-Marseille University, Marseille, France.,ORS PACA, Southeastern Health Regional Observatory, Marseille, France
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False Vaccine Contraindications Among Healthcare Providers in Europe: A Short Survey Among Members of The European Society of Pediatric Infectious Diseases. Pediatr Infect Dis J 2019; 38:974-976. [PMID: 31261366 DOI: 10.1097/inf.0000000000002401] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Some healthcare providers hold or delay vaccination because of false vaccine contraindications. This study suggests that in 21.4% of scenarios (877/4096) physicians would postpone or contraindicate the vaccination, and 24.2% (237/978) of scenarios would be vaccinated despite the existence of a true contraindication or reason for delay. Addressing false contraindications may result in increasing vaccination uptake in Europe.
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Arapović J, Sulaver Ž, Rajič B, Pilav A. The 2019 measles epidemic in Bosnia and Herzegovina: What is wrong with the mandatory vaccination program? Bosn J Basic Med Sci 2019; 19:210-212. [PMID: 31064166 DOI: 10.17305/bjbms.2019.4266] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Accepted: 05/05/2019] [Indexed: 11/16/2022] Open
Abstract
Measles is a highly contagious and communicable viral disease which may be prevented by a sustained vaccination program. Due to missed vaccination, two major epidemics of measles (1997-1999 and 2014-2015) have been recorded after the war in Bosnia and Herzegovina (BH) with over 10,000 patients registered. According to the World Health Organization, BH is categorized as a country with endemic transmission of measles. The last measles epidemic was between 2014 and 2015, with 5,083 documented patients in the Federation of BH. In the first four months of 2019, more than 700 measles cases were registered in the same region. Significant transmission rate has been observed in Sarajevo Canton (SC) with 570 documented measles cases. Out of 570 measles cases in SC, 92.5% were unvaccinated. The most affected were children up to 6 years of age (62.8%), with one documented case of death (7-month old infant). In addition to this report, we discussed key stakeholders and possible circumstances responsible for the epidemic. The measles epidemic is still ongoing.
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Affiliation(s)
- Jurica Arapović
- Department of Infectious Diseases, University Clinical Hospital Mostar, Mostar, Bosnia and Herzegovina.
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Storr C, Sanftenberg L, Schelling J, Heininger U, Schneider A. Measles Status-Barriers to Vaccination and Strategies for Overcoming Them. DEUTSCHES ARZTEBLATT INTERNATIONAL 2019; 115:723-730. [PMID: 30518471 DOI: 10.3238/arztebl.2018.0723] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Revised: 06/23/2017] [Accepted: 07/09/2018] [Indexed: 02/02/2023]
Abstract
BACKGROUND The World Health Organization (WHO) set the year 2020 as a target date for the eradication of measles in Europe, yet Germany is still far away from this goal. In this article, we provide an overview of current vaccination gaps and barriers to vaccination among children and adults in Germany, as well as potential strategies for overcoming them. METHODS This review is based on pertinent publications identified by a selective literature search in PubMed (Medline). RESULTS Measles vaccinations are not carried out in the appropriate timely fashion in Germany. Moreover, current vaccination rates among both children and adults are too low to achieve the goal of measles eradication. For example, among children born in 2014, the recommended vaccination rate of more than 95% was only reached when these children were 24 months old. Primary care physicians bear the responsibility for this situation, as they have the greatest influence on the decision to vaccinate. The main causes of vaccination gaps are safety worries and complacen- cy on the patients' part, and partial skepticism regarding vaccination on the part of the caregivers. We identified promising strategies for overcoming these problems: an instructive talk to provide evidence-based information to patients in an atmos- phere of mutual trust, reminder systems, multifactorial interventions, and facilitated access to vaccination, or, as a last resort, the reintroduction of compulsory vacci- nation. CONCLUSION Primary care physicians play a key role in vaccination. The focus of further strategies should lie above all in improved patient education and in targeted reminders for patients who neglect to vaccinate themselves and/or their children.
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Affiliation(s)
- Constanze Storr
- Institute of General Practice, Technische Universität München: The Max Planck Society's Max Planck Institute of Psychiatry, Munich; Institute of General Practice, Ludwig-Maximilians-Universität München; Department of Pediatric Infectiology and Vaccinology, Universitäts-Kinderspital beider Basel (UKBB); Institute of General Practice, Technische Universität München
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Detoc M, Touche C, Charles R, Lucht F, Gagneux-Brunon A, Botelho-Nevers E. Primary physicians' attitudes toward their patients receiving a proposal to participate in a vaccine trial. Hum Vaccin Immunother 2019; 15:2969-2979. [PMID: 31241393 DOI: 10.1080/21645515.2019.1625646] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
A trustworthy relationship between primary physicians (PPs) and their patients is crucial for vaccine acceptance. Little is known about attitudes of PPs toward participation of their patients in a preventive vaccine trial (PVT) proposed by investigation sites.A cross-sectional study was conducted in Auvergne-Rhône-Alpes region (France) including an anonymous questionnaire for general practitioners (GPs) and other specialists as well as face-to-face interviews. A scenario of a patient, with chronic medical conditions, invited to participate in a PVT and reporting this situation to his/her PP was drawn up. PPs' attitudes were assessed in quantitative approach by a 5-point Likert scale and in qualitative approach by semi-directed individual interviews.Among the 521 respondents to the questionnaire, 429 (82.3%) were GPs and 92 (17.7%) were other specialists. Only 7.5% (39/521) of respondents regularly practice clinical research. Confronted with the scenario, 312 respondents (59.8%) declared they would give their opinion spontaneously. Before giving their opinion, PPs would like more information about the trial (91.4%, n = 476). Whatever their attitude, 488 (93.7%) would be influenced by available safety data. Face-to-face interviews confirmed that PPs lack of knowledge about clinical research, and would like to obtain information from investigators, particularly about safety.PPs seem to be concerned by the decision of their patients to participate or not in a PVT but would like more information about the trial and clinical research before giving their opinion. Getting PPs to be more involved in the enrollment of patients in PVT may improve recruitment.
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Affiliation(s)
- Maelle Detoc
- Clinical trial center, INSERM CICEC 1408, University Hospital of Saint-Etienne, Saint-Etienne, France.,Groupe Immunité Muqueuse et Agents Pathogènes (GIMAP), EA3064 - Medical School of Saint-Etienne, University of Lyon, Saint-Etienne, France
| | - Camille Touche
- General Practice Department, University of Lyon, Saint-Etienne, France
| | - Rodolphe Charles
- General Practice Department, University of Lyon, Saint-Etienne, France
| | - Frédéric Lucht
- Clinical trial center, INSERM CICEC 1408, University Hospital of Saint-Etienne, Saint-Etienne, France.,Groupe Immunité Muqueuse et Agents Pathogènes (GIMAP), EA3064 - Medical School of Saint-Etienne, University of Lyon, Saint-Etienne, France
| | - Amandine Gagneux-Brunon
- Clinical trial center, INSERM CICEC 1408, University Hospital of Saint-Etienne, Saint-Etienne, France.,Groupe Immunité Muqueuse et Agents Pathogènes (GIMAP), EA3064 - Medical School of Saint-Etienne, University of Lyon, Saint-Etienne, France
| | - Elisabeth Botelho-Nevers
- Clinical trial center, INSERM CICEC 1408, University Hospital of Saint-Etienne, Saint-Etienne, France.,Groupe Immunité Muqueuse et Agents Pathogènes (GIMAP), EA3064 - Medical School of Saint-Etienne, University of Lyon, Saint-Etienne, France
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Miko D, Costache C, Colosi HA, Neculicioiu V, Colosi IA. Qualitative Assessment of Vaccine Hesitancy in Romania. ACTA ACUST UNITED AC 2019; 55:medicina55060282. [PMID: 31213037 PMCID: PMC6631779 DOI: 10.3390/medicina55060282] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Revised: 06/12/2019] [Accepted: 06/14/2019] [Indexed: 11/16/2022]
Abstract
Background and objectives: Health systems all over the world are confronted with an alarming rise of cases in which individuals hesitate, delay, and even refuse vaccination, despite availability of quality vaccine services. In order to mitigate and combat this phenomenon, which are now defined by the World Health Organization (WHO) as vaccine hesitancy (VH), we must first understand the factors that lead to its occurrence in an era characterized by wide access to safe and effective vaccines. To achieve this, we conducted field testing of the Vaccine Hesitancy Scale (VHS), as it was developed by the Strategic Advisory Group of Experts Working Group (SAGE WG), in Cluj-Napoca city, Cluj County, Romania. The scale is designed to quantify VH prevalence in a population, establish which vaccines generate the highest percentage of hesitancy, and allow a qualitative assessment of the individual’s reasons for hesitance. Materials and Methods: We conducted an observational cross-sectional survey, which was comprised of descriptive, analytical, and qualitative elements regarding VH. The necessary sample size was 452 individuals. The VHS and Matrix of Determinants (recommended by SAGE WG) for reasons people gave to justify their hesitance, was interpreted by qualitative thematic analysis (QTA) to ensure the validity and reliability in detecting hesitancy across various cultural settings and permit global comparisons. Results: We found a VH of 30.3% and 11.7% of parents reported refusing to vaccinate their child. Among the VH responders, the varicella vaccine generated 35% hesitancy, measles vaccine 27.7%, Human Papillomavirus (HPV) 24.1%, and mumps vaccine 23.4%, respectively. The QTA values for percent agreement ranged from 91% to 100%. Cohen’s Kappa values ranged from 0.45 to 0.95. Contextual influences identified for VH were “media,” “leaders and lobbies,” and “perception of the pharmaceutical industry.” Individual and group influences for VH were “beliefs,” “knowledge,” and “risk/benefits (perceived).” Vaccine and vaccination specific issues for VH were “risk/benefit (rational)” and “health care practitioners (trustworthiness, competence).” Conclusions: One-third of the investigated population had expressed VH, and a further one-third of these had refused a vaccine for their child. Chicken Pox, Measles, Mumps, Rubella (MMR), and HPV vaccines generated the most hesitation. Negative information from the media was the most frequently evoked reason for VH.
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Affiliation(s)
- David Miko
- Iuliu Hațieganu University of Medicine and Pharmacy, 400349 Cluj-Napoca, Romania.
| | - Carmen Costache
- Department of Microbiology, Iuliu Hațieganu University of Medicine and Pharmacy, 400349 Cluj-Napoca, Romania.
| | - Horațiu Alexandru Colosi
- Department of Medical Education, Division of Medical Informatics and Biostatistics, Iuliu Hațieganu University of Medicine and Pharmacy, 400349 Cluj-Napoca, Romania.
| | - Vlad Neculicioiu
- Department of Microbiology, Iuliu Hațieganu University of Medicine and Pharmacy, 400349 Cluj-Napoca, Romania.
| | - Ioana Alina Colosi
- Department of Microbiology, Iuliu Hațieganu University of Medicine and Pharmacy, 400349 Cluj-Napoca, Romania.
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32
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Eliminating measles and rubella in Europe. Clin Microbiol Infect 2017; 23:502-503. [DOI: 10.1016/j.cmi.2017.04.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Revised: 04/06/2017] [Accepted: 04/06/2017] [Indexed: 01/18/2023]
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33
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Dubé E. Addressing vaccine hesitancy: the crucial role of healthcare providers. Clin Microbiol Infect 2017; 23:279-280. [DOI: 10.1016/j.cmi.2016.11.007] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2016] [Revised: 11/01/2016] [Accepted: 11/04/2016] [Indexed: 10/20/2022]
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