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Mtei M, Mwasamila B D, Amour C, Bilakwate JS, Shirima LJ, Farah A, Mboya IB, Ngocho J, George JM, Msuya SE. COVID-19 vaccine confidence and its effect on vaccine uptake among people with hypertension or diabetes mellitus in Kilimanjaro region, Tanzania. Hum Vaccin Immunother 2024; 20:2396213. [PMID: 39222941 PMCID: PMC11370906 DOI: 10.1080/21645515.2024.2396213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2024] [Revised: 08/12/2024] [Accepted: 08/21/2024] [Indexed: 09/04/2024] Open
Abstract
COVID-19 vaccination effectively reduces disease severity, hospitalization, and mortality, particularly among individuals with chronic conditions who bear a disproportionate burden of disease complications. Vaccine confidence - belief in its safety, effectiveness, and importance - boosts uptake. However, limited data on vaccine confidence in this population hinders the development of targeted interventions. This study examined COVID-19 vaccine confidence and its impact on uptake among individuals with hypertension or diabetes mellitus in the Kilimanjaro region, Tanzania. A community-based cross-sectional study was conducted in March 2023 among 646 randomly selected adults aged ≥18 years with hypertension or diabetes mellitus in three districts of Kilimanjaro region, northern Tanzania. An interviewer-administered electronic questionnaire assessed confidence and uptake of COVID-19 vaccines in addition to related knowledge and demographic characteristics. Data analysis was done for 646 individuals who consented to participate. Multivariable logistic regression models determined the factors associated with COVID-19 vaccine confidence and its effect on vaccine uptake. The proportion of COVID-19 vaccine confidence among all 646 participants was 70% and was highest for perceived vaccine importance (80%), followed by perceived vaccine effectiveness (77%) and perceived vaccine safety (74%). Good knowledge of COVID-19 vaccines and living in the Mwanga municipal council (MC), a semi-urban district, was independently associated with confidence in the vaccines' importance, safety, effectiveness, and overall COVID-19 vaccine confidence. Confidence in COVID-19 vaccines increased the odds of vaccine uptake. Targeted interventions to boost vaccine confidence are therefore essential to enhance vaccine uptake in this high-risk population.
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Affiliation(s)
- Monica Mtei
- Institute of Public Health, Department of Epidemiology and Biostatistics, Kilimanjaro Christian Medical University College, Moshi, Tanzania
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Daimon Mwasamila B
- Institute of Public Health, Department of Epidemiology and Biostatistics, Kilimanjaro Christian Medical University College, Moshi, Tanzania
- Department of Immunology and Allergy, University of Lausanne, Basel, Switzerland
| | - Caroline Amour
- Institute of Public Health, Department of Epidemiology and Biostatistics, Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Julieth S Bilakwate
- Institute of Public Health, Department of Community Health, Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Laura J Shirima
- Institute of Public Health, Department of Epidemiology and Biostatistics, Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Amina Farah
- Joint Malaria Program, Kilimanjaro Christian Medical Centre, Moshi, Tanzania
| | - Innocent B Mboya
- Institute of Public Health, Department of Epidemiology and Biostatistics, Kilimanjaro Christian Medical University College, Moshi, Tanzania
- Department of Translational Medicine, Lund University, Malmö, Sweden
| | - James Ngocho
- Institute of Public Health, Department of Epidemiology and Biostatistics, Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Johnston M George
- Institute of Public Health, Department of Epidemiology and Biostatistics, Kilimanjaro Christian Medical University College, Moshi, Tanzania
- Institute of Public Health, Department of Community Health, Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Sia E Msuya
- Institute of Public Health, Department of Epidemiology and Biostatistics, Kilimanjaro Christian Medical University College, Moshi, Tanzania
- Institute of Public Health, Department of Community Health, Kilimanjaro Christian Medical University College, Moshi, Tanzania
- Community Health Department, Kilimanjaro Christian Medical Centre, Moshi, Tanzania
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Adeyanju GC, Betsch C. Vaccination decision-making among mothers of children 0-12 months old in Nigeria: A qualitative study. Hum Vaccin Immunother 2024; 20:2355709. [PMID: 38839600 PMCID: PMC11155705 DOI: 10.1080/21645515.2024.2355709] [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: 11/06/2023] [Accepted: 05/13/2024] [Indexed: 06/07/2024] Open
Abstract
The contribution of vaccination to global health, especially in low-middle-income countries is one of the achievements in global governance of modern medicine, averting 2-3 million child deaths annually. However, in Nigeria, vaccine-preventable-diseases still account for one-in-eight child deaths before their fifth-year birthday. Nigeria is one of the ten countries where 4.3 million children under five are without complete immunization. Therefore, the goal of this contribution is to shed light on the reasons to set a foundation for future interventions. To conduct focus groups, a simplified quota sampling approach was used to select mothers of children 0-12 months old in four geographical clusters of Nigeria. An interview guide developed from the 5C psychological antecedence model was used (assessing confidence, complacency, calculation, constraints, collective responsibility); two concepts were added that had proved meaningful in previous work (religion and masculinity). The data were analyzed using a meta-aggregation approach. The sample was relatively positive toward vaccination. Still, mothers reported low trust in vaccine safety and the healthcare system (confidence). Yet, they had great interest in seeking additional information (calculation), difficulties in prioritizing vaccination over other equally competing priorities (constraints) and were aware that vaccination translates into overall community wellbeing (collective responsibility). They had a bias toward God as ultimate giver of good health (religion) and their husbands played a dominant role in vaccination decision-making (masculinity). Mothers perceived their children vulnerable to disease outbreaks, hence, motivated vaccination (complacency). The study provided a useful qualitative tool for understanding mothers' vaccination decision-making in low resources settings.
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Affiliation(s)
- Gbadebo Collins Adeyanju
- Media and Communication Science, University of Erfurt, Erfurt, Germany
- Centre for Empirical Research in Economics and Behavioral Science (CEREB), University of Erfurt, Erfurt, Germany
- German Alliance for Global Health Research (GLOHRA), Berlin, Germany
| | - Cornelia Betsch
- Media and Communication Science, University of Erfurt, Erfurt, Germany
- Centre for Empirical Research in Economics and Behavioral Science (CEREB), University of Erfurt, Erfurt, Germany
- Health Communication Working Group, Bernhard Nocht Institute of Tropical Medicine (BNITM), Hamburg, Germany
- Institute for Planetary Health Behaviour, University of Erfurt, Erfurt, Germany
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White P, Alberti H, Rowlands G, Tang E, Gagnon D, Dubé È. Vaccine hesitancy educational interventions for medical students: A systematic narrative review in western countries. Hum Vaccin Immunother 2024; 20:2397875. [PMID: 39323010 PMCID: PMC11441049 DOI: 10.1080/21645515.2024.2397875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2024] [Revised: 08/15/2024] [Accepted: 08/24/2024] [Indexed: 09/27/2024] Open
Abstract
Physician recommendations can reduce vaccine hesitancy (VH) and improve uptake yet are often done poorly and can be improved by early-career training. We examined educational interventions for medical students in Western countries to explore what is being taught, identify effective elements, and review the quality of evidence. A mixed methods systematic narrative review, guided by the JBI framework, assessed the study quality using MERSQI and Cote & Turgeon frameworks. Data were extracted to analyze content and framing, with effectiveness graded using value-based judgment. Among the 33 studies with 30 unique interventions, effective studies used multiple methods grounded in educational theory to teach knowledge, skills, and attitudes. Most interventions reinforced a deficit-based approach (assuming VH stems from misinformation) which can be counterproductive. Effective interventions used hands-on, interactive methods emulating real practice, with short- and long-term follow-ups. Evidence-based approaches like motivational interviewing should frame interventions instead of the deficit model.
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Affiliation(s)
- Philip White
- Population Health Sciences Institute, Newcastle University Medical School, Newcastle upon Tyne, UK
| | - Hugh Alberti
- School of Medical Education, Newcastle University Medical School, Newcastle upon Tyne, UK
| | - Gill Rowlands
- Population Health Sciences Institute, Newcastle University Medical School, Newcastle upon Tyne, UK
| | - Eugene Tang
- Population Health Sciences Institute, Newcastle University Medical School, Newcastle upon Tyne, UK
| | - Dominique Gagnon
- Direction des risques biologiques, Institut national de santé publique du Québec, Quebec, Canada
| | - Ève Dubé
- Department of Anthropology, Laval University, Quebec, Canada
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Tinessia A, Clark K, Randell M, Leask J, King C. Strategies to address COVID-19 vaccine hesitancy in First Nations peoples: a systematic review. Glob Health Action 2024; 17:2384497. [PMID: 39230093 PMCID: PMC11376305 DOI: 10.1080/16549716.2024.2384497] [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: 05/06/2024] [Accepted: 07/22/2024] [Indexed: 09/05/2024] Open
Abstract
BACKGROUND First Nations peoples face disproportionate vaccine-preventable risks due to social, economic, and healthcare disparities. Additionally, during the COVID-19 pandemic, there was also mistrust and hesitancy about the COVID-19 vaccines among First Nations peoples. These are rooted in factors such as colonial histories, discriminatory medical practices, and unreliable information. OBJECTIVE To examine strategies to address COVID-19 vaccine hesitancy among First Nations peoples globally. METHODS A systematic review was conducted. Searches were undertaken in OVID MEDLINE, OVID EMBASE, OVID PsycINFO, CINAHL, and Informit. Searches were date limited from 2020. Items included in this review provided primary data that discussed strategies used to address COVID-19 vaccine hesitancy in First Nations peoples. RESULTS We identified several key strategies across four countries - Australia, the USA, Canada, and Guatemala in seventeen papers. These included understanding communities' needs, collaborating with communities, tailored messaging, addressing underlying systemic traumas and social health gaps, and early logistics planning. CONCLUSION The inclusion of First Nations-centred strategies to reduce COVID-19 vaccine hesitancy is essential to delivering an equitable pandemic response. Implementation of these strategies in the continued effort to vaccinate against COVID-19 and in future pandemics is integral to ensure that First Nations peoples are not disproportionately affected by disease.
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Affiliation(s)
- Adeline Tinessia
- School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Katrina Clark
- National Centre for Immunisation Research and Surveillance (NCIRS), Kids Research, Sydney Children's Hospital Network, Sydney, Australia
- Population Health - Hunter New England Health, Wallsend, Australia
| | - Madeleine Randell
- School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Julie Leask
- School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Catherine King
- School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
- National Centre for Immunisation Research and Surveillance (NCIRS), Kids Research, Sydney Children's Hospital Network, Sydney, Australia
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Charmasson A, Ecollan M, Jaury P, Partouche H, Frachon A, Pinot J. Perceived impact of discussions with a healthcare professional on patients' decision regarding COVID-19 vaccine. Hum Vaccin Immunother 2024; 20:2307735. [PMID: 38346925 PMCID: PMC10863372 DOI: 10.1080/21645515.2024.2307735] [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: 11/13/2023] [Accepted: 01/17/2024] [Indexed: 02/15/2024] Open
Abstract
There is evidence that advice from Healthcare Professionals (HCPs) plays an important role in patients' decision to get vaccinated, but the extent to which patients perceive this impact is unclear. The aim of this study was to assess the perceived impact of a discussion with a HCP on participants' decision to be vaccinated against COVID-19. A cross-sectional survey was conducted among adults who consulted a general practitioner (GP) or a pharmacist in Ile-de-France, France, after COVID-19 vaccines became available (October-November 2021 period). A total of 344 participants were included, 65.2% of whom reported having had a discussion about COVID-19 vaccines with a HCP. Overall, 55% of participants were advised to be vaccinated by their HCP. Most of the discussions took place with a GP (n = 203, 48.9%). According to 52.5% of participants, the discussion had a positive impact, i.e. it was perceived as encouraging vaccination. The latter reported that, among HCPs, GPs had the greatest number of discussions with a positive impact on the decision to be vaccinated against COVID-19 (93.1%). In the study population, the COVID-19 vaccine hesitancy rate, according to the WHO definition, was high (38.1%), although the COVID-19 vaccine coverage rate was 87.1%. Vaccine hesitant participants were more likely to report a discussion that had a perceived negative impact on their decision to get vaccinated (20.0%) than non-hesitant participants (5.8%, p = .004).
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Affiliation(s)
- Alric Charmasson
- Department of General Practice, Université Paris Cité, Paris, France
| | - Marie Ecollan
- Department of General Practice, Université Paris Cité, Paris, France
| | - Philippe Jaury
- Department of General Practice, Université Paris Cité, Paris, France
| | - Henri Partouche
- Department of General Practice, Université Paris Cité, Paris, France
| | - Adèle Frachon
- Department of General Practice, Université Paris Cité, Paris, France
| | - Juliette Pinot
- Department of General Practice, Université Paris Cité, Paris, France
- INSERM, IAME, Université Paris Cité and Université Sorbonne Paris Nord, Paris, France
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Rana B, Jimenez HR, Khan ZM, Narayanan N. Association between Socioeconomic Status and Vaccination Hesitancy, Reluctancy and Confidence among Asian-Americans Living in the State of New Jersey. J Community Health 2024; 49:829-834. [PMID: 39014152 PMCID: PMC11345316 DOI: 10.1007/s10900-024-01381-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/28/2024] [Indexed: 07/18/2024]
Abstract
BACKGROUD Socioeconomic status (SES) plays a vital role in determining vaccination uptake and attitudes. Vaccine hesitancy varies among different communities, yet knowledge of vaccine attitudes among Asian-Americans is limited. OBJECTIVE This study aims to investigate the relationship between SES and vaccine attitudes among Asian-Americans in the State of New Jersey (NJ). METHODS Asian-Americans aged ≥ 18 years living in NJ were included (N = 157). SES was measured by education level, employment type, employment status, and household income. The primary outcomes were vaccine hesitancy, reluctance, and confidence for COVID-19, influenza, and pneumococcal vaccines. Descriptive and inferential statistics were performed. Multivariable logistic regression was used to identify associations between SES and vaccine hesitancy while controlling for confounders such as age, gender, birthplace, and religion. RESULTS Among 157 participants, 12.1% reported vaccine hesitancy. There was no statistically significant association between vaccine hesitancy and education level (p = 0.68), employment status (p = 1), employment type (p = 0.48), and household income (p = 0.15). Multivariable logistic regression modeling confirmed that none of the SES predictor variables were associated with vaccine hesitancy. However, as exploratory finding, gender was found to be a significant predictor, with males having lower odds of vaccine hesitancy than females (Adjusted OR = 0.14; p < 0.05). Confidence in influenza and pneumococcal vaccines increased during the pandemic, from 62.34% to 70.13% and from 59.2% to 70.51%, respectively. For the COVID-19 vaccine, 73.1% of participants reported having "a lot of confidence" in taking vaccine. CONCLUSION Most sampled Asian-Americans in NJ have high confidence in taking COVID-19 vaccines, and there is no significant association between vaccine hesitancy and SES.
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Affiliation(s)
- Brijesh Rana
- School of Public Health, Rutgers, The State University of New Jersey, 683 Hoes Lane West, Piscataway, NJ, 08854, USA.
- Rutgers Cancer Institute of New Jersey, 195 Little Albany Street, New Brunswick, NJ, 08901, USA.
| | - Humberto R Jimenez
- Rutgers University Ernest Mario School of Pharmacy, 160 Frelinghuysen Rd, Piscataway, NJ, 08854, USA
| | - Zeba M Khan
- Rutgers University Ernest Mario School of Pharmacy, 160 Frelinghuysen Rd, Piscataway, NJ, 08854, USA
| | - Navaneeth Narayanan
- Rutgers University Ernest Mario School of Pharmacy, 160 Frelinghuysen Rd, Piscataway, NJ, 08854, USA
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Chen N. Income insecurity and social protection: Examining the impact of the COVID-19 pandemic across income groups. PLoS One 2024; 19:e0310680. [PMID: 39302925 DOI: 10.1371/journal.pone.0310680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2024] [Accepted: 08/29/2024] [Indexed: 09/22/2024] Open
Abstract
The COVID-19 pandemic has wrought unprecedented disruption on global economies, leading to widespread income insecurity among individuals and households. This study investigates the impact of the pandemic on income insecurity across different income groups and assesses the role of social protection measures in mitigating these effects. Using cross-country data, we analyze the prevalence of income reduction and the effectiveness of social assistance programs in high-income, upper middle-income, lower middle-income, and low-income countries. Our findings reveal significant variations in income insecurity and social protection responses across these groups. the pandemic had a significant impact on household incomes globally, with lower-middle-income countries experiencing the most significant income reductions. The average per capita transfer amounts show a general decrease over time, which could be due to the economic strain on governments and the need for more sustainable social protection programs. The correlation between transfer amounts and the proportion of households with reduced income indicates that countries with higher income reduction rates tended to have lower average per capita transfer amounts, suggesting a potential lack of adequate support for those in need. The study highlights the importance of robust social safety nets in cushioning the economic blow of the pandemic, particularly for vulnerable populations in lower-income countries.
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Affiliation(s)
- Na Chen
- School of Government, Beijing Normal University, Beijing, China
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Nicholls N, Pleace M, Yitbarek E. Trust in government, social media and willingness to vaccinate. Soc Sci Med 2024; 360:117302. [PMID: 39270575 DOI: 10.1016/j.socscimed.2024.117302] [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: 02/06/2024] [Revised: 08/18/2024] [Accepted: 09/05/2024] [Indexed: 09/15/2024]
Abstract
Vaccine hesitancy is considered one of the biggest global health threats. The prevalence of false information about vaccines on social media amplifies this challenge, making it more urgent. This study examines the relationship between social media use, trust in information sources, beliefs about vaccination rates, and willingness to adopt vaccines using data gathered in late 2023 from 975 respondents in South Africa. Our results suggest that people who rely on social media as their primary news source are more hesitant to get vaccinated for themselves and their children. Trust, which includes various sources including confidence in the government, is positively linked to vaccination decisions. Trust is especially important when it comes to less traditional vaccines such as COVID-19 and flu vaccines for both adults and children. We also note gender differences, with South African men showing more reluctance to get vaccinated as adults. Additionally, there is a negative correlation between social media use and the willingness of males to get vaccinated, but this relationship is not evident among females. Our research highlights the need for targeted interventions aimed at improving vaccine uptake, taking into account the links with information sources about vaccination and government trust.
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Affiliation(s)
- Nicky Nicholls
- Department of Economics, Tukkiewerf Building, University of Pretoria, Lynnwood Road, Pretoria, 0002, South Africa.
| | | | - Eleni Yitbarek
- University of Pretoria, South Africa, The Partnership for Economic Policy (PEP)
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Anino CO, Sanga P. Usage of social media and Covid 19 vaccine hesitancy among medical students in Kericho County. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0003529. [PMID: 39173009 PMCID: PMC11341036 DOI: 10.1371/journal.pgph.0003529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Accepted: 07/07/2024] [Indexed: 08/24/2024]
Abstract
The recent Covid 19 pandemic revealed the global challenge posed by infectious diseases. Vaccines are a crucial tool in preventing pandemics, as evidenced by their success in controlling past outbreaks. The rise of information and communication technology has introduced social media platforms as potential game-changers in both preventing and managing future pandemics. However, these same platforms can also be a double-edged sword, hindering the uptake of essential vaccination services. This study investigated the association between social media use and vaccine hesitancy among medical students. The study was designed as an institution based cross sectional study of 423 medical students in Kenya Medical Training College and University of Kabianga in Kericho County. Stratified sampling was used to decide on the two institutions and systematic random sampling was used to select the study participants. Research administered questionnaires were used to collect data on the socio-demographic characteristics, use of social media platforms, social media campaigns, and uptake of Covid 19 vaccines. The collected data was analyzed using Statistical Package for Social Sciences version 25. Chi square was used to establish the association between the independent variables and uptake of Covid 19 vaccines. The variables that were significantly associated with hesitancy to Covid 19 vaccines were further analyzed using binary logistic regression. The confidence interval (CI) was set at 95% and statistical significance was considered at p < 0.05. The study found significant associations between vaccine hesitancy and several factors, including academic level, preferred social media platform, the influence of social media on attitudes towards vaccines, concerns about vaccine safety and efficacy, and confidence in vaccines. The findings present social media as a potential platform for promotion of vaccines utilization during pandemics when used well.
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Affiliation(s)
| | - Philip Sanga
- Department of Community Health, Maseno University, Kisumu, Kenya
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Wang X, Liu M, Li Y, Mei X, Liao S, Liang Q, Liu Y. What determinants of COVID-19 vaccine hesitancy among Chinese nursing students? A cross-sectional study. Front Public Health 2024; 12:1432225. [PMID: 39228852 PMCID: PMC11368718 DOI: 10.3389/fpubh.2024.1432225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2024] [Accepted: 08/05/2024] [Indexed: 09/05/2024] Open
Abstract
Background The coronavirus disease 2019 (COVID-19) continues to threaten human health, and health professionals, including nursing students, usually work in healthcare frontiers with a high risk of infection. Vaccination is currently one of the most effective preventive measures. This study aimed to explore the determinants of COVID-19 vaccine hesitancy in nursing students. Methods In November 2022, a sample of undergraduate nursing students was recruited from several medical schools in Anhui Province, China, and an online cross-sectional survey was conducted using the questionnaire star platform (Wenjuanxin). A Chi-square test was used to explore vaccine hesitancy among nursing students with different social demographic characteristics and vaccine attitudes. Binary logistic regression analysis was then used to determine the influence factors of vaccine hesitancy among nursing students. Results A total of 1,090 valid samples were collected in this study. Of these, 27.06% (295) of nursing students reported COVID-19 vaccine hesitancy. The results showed "the need to go out of town recently" (OR = 0.670), "very confident that the outbreak could be controlled sustainably" (OR = 0.393), "feeling at risk of infection" (OR = 0.658), "not being worried/being generally worried about the vaccine's safety" (OR = 0.226 and OR = 0.686, respectively), and "not being worried about the vaccine's effectiveness" (OR = 0.411). These five factors are protective factors associated with COVID-19 vaccine hesitancy in nursing students. The factors "considering the country completely safe from an outbreak" (OR = 3.436), "considering themselves safe because others are vaccinated" (OR = 2.239), and "Agreeing that other protective measures can be relaxed after vaccination with the COVID-19 vaccine" (OR = 2.007) are risk factors associated with COVID-19 vaccine hesitancy among nursing students (P < 0.05). Conclusion Overall, relatively few nursing students had COVID-19 vaccine hesitancy. Schools and relevant institutions still need to actively guide them to improve their confidence in the COVID-19 vaccine, strengthen the prevention and control measures of the epidemic, and improve their awareness of the crisis to improve the vaccination rate to reduce the COVID-19 vaccine hesitancy in nursing students.
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Affiliation(s)
- Xin Wang
- Faculty of Health Sciences and Sports, Macao Polytechnic University, Macao, Macao SAR, China
| | - Ming Liu
- Peking University Health Science Center-Macao Polytechnic University Nursing Academy, Macao Polytechnic University, Macao, Macao SAR, China
| | - Yuanzhen Li
- School of Nursing, Wannan Medical College, Wuhu, China
| | - Xiaoxiao Mei
- School of Nursing, Hong Kong Polytechnic University, Hong Kong, China
| | - Shuting Liao
- Faculty of Health Sciences and Sports, Macao Polytechnic University, Macao, Macao SAR, China
| | - Qingqing Liang
- Faculty of Health Sciences and Sports, Macao Polytechnic University, Macao, Macao SAR, China
| | - Yachen Liu
- Faculty of Health Sciences and Sports, Macao Polytechnic University, Macao, Macao SAR, China
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Peretti-Watel P, Fressard L, Giry B, Verger P, Ward JK. Social Stigma and COVID-19 Vaccine Refusal in France. JOURNAL OF HEALTH POLITICS, POLICY AND LAW 2024; 49:567-598. [PMID: 38324348 DOI: 10.1215/03616878-11186095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2024]
Abstract
CONTEXT In 2021, French health authorities strongly promoted vaccination against COVID-19. The authors assumed that refusing this vaccine became a stigma, and they investigated potential public stigma toward unvaccinated people among the French population. METHODS A representative sample of the French adult population (N = 2,015) completed an online questionnaire in September 2021. The authors focused on participants who were already vaccinated against COVID-19 or intended to get vaccinated (N = 1,742). A cluster analysis was used to obtain contrasted attitudinal profiles, and the authors investigated associated factors with logistic regressions. FINDINGS Regarding attitudes toward unvaccinated people, a majority of respondents supported several pejorative statements, and a significant minority also endorsed social rejection attitudes. The authors found four contrasting attitudinal profiles: moral condemnation only (32% of respondents), full stigma (26%), no stigma (26%), and stigma rejection (16%). Early vaccination, civic motives for it, faith in science, rejection of political extremes, and being aged 65 or older were the main factors associated with stigmatizing attitudes toward unvaccinated people. CONCLUSIONS The authors found some evidence of stigmatization toward unvaccinated people, but further research is needed, especially to investigate perceived stigmatization among them. The authors discuss their results with reference to the concept of "folk devils" and from a public health perspective.
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Gialama M, Kleisiaris C, Malliarou M, Papagiannis D, Papathanasiou IV, Karavasileiadou S, Almegewly WH, Tsaras K. Validity and Reliability of the Greek Version of Adult Vaccine Hesitancy Scale in Terms of Dispositional Optimism in a Community-Dwelling Population: A Cross-Sectional Study. Healthcare (Basel) 2024; 12:1460. [PMID: 39120164 PMCID: PMC11311501 DOI: 10.3390/healthcare12151460] [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: 06/12/2024] [Revised: 07/05/2024] [Accepted: 07/20/2024] [Indexed: 08/10/2024] Open
Abstract
Vaccine hesitancy is an important public health issue referring to concerns about the safety and efficacy of vaccination. Within a framework, this study aimed to assess the cultural adaptation, validity, and reliability of the Greek version of the adult Vaccine Hesitancy Scale (aVHS) as well as to identify the determinants of vaccine hesitancy among a large regional population in central Greece. A cross-sectional study was conducted enrolling 300 adults who had received primary healthcare services in the Health Centers and Local Health Units of the Magnesia Region from October to December 2022. The aVHS and the Life Orientation Test-Revised (LOT-R) were used to identify vaccine hesitancy and the dispositional level of optimism, respectively. For survey translation, the procedure of forward and backward translation was followed. Also, the aVHS was tested in a pilot study with a sample of 18 responders. Construct validity and internal consistency reliability were investigated via exploratory and confirmatory factor analysis and Cronbach's alpha coefficients, respectively. Simple and multiple linear regression analysis were used to determine predictors for vaccine hesitancy. Factor analyses indicated that the aVHS comprises two constructs ("lack of confidence" and "risk perception") explaining 68.9% of the total variance. The Cronbach's alpha of the total scale was 0.884, indicating its high internal consistency. Participants who lived in rural areas, had a lower annual income, and reported a lower level of optimism showed a higher lack of confidence in vaccination. On the other hand, people aged above 45 years old who had graduated from high school or elementary school and were unemployed showed greater aversion to the risks of side effects. Finally, certain socio-demographic characteristics were associated with vaccine hesitancy. Our data suggest that the aVHS is a valid and reliable instrument for measuring vaccine-related attitudes and perceptions in Greek society, providing meaningful insight into designing vaccination-related preventive interventions in the community.
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Affiliation(s)
- Marilena Gialama
- Department of Nursing, School of Health Sciences, University of Thessaly, 41500 Larissa, Greece
| | - Christos Kleisiaris
- Department of Nursing, School of Health Sciences, University of Thessaly, 41500 Larissa, Greece
| | - Maria Malliarou
- Department of Nursing, School of Health Sciences, University of Thessaly, 41500 Larissa, Greece
| | - Dimitrios Papagiannis
- Department of Nursing, School of Health Sciences, University of Thessaly, 41500 Larissa, Greece
| | - Ioanna V Papathanasiou
- Department of Nursing, School of Health Sciences, University of Thessaly, 41500 Larissa, Greece
| | - Savvato Karavasileiadou
- Department of Community and Psychiatric Mental Health Nursing, College of Nursing, Princess Nourah bint Abdulrahman University, Riyadh 11671, Saudi Arabia
| | - Wafa Hamad Almegewly
- Department of Community and Psychiatric Mental Health Nursing, College of Nursing, Princess Nourah bint Abdulrahman University, Riyadh 11671, Saudi Arabia
| | - Konstantinos Tsaras
- Department of Nursing, School of Health Sciences, University of Thessaly, 41500 Larissa, Greece
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13
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Yamakawa M, Tanaka Y, Tokinobu A, Tsuda T. Concerns about vaccines and vaccination behavior among Japanese budget travelers to India. J Infect Chemother 2024:S1341-321X(24)00189-2. [PMID: 39004400 DOI: 10.1016/j.jiac.2024.07.011] [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: 03/03/2024] [Revised: 05/27/2024] [Accepted: 07/11/2024] [Indexed: 07/16/2024]
Abstract
BACKGROUND Low vaccination coverage among travelers poses a critical challenge to global health security. Indeed, public concerns regarding vaccines can lead to vaccine reluctance and refusal, but evidence about the impacts of concerns regarding vaccines on the uptake of travel vaccinations remains sparse. We examined the associations between concerns about vaccines and vaccination behavior among travelers. METHODS Japanese travelers aged 18 years or older, who stayed at a guesthouse in New Delhi, India, were targeted (n = 153). We conducted cross-sectional surveys from August 23 to September 2, 2019, and from February 19 to March 5, 2020. We examined the associations of three concerns regarding vaccines (5-point scale)-serious side effects from vaccines, vaccine safety, and vaccine effectiveness-with the uptake of travel vaccinations. RESULTS In total, 60 participants (39.2 %) had been vaccinated for this or a past trip. After adjusting for all potential confounding variables, concerns about serious side effects from vaccines and vaccine safety were negatively associated with the uptake of travel vaccinations. The ORs (95 % CIs) for 1-point increases in concerns about serious side effects from vaccines and vaccine safety were 0.72 (0.52, 0.99) and 0.71 (0.52, 0.96), respectively. Sensitivity analyses did not change the results substantially. CONCLUSIONS Concerns about vaccine safety issues were negatively associated with the uptake of travel vaccinations among the participants, with no corresponding association observed for vaccine effectiveness. Addressing concerns about vaccine safety issues, rather than vaccine effectiveness may contribute to an increased uptake of travel vaccinations.
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Affiliation(s)
- Michiyo Yamakawa
- Department of Epidemiology and Preventive Medicine, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu, 501-1194, Japan.
| | - Yuko Tanaka
- Graduate School of Engineering, Nagoya Institute of Technology, Gokiso-cho, Showa-ku, Nagoya, 466-8555, Japan.
| | - Akiko Tokinobu
- Center for Diversity and Inclusion, Okayama University Hospital, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan.
| | - Toshihide Tsuda
- Department of Human Ecology, Graduate School of Environmental and Life Science, Okayama University, 3-1-1 Tsushima-naka, Kita-ku, Okayama, 700-8530, Japan.
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14
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Kotsia A, Pechlivanidou E, Kalpourtzi N, Vourli G, Papaevangelou V, Touloumi G, Benetou V. Exploring Parental Attitudes and Perceptions Regarding Childhood Vaccinations in Greece: A Study Within the Framework of the National Health Examination Survey (EMENO). Cureus 2024; 16:e64588. [PMID: 39144858 PMCID: PMC11324001 DOI: 10.7759/cureus.64588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/15/2024] [Indexed: 08/16/2024] Open
Abstract
AIM Vaccinations have reduced illnesses and mortality rates globally, yet negative attitudes and uncertainty about them hinder their acceptability and efficacy. The study aims to document Greek parents' immunization perceptions and risk factors. METHODS Spanning 2014-2017, 447 parents (68% mothers) who participated in the Greek Health Examination Survey EMENO (National Survey of Morbidity and Risk Factors) completed an interview-delivered questionnaire. Attitudes were categorized into three groups: absolutely positive, positive, and negative. Absolutely positive attitudes included positive responses to all five statements in favor of vaccination and negative responses to the two statements against vaccination. Negative attitudes included positive responses to either one or both statements against vaccination and negative responses to all five statements in favor of vaccination.. All other participants were categorized as having a positive attitude. Skepticism towards vaccinations was classified into skeptical and non-skeptical groups based on responses to five statements implying uncertainty or skepticism. Participants were considered skeptical if they provided positive responses to at least three of these statements, and non-skeptical if they had none or up to two positive responses. The statistical analysis accounted for the study design whereas inverse probability weighting was used to adjust for non-response and multiple imputations were employed to impute missing values. The components of parental attitude and vaccine skepticism were identified using weighted multinomial logistic regression and logistic regression, respectively. RESULTS In total, 16.6% were classified as having absolutely positive attitudes towards vaccinations whereas 42.1% were skeptical of vaccines. Of all participants, 96.0% agreed that vaccinations are essential for their child's well-being and adhere to scientific recommendations. However, concerns were also mentioned, with 26.2% worrying about potential adverse effects, and 21.6% believing it is better to acquire immunity through illness rather than vaccination. Positive participants, compared to absolutely positive ones, were more likely to be of Greek origin (adjusted relative rate ratio (aRRR): 3.35; 95% CI: 1.53-7.30) and living in semi-urban areas (aRRR: 4.84; 95% CI: 1.77-13.29). Negative participants, in contrast, were more likely to have higher education (aRRR: 2.98; 95% CI: 1.05-8.44) but also to live in semi-urban areas (aRRR: 6.43; 95% CI: 1.69-24.56). Furthermore, parents of Greek origin had significantly higher odds of being skeptical towards vaccination (adjusted Odds Ratio (aOR): 2.86; 95% CI: 1.36-5.98), while married or cohabiting parents had lower odds of being skeptical compared to single parents (aOR: 0.60; 95% CI: 0.35-1.06). CONCLUSIONS While parents in this study recognize the importance of childhood immunizations, there is a widespread presence of negative attitudes and skepticism that can have a detrimental impact on vaccination rates.
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Affiliation(s)
- Alkisti Kotsia
- Department of Hygiene, Epidemiology and Medical Statistics, National and Kapodistrian University of Athens School of Medicine, Athens, GRC
| | - Evmorfia Pechlivanidou
- Department of Hygiene, Epidemiology and Medical Statistics, National and Kapodistrian University of Athens School of Medicine, Athens, GRC
| | - Natasa Kalpourtzi
- Department of Hygiene, Epidemiology and Medical Statistics, National and Kapodistrian University of Athens School of Medicine, Athens, GRC
| | - Georgia Vourli
- Department of Hygiene, Epidemiology and Medical Statistics, National and Kapodistrian University of Athens School of Medicine, Athens, GRC
| | - Vana Papaevangelou
- Third Department of Pediatrics, Attikon University Hospital, National and Kapodistrian University of Athens School of Medicine, Athens, GRC
| | - Giota Touloumi
- Department of Hygiene, Epidemiology and Medical Statistics, National and Kapodistrian University of Athens School of Medicine, Athens, GRC
| | - Vasiliki Benetou
- Department of Hygiene, Epidemiology and Medical Statistics, National and Kapodistrian University of Athens School of Medicine, Athens, GRC
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15
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Botelho RDO, Coelho CCF, Andrade EF, Castelo PM, Pardi V, Murata RM, Pereira LJ. Fear of the COVID-19 vaccine in a public healthcare system and university setting. PLoS One 2024; 19:e0304000. [PMID: 38917110 PMCID: PMC11198793 DOI: 10.1371/journal.pone.0304000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 05/04/2024] [Indexed: 06/27/2024] Open
Abstract
Despite the known benefits, some individuals remain apprehensive about receiving the COVID-19 vaccine, which hampers vaccination efforts and the achievement of herd immunity. Therefore, this cross-sectional study aimed to assess vaccination rates and identify factors influencing fear of the COVID-19 vaccine among individuals served by the public healthcare system (Family Health Strategy - FHS) and in a university community in Minas Gerais, Brazil. Surveys were conducted face-to-face with FHS participants and online with university members, employing a free sharing approach on social media. A total of 1896 and 312 responses were collected, respectively. The survey covered sociodemographic information, COVID-19 fear levels, and vaccination status for both individuals and their children Vaccination coverage was 83% among FHS participants and 99.1% in the university setting. Female respondents in both groups exhibited higher levels of COVID-19 fear (p<0.05), with FHS-assisted women reporting greater apprehension towards vaccination (p<0.05). Educated parents demonstrated better understanding of the importance of child vaccination, while younger parents expressed heightened concerns about vaccine side effects. Among FHS participants, women exhibited a 1.6 times higher fear of vaccination compared to men. Additionally, fear of vaccination increased by 1.10 times for each additional point on the COVID-19 Fear Scale (physiological domain). Effective communication strategies and dispelling misconceptions surrounding immunization could alleviate fear and promote vaccination acceptance.
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Affiliation(s)
| | | | | | - Paula Midori Castelo
- Department of Pharmaceutical Sciences, Universidade Federal de São Paulo (UNIFESP), Diadema, SP, Brazil
| | - Vanessa Pardi
- Department of Foundational Sciences, School of Dental Medicine, East Carolina University (ECU), Greenville, NC, United States of America
| | - Ramiro Mendonça Murata
- Department of Foundational Sciences, School of Dental Medicine, East Carolina University (ECU), Greenville, NC, United States of America
| | - Luciano José Pereira
- Department of Medicine, Universidade Federal de Lavras (UFLA), Lavras, MG, Brazil
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16
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Lermytte E, Bracke P, Ceuterick M. Healthcare Professionals' Discursive Constructions of Parental Vaccine Hesitancy: A Tale of Multiple Moralities. QUALITATIVE HEALTH RESEARCH 2024:10497323241245646. [PMID: 38881208 DOI: 10.1177/10497323241245646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2024]
Abstract
Healthcare professionals play a crucial role in addressing the concerns of vaccine-hesitant parents since they form a trusted source for vaccine-related information. An increasing body of evidence suggests that healthcare professionals are faced with complexities when navigating the sensitive topic of parental vaccine hesitancy, as they balance their own vaccine- and context-specific concerns with institutional and societal pressures to vaccinate. Furthermore, health choices, such as parental choices for childhood vaccination, are often linked to moralisation. Given the emphasis on effective communication with vaccine-hesitant parents in the patient-centred care literature, it is important to consider healthcare professionals' interpretations of parental vaccine hesitancy. Hence, a deeper understanding of how healthcare professionals make sense of, and moralise, childhood vaccination can help us understand how moralisation might appear in their communication with hesitant parents (in)directly. Drawing on a critical social-psychological framework for discourse analysis, this study analyses 39 semi-structured interviews with healthcare professionals in Flanders, Belgium, and presents the discursive patterns articulated by healthcare professionals on parental vaccine hesitancy. The findings elucidate how healthcare professionals perpetuate, or resist, moral discourse in their accounts of vaccine hesitancy by constructing five different interpretative repertoires, that is, a "good" or "bad" parenting repertoire, a freedom of choice repertoire, an individual risk-benefit repertoire, a public health repertoire, and an accessibility repertoire. Our study highlights the complexities healthcare professionals experience in negotiating vaccine hesitancy, as their understandings of vaccine hesitancy are affected by, and contribute to, existing moral dilemmas and dominant discourses surrounding health and parenting.
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Affiliation(s)
| | - Piet Bracke
- Department of Sociology, Ghent University, Ghent, Belgium
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17
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Wulkotte E, Schmid-Küpke N, Bozorgmehr K, Razum O, Wichmann O, Neufeind J. Barriers and drivers to COVID-19 vaccination among the migrant and non-migrant population in Germany, 2021. Eur J Public Health 2024; 34:530-536. [PMID: 38335139 PMCID: PMC11161154 DOI: 10.1093/eurpub/ckae017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2024] Open
Abstract
BACKGROUND During the Coronavirus Disease 2019 (COVID-19) pandemic, immunization programmes struggled to reach all population groups equally. While migrant groups face multiple barriers to health systems, including vaccination, little is known about their vaccine uptake. METHODS We conducted a cross-sectional telephone survey on adults with and without migration history in Germany to investigate barriers and drivers to COVID-19 vaccination (11 April 2021 to 18 December 2021). Interviews were conducted in six languages. We used logistic regression models and a mediation model to analyze the association between migration history and vaccine uptake. Furthermore, we determined the effect of psychological determinants (5C model) on vaccine uptake. RESULTS The survey comprised 2039 individuals, including 1015 with migration history. Of these, 448 were interviews conducted in languages other than German. Individuals with migration history had a significantly lower vaccine uptake but, while still unvaccinated, had a higher intention to get vaccinated (P = 0.015) compared with those without migration history. The association between migration history and vaccine uptake was no longer significant when other factors were included in the regression model (odds ratio = 0.9; 95% confidence interval: 0.57-1.47). Socio-economic index, language skills and discrimination experience fully mediated this association. Among the psychological determinants, 'higher confidence' and 'higher collective responsibility' increased the chance of individuals with migration history to be vaccinated. CONCLUSION Migration history alone cannot explain vaccine uptake; socio-economic index, language skills and discrimination experiences need to be considered. To achieve vaccine equity, future public health policy should aim to reduce relevant barriers through tailored interventions.
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Affiliation(s)
- Elisa Wulkotte
- Immunization Unit, Robert Koch Institute, Berlin, Germany
| | | | - Kayvan Bozorgmehr
- School of Public Health, Bielefeld University, Bielefeld, Germany
- Section Equity Studies & Migration, University Hospital Heidelberg, Heidelberg, Germany
| | - Oliver Razum
- School of Public Health, Bielefeld University, Bielefeld, Germany
| | - Ole Wichmann
- Immunization Unit, Robert Koch Institute, Berlin, Germany
| | - Julia Neufeind
- Immunization Unit, Robert Koch Institute, Berlin, Germany
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18
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Cable CE, Watson KE, Tsuyuki RT. Case-finding for HPV vaccination eligibility within a dental office with concurrent development of a dialogue tool. Vaccine X 2024; 18:100492. [PMID: 38737622 PMCID: PMC11088327 DOI: 10.1016/j.jvacx.2024.100492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Revised: 04/19/2024] [Accepted: 04/22/2024] [Indexed: 05/14/2024] Open
Abstract
Background Human papillomavirus (HPV) immunization can prevent cancers, but uptake has been incomplete (and worse with the COVID-19 pandemic). Dental clinicians already screen for oral cancers, many of which are caused by HPV, and could identify vaccination candidates, but this requires a case-finding strategy. Objective The purpose of this study was (1) to develop and test a case-finding approach to identify patients who were candidates for HPV vaccinations, (2) to test an HPV vaccination intervention by dental professionals on vaccination uptake. Methods Design: Prospective, non-randomized feasibility case finding study with a 4-week enrollment period and a 6 week follow up period in general dental offices.Setting: Two general and non-commercial dentistry offices in Edmonton, Alberta Canada.Subjects: Consecutive scheduled (non-emergent) patients who met the Health Canada criteria for HPV vaccination: immunocompetent males and females aged 9-45 years and those who are immunocompromised. Consent for the discussion was obtained from each subject or parent.Intervention: Scheduled dental patients meeting the inclusion criteria were flagged by a research assistant who reviewed the appointment schedule each week for 4 weeks. For these subjects, dental clinicians (dentists and dental hygienists) used our Dental Dialogue Tool to discuss HPV vaccination and answer questions. Participating patients who consented to receive the HPV vaccine were given a prescription by the attending dentist and were directed to follow-up with a local pharmacy to have the vaccine administered. Each participant that was provided with an HPV prescription was contacted after 6 weeks to identify if they received the first dose of vaccine.Outcomes: Yield of our case-finding strategy and receipt of a patient's first HPV vaccine dose during 6 weeks post vaccine prescription. Results Our case-finding strategy assessed 656 scheduled patients over 4 weeks. From this screening,179 (a case-finding yield of 20.4 %), were candidates for HPV vaccine discussion. Forty-three of these 179 patients (24 %) were already vaccinated.. Two patients (1.1 %) did not consent to be spoken with and 134 (74.8 %) consented to the HPV vaccine discussion.. Forty-eight of 134 patients (35.8 %) of patients accepted a prescription from the dentist after speaking with the dental clinician. Ultimately, 8/48 (16 %) (patients received their first dose of the HPV vaccine by the 6 week of follow-up call. However, this is only 4.5 % (8/177) of those patients who did consent for the discussion of HPV cancers and vaccination from their dentist. Conclusion We demonstrated that case-finding for HPV vaccine candidates in general dental offices was feasible, with a reasonable yield. While the dental dialogue tool was described as a great resource to explain the facts and answer questions, very few patients were vaccinated after 6 weeks of follow-up. Further work is necessary to sharpen the intervention, perhaps including follow-up discussions with the dental clinicians.
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Affiliation(s)
- Cheryl E. Cable
- School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Canada
- EPICORE, Department of Medicine, University of Alberta, Canada
| | - Kaitlyn E. Watson
- EPICORE, Department of Medicine, University of Alberta, Canada
- Faculty of Pharmacy and Pharmaceutical Sciences. University of Alberta, Canada
| | - Ross T. Tsuyuki
- EPICORE, Department of Medicine, University of Alberta, Canada
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19
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Unfried K, Priebe J. Vaccine hesitancy and trust in sub-Saharan Africa. Sci Rep 2024; 14:10860. [PMID: 38740790 DOI: 10.1038/s41598-024-61205-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 05/02/2024] [Indexed: 05/16/2024] Open
Abstract
Lack of trust is a primary reason behind the global rise in vaccine hesitancy. Existing research on the trust-vaccine hesitancy nexus has almost exclusively focused on COVID-19 with the vast majority of studies examining industrialized countries. In this study, we investigated the influence of trust in different policy-relevant actors (government, science, media, pharmaceutical companies, society) on vaccine hesitancy for recently available vaccines related to polio and HPV which we benchmark against a COVID-19 vaccine. Leveraging unique primary data on 5203 individuals from six countries (Ghana, Kenya, Nigeria, South Africa, Tanzania, and Uganda), we showed that individuals' trust in the government and society are key predictors of vaccine hesitancy. Furthermore, we demonstrated that these relationships are remarkably stable across vaccine, disease, and country contexts.
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Affiliation(s)
- Kerstin Unfried
- Health Economics Research Group, Bernhard Nocht Institute for Tropical Medicine (BNITM), Hamburg, Germany.
| | - Jan Priebe
- Health Economics Research Group, Bernhard Nocht Institute for Tropical Medicine (BNITM), Hamburg, Germany.
- Hamburg Center for Health Economics (HCHE), Hamburg, Germany.
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20
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Vuolanto P, Almeida AN, Anderson A, Auvinen P, Beja A, Bracke P, Cardano M, Ceuterick M, Correia T, De Vito E, Delaruelle K, Delicado A, Esposito M, Ferrara M, Gariglio L, Guerreiro C, Marhánková JH, Hilário AP, Hobson-West P, Iorio J, Järvinen KM, Koivu A, Kotherová Z, Kuusipalo A, Lermytte E, Mendonça J, Morais R, Numerato D, Polak P, Rudek T, Sbaragli S, Scavarda A, Silva K, da Silva PA, Sivelä J, Moura ES, Świątkiewicz-mośny M, Tipaldo G, Wagner A. Trust matters: The Addressing Vaccine Hesitancy in Europe Study. Scand J Public Health 2024; 52:379-390. [PMID: 38346923 PMCID: PMC11067405 DOI: 10.1177/14034948231223791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 12/07/2023] [Accepted: 12/13/2023] [Indexed: 05/04/2024]
Abstract
This article presents the design of a seven-country study focusing on childhood vaccines, Addressing Vaccine Hesitancy in Europe (VAX-TRUST), developed during the COVID-19 pandemic. The study consists of (a) situation analysis of vaccine hesitancy (examination of individual, socio-demographic and macro-level factors of vaccine hesitancy and analysis of media coverage on vaccines and vaccination and (b) participant observation and in-depth interviews of healthcare professionals and vaccine-hesitant parents. These analyses were used to design interventions aimed at increasing awareness on the complexity of vaccine hesitancy among healthcare professionals involved in discussing childhood vaccines with parents. We present the selection of countries and regions, the conceptual basis of the study, details of the data collection and the process of designing and evaluating the interventions, as well as the potential impact of the study. Laying out our research design serves as an example of how to translate complex public health issues into social scientific study and methods.
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Affiliation(s)
- Pia Vuolanto
- Tampere University, Faculty of Social Sciences, Research Center for Knowledge, Science, Technology and Innovation Studies, Finland
| | | | | | - Petra Auvinen
- Tampere University, Faculty of Social Sciences, Research Center for Knowledge, Science, Technology and Innovation Studies, Finland
| | - André Beja
- Global Health and Tropical Medicine, GHTM, Associate Laboratory in Translation and Innovation Towards Global Health, LA-REAL, Instituto de Higiene e Medicina Tropical, IHMT, Universidade Nova de Lisboa, UNL, Portugal
| | - Piet Bracke
- Ghent University, Department of Sociology, Health and Demographic Research, Belgium
| | - Mario Cardano
- University of Turin, Department of Cultures, Politics and Society, Italy
| | - Melissa Ceuterick
- Ghent University, Department of Sociology, Health and Demographic Research, Belgium
| | - Tiago Correia
- Global Health and Tropical Medicine, GHTM, Associate Laboratory in Translation and Innovation Towards Global Health, LA-REAL, Instituto de Higiene e Medicina Tropical, IHMT, Universidade Nova de Lisboa, UNL, Portugal
| | - Elisabetta De Vito
- University of Cassino and Southern Lazio, Department of Human, Social and Health Sciences, Italy
| | - Katrijn Delaruelle
- Ghent University, Department of Sociology, Health and Demographic Research, Belgium
| | - Ana Delicado
- Universidade de Lisboa, Instituto de Ciências Sociais, Portugal
| | - Maurizio Esposito
- University of Cassino and Southern Lazio, Department of Human, Social and Health Sciences, Italy
| | - Maria Ferrara
- University of Cassino and Southern Lazio, Department of Human, Social and Health Sciences, Italy
| | - Luigi Gariglio
- University of Turin, Department of Cultures, Politics and Society, Italy
| | - Cátia Guerreiro
- Global Health and Tropical Medicine, GHTM, Associate Laboratory in Translation and Innovation Towards Global Health, LA-REAL, Instituto de Higiene e Medicina Tropical, IHMT, Universidade Nova de Lisboa, UNL, Portugal
| | | | | | - Pru Hobson-West
- University of Nottingham, School of Sociology and Social Policy, UK
| | - Juliana Iorio
- Universidade de Lisboa, Instituto de Ciências Sociais, Portugal
| | - Katri-Maria Järvinen
- Tampere University, Faculty of Social Sciences, Research Center for Knowledge, Science, Technology and Innovation Studies, Finland
| | - Annariina Koivu
- Tampere University, Faculty of Social Sciences, Research Center for Knowledge, Science, Technology and Innovation Studies, Finland
| | - Zuzana Kotherová
- Charles University, Faculty of Social Sciences, the Czech Republic
| | - Aapo Kuusipalo
- Tampere University, Faculty of Social Sciences, Research Center for Knowledge, Science, Technology and Innovation Studies, Finland
| | - Esther Lermytte
- Ghent University, Department of Sociology, Health and Demographic Research, Belgium
| | - Joana Mendonça
- Universidade de Lisboa, Instituto de Ciências Sociais, Portugal
| | - Rita Morais
- Universidade de Lisboa, Instituto de Ciências Sociais, Portugal
| | - Dino Numerato
- Charles University, Faculty of Social Sciences, the Czech Republic
| | - Paulina Polak
- Jagiellonian University, Institute of Sociology, Poland
| | - Tadeusz Rudek
- Jagiellonian University, Institute of Sociology, Poland
| | - Sara Sbaragli
- University of Cassino and Southern Lazio, Department of Human, Social and Health Sciences, Italy
| | - Alice Scavarda
- University of Turin, Department of Cultures, Politics and Society, Italy
| | - Katielle Silva
- Universidade de Lisboa, Instituto de Ciências Sociais, Portugal
| | | | - Jonas Sivelä
- Finnish Institute for Health and Welfare, Cultural, Behavioural and Media Insights Center, Finland
| | - Eva Soares Moura
- Charles University, Faculty of Social Sciences, the Czech Republic
| | | | - Giuseppe Tipaldo
- University of Turin, Department of Cultures, Politics and Society, Italy
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21
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Li M, Ren Y, Liu P, Wang J, Wang Y, Xu J, Yang J. Effect of chronic diseases on willingness to receive the second COVID-19 vaccine booster dose among cancer patients: A multicenter cross-sectional survey in China. Am J Infect Control 2024; 52:533-540. [PMID: 38007097 DOI: 10.1016/j.ajic.2023.11.011] [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: 09/29/2023] [Revised: 10/25/2023] [Accepted: 11/21/2023] [Indexed: 11/27/2023]
Abstract
BACKGROUND Cancer patients and those with chronic diseases face severe outcomes from SARS-CoV-2 infection. However, their willingness to receive a second booster dose remains low. This study identified factors affecting the willingness of cancer patients with chronic diseases (CPCD) and cancer patients without chronic diseases (non-CPCD) to receive the second COVID-19 booster vaccine dose. METHODS A multicenter cross-sectional study was conducted across 4 tertiary care hospitals in China. Based on the Health Belief Model, a questionnaire assessed respondents' perceptions of the second booster dose. Multivariable logistic regression analyzed factors influencing the willingness to receive a second vaccine dose. RESULTS Out of 171 CPCD and 722 non-CPCD, CPCD showed a higher willingness to receive the second booster dose than non-CPCD (46.8% vs 32.3%, P < .001). Factors influencing CPCD's willingness included the belief that vaccination was detrimental to cancer treatment and the perceived higher infection risk compared to healthy individuals. Fear of vaccination's negative impact on cancer treatment was the main factor affecting non-CPCD's willingness (each P < .05). CONCLUSIONS Different factors influenced the willingness of the 2 groups. Health education interventions should be implemented alongside vaccination, involving patients' relatives and medical staff, for both CPCD and non-CPCD populations. Additionally, health management service interventions should emphasize the benefits of vaccination for CPCD to improve their second dose coverage.
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Affiliation(s)
- Mufan Li
- Department of Public Health and Preventive Medicine, Epidemiology and Public Health, Shanxi Medical University, Taiyuan, China
| | - Yizhou Ren
- Department of Public Health and Preventive Medicine, Epidemiology and Public Health, Shanxi Medical University, Taiyuan, China
| | - Ping Liu
- Department of Oncology, Heping Hospital, Changzhi Medical College, Changzhi, China
| | - Jiayu Wang
- Department of Public Health and Preventive Medicine, Epidemiology and Public Health, Shanxi Medical University, Taiyuan, China
| | - Ying Wang
- Department of Public Health and Preventive Medicine, Epidemiology and Public Health, Shanxi Medical University, Taiyuan, China
| | - Junjie Xu
- Department of Public Health and Preventive Medicine, Changzhi Medical College, Changzhi, China.
| | - Jianzhou Yang
- Department of Public Health and Preventive Medicine, Epidemiology and Public Health, Shanxi Medical University, Taiyuan, China; Department of Public Health and Preventive Medicine, Changzhi Medical College, Changzhi, China.
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22
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Cebrino J, Portero de la Cruz S. A Worldwide Bibliometric Analysis of Published Literature Assessing Fear of COVID-19. Clin Pract 2024; 14:672-684. [PMID: 38804386 PMCID: PMC11130842 DOI: 10.3390/clinpract14030054] [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: 03/26/2024] [Revised: 04/17/2024] [Accepted: 04/21/2024] [Indexed: 05/29/2024] Open
Abstract
Many people experience intense fear of COVID-19. The purpose of this study was to provide a comprehensive visual overview of the published literature from 2020 to 2022 assessing fear of COVID-19. From 2020 to 2022, we employed the Scopus database to conduct a bibliometric analysis. We used the VOSviewer program to perform the author co-citation analysis, Mapchart to produce a worldwide map, and Wordart to make a word cloud image. From the 1769 records examined, 1654 (93.50%) were articles, with English being the most common language (96.31%). From 2020 to 2022, annual citations experienced significant growth (R2 = 99.91%; p = 0.0195). The Institut National de la Santé et de la Recherche Médicale (INSERM, France) and China led in terms of publication output (n = 36; n = 255). M. D. Griffiths authored the highest number of articles (n = 21). The most active journal was the International Journal of Environmental Research and Public Health (n = 146), and the most prevalent keyword was "human/s" (11.51%). This bibliometric analysis evaluates the quality of the research on fear of the pandemic and the crisis management of COVID-19, which can provide managers and researchers with crucial insights for future decision making.
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Affiliation(s)
- Jesús Cebrino
- Department of Preventive Medicine and Public Health, Faculty of Medicine, University of Seville, Avda. Sánchez Pizjuán, S/N, 41009 Seville, Spain;
| | - Silvia Portero de la Cruz
- Department of Nursing, Pharmacology and Physiotherapy, Faculty of Medicine and Nursing, University of Córdoba, Avda. Menéndez Pidal, S/N, 14071 Córdoba, Spain
- Research Group GE10 Clinical and Epidemiological Research in Primary Care, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Hospital Universitario Reina Sofía, 14071 Córdoba, Spain
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Klüwer B, Gleditsch R, Rydland KM, Mamelund SE, Laake I. Higher educational attainment associated with higher confidence in influenza vaccination in Norway. Vaccine 2024; 42:2837-2847. [PMID: 38519343 DOI: 10.1016/j.vaccine.2024.03.049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 03/07/2024] [Accepted: 03/19/2024] [Indexed: 03/24/2024]
Abstract
AIMS To explore public confidence in influenza vaccination through the use of attitudinal indicators, and study whether educational attainment is related to attitudes towards influenza vaccination. METHODS Confidence in influenza vaccination was measured with three questions adapted from the Vaccine Confidence Project. These questions have been included in four study years of a Norwegian nationally representative telephone survey that cover influenza seasons 2016/17, 2019/20, 2020/21 and 2021/22. Over these four years, a total of 8 436 individuals aged 18-79 years responded to the survey and are included in the analysis. Risk differences (RDs) with 95 % confidence intervals were estimated using multivariable Poisson regression. RESULTS Influenza vaccine confidence increased over time, with approximately 80 % of the general population expressing trust in the vaccine in the 2021/22 season. There was a tendency towards higher confidence in the oldest age group (65-79 years). Moreover, confidence increased with increasing educational attainment. The proportion of participants who agreed that influenza vaccine is compatible with their basic values was close to 20 percentage points lower among those with only compulsory education than among those with higher education at graduate level, RD = -18.4 % (95 % CI -21.4 % to -15.5 %). Educational attainment was consistently associated with influenza vaccine confidence in all seasons, among risk groups 18-64 years, and among health care workers. CONCLUSIONS We observed an increase in confidence in influenza vaccination over the seasons examined in the study. However, the increase has not been equal in all groups and there is a clear educational gradient in influenza vaccine confidence. These findings indicate that despite efforts to increase influenza coverage over several years, the implemented measures have failed to reach all parts of the population.
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Affiliation(s)
- Birgitte Klüwer
- Division of Infection Control, Norwegian Institute of Public Health, PO Box 222, Skøyen, N-0213 Oslo, Norway.
| | - Rebecca Gleditsch
- Division of Infection Control, Norwegian Institute of Public Health, PO Box 222, Skøyen, N-0213 Oslo, Norway.
| | - Kjersti Margrethe Rydland
- Division of Infection Control, Norwegian Institute of Public Health, PO Box 222, Skøyen, N-0213 Oslo, Norway.
| | - Svenn-Erik Mamelund
- Centre for Research on Pandemics & Society, Oslo Metropolitan University, Senter for velferds- og arbeidslivsforskning, OsloMet - storbyuniversitetet, Postboks 4, St. Olavs plass, 0130 Oslo, Norway.
| | - Ida Laake
- Division of Infection Control, Norwegian Institute of Public Health, PO Box 222, Skøyen, N-0213 Oslo, Norway.
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Mastrovito B, Lardon A, Dubromel A, Nave V, Beny K, Dussart C. Understanding the gap between guidelines and influenza vaccination coverage in people with diabetes: a scoping review. Front Public Health 2024; 12:1360556. [PMID: 38706547 PMCID: PMC11066301 DOI: 10.3389/fpubh.2024.1360556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Accepted: 04/09/2024] [Indexed: 05/07/2024] Open
Abstract
Background Diabetes affects millions of people worldwide, making them more vulnerable to infections, including seasonal influenza. It is therefore particularly important for those suffering from diabetes to be vaccinated against influenza each year. However, influenza vaccination coverage remains low in this population. This review primarily aims to identify the determinants of influenza vaccination in people with diabetes (T1D or T2D). Secondly, it aims to assess main recommendations for influenza vaccination, vaccine effectiveness, vaccination coverage, and how education and pharmacists can encourage uptake of the vaccine in the diabetic population. Methods A scoping review was conducted in January 2022 to systematically review evidence on influenza vaccination in people with diabetes using data from PubMed, Science Direct, and EM Premium with terms such as "Diabetes mellitus," "Immunization Programs," "Vaccination," and "Influenza Vaccines." Quality assessment and data extraction were independently conducted by two authors. Disagreements between the authors were resolved through discussion and consensus, and if necessary, by consulting a third author. Results Of the 333 records identified, 55 studies met the eligibility criteria for inclusion in this review. Influenza vaccination was recommended for people ≥6 months. Despite effectiveness evidence showing a reduction in mortality and hospitalizations in people with diabetes vaccinated vs. non-vaccinated ones, very few studies reported a coverage rate ≥ 75%, which is WHO's target objective. Determinants such as advanced age, presence of comorbidities and healthcare givers' advice were associated with increased vaccination uptake. On the contrary, fear of adverse reactions and concerns about vaccine effectiveness were significant barriers. Finally, education and pharmacists' intervention played a key role in promoting vaccination and increasing vaccination uptake. Conclusion Influenza vaccination coverage in people with diabetes remains low despite recommendations and evidence on vaccine effectiveness. Motivators and barriers as well as several socio-demographic and clinical factors have been identified to explain this trend. Efforts are now needed to increase the number of diabetics vaccinated against influenza, mainly through education and the involvement of healthcare givers.
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Affiliation(s)
- Brice Mastrovito
- Hospices Civils de Lyon, Pharmacie et Stérilisation Centrales, Pharmacie centrale, Saint-Genis-Laval, France
| | - Alexia Lardon
- Hospices Civils de Lyon, Pharmacie et Stérilisation Centrales, Pharmacie centrale, Saint-Genis-Laval, France
| | - Amelie Dubromel
- Hospices Civils de Lyon, Pharmacie et Stérilisation Centrales, Pharmacie centrale, Saint-Genis-Laval, France
| | - Viviane Nave
- Hospices Civils de Lyon, Pharmacie et Stérilisation Centrales, Pharmacie centrale, Saint-Genis-Laval, France
| | - Karen Beny
- Hospices Civils de Lyon, Pharmacie et Stérilisation Centrales, Pharmacie centrale, Saint-Genis-Laval, France
| | - Claude Dussart
- Hospices Civils de Lyon, Pharmacie et Stérilisation Centrales, Pharmacie centrale, Saint-Genis-Laval, France
- EA 4129 P2S Parcours Santé Systémique, Claude Bernard University Lyon 1, Lyon, France
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Razafindrakoto M, Roubaud F, Castilho MR, Pero V, Saboia J. Investigating the 'Bolsonaro effect' on the spread of the Covid-19 pandemic: An empirical analysis of observational data in Brazil. PLoS One 2024; 19:e0288894. [PMID: 38635577 PMCID: PMC11025779 DOI: 10.1371/journal.pone.0288894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 01/30/2024] [Indexed: 04/20/2024] Open
Abstract
Brazil counts among the countries the hardest hit by the Covid-19 pandemic. A great deal has been said about the negative role played by President Bolsonaro's denialism, but relatively few studies have attempted to measure precisely what impact it actually had on the pandemic. Our paper conducts econometric estimates based on observational data at municipal level to quantitatively assess the 'Bolsonaro effect' over time from March 2020 to December 2022. To our knowledge, this paper presents the most comprehensive investigation of Bolsonaro's influence in the spread of the pandemic from two angles: considering Covid-19 mortality and two key transmission mitigation channels (social distancing and vaccination); and exploring the full pandemic cycle (2020-2022) and its dynamics over time. Controlling for a rich set of relevant variables, our results find a strong and persistent 'Bolsonaro effect' on the death rate: municipalities that were more pro-Bolsonaro recorded significantly more fatalities. Furthermore, evidence suggests that the president's attitude and decisions negatively influenced the population's behaviour. Firstly, pro-Bolsonaro municipalities presented a lower level of compliance with social distancing measures. Secondly, vaccination was relatively less widespread in places more in favour of the former president. Finally, our analysis points to longer-lasting and damaging repercussions. Regression results are consistent with the hypothesis that the 'Bolsonaro effect' impacted not only on Covid-19 vaccination, but has affected vaccination campaigns in general thereby jeopardizing the historical success of the National Immunization Program in Brazil.
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Affiliation(s)
- Mireille Razafindrakoto
- Institut de Recherche pour le Développement, LEDa-DIAL Research Unit, IRD, Université Paris-Dauphine, PSL Research University, Paris, France
| | - François Roubaud
- Institut de Recherche pour le Développement, LEDa-DIAL Research Unit, IRD, Université Paris-Dauphine, PSL Research University, Paris, France
| | - Marta Reis Castilho
- Institute of Economics, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Valeria Pero
- Institute of Economics, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - João Saboia
- Institute of Economics, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
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Amirul Amzar Megat Hashim MM, Hanafi NSH. Experiences of Malaysian primary healthcare providers with vaccine hesitancy: A qualitative study. MALAYSIAN FAMILY PHYSICIAN : THE OFFICIAL JOURNAL OF THE ACADEMY OF FAMILY PHYSICIANS OF MALAYSIA 2024; 19:22. [PMID: 38725610 PMCID: PMC11081770 DOI: 10.51866/oa.388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2024]
Abstract
Introduction Vaccine hesitancy was declared as one of the ten threats to global public health by the World Health Organization in 2019. It undermines the effort towards eradication of vaccine-preventable diseases. Healthcare providers, who are directly involved in vaccination services and vaccine advocacies, are important in combating vaccine hesitancy. Studies have shown that vaccine refusers have various reasons for refusal including distrust towards healthcare providers. Hence, it is important to understand healthcare providers' perspectives. This study aimed to explore primary healthcare providers (PHCPs)' experiences in dealing with vaccine hesitancy. Methods This qualitative study was conducted among public PHCPs across six states in Malaysia. Purposive and snowball sampling methods were used. Fifteen primary healthcare doctors and nurses underwent in-depth interviews. Recruitment was stopped when data saturation was achieved. Data were thematically analysed. Results Four themes emerged: 1) views towards vaccination and vaccine hesitancy, 2) disparity in strategies and resources used among PHCPs, 3) fixed-minded vaccine deniers and religious incompatibility: the two towering hurdles and 4) negative impact after encounters with vaccine hesitancy. Conclusion Malaysian PHCPs encounter negative experiences with vaccine hesitancy, impacting them negatively. These experiences are attributed to the challenges and lack of standardised resources for reference. These findings suggest the development of a more flexible policy, a training module inclusive of all professional roles and a standardised repository of resources for managing vaccine hesitancy.
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Affiliation(s)
| | - Nik Sherina Haidi Hanafi
- MBBS, MMed, PhD, Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia
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De Waele A, Hendrickx G, Valckx S, Domínguez À, Toledo D, Castilla J, Tuells J, Van Damme P. The Vaccine Training Barometer: Assessing healthcare providers' confidence to answer vaccine-related questions and their training needs. Vaccine 2024; 42:2421-2428. [PMID: 38458873 DOI: 10.1016/j.vaccine.2024.02.078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 01/19/2024] [Accepted: 02/25/2024] [Indexed: 03/10/2024]
Abstract
Healthcare providers (HCP) are seen by the public as the most trustworthy source of information about vaccination. While HCPs could be a valuable partner to increase vaccine confidence in general, it is not clear whether they feel confident themselves to address questions concerning vaccination. In the context of the EU Joint Action on Vaccination (EU-JAV), the Vaccine Training Barometer, an online survey tool, was developed to assess how frequently HCPs receive questions about vaccination, how confident they feel to answer these questions, and to what extent they are willing to follow extra training. After a pilot test in Flanders, Belgium, the Barometer was launched and completed by 833 HCPs in Flanders and 291 HCPs in the Spanish regions of Catalonia, Navarre and Valencian Community from November 2020 until January 2021, during the COVID-19 pandemic, just before and during the start of the first COVID-19 vaccination campaigns. In both countries, HCPs frequently received questions about vaccination (mostly on a daily or weekly basis), and about two thirds of them indicated that the frequency of questions had increased during the three months prior to completing the survey. Most questions were about the side effects and safety of vaccines. In both countries, a considerable proportion of HCPs did not feel confident to answer vaccine-related questions (31.5% felt confident in Flanders, 21.6% in Spain). A large proportion of HCPs received questions in the last three months before the survey that they could not answer (52.4% of respondents in Flemish sample, 41.5% in Spanish sample). Only 11.4% (Flanders) and 11.3% (Spain) of the respondents felt they gained sufficient knowledge through their standard education to be able to answer questions about vaccination. Almost all respondents were willing to follow extra training on vaccination (Flanders: 95.4%, Spain: 96.6%). The Vaccine Training Barometer is thus a useful tool to monitor HCPs' confidence to answer questions about vaccination and to capture their training needs.
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Affiliation(s)
- Aurélie De Waele
- Centre for Evaluation of Vaccination, University of Antwerp, Drie Eikenstraat 663, 2650 Edegem, Belgium; Departement of Communication Studies, Faculty of Social Sciences, University of Antwerp, Sint-Jacobsstraat 2, 2000 Antwerp, Belgium.
| | - Greet Hendrickx
- Centre for Evaluation of Vaccination, University of Antwerp, Drie Eikenstraat 663, 2650 Edegem, Belgium.
| | - Sara Valckx
- Centre for Evaluation of Vaccination, University of Antwerp, Drie Eikenstraat 663, 2650 Edegem, Belgium.
| | - Àngela Domínguez
- Universitat de Barcelona, Department of Medicine, C/ de Casanova, 143, 08036 Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, C/ Monforte de Lemos 3-5, Pabellón 11, Planta 0, 28029 Madrid, Spain.
| | - Diana Toledo
- Universitat de Barcelona, Department of Medicine, C/ de Casanova, 143, 08036 Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, C/ Monforte de Lemos 3-5, Pabellón 11, Planta 0, 28029 Madrid, Spain.
| | - Jesús Castilla
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, C/ Monforte de Lemos 3-5, Pabellón 11, Planta 0, 28029 Madrid, Spain; Instituto de Salud Pública de Navarra (IdiSNA), C. de Irunlarrea, 3, 31008 Pamplona, Navarra, Spain.
| | - José Tuells
- Edificio Ciencias Sociales, University of Alicante, Carr. de San Vicente del Raspeig, 03690 San Vicente del Raspeig, Alicante, Spain; Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Avda Pintor Baeza, 12, 03010 Alicante, Spain.
| | - Pierre Van Damme
- Centre for Evaluation of Vaccination, University of Antwerp, Drie Eikenstraat 663, 2650 Edegem, Belgium.
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Truong BQQ, Ong KIC, Shibanuma A, Kiriya J, Jimba M. Adaptation and application of the Parent Attitudes About Childhood Vaccines survey tool in the Vietnamese language: a cross-sectional study. BMC Public Health 2024; 24:946. [PMID: 38566076 PMCID: PMC10986030 DOI: 10.1186/s12889-024-18389-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 03/19/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND Parental vaccine hesitancy could lead to outbreaks of vaccine-preventable diseases. Although parental vaccine hesitancy exists in the Vietnamese community, no research has directly investigated this social phenomenon in Vietnam. Among the validated measures, the 15-item Parent Attitudes About Childhood Vaccines survey tool (PACV) was reliable for predicting vaccine-hesitant parents. However, the PACV was not available in Vietnamese. This study aimed to develop a Vietnamese version of the PACV and examine factors associated with parental vaccine hesitancy in Hue city, Vietnam. METHODS This study was a cross-sectional study. The English PACV was translated into Vietnamese with content and face validation. Self-administered questionnaires were distributed to 400 parents at ten commune health centres in Hue city, Vietnam. The parents were asked to answer the questionnaire again after two weeks for the test-retest reliability. The Vietnamese PACV reliability was assessed using Cronbach's alpha and McDonald's omega, and the intra-class correlation (ICC) coefficients were used for the test-retest reliability. The construct validity was tested by the hypothesis that parental vaccine hesitancy would be related to the intention of getting the children vaccinated. Exploratory factor analysis was also undertaken to determine the construct validity. Bivariate and multivariable logistic regression were used to identify the factors associated with parental vaccine hesitancy. RESULTS The Vietnamese PACV final version (PACV-Viet) contained 14 items. Three hundred and fifteen parents returned completed questionnaires, giving a response rate of 78.8%. The Cronbach's alpha and McDonald's omega were 0.72 and 0.70, respectively. Out of 315 parents, 84 responses were returned for test-retest reliability. All ICCs were good to excellent, ranging from 0.81 to 0.99. The PACV-Viet was confirmed to have construct validity. Using the PACV-Viet, 8.9% of the parents were found hesitant to childhood vaccination. Being unemployed and having seen the news about adverse events following immunisation were associated with parental vaccine hesitancy, with AOR = 3.2 (95% CI 1.3-8.0) and AOR = 4.5 (95% CI 1.2-16.7), respectively. CONCLUSIONS The PACV-Viet is a valid and reliable tool. Community outreach is necessary to alleviate parents' concerns about childhood vaccination.
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Affiliation(s)
- Bao Quy Quoc Truong
- Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Institute for Community Health Research, University of Medicine and Pharmacy, Hue University, Hue, Vietnam
| | - Ken Ing Cherng Ong
- Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
| | - Akira Shibanuma
- Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Junko Kiriya
- Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Masamine Jimba
- Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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Dib F, Chauvin P, Launay O. When an Immunization Stress-Related Response Interrupts a School-Based Vaccination Program: The Case of France. J Adolesc Health 2024; 74:854. [PMID: 38519252 DOI: 10.1016/j.jadohealth.2024.01.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 01/10/2024] [Indexed: 03/24/2024]
Affiliation(s)
- Fadia Dib
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), Equipe de Recherche en Epidémiologie Sociale (ERES), Paris, France; Université Paris Cité, INSERM, F-CRIN I REIVAC, Assistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, France
| | - Pierre Chauvin
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), Equipe de Recherche en Epidémiologie Sociale (ERES), Paris, France
| | - Odile Launay
- Université Paris Cité, INSERM, F-CRIN I REIVAC, Assistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, France
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Martinelli M, Veltri GA. COVID-19 vaccine acceptance: A comparative longitudinal analysis of the association between risk perception, confidence, and the acceptance of a COVID-19 vaccine. RISK ANALYSIS : AN OFFICIAL PUBLICATION OF THE SOCIETY FOR RISK ANALYSIS 2024; 44:802-816. [PMID: 37496470 DOI: 10.1111/risa.14200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 06/29/2023] [Accepted: 07/01/2023] [Indexed: 07/28/2023]
Abstract
Following the outbreak of COVID-19, scientists rushed to develop vaccines to protect individuals and ferry the world out of the pandemic. Unfortunately, vaccine hesitancy is a major threat to the success of vaccination campaigns. Research on previous pandemics highlighted the centrality of perceived risk and confidence as core determinants of vaccine acceptance. Research on COVID-19 is less conclusive, and frequently it relies on one-country, cross-sectional data, thus making it hard to generalize results across contexts and observe these relationships over time. To bridge these gaps, in this article, we analyzed the association between perceived risk, confidence, and vaccine acceptance cross-sectionally at individual and country levels. Then, we longitudinally explored whether a within-country variation in perceived risk and confidence was correlated with a variation in vaccine acceptance. We used data from a large-scale survey of individuals in 23 countries and 19 time-points between June 2020 and March 2021 and comparative longitudinal multilevel models to estimate the associations at different levels of analysis simultaneously. Results show the existence of cross-sectional relationships at the individual and country levels but no significant associations within countries over time. This article contributes to our understanding of the roles of risk perception and confidence in COVID-19 vaccines' acceptance by underlining that these relationships might differ at diverse levels of analysis. To foster vaccine uptake, it might be important to address individual concerns and persisting contextual characteristics, but increasing levels of perceived risk and confidence might not be a sufficient strategy to increase vaccine acceptance rates.
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Affiliation(s)
- Mauro Martinelli
- Department of Sociology, University of Copenhagen, København, Denmark
| | - Giuseppe A Veltri
- Department of Sociology and Social Research, University of Trento, Trento, Italy
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Lanza-León P, Cantarero-Prieto D, Pascual-Sáez M. Exploring trends and determinants of basic childhood vaccination coverage: Empirical evidence over 41 years. PLoS One 2024; 19:e0300404. [PMID: 38512892 PMCID: PMC10956826 DOI: 10.1371/journal.pone.0300404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 02/26/2024] [Indexed: 03/23/2024] Open
Abstract
Vaccination is widely considered to be one of the most important prevention measures as a health strategy. This paper examines trends in basic childhood vaccination coverage and which country and time-dependent determinants may have influenced childhood immunization rates (1-dose BCG, 1- and 3-dose DTP (diphtheria, tetanus, pertussis), 1-dose measles, and 3-dose polio) between 1980 and 2020 across 94 countries. We identify economic, inequality, demographic, health, education, labor market, environmental, and political stability factors of immunization. To do this, we use data from the annual WHO and United Nations International Children's Emergency Fund (UNICEF) coverage estimates. The empirical analysis consists of generalized estimating equation models to assess relationships between immunization rates and socioeconomic factors. Additionally, we follow the Barro and Sala-i-Martín approach to identify conditional convergence. Our findings show the strongest positive statistically significant association between immunization rates and GDP per capita, as well as births attended by skilled health staff. Moreover, our research demonstrates conditional convergence, indicating that countries converge towards different steady states. The present study brings new insights to investigating the determinants of childhood vaccination coverage and provides significant implications for health policies.
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Affiliation(s)
- Paloma Lanza-León
- Departamento de Economía, Universidad de Cantabria, Santander, Spain
- Health Economics Research Group, Valdecilla Biomedical Research Institute—IDIVAL Santander, Spain
| | - David Cantarero-Prieto
- Departamento de Economía, Universidad de Cantabria, Santander, Spain
- Health Economics Research Group, Valdecilla Biomedical Research Institute—IDIVAL Santander, Spain
- Santander Financial Institute—SANFI, Santander, Spain
| | - Marta Pascual-Sáez
- Departamento de Economía, Universidad de Cantabria, Santander, Spain
- Health Economics Research Group, Valdecilla Biomedical Research Institute—IDIVAL Santander, Spain
- Santander Financial Institute—SANFI, Santander, Spain
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Zhang L, Yang J, Su R, Lan X, Song M, Zhang L, Xu J. Willingness to receive the second booster of COVID-19 vaccine among older adults with cancer: a stratified analysis in four provinces of China. Front Public Health 2024; 12:1298070. [PMID: 38454989 PMCID: PMC10917962 DOI: 10.3389/fpubh.2024.1298070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 02/13/2024] [Indexed: 03/09/2024] Open
Abstract
Background Despite the elevated COVID-19 risk for older adults with cancer, vaccine hesitancy poses a significant barrier to their immunization. Intriguingly, there is limited research on the prevalence of willingness to receive the second booster dose and associated determinants in older adults with cancer. Objective Our objective was to ascertain the level of awareness about COVID-19 vaccines and to uncover the factors influencing the willingness to receive the second booster among Chinese cancer patients aged 65 years and over. Methods To achieve our objective, we conducted a multicenter cross-sectional study in four tertiary hospitals from four provinces of China. This involved using a Health Belief Model (HBM) based self-administered questionnaire and medical records. Subsequently, we employed multivariable logistic regression to identify factors influencing the second COVID-19 booster vaccine willingness. Results Our results showed that among 893 eligible participants, 279 (31.24%) were aged 65 years and over, and 614 (68.76%) were younger. Interestingly, the willingness to receive the second COVID-19 booster vaccine was 34.1% (95/279) (OR: 1.043, 95% CI: 0.858, 1.267) in participants aged 65 years and over, which was similar to participants aged under 65 years (34.1% vs. 35.5%, p = 0.673). Furthermore, our findings revealed that a positive attitude toward the booster and recommendations from healthcare providers and family members were positively associated with vaccine willingness. Conversely, perceptions of negative impacts on cancer control and vaccine accessibility regarding the second COVID-19 booster were inversely related to the outcome event (all p < 0.05). Conclusion Our study concludes with the finding of a low willingness toward the second COVID-19 booster in Chinese cancer patients, particularly in the older adults, a fact which warrants attention. This reluctance raises their risk of infection and potential for severe outcomes. Consequently, we recommend using media and community outreach to dispel misconceptions, promote the booster's benefits, and encourage vaccine discussions with healthcare providers and family members.
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Affiliation(s)
- Liangyuan Zhang
- Clinical Research Academy, Peking University Shenzhen Hospital, Shenzhen, China
- Department of Epidemiology, China Medical University, Shenyang, Liaoning, China
| | - Jianzhou Yang
- Department of Public Health and Preventive Medicine, Changzhi Medical College, Changzhi, Shanxi, China
| | - Rila Su
- Cancer Center of Inner Mongolia People's Hospital, Hohhot, Inner Mongolia, China
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Xinquan Lan
- Clinical Research Academy, Peking University Shenzhen Hospital, Shenzhen, China
- Department of Epidemiology, China Medical University, Shenyang, Liaoning, China
| | - Moxin Song
- Clinical Research Academy, Peking University Shenzhen Hospital, Shenzhen, China
- Department of Epidemiology, China Medical University, Shenyang, Liaoning, China
| | - Lei Zhang
- Department of Oncology, Peking University Shenzhen Hospital, Shenzhen, China
| | - Junjie Xu
- Department of Public Health and Preventive Medicine, Changzhi Medical College, Changzhi, Shanxi, China
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Chan AHY, Tao M, Marsh S, Petousis-Harris H. Vaccine decision making in New Zealand: a discrete choice experiment. BMC Public Health 2024; 24:447. [PMID: 38347498 PMCID: PMC10863187 DOI: 10.1186/s12889-024-17865-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 01/23/2024] [Indexed: 02/15/2024] Open
Abstract
BACKGROUND Vaccine hesitancy is a significant threat to global health. A key part of addressing hesitancy is to ensure that public health messaging prioritises information that is considered important to the public. This study aimed to examine how different vaccine characteristics affect public preferences for vaccines in New Zealand, what trade-offs they are willing to make between different vaccine characteristics, and how their preferences are affected by their vaccine-related conspiracy beliefs and COVID-19 vaccination status. METHODS An online discrete choice experiment (DCE) was designed to elicit individual preferences about vaccines using the 1000minds platform. Members of the general population of New Zealand aged ≥ 18 years were invited to complete the DCE. Participants were asked to indicate their preference between two options showing different combinations of vaccine characteristics. Data on sociodemographic characteristics were collected. Beliefs were measured using the vaccine conspiracy beliefs scale (VCBS) with scores ≥ 19 indicating strong vaccine-related conspiracy beliefs. The DCE was analysed using the PAPRIKA method (Potentially All Pairwise RanKings of all possible Alternatives) and preferences compared between respondents with high versus low VCBS scores and vaccinated versus unvaccinated respondents for COVID-19. RESULTS A total of 611 respondents from 15 regions completed the DCE. Mean (SD) age was 45.9 (14.7) years with most having had 2 or more doses of the coronavirus vaccine (86%). Mean (SD) VCBS score was 18.5 (12.4) indicating moderate vaccine-related conspiracy beliefs. Risk of severe adverse effects was the most highly valued vaccine characteristic, followed by vaccine effectiveness and duration of protection. Vaccine origin and route of administration were ranked least important. Respondents scoring high on the VCBS placed less value on the effectiveness of vaccines but greater value on development time and total number of doses (p < 0.001). COVID-19 unvaccinated respondents ranked development time and total number of doses more highly than those vaccinated respondents (p < 0.001). CONCLUSIONS Risk of severe adverse effects, vaccine effectiveness and duration of protection were rated by the New Zealand public as the top three most important vaccine characteristics. This information is important for informing public health messaging to promote vaccine uptake and inform vaccine decision-making.
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Affiliation(s)
- Amy Hai Yan Chan
- School of Pharmacy, University of Auckland, Level 3, Building 505, 85 Park Road, Grafton, 1023, Auckland, New Zealand.
| | - Marvin Tao
- School of Medicine, University of Auckland, Building 505, 85 Park Road, Grafton, 1023, Auckland, New Zealand
| | - Samantha Marsh
- School of Population Health, University of Auckland, 85 Park Road, Grafton, 1023, Auckland, New Zealand
| | - Helen Petousis-Harris
- School of Population Health, University of Auckland, 85 Park Road, Grafton, 1023, Auckland, New Zealand
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Dahes S, Damerval M, Bataillard T, Lepiller Q, Nerich V. Knowledge and perceptions of French community pharmacists and pharmacy students about the papillomavirus vaccine. Infect Dis Now 2024; 54:104796. [PMID: 37804919 DOI: 10.1016/j.idnow.2023.104796] [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: 05/02/2023] [Revised: 09/27/2023] [Accepted: 10/02/2023] [Indexed: 10/09/2023]
Abstract
INTRODUCTION In a French context of low vaccination coverage for human papillomavirus (HPV) disease, we conducted a study on pharmacy students and community pharmacists to assess their self-reported knowledge about HPV infection and vaccination and their perceptions of vaccination. MATERIAL AND METHODS A prospective volunteered-based study was conducted in the French Franche-Comté region based on a questionnaire targeting pharmacy students (from the 2nd to 6th years) and community pharmacists. RESULTS All in all, 220 students and 55 pharmacists completed a questionnaire. Fewer than a third knew which HPV genotypes are considered to be high-risk (p-value = 0.11) and were aware of the diversified nature of HPV-induced cancers (p-value = 0.02). Their overall level of general knowledge about vaccination was estimated to be good by 62% of students and 85% of pharmacists (p-value = 10-3). More than 75% of students and pharmacists considered that HPV vaccination has a positive benefit-risk balance (p-value = 0.44) but that its low coverage is due to non-confirmed adverse events that were suggested in the past (p-value = 0.60). Pharmacists had a better perception of the safety of HPV vaccination (84% versus 64%, p-value = 6·10-3). More than 50% of students and pharmacists agreed with mandatory HPV vaccination for girls and boys (11-14 years). CONCLUSION This study allowed us to assess the knowledge of students and community pharmacists and their more or less favorable perceptions of HPV vaccination. It helped us to suggest their needs in terms of practical training. Future changes should include pharmacists in the implementation of public health policies and to improve vaccination coverage.
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Affiliation(s)
- S Dahes
- CHU Besançon, Pôle Pharmacie, F-25030 Besançon Cedex, France
| | - M Damerval
- CHU Besançon, Pôle Pharmacie, F-25030 Besançon Cedex, France
| | - T Bataillard
- CHU Besançon, Pôle Pharmacie, F-25030 Besançon Cedex, France
| | - Q Lepiller
- CHU Besançon, Pôle Pharmacie, F-25030 Besançon Cedex, France; EA3181 - Université de Franche-Comté, F-25000 Besançon, France; Université de Franche-Comté, CHU Besançon, Service de Virologie, F-25030 Besançon Cedex, France EA3181 - Université de Franche-Comté, F-25000 Besançon, France
| | - V Nerich
- CHU Besançon, Pôle Pharmacie, F-25030 Besançon Cedex, France; INSERM, EFS BFC, UMR1098, RIGHT, Université de Bourgogne - Franche-Comté, F-25000 Besançon, France; Université de Franche-Comté, CHU Besançon, Service de Virologie, F-25030 Besançon Cedex, France EA3181 - Université de Franche-Comté, F-25000 Besançon, France.
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Ferroni E, Gennaro N, Maifredi G, Leoni O, Profili F, Stasi C, Cacciani L, Calandrini E, di Napoli A, Petrelli A, Zorzi M. Access to SARS-CoV-2 vaccination in immigrants in Italy, by geographical area of origin. Vaccine 2024; 42:375-382. [PMID: 38097455 DOI: 10.1016/j.vaccine.2023.11.043] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 08/25/2023] [Accepted: 11/20/2023] [Indexed: 01/01/2024]
Abstract
OBJECTIVE Immigrants are commonly considered disadvantaged and at high risk of not receiving appropriate care, including vaccination. This study aimed to evaluate the access to SARS-CoV-2 vaccination in immigrants, by geographical area of origin, compared with Italian citizens. We also evaluated sex differences in vaccine's coverage by geographical area of origin. METHODS We performed a retrospective observational study in four Italian regions, including all resident subjects aged 5-69 years, and undergoing first dose SARS-CoV-2 vaccination in the period 28th December 2020- 3rd April 2022. We estimated cumulative coverage percentages, by age class and geographical area. To compare first-dose vaccine coverage by geographical area of origin, we estimated, through a Poisson analysis, Vaccine Coverage Ratios (VCR) with 95 % confidence intervals (95 %CI), adjusting for age and sex. RESULTS We included 16,294,785 Italian citizens and 2,534,351 immigrants aged 5-69 years and resident in the four regions considered. Regarding the geographical area of origin, 40.7 % of immigrants came from Eastern Europe, 13.5 % from North Africa and 13.1 % from Western Asia. A great variability in the first dose vaccine coverage emerged. We documented substantial heterogeneity in the first-dose vaccine coverage within immigrant's population, expressed with Italy as a reference, ranging from 0,768 (95 %CI: 0,766-0,769) in Eastern Europe countries to 1,013 (95 %CI: 1,009 - 1,018) in Eastern Asia. The chance of being vaccinated was found higher in males compared with females for African countries (VCR 1.07, 95 %CI 1.06-1.08) and Western Asian countries (VCR 1.08, 95 %CI 1.07-1.09). CONCLUSION We observed substantial heterogeneity in first-dose SARS-CoV-2 vaccination coverage in immigrants, suggesting a different propensity to vaccines according to the geographical area of origin. These data can help define appropriate and tailored strategies in order to improve vaccine coverage in some specific immigrant groups at the local health district level.
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Affiliation(s)
- Eliana Ferroni
- Epidemiological Department (SER), Azienda Zero of the Veneto Region, Padua, Italy.
| | - Nicola Gennaro
- Epidemiological Department (SER), Azienda Zero of the Veneto Region, Padua, Italy
| | | | - Olivia Leoni
- Directorate General for Health, Lombardy Region, Milan, Italy
| | | | - Cristina Stasi
- Epidemiology Unit, Tuscany Regional Health Agency, Florence, Italy
| | - Laura Cacciani
- Department of Epidemiology - Regional Health Service, ASL Roma 1, Rome, Italy
| | - Enrico Calandrini
- Department of Epidemiology - Regional Health Service, ASL Roma 1, Rome, Italy
| | - Anteo di Napoli
- Epidemiology Unit, National Institute for Health, Migration and Poverty (INMP), Rome, Italy
| | - Alessio Petrelli
- Epidemiology Unit, National Institute for Health, Migration and Poverty (INMP), Rome, Italy
| | - Manuel Zorzi
- Epidemiological Department (SER), Azienda Zero of the Veneto Region, Padua, Italy
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Lescop J, Pennes B, Epaulard O. Mind the gap: Concordance between perceptions regarding vaccination as declared by patients and their evaluation by their general practitioner. Vaccine 2024; 42:310-314. [PMID: 38065770 DOI: 10.1016/j.vaccine.2023.11.065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 11/29/2023] [Accepted: 11/30/2023] [Indexed: 01/01/2024]
Abstract
BACKGROUND The high level of vaccine hesitancy reported in the French population may lead general practitioners to anticipate difficult discussions on this topic. We aimed to assess the extent to which general practitioners' evaluation of their patients' vaccine hesitancy was correlated with the real vaccine hesitancy expressed by these patients. METHODS The study was based on two brief paper questionnaires completed in private by the general practitioner and the patient at the beginning of a medical appointment: one for the physician to evaluate on three quantitative and non-graduated visual scales (then analysed as a 0-100 scale) their patients' perceptions regarding vaccine safety, vaccine efficacy and 'being in favour of vaccination'; and one for the patient to express their perceptions for the same three axes using the same scales. RESULTS Overall, 31 physicians participated in the study, with 540 physician-patient pairs being included. The physicians' evaluation of patient perceptions was more positive when the physician was male (vs female), when the patient was male (vs female) and when both were males (vs both females). The median differences (in absolute values) between the physician evaluations and the patient perceptions were between 9 and 11 (on the 0-100 scale) for the three axes (vaccine safety, vaccine efficacy and 'being in favour'). A correlation was observed between the physicians' evaluation and the patients' declaration (Kendall test: vaccine efficacy: tau = 0.199, p < 0.001; vaccine safety: tau = 0.234, p < 0.001; being in favour of vaccination: tau = 0.365, p < 0.001). Physicians correctly classified 83.4 % of the patients with high perceptions of vaccine safety and efficacy (>75/100 for both scales) but only 54.5 % of those with low perceptions (<75/100 for both scales). CONCLUSION Physicians tend to correctly identify patients with the most favourable perceptions about vaccination but not those with the least favourable perceptions.
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Affiliation(s)
- Juliette Lescop
- Université Grenoble Alpes, Centre Hospitalier Universitaire Grenoble Alpes, Service des Maladies Infectieuses, Grenoble, France; Groupe de Recherche en Infectiologie Clinique, CIC-1406 Inserm-CHUGA-UGA, Grenoble, France
| | - Bertille Pennes
- Université Grenoble Alpes, Centre Hospitalier Universitaire Grenoble Alpes, Service des Maladies Infectieuses, Grenoble, France; Groupe de Recherche en Infectiologie Clinique, CIC-1406 Inserm-CHUGA-UGA, Grenoble, France
| | - Olivier Epaulard
- Université Grenoble Alpes, Centre Hospitalier Universitaire Grenoble Alpes, Service des Maladies Infectieuses, Grenoble, France; Groupe de Recherche en Infectiologie Clinique, CIC-1406 Inserm-CHUGA-UGA, Grenoble, France.
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Jiang W, Lu C, Yan X, Tucker JD, Lin L, Li J, Larson HJ, Gong W, Wu D. Vaccine confidence mediates the association between a pro-social pay-it-forward intervention and improved influenza vaccine uptake in China: A mediation analysis. Vaccine 2024; 42:362-368. [PMID: 38103961 PMCID: PMC10789265 DOI: 10.1016/j.vaccine.2023.11.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 11/05/2023] [Accepted: 11/22/2023] [Indexed: 12/19/2023]
Abstract
INTRODUCTION A Chinese clinical trial has demonstrated that a prosocial pay-it-forward intervention that offered subsidized vaccination and postcard messages effectively increased influenza vaccine uptake and vaccine confidence. This secondary analysis explored the potential mediating role of vaccine confidence on the association between a pay-it-forward intervention and influenza vaccine uptake, and how this might vary by individual annual income levels. METHODS Data from 300 participants (150 standard-of-care and 150 pay-it-forward participants) were included in the analysis. We conducted descriptive analysis of demographic and vaccine confidence variables. Multivariable regression and mediation analysis on interventions, vaccine confidence and vaccine uptake were conducted. A sub-group analysis was conducted to further understand whether associations between these variables vary by income levels (<=$1860 or >$1860). RESULTS The pay-it-forward intervention was significantly associated with greater levels of perceived influenza vaccine importance (adjusted odds ratio (aOR) = 3.60, 95 %CI: 1.77-7.32), effectiveness (aOR = 3.37, 95 %CI: 1.75-6.52) and safety (aOR = 2.20, 95 %CI: 1.17-4.15). Greater perceived influenza vaccine importance was associated with increased vaccine uptake (aOR = 8.51, 95 %CI: 3.04-23.86). The indirect effect of the pay-it-forward intervention on vaccination was significant through improved perceived influenza vaccine importance (indirect effect1 = 0.07, 95 %CI: 0.02-0.11). This study further revealed that, irrespective of the individual income level, the pay-it-forward intervention was associated with increased vaccine uptake when compared to the standard-of-care approach. CONCLUSIONS Pay-it-forward intervention may be a promising strategy to improve influenza vaccine uptake. Perceived confidence in vaccine importance appears to be a potential mediator of the association between pay-it-forward and vaccine uptake.
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Affiliation(s)
- Wenwen Jiang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China; School of Public Health of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Chunlei Lu
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China; School of Public Health of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Xumeng Yan
- University of North Carolina Project-China, Guangzhou, China; SESH (Social Entrepreneurship to Spur Health) Team, Guangzhou, China
| | - Joseph D Tucker
- SESH (Social Entrepreneurship to Spur Health) Team, Guangzhou, China; School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, Room 360, Keppel St, London WC1E 7HT, UK
| | - Leesa Lin
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK; Laboratory of Data Discovery for Health Limited (D24H), Hong Kong Science Park, Hong Kong Special Administrative Region; WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region
| | - Jing Li
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Heidi J Larson
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK; Institute for Health Metrics and Evaluation, University of Washington, Seattle, USA
| | - Wenfeng Gong
- China Country Office of the Bill and Melinda Gates Foundation, China
| | - Dan Wu
- Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, Room 360, Keppel St, London WC1E 7HT, UK; Department of Social Medicine and Health Education, School of Public Health of Nanjing Medical University, Nanjing, Jiangsu, China.
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Tron A, Schlegel V, Pinot J, Bruel S, Ecollan M, Bel JL, Rossignol L, Gauchet A, Gagneux-Brunon A, Mueller J, Banaszuk AS, Thilly N, Gilberg S, Partouche H. Barriers and facilitators to the HPV vaccine: a multicenter qualitative study of French general practitioners. Arch Public Health 2024; 82:2. [PMID: 38178269 PMCID: PMC10768163 DOI: 10.1186/s13690-023-01227-8] [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: 06/02/2023] [Accepted: 12/04/2023] [Indexed: 01/06/2024] Open
Abstract
BACKGROUND In France, human papillomavirus (HPV) vaccination coverage is low, with 30.7% of 17-year-old girls having received a complete HPV vaccination schedule in 2020. AIM To determine the perspective and behaviors of general practitioners (GPs) regarding HPV vaccination with their patients and if a reluctance is observed. DESIGN AND SETTING A qualitative study based on semi-directed individual interviews was conducted between December 2019 and December 2020. A representative sample of GPs with various profiles were included in 4 French regions. METHOD A purposive sampling was used and interviews were continued until data saturation was reached. The analysis was based on the grounded theory. RESULTS Twenty-six GPs aged 29-66 years were interviewed. The measures taken by the French health authorities (lowering the target age, reimbursing the vaccine, extending the target population to boys) were perceived as facilitators. The reported barriers were organizational, due to low attendance of adolescents, and relational, mainly due to parental vaccine hesitancy. Physicians had to deal with fears about the perceived risks and concerns about sexuality conveyed by HPV vaccination and linked to the socio-cultural characteristics of the families. Physicians developed strategies, including scientific knowledge mobilization, empowerment of families by promoting health through prevention, repetition of the vaccination proposals, personal experience and relationship. Different practices were identified according to three GP typologies: effective, convinced but unpersuasive, and reluctant physicians. CONCLUSION Based on these results, specific interventions, including communication techniques, especially for hesitant or unpersuasive physicians, are needed to enable GPs to become more effective.
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Affiliation(s)
- Arthur Tron
- Faculté de Santé, Département de médecine générale, Université de Paris, UFR de Médecine - Site Cochin, 24, rue du Faubourg Saint-Jacques, Paris, F-75014, France.
| | - Vincent Schlegel
- Institut de recherche et de documentation en économie de la santé (IRDES), 117 bis rue Manin, Paris, 75019, France
| | - Juliette Pinot
- Faculté de Santé, Département de médecine générale, Université de Paris, UFR de Médecine - Site Cochin, 24, rue du Faubourg Saint-Jacques, Paris, F-75014, France
| | - Sébastien Bruel
- Department of General Practice, Jacques Lisfranc Faculty of Medicine, Saint-Etienne-Lyon University, Saint-Etienne, France
- Univ Lyon, Université Claude Bernard Lyon 1, Lyon, P2S UR4129, F-69008, France
- CIC-INSERM 1408, Saint-Etienne University Hospital, Saint-Etienne, France
| | - Marie Ecollan
- Faculté de Santé, Département de médecine générale, Université de Paris, UFR de Médecine - Site Cochin, 24, rue du Faubourg Saint-Jacques, Paris, F-75014, France
| | - Josselin Le Bel
- Faculté de Santé, Département de médecine générale, Université de Paris, UFR de Médecine - Site Cochin, 24, rue du Faubourg Saint-Jacques, Paris, F-75014, France
| | - Louise Rossignol
- Faculté de Santé, Département de médecine générale, Université de Paris, UFR de Médecine - Site Cochin, 24, rue du Faubourg Saint-Jacques, Paris, F-75014, France
| | - Aurélie Gauchet
- Laboratory of Psychology, University Grenoble Alps, Grenoble, France
| | - Amandine Gagneux-Brunon
- CIC-INSERM 1408, Saint-Etienne University Hospital, Saint-Etienne, France
- Centre International de Recherche en Infectiologie, Team GIMAP, Univ Lyon, Université Jean Monnet, Université Claude Bernard Lyon 1, Inserm, U1111, CNRS, UMR530, Lyon, France
| | - Judith Mueller
- EHESP French School of Public Health, Institut Pasteur, Paris cedex 15, Paris, France
| | - Anne-Sophie Banaszuk
- Centre régional de Coordination des Dépistages des Cancers-Pays de la Loire, 5 rue des Basses Fouassières, Angers, 49000, France
| | - Nathalie Thilly
- Université de Lorraine, APEMAC, Nancy, F-54000, France
- Département Méthodologie, Promotion, Investigation, Université de Lorraine, CHRU-Nancy, Nancy, F-54000, France
| | - Serge Gilberg
- Faculté de Santé, Département de médecine générale, Université de Paris, UFR de Médecine - Site Cochin, 24, rue du Faubourg Saint-Jacques, Paris, F-75014, France
| | - Henri Partouche
- Faculté de Santé, Département de médecine générale, Université de Paris, UFR de Médecine - Site Cochin, 24, rue du Faubourg Saint-Jacques, Paris, F-75014, France
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Rybak A, Ouldali N, Varon E, Taha MK, Bonacorsi S, Béchet S, Angoulvant F, Cohen R, Levy C. Vaccine-preventable Pediatric Acute Bacterial Meningitis in France: A Time Series Analysis of a 19-Year Prospective National Surveillance Network. Pediatr Infect Dis J 2024; 43:74-83. [PMID: 38108805 PMCID: PMC10723767 DOI: 10.1097/inf.0000000000004134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/08/2023] [Indexed: 12/19/2023]
Abstract
BACKGROUND In France, vaccination has been implemented against Hi serotype b (Hib), pneumococcus with pneumococcal conjugate vaccines (PCV), and Neisseria meningitidis serogroup C (MenC). These interventions with different coverage and uptake have disrupted the epidemiology of vaccine-preventable acute bacterial meningitis (ABM). METHODS We analyzed data from a French prospective surveillance network of ABM in children ≤15 years old enrolled by 259 pediatric wards (estimated national coverage: 61%). From 2001 to 2020, the effect of vaccine implementation was estimated with segmented linear regression. RESULTS We analyzed 7,186 cases, mainly due to meningococcus (35.0%), pneumococcus (29.8%), and Hi (3.7%). MenC ABM incidence decreased (-0.12%/month, 95% CI: -0.17 to -0.07, P < 0.001) with no change for the overall meningococcal ABM when comparing the pre-MenC vaccination and the post-MenC vaccination trends. Despite a decreasing MenB ABM incidence without a vaccination program (-0.43%/month, 95% CI: -0.53 to -0.34, P < 0.001), 68.3% of meningococcal ABM involved MenB. No change in pneumococcal ABM incidence was observed after the PCV7 recommendation. By contrast, this incidence significantly decreased after the switch to PCV13 (-0.9%/month, 95% CI: -1.6 to -0.2%, P = 0.01). After May 2014, a rebound occurred (0.5%/month, 95% CI: 0.3-0.8%, P < 0.001), with 89.5% of non-PCV13 vaccine serotypes. Hib ABM incidence increased after June 2017. CONCLUSIONS PCV7 and MenC vaccine introduction in France, with slow vaccine uptake and low coverage, had no to little impact as compared to the switch from PCV7 to PCV13, which occurred when coverage was optimal. Our data suggest that MenB and next-generation PCVs could prevent a large part of the ABM incidence in France.
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Affiliation(s)
- Alexis Rybak
- From the ACTIV, Association Clinique et Thérapeutique Infantile du Val-de-Marne, Créteil, Ile-de-France, France
- ECEVE, Epidémiologie Clinique et Evaluation Economique Appliquées aux Populations Vulnérables, UMR S-1123, INSERM, Université Paris Cité, Paris, Ile-de-France, France
- Department of Pediatric Emergency, Trousseau University Hospital, Sorbonne Université, Paris, Ile-de-France, France
| | - Naïm Ouldali
- From the ACTIV, Association Clinique et Thérapeutique Infantile du Val-de-Marne, Créteil, Ile-de-France, France
- Department of Pediatrics, Department Woman-Mother-Child, Lausanne University Hospital (Centre Hospitalier Universitaire Vaudois), Lausanne, Vaud, Switzerland
- Institut National de la Santé et de la Recherche Médicale, Centre de Recherche des Cordeliers, Sorbonne Université, Université Paris Cité, Paris, Ile-de-France, France
| | - Emmanuelle Varon
- Laboratory of Microbiology and National Reference Centre for Pneumococci, Centre Hospitalier Intercommunal de Créteil, Université Paris Est, Créteil, Ile-de-France, France
| | - Muhamed-Kheir Taha
- Invasive Bacterial Infections Unit and National Reference Centre for Meningococci and Haemophilus Influenzae, Institut Pasteur, Paris, Ile-de-France, France
| | - Stéphane Bonacorsi
- Laboratory of Microbiology, Robert Debré University Hospital, Assistance Publique-Hôpitaux de Paris, Université Paris Cité, Paris, Ile-de-France, France
| | - Stéphane Béchet
- From the ACTIV, Association Clinique et Thérapeutique Infantile du Val-de-Marne, Créteil, Ile-de-France, France
| | - François Angoulvant
- GPIP, Groupe de Pathologie Infectieuse Pédiatrique, Paris, Ile-de-France, France
- Department of Pediatrics, Department Woman-Mother-Child, Lausanne University Hospital (Centre Hospitalier Universitaire Vaudois), Lausanne, Vaud, Switzerland
- Institut National de la Santé et de la Recherche Médicale, Centre de Recherche des Cordeliers, Sorbonne Université, Université Paris Cité, Paris, Ile-de-France, France
- HeKA, Inria Paris, Université Paris Cité, Paris, Ile-de-France, France
| | - Robert Cohen
- From the ACTIV, Association Clinique et Thérapeutique Infantile du Val-de-Marne, Créteil, Ile-de-France, France
- GPIP, Groupe de Pathologie Infectieuse Pédiatrique, Paris, Ile-de-France, France
- Research Center, Centre Hospitalier Intercommunal de Créteil, Université Paris Est, Créteil, Ile-de-France, France
- GEMINI, Groupe de Recherche Clinique-Groupe d’Etude des Maladies Infectieuses Néonatales et Infantiles, Institut Mondor de Recherche Biomédicale, Université Paris Est, Créteil, Ile-de-France, France
| | - Corinne Levy
- From the ACTIV, Association Clinique et Thérapeutique Infantile du Val-de-Marne, Créteil, Ile-de-France, France
- GPIP, Groupe de Pathologie Infectieuse Pédiatrique, Paris, Ile-de-France, France
- Research Center, Centre Hospitalier Intercommunal de Créteil, Université Paris Est, Créteil, Ile-de-France, France
- GEMINI, Groupe de Recherche Clinique-Groupe d’Etude des Maladies Infectieuses Néonatales et Infantiles, Institut Mondor de Recherche Biomédicale, Université Paris Est, Créteil, Ile-de-France, France
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Freese J, Abuzaid F, Sayles H, Abdellatif M, Fadul N. Perceptions of the COVID-19 Vaccination Within a Convenience Sample of Sudanese Americans. J Prim Care Community Health 2024; 15:21501319241234868. [PMID: 38414263 PMCID: PMC10900865 DOI: 10.1177/21501319241234868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/29/2024] Open
Abstract
INTRODUCTION Sudanese American and other immigrant and refugee communities are at greater risk for exposure to COVID-19. This survey sought to better characterize COVID-19 vaccination practices, motivators, and drivers for hesitancy among Sudanese Americans. METHODS We developed an online, cross-sectional survey in English and Arabic distributed by Sudanese American community leaders in April 2022 with data stored anonymously in REDCap. Inclusion criteria were self-reporting being born within Sudan and living in the US within the last 2 years. Descriptive analysis tested survey responses for possible associations between the primary outcome, self-reported vaccination status, and questions regarding vaccination history, perspectives on vaccination, and demographic characteristics using Fishers Exact and Chi Squared Tests. RESULTS Of 111 survey responses received, 107 met inclusion criteria. 93% of respondents reported COVID-19 vaccine uptake with the primary motivation to protect oneself from disease. The most cited reason for vaccine hesitancy was belief it had not been studied enough. The group that reported vaccination had higher levels of education (.032) and were more likely to perceive that COVID-19 vaccinations were able to reduce spread (.001), decrease severe outcomes (.004), and benefits outweighing their risks (.004). DISCUSSION AND CONCLUSIONS This survey population of Sudanese Americans demonstrated high levels of vaccine uptake (93%), far greater than either the corresponding US (78%) or Sudanese population (15%). It is likely that high levels of educational attainment moderated vaccine uptake, though our survey may not have had the power to fully evaluate vaccine hesitancy.
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Affiliation(s)
| | | | - Harlan Sayles
- University of Nebraska Medical Center, Omaha, NE, USA
| | | | - Nada Fadul
- University of Nebraska Medical Center, Omaha, NE, USA
- Department of Internal Medicine, University of Nebraska Medical Center, Omaha, Nebraska, USA
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Lelliott M, Sakata M, Kohno A, Toyomoto R, Matsumoto A, Furukawa TA. Perspectives on childhood coronavirus disease vaccination in Japan and influencing factors. Pediatr Int 2024; 66:e15819. [PMID: 39349402 DOI: 10.1111/ped.15819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 04/12/2024] [Accepted: 06/03/2024] [Indexed: 10/02/2024]
Abstract
BACKGROUND To support parental decision-making it is important to understand parents' perspectives on vaccination for their children and the factors that contribute to their vaccine hesitancy. There have been relatively few studies in this area in Japan, particularly with longitudinal and mixed methodologies. METHODS We used an explanatory sequential mixed methods approach to describe longitudinal changes in vaccine acceptance and to explore factors associated with parental coronavirus 2019 (COVID-19) vaccine hesitancy. We recruited parents who had children aged 6 months to 11 years old from five facilities in Japan. Two cross-sectional online surveys and semi-structured online interviews were conducted. Logistic regression analysis was used to explore factors associated with parents' vaccine hesitancy for their children, and thematic analysis was used to analyze the interview data. RESULTS In total, 134 parents responded to both online surveys and, of those, 10 participated in interviews. Acceptance rates of COVID-19 vaccination for their children were 19.4% (26/134) at the first survey and 11.2% (15/134) at the second survey. Integration of the data identified that the main factors for vaccine hesitancy included vaccine safety, vaccine effectiveness, government policy, and recommendations from people close to parents. CONCLUSIONS Readily available and more balanced information, and community-wide support from people close to parents and familiar health-care providers are likely to provide better support for parents' decision-making. Further investigation is required on how to provide information in an easily understood manner.
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Affiliation(s)
- Madoka Lelliott
- Department of Health Promotion and Human Behavior, Kyoto University Graduate School of Medicine and School of Public Health, Kyoto, Japan
| | - Masatsugu Sakata
- Department of Health Promotion and Human Behavior, Kyoto University Graduate School of Medicine and School of Public Health, Kyoto, Japan
| | - Ayako Kohno
- Internationalization Promotion Office, School of Public Health, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Rie Toyomoto
- Department of Health Promotion and Human Behavior, Kyoto University Graduate School of Medicine and School of Public Health, Kyoto, Japan
| | - Ayuko Matsumoto
- Department of Education, Koyasan University, Wakayama, Japan
| | - Toshi A Furukawa
- Department of Health Promotion and Human Behavior, Kyoto University Graduate School of Medicine and School of Public Health, Kyoto, Japan
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Hansen RK, Baiju N, Gabarron E. Social Media as an Effective Provider of Quality-Assured and Accurate Information to Increase Vaccine Rates: Systematic Review. J Med Internet Res 2023; 25:e50276. [PMID: 38147375 PMCID: PMC10777282 DOI: 10.2196/50276] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 10/31/2023] [Accepted: 10/31/2023] [Indexed: 12/27/2023] Open
Abstract
BACKGROUND Vaccination programs are instrumental in prolonging and improving people's lives by preventing diseases such as measles, diphtheria, tetanus, pertussis, and influenza from escalating into fatal epidemics. Despite the significant impact of these programs, a substantial number of individuals, including 20 million infants annually, lack sufficient access to vaccines. Therefore, it is imperative to raise awareness about vaccination programs. OBJECTIVE This study aims to investigate the potential utilization of social media, assessing its scalability and robustness in delivering accurate and reliable information to individuals who are contemplating vaccination decisions for themselves or on behalf of their children. METHODS The protocol for this review is registered in PROSPERO (identifier CRD42022304229) and is being carried out in compliance with the Cochrane Handbook for Systematic Reviews of Interventions. Comprehensive searches have been conducted in databases including MEDLINE, Embase, PsycINFO, CINAHL (Cumulative Index to Nursing and Allied Health), CENTRAL (Cochrane Central Register of Controlled Trials), and Google Scholar. Only randomized controlled trials (RCTs) were deemed eligible for inclusion in this study. The target population encompasses the general public, including adults, children, and adolescents. The defined interventions comprise platforms facilitating 2-way communication for sharing information. These interventions were compared against traditional interventions and teaching methods, referred to as the control group. The outcomes assessed in the included studies encompassed days unvaccinated, vaccine acceptance, and the uptake of vaccines compared with baseline. The studies underwent a risk-of-bias assessment utilizing the Cochrane Risk-of-Bias tool for RCTs, and the certainty of evidence was evaluated using the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) assessment. RESULTS This review included 10 studies, detailed in 12 articles published between 2012 and 2022, conducted in the United States, China, Jordan, Australia, and Israel. The studies involved platforms such as Facebook, Twitter, WhatsApp, and non-general-purpose social media. The outcomes examined in these studies focused on the uptake of vaccines compared with baseline, vaccine acceptance, and the number of days individuals remained unvaccinated. The overall sample size for this review was 26,286, with individual studies ranging from 58 to 21,592 participants. The effect direction plot derived from articles of good and fair quality indicated a nonsignificant outcome (P=.12). CONCLUSIONS The findings suggest that, in a real-world scenario, an equal number of positive and negative results may be expected due to the interventions' impact on the acceptance and uptake of vaccines. Nevertheless, there is a rationale for accumulating experience to optimize the use of social media with the aim of enhancing vaccination rates. Social media can serve as a tool with the potential to disseminate information and boost vaccination rates within a population. However, relying solely on social media is not sufficient, given the complex structures at play in vaccine acceptance. Effectiveness hinges on various factors working in tandem. It is crucial that authorized personnel closely monitor and moderate discussions on social media to ensure responsible and accurate information dissemination.
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Affiliation(s)
- Rita-Kristin Hansen
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Nikita Baiju
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Elia Gabarron
- Department of Education, ICT and Learning, Østfold University College, Halden, Norway
- Norwegian Centre for E-health Research, Tromsø, Norway
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Song MY, Blake-Hepburn D, Fadel S, Allin S, Ataullahjan A, Di Ruggiero E. Faith-based organisations and their role in supporting vaccine confidence and uptake: a scoping review protocol. BMJ Open 2023; 13:e070843. [PMID: 38135322 DOI: 10.1136/bmjopen-2022-070843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2023] Open
Abstract
INTRODUCTION Faith-based organisations (FBOs) and religious actors increase vaccine confidence and uptake among ethnoracially minoritised communities in low-income and middle-income countries. During the COVID-19 pandemic and the subsequent vaccine rollout, global organisations such as the WHO and UNICEF called for faith-based collaborations with public health agencies (PHAs). As PHA-FBO partnerships emerge to support vaccine uptake, the scoping review aims to: (1) outline intervention typologies and implementation frameworks guiding interventions; (2) describe the roles of PHAs and FBOs in the design, implementation and evaluation of strategies and (3) synthesise outcomes and evaluations of PHA-FBO vaccine uptake initiatives for ethnoracially minoritised communities. METHODS AND ANALYSIS We will perform six library database searches in PROQUEST-Public Health, OVID MEDLINE, Cochrane Library, CINAHL, SCOPUS- all, PROQUEST - Policy File index; three theses repositories, four website searches, five niche journals and 11 document repositories for public health. These databases will be searched for literature that describe partnerships for vaccine confidence and uptake for ethnoracially minoritised populations, involving at least one PHA and one FBO, published in English from January 2011 to October 2023. Two reviewers will pilot-test 20 articles to refine and finalise the inclusion/exclusion criteria and data extraction template. Four reviewers will independently screen and extract the included full-text articles. An implementation science process framework outlining the design, implementation and evaluation of the interventions will be used to capture the array of partnerships and effectiveness of PHA-FBO vaccine uptake initiatives. ETHICS AND DISSEMINATION This multiphase Canadian Institutes of Health Research (CIHR) project received ethics approval from the University of Toronto. Findings will be translated into a series of written materials for dissemination to CIHR, and collaborating knowledge users (ie, regional and provincial PHAs), and panel presentations at conferences to inform the development of a best-practices framework for increasing vaccine confidence and uptake.
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Affiliation(s)
- Melodie Yunju Song
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | | | - Shaza Fadel
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Sara Allin
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Anushka Ataullahjan
- School of Health Studies, Faculty of Health Sciences, Western University, London, Ontario, Canada
| | - Erica Di Ruggiero
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
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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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Brosset E, Fressard L, Cogordan C, Bocquier A, Annequin M, Bourrelly M, Constance J, Michels D, Mora M, Morel S, Oliveri C, Maradan G, Berenger C, Spire B, Verger P. Gradient of vaccine hesitancy among French men having sex with men: An electronic cross-sectional survey in 2022. Hum Vaccin Immunother 2023; 19:2293489. [PMID: 38093684 PMCID: PMC10730215 DOI: 10.1080/21645515.2023.2293489] [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: 10/23/2023] [Accepted: 12/07/2023] [Indexed: 12/18/2023] Open
Abstract
In developed countries, vaccinations against hepatitis B (HBV), hepatitis A (HAV), and human papillomavirus (HPV) are often recommended to men who have sex with men (MSM) because of the risky sexual practices in which some engage. Vaccine coverage against these diseases is not optimal in France, probably due in part to vaccine hesitancy (VH). The overall aim of this survey among MSM was to estimate the prevalence of different grades of VH for these vaccines as well as of general VH (toward any vaccine). The specific objectives were to study the sociodemographic correlates of MSM specific and general VH and its association with vaccine uptake. A cross-sectional electronic survey (February-August 2022) collected information from 3,730 French MSM about their perceptions of HBV, HAV, and HPV and their related vaccines, to construct "specific VH" variables. Information about their past vaccination behaviors for any vaccine was used to construct a "general VH" variable, based on the World Health Organization definition. Almost 90% of MSM showed moderate or high specific VH for HBV, HAV, and/or HPV, and 54% general VH. A higher education level and comfortable financial situation were associated with lower grades of specific and general VH. Younger age was associated with less frequent specific VH and more frequent general VH. Specific VH, versus general, was more strongly associated with frequent self-reported non-vaccination against these three disease. Addressing their concerns about vaccines, improving their knowledge of vaccine-preventable sexually transmitted infections, and motivating them to get vaccinated are public health priorities.
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Affiliation(s)
- Emeline Brosset
- ORS PACA, Southeastern Health Regional Observatory, Marseille, France
| | - Lisa Fressard
- ORS PACA, Southeastern Health Regional Observatory, Marseille, France
| | - Chloé Cogordan
- ORS PACA, Southeastern Health Regional Observatory, Marseille, France
| | - Aurélie Bocquier
- ORS PACA, Southeastern Health Regional Observatory, Marseille, France
- Université de Lorraine, APEMAC , Nancy, France
| | - Margot Annequin
- ORS PACA, Southeastern Health Regional Observatory, Marseille, France
- INSERM, IRD, SESSTIM, ISSPAM, Aix Marseille University, Marseille, France
| | - Michel Bourrelly
- INSERM, IRD, SESSTIM, ISSPAM, Aix Marseille University, Marseille, France
| | - Jean Constance
- ORS PACA, Southeastern Health Regional Observatory, Marseille, France
| | - David Michels
- AIDES, Pantin, France
- Laboratoire de recherche communautaire, Coalition PLUS, Pantin, France
| | - Marion Mora
- INSERM, IRD, SESSTIM, ISSPAM, Aix Marseille University, Marseille, France
| | | | - Camilla Oliveri
- ORS PACA, Southeastern Health Regional Observatory, Marseille, France
- INSERM, IRD, SESSTIM, ISSPAM, Aix Marseille University, Marseille, France
| | - Gwenaëlle Maradan
- ORS PACA, Southeastern Health Regional Observatory, Marseille, France
| | - Cyril Berenger
- ORS PACA, Southeastern Health Regional Observatory, Marseille, France
| | - Bruno Spire
- INSERM, IRD, SESSTIM, ISSPAM, Aix Marseille University, Marseille, France
| | - Pierre Verger
- ORS PACA, Southeastern Health Regional Observatory, Marseille, France
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Arzilli G, Stacchini L, Casigliani V, Mazzilli S, Aquino F, Oradini-Alacreu A, Bruni B, Quattrone F, Papini F, Sironi D, Porretta AD, Privitera GP, Rizzo C, Tavoschi L, Lopalco PL. Assessing vaccine hesitancy and health literacy using a new Italian vaccine confidence index and a modified Italian medical term recognition test: A cross-sectional survey on Italian parents. Hum Vaccin Immunother 2023; 19:2271765. [PMID: 37906161 PMCID: PMC10760377 DOI: 10.1080/21645515.2023.2271765] [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: 07/04/2023] [Accepted: 10/13/2023] [Indexed: 11/02/2023] Open
Abstract
The decline in children's vaccination coverage and the resurgence of preventable infectious diseases draw attention to parents' vaccine hesitancy. Our study introduces two validated tools to independently assess vaccine hesitancy and health literacy among parents with school-age children. We developed a Vaccine Confidence Index (VCI) from 10 Likert items, exploring their relationships through exploratory and confirmatory factor analyses. We modified the IMETER (Italian medical term recognition test) to measure health literacy. We assessed the internal consistency of the modified IMETER and the 10 Likert items using Cronbach's alpha test (α) and McDonald's omega total coefficient (ω) with good results (ω = 0.92, α = 0.90; ω = 0.87, α = 0.82 respectively). We used these tools within a questionnaire conducted on 743 parents recruited from pediatric clinic waiting rooms in Italy, collecting demographic data, information sources on vaccines and vaccine-preventable diseases knowledge. The VCI resulting from factor analyses consisted of six items on a ten-point Likert scale, reflecting the ratio of positive to negative items. The survey revealed significant variations in the VCI according to individual features such as education, use of social networks, or Health institutions as sources of information. Multivariate logistic regression identified an association between vaccine intention and the VCI. Health literacy was functional for 91.2% of participants, but knowledge about vaccine-preventable diseases was generally low. The VCI showed no significant association with health literacy and vaccine-preventable diseases knowledge. The VCI and the modified IMETER effectively assess vaccination attitude and health literacy, offering valuable public health tools for tailoring vaccination campaigns to hesitant population subgroups.
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Affiliation(s)
- Guglielmo Arzilli
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Lorenzo Stacchini
- Department of Health Science, University of Florence, Florence, Italy
| | - Virginia Casigliani
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | | | - Francesco Aquino
- Department of Public Health and Hygiene, Azienda USL Toscana Nord Ovest, Versilia, Italy
| | - Aurea Oradini-Alacreu
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Beatrice Bruni
- Department of Public Health and Hygiene, Azienda USL Toscana Nord Ovest, Versilia, Italy
| | - Filippo Quattrone
- Management and Healthcare Laboratory, Institute of Management and Department EMbeDS, Scuola Superiore Sant’Anna, Pisa, Italy
| | - Francesca Papini
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Daniele Sironi
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Andrea Davide Porretta
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
- University Hospital of Pisa, Pisa, Italy
| | - Gaetano Pierpaolo Privitera
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Caterina Rizzo
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
- University Hospital of Pisa, Pisa, Italy
| | - Lara Tavoschi
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Pier Luigi Lopalco
- Department of Biological and Environmental Sciences and Technology, University of Salento, Lecce, Italy
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Hurstak E, Farina FR, Paasche-Orlow MK, Hahn EA, Henault LE, Moreno P, Weaver C, Marquez M, Serrano E, Thomas J, Griffith JW. COVID-19 Vaccine Confidence Mediates the Relationship between Health Literacy and Vaccination in a Diverse Sample of Urban Adults. Vaccines (Basel) 2023; 11:1848. [PMID: 38140251 PMCID: PMC10747333 DOI: 10.3390/vaccines11121848] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 12/01/2023] [Accepted: 12/08/2023] [Indexed: 12/24/2023] Open
Abstract
We sought to analyze the relationship between health literacy, confidence in COVID-19 vaccines, and self-reported vaccination. We hypothesized that the relationship between health literacy and vaccination would be mediated by vaccine confidence. We recruited (N = 271) English- and Spanish-speaking adults in Boston and Chicago from September 2018 to September 2021. We performed a probit mediation analysis to determine if confidence in COVID-19 vaccines and health literacy predicted self-reported vaccination. We hypothesized that the relationship between health literacy and vaccination would be mediated by vaccine confidence. Participants were on average 50 years old, 65% female, 40% non-Hispanic Black, 25% Hispanic, and 30% non-Hispanic White; 231 (85%) reported at least one COVID-19 vaccination. A higher mean vaccine confidence score (t = -7.9, p < 0.001) and higher health literacy (t = -2.2, p = 0.03) were associated with vaccination, but only vaccine confidence predicted vaccination in a multivariate model. Vaccine confidence mediated the relationship between health literacy and COVID-19 vaccination (mediated effects: 0.04; 95% CI [0.02, 0.08]). We found that using a simple tool to measure vaccine confidence identified people who declined or delayed COVID-19 vaccination in a diverse sample of adults with varying levels of health literacy. Simple short survey tools can be useful to identify people who may benefit from vaccine promotion efforts and evidence-based communication strategies.
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Affiliation(s)
- Emily Hurstak
- Section of General Internal Medicine, Boston University Chobanian & Avedisian School of Medicine, Boston, MA 02119, USA;
| | - Francesca R. Farina
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA; (F.R.F.); (E.A.H.); (C.W.); (M.M.); (E.S.); (J.T.); (J.W.G.)
| | - Michael K. Paasche-Orlow
- Department of Medicine, Tufts University School of Medicine, Tufts Medical Center, Boston, MA 02116, USA;
| | - Elizabeth A. Hahn
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA; (F.R.F.); (E.A.H.); (C.W.); (M.M.); (E.S.); (J.T.); (J.W.G.)
| | - Lori E. Henault
- Section of General Internal Medicine, Boston University Chobanian & Avedisian School of Medicine, Boston, MA 02119, USA;
| | - Patricia Moreno
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL 33136, USA;
| | - Claire Weaver
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA; (F.R.F.); (E.A.H.); (C.W.); (M.M.); (E.S.); (J.T.); (J.W.G.)
| | - Melissa Marquez
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA; (F.R.F.); (E.A.H.); (C.W.); (M.M.); (E.S.); (J.T.); (J.W.G.)
| | - Eloisa Serrano
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA; (F.R.F.); (E.A.H.); (C.W.); (M.M.); (E.S.); (J.T.); (J.W.G.)
| | - Jessica Thomas
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA; (F.R.F.); (E.A.H.); (C.W.); (M.M.); (E.S.); (J.T.); (J.W.G.)
| | - James W. Griffith
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA; (F.R.F.); (E.A.H.); (C.W.); (M.M.); (E.S.); (J.T.); (J.W.G.)
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Pouvrasseau A, Jeannot E. Vaccine hesitancy among nursing and midwifery undergraduate students in Switzerland: protocol for an online national study. Front Public Health 2023; 11:1302676. [PMID: 38155889 PMCID: PMC10754524 DOI: 10.3389/fpubh.2023.1302676] [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: 09/29/2023] [Accepted: 11/27/2023] [Indexed: 12/30/2023] Open
Abstract
Background Vaccine hesitancy is a persistent challenge in public health, exacerbated by the proliferation of anti-vaccine sentiments facilitated by social networks. The COVID-19 pandemic has underscored the importance of addressing vaccine hesitancy, designated by the WHO as a top global health threat. This study explores vaccine hesitancy among nursing and midwifery undergraduate students in Switzerland-a cohort crucial to public health given their future roles as healthcare professionals-with a particular emphasis on the HPV vaccine, which exhibits lower confidence levels compared to other vaccines. Methods This study will employ an online questionnaire distributed to nursing and midwifery undergraduate students from various healthcare universities. The questionnaire will collect data on vaccine hesitancy (general confidence in vaccines and specifically in the HPV vaccine), HPV vaccine coverage, socio-demographics, likelihood to recommend vaccines to patients, perception of vaccination education and interest in complementary medicine. Conclusion The study's findings will contribute to our understanding of vaccine hesitancy among nursing and midwifery undergraduate students, providing insights that can inform targeted interventions and education strategies to bolster vaccine confidence among future healthcare professionals, thereby enhancing public health efforts.
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Affiliation(s)
- Audrey Pouvrasseau
- Faculty of Medicine, Institute of Global Health, University of Geneva, Geneva, Switzerland
| | - Emilien Jeannot
- Faculty of Medicine, Institute of Global Health, University of Geneva, Geneva, Switzerland
- Department of Psychiatry, Center for Excessive Gambling, Addiction Medicine (Service), Lausanne University Hospital (CHUV), Lausanne, Switzerland
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Deng JS, Ying CQ, Lin XQ, Huang CL, Zhang MX, Tung TH, Zhu JS. Impact of household decision makers' hesitancy to vaccinate children against COVID-19 on other household members: A family-based study in Taizhou, China. SSM Popul Health 2023; 24:101517. [PMID: 37767519 PMCID: PMC10520923 DOI: 10.1016/j.ssmph.2023.101517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Revised: 08/13/2023] [Accepted: 09/18/2023] [Indexed: 09/29/2023] Open
Abstract
Background Vaccination is the most effective means of preventing outbreaks of infectious diseases, and family ;decision makers play an important role in decision-making regarding family matters and may influence other family members to take an active role in vaccinating children against COVID-19. Purpose This study examined the influence of family decision makers on the hesitation of other family members to vaccinate their children against COVID-19. Methods A population-based, self-administered online questionnaire was administered in Taizhou, China, from September 1, 2021, to September 15, 2021. The questionnaire included demographic information, knowledge, attitudes, and perceptions about the COVID-19 vaccine as well as hesitation regarding the use of the COVID-19 vaccination in children. In total, 490 respondents were included in this study. Logistic regression was used to assess the factors associated with vaccine hesitancy. Results In total, 490 respondents from 190 households were interviewed. Of the 190 family decision makers, 43.7% (83/190) were hesitant to vaccinate their children against COVID-19. When family decision makers were hesitant to vaccinate children against COVID-19, 65.1% (82/126) of the other family members expressed similar hesitancy regarding vaccination. When family decision makers were not hesitant to vaccinate children, only 21.3% (37/174) of other family members were hesitant to do so. In the regression analysis, family decision makers' hesitation to vaccinate their children was associated with other family members' hesitation (OR=6.264, 95% CI:3.132-12.526). In addition, decision makers' perceptions of the safety of the vaccine (OR=0.422, 95% CI:0.215-0.826) and hesitation to vaccinate themselves (OR=8.967, 95% CI:4.745-16.948) influenced their hesitation to vaccinate their children. Conclusion The present study found that family decision makers' hesitation to vaccinate children against COVID-19 influenced other family members' hesitation to vaccinate children. In addition, family decision makers' perceptions of the safety of the vaccine and their hesitation to vaccinate themselves influenced other family members' hesitation to vaccinate their children.
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Affiliation(s)
- Jing-Shan Deng
- Department of Infectious Diseases, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, Zhejiang, 317000, China
| | - Chen-Qian Ying
- Department of Infectious Diseases, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, Zhejiang, 317000, China
| | - Xiao-Qing Lin
- Department of Infectious Diseases, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, Zhejiang, 317000, China
| | - Chun-Lian Huang
- Department of Infectious Diseases, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, Zhejiang, 317000, China
| | - Mei-Xian Zhang
- Evidence-based Medicine Center, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, Zhejiang, 317000, China
| | - Tao-Hsin Tung
- Evidence-based Medicine Center, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, Zhejiang, 317000, China
| | - Jian-Sheng Zhu
- Department of Infectious Diseases, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, Zhejiang, 317000, China
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Guarducci G, Mereu G, Golinelli D, Galletti G, Gemmi F, Cartocci A, Holczer N, Bacci L, Sergi A, Messina G, Mari V, Nante N. Factors Influencing the Healthcare Workers' Willingness to Receive the COVID-19 Booster Dose in Tuscany (Italy). Vaccines (Basel) 2023; 11:1751. [PMID: 38140156 PMCID: PMC10748028 DOI: 10.3390/vaccines11121751] [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: 10/17/2023] [Revised: 11/21/2023] [Accepted: 11/22/2023] [Indexed: 12/24/2023] Open
Abstract
BACKGROUND The World Health Organization has defined vaccine hesitancy as behavior influenced by several factors, including trust in the vaccine itself or its provider or the perceived need for vaccination. The aim of this study was to investigate the factors influencing the willingness to receive the COVID-19 vaccine among the employees and healthcare professionals of the Central Tuscany Local Health Authority (CT-LHA) in Italy. METHODS From July to October 2022, a cross-sectional study was conducted. An online questionnaire was administered to 7000 employees of the CT-LHA. The questionnaire analyzed the factors that influenced receiving the booster dose of the COVID-19 vaccine. The sample was stratified by gender, age, type of occupation (healthcare or non-healthcare workers), and seniority. Incomplete questionnaires were excluded. A chi-squared test was performed through STATA. The significance level was set at 95%. RESULTS Of the questionnaires administered, 1885 (26.9%) questionnaires were eligible for the study. In the previous vaccination campaign, the healthcare workers (HCWs) considered the vaccine used by CT-LHA as safe, in contrast to non-healthcare workers (N-HCWs), who considered it less secure (p < 0.05). The HCWs showed a higher propensity for vaccine safety to receive the booster dose than N-HCWs. N-HCWs appeared to be less affected by an updated booster dose than HCWs (p < 0.05). CONCLUSIONS The factors studied appear to influence HCWs differently from N-HCWs. Both HCWs and N-HCWs would choose an upgraded mRNA vaccine for the booster dose.
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Affiliation(s)
- Giovanni Guarducci
- Post Graduate School of Public Health, University of Siena, 53100 Siena, Italy; (D.G.); (G.M.); (N.N.)
| | - Giovanna Mereu
- Department of Technical Health Professions, Central Tuscany Local Health Authority, 50121 Florence, Italy;
| | - Davide Golinelli
- Post Graduate School of Public Health, University of Siena, 53100 Siena, Italy; (D.G.); (G.M.); (N.N.)
- Department of Molecular and Developmental Medicine, University of Siena, 53100 Siena, Italy
| | - Giacomo Galletti
- Quality and Equity Unit, Regional Health Agency of Tuscany, 50141 Florence, Italy; (G.G.); (F.G.)
| | - Fabrizio Gemmi
- Quality and Equity Unit, Regional Health Agency of Tuscany, 50141 Florence, Italy; (G.G.); (F.G.)
| | - Alessandra Cartocci
- Department of Medical Biotechnologies, University of Siena, 53100 Siena, Italy;
| | - Nora Holczer
- General Direction, Central Tuscany Local Health Authority, 50121 Florence, Italy (V.M.)
| | - Luca Bacci
- Web Communication and Promotion, Central Tuscany Local Health Authority, 50121 Florence, Italy;
| | - Alessandro Sergi
- Healthcare Management, Central Tuscany Local Health Authority, 50121 Florence, Italy;
| | - Gabriele Messina
- Post Graduate School of Public Health, University of Siena, 53100 Siena, Italy; (D.G.); (G.M.); (N.N.)
- Department of Molecular and Developmental Medicine, University of Siena, 53100 Siena, Italy
| | - Valerio Mari
- General Direction, Central Tuscany Local Health Authority, 50121 Florence, Italy (V.M.)
| | - Nicola Nante
- Post Graduate School of Public Health, University of Siena, 53100 Siena, Italy; (D.G.); (G.M.); (N.N.)
- Department of Molecular and Developmental Medicine, University of Siena, 53100 Siena, Italy
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