The myth of vaccination and autism spectrum

The Impact of Video-Based Educational Intervention on Parents' Decision to Uptake the Measles-Rubella (MR) Vaccine in Jordan

BACKGROUND

Interventions are needed to decrease measles and rubella (MR) vaccine hesitancy/refusal among Jordanian parents during the implementation campaign in Jordan by 2023. This study developed an educational video for parents with hesitancy or refusal to enhance their attitudes and decisions toward the MR vaccine.

OBJECTIVE

This study aimed to assess the impact of video-based educational intervention on the attitudes of parents toward the MR vaccine and the decision to accept the MR vaccine.

METHOD

One group pretest-posttest experimental design was used. A 5-min MR vaccine education video was shown to parents. Parents' decisions on the MR vaccine and the parent attitudes about childhood vaccines (PACV) scale were collected before, immediately, and 2 weeks after the video, the differences in the scores were also measured.

RESULTS

The initial PACV scale score averaged 24 ± 1.5. After watching the MR education video, the PACV scores immediately and after 2 weeks were 21 ± 1.6 and 21.8 ± 1.4, respectively, with a statistically significant difference (p value < 0.05). The parents' likelihood of refusing the MR vaccine decreased immediately and 2 weeks after watching the video (68% and 70.5%; respectively), and this decrease was sustained after 2 weeks (p value = 0.617).

CONCLUSION

An educational video intervention was associated with improved PACV and improved parents' attitudes toward the MR vaccine, potentially altering the decisions of hesitant or refusing parents to accept the vaccine during the 2023 MR vaccine campaign in Jordan. These positive effects appeared to persist even 2 weeks after the intervention.

The Impact of Age and Vaccine Conspiracy Beliefs on COVID-19 Vaccine Uptake among United States Adults

This observational study examined the relationships between age, vaccine conspiracy beliefs, and COVID-19 vaccine uptake in emerging adults (ages 20-30) and middle-aged adults (ages 50-60) residing in the United States. It also examined sociodemographic predictors of vaccine conspiracy beliefs and COVID-19 vaccine uptake-political conservativism, household income, and educational attainment. We recruited 198 emerging adults and 198 middle-aged adults to complete an online survey assessing vaccine conspiracy beliefs and COVID-19 vaccination status. First, we found that emerging adults reported stronger vaccine conspiracy beliefs than middle-aged adults (estimated mean difference = 0.43, 95CI = 0.08, 0.79, p = 0.017), but that emerging adults and middle-aged adults did not differ in their likelihood of being vaccinated with estimated rates of COVID-19 vaccination uptake of 63% in emerging adults and 64% in middle-aged adults. Political conservativism was associated with stronger vaccine conspiracy beliefs and lower COVID-19 vaccine uptake. Lower household income and lower educational attainment were associated with lower COVID-19 vaccine uptake but not associated with vaccine conspiracy beliefs. Second, we found that age moderated the relationship between vaccine conspiracy beliefs and COVID-19 vaccine uptake; stronger vaccine conspiracy beliefs predicted lower COVID-19 vaccine uptake among middle-aged adults (B = -0.63, 95CI = -0.90, -0.36, p < 0.001) but were not associated with COVID-19 vaccine uptake among emerging adults (B = -0.21, 95CI = -0.47, 0.05, p = 0.12). These results provide insight into the sociodemographic and psychological factors that influence COVID-19 vaccine uptake. Our findings can help to inform the design of targeted public health interventions to increase vaccine uptake in the ongoing fight against COVID-19. Given the crucial role of vaccination in controlling the spread of COVID-19, it is also imperative for future studies to continue investigating how age and vaccine conspiratorial beliefs intersect to impact vaccine uptake.

Analyzing Google COVID-19 Vaccine Intent Search Trends and Vaccine Readiness in the United States: Panel Data Study

BACKGROUND

Factors such as anxiety, worry, and perceptions of insufficient knowledge about a topic motivate individuals to seek web-based health information to guide their health-related decision-making. These factors converged during the COVID-19 pandemic and were linked to COVID-19 vaccination decision-making. While research shows that web-based search relevant to COVID-19 was associated with subsequent vaccine uptake, less is known about COVID-19 vaccine intent search (which assesses vaccine availability, accessibility, and eligibility) as a signal of vaccine readiness.

OBJECTIVE

To increase knowledge about vaccine intent search as a signal of vaccine readiness, we investigated the relationship between COVID-19 vaccine readiness and COVID-19 vaccine intent relative search volume on Google.

METHODS

We compiled panel data from several data sources in all US counties between January 2021 and April 2023, a time during which those with primary COVID-19 vaccinations increased from <57,000 to >230 million adults. We estimated a random effects generalized least squares regression model with time-fixed effects to assess the relationship between county-level COVID-19 vaccine readiness and COVID-19 vaccine intent relative search volume. We controlled for health care capacity, per capita COVID-19 cases and vaccination doses administered, and sociodemographic indicators.

RESULTS

The county-level proportions of unvaccinated adults who reported that they would wait and see before getting a COVID-19 vaccine were positively associated with COVID-19 vaccine intent relative search volume (β=9.123; Z=3.59; P<.001). The county-level proportions of vaccine-enthusiast adults, adults who indicated they were either already vaccinated with a primary COVID-19 vaccine series or planned to complete the vaccine series soon, were negatively associated with COVID-19 vaccine intent relative search volume (β=-10.232; Z=-7.94; P<.001). However, vaccine intent search was higher in counties with high proportions of people who decided to wait and see and lower in counties with high proportions of vaccine enthusiasts.

CONCLUSIONS

During this period of steep increase in COVID-19 vaccination, web-based search may have signaled differences in county-level COVID-19 vaccine readiness. More vaccine intent searches occurred in high wait-and-see counties, whereas fewer vaccine intent searches occurred in high vaccine-enthusiast counties. Considering previous research that identified a relationship between vaccine intent search and subsequent vaccine uptake, these findings suggest that vaccine intent search aligned with people's transition from the wait-and-see stage to the vaccine-enthusiast stage. The findings also suggest that web-based search trends may signal localized changes in information seeking and decision-making antecedent to vaccine uptake. Changes in web-based search trends illuminate opportunities for governments and other organizations to strategically allocate resources to increase vaccine uptake. Resource use is part of the larger public policy decisions that influence vaccine uptake, such as efforts to educate the public during evolving public health crises, including future pandemics.

Highly Educated Mother's Perception of Childhood Vaccination Hesitancy in Kazakhstan: A Thematic Analysis

Background

Vaccine hesitancy among parents directly affects the child's vaccination status since they are the legal decision-makers regarding vaccinating their children. The study aimed to describe the perceptions of highly educated Kazakhstani mothers about childhood vaccination hesitancy.

Methods

The study utilized a thematic analysis to explore the mothers' perceptions. A sample of 95 participants comprehensively answered the free-text questions in an online questionnaire from January to February 2023. The analysis of the free-text responses followed a semantic thematic analysis approach. The data were coded manually.

Results

From the in-depth analysis of the data, 285 initial codes were extracted. The combination of similar meanings and concept codes led to 14 sub-themes and finally yielded four significant themes: misconceptions about childhood vaccination, fear of the effect of vaccine on children, distrust of the healthcare system, and social learning factors.

Conclusion

The perceptions of Kazakh mothers about childhood vaccination hesitancy may lead to behaviors of delaying and refusing some or all childhood vaccines. Therefore, motivational and educational strategies can be used by healthcare providers to instill trust in parents about childhood vaccines and their safety and effectiveness.

Development and evaluation of three automated media pooling and molecular diagnostic systems for the detection of SARS-CoV-2

Pooled testing combined with molecular diagnostics for the detection of SARS-CoV-2 is a promising method that can increase testing capacities and save costs. However, pooled testing is also associated with the risks of decreased test sensitivity and specificity. To perform reliable pooled testing, we developed and validated three automated media pooling and molecular diagnostic systems. These pooling systems (geneLEAD-PS, Panther-PS, and Biomek-PS) comprised existing automated molecular detection platforms, corresponding automated media pooling devices, and laboratory information management systems. Analytical sensitivity analysis and mock sample evaluation were performed, and the obtained data were used to determine the sizes of the pool for the validation study. In the validation study, a total of 2,448, 3,228, and 6,420 upper respiratory samples were used for geneLEAD-PS, Panther-PS, and Biomek-PS, respectively, and the diagnostic performances were compared with the reference RT‒PCR assay. A pool size of 6 for geneLEAD-PS and a pool size of 4 for Panther-PS and Biomek-PS were selected for the validation studies. All three systems showed high positive percent agreement values of ≥90.5% and negative percent agreement values of ≥99.8% for any specimen type. Pooled testing resulted in a 65%-71% reduction in cost per sample. The testing capacities of geneLEAD-PS, Panther-PS, and Biomek-PS were 144 samples in 3 hours, 384 samples in 5.5 hours, and 376 samples in 4 hours, respectively. The developed pooling systems showed robust diagnostic performances and will increase the testing capacities of molecular diagnostic tests while saving costs and may contribute to infection control of COVID-19.IMPORTANCEDuring the COVID-19 pandemic, there have been surges in demand for accurate molecular diagnostic testing and laboratory supply shortages. Pooled testing combined with highly sensitive molecular testing, which entails mixing multiple samples as a single sample, is a promising approach to increase testing capacities while reducing the use of consumables. However, pooled testing is associated with risks that compromise diagnostic performance, such as false negatives due to dilution of positive samples or false positives due to cross-contamination. To perform reliable pooled testing, three different pooling systems (an automated pooling device, an automated molecular detection platform, and a laboratory information management system) were developed to accurately interpret pooled testing results. These three systems were validated using multiple clinical samples and showed high concordance with individual testing. The developed pooling systems will contribute to increasing reliable molecular testing capacities while using fewer consumables and saving costs.

Psychological and Social Aspects of Vaccination Hesitancy-Implications for Travel Medicine in the Aftermath of the COVID-19 Crisis: A Narrative Review

Vaccines are an important tool of preventive medicine. Although organized vaccination programs have saved large populations from serious infectious diseases, there is a considerable part of the population who oppose vaccinations. In particular, anti-vaccination perceptions, among travelers to countries with endemic diseases, are a major public health concern. Although hesitancy towards vaccinations is not a novel phenomenon, it came back to the forefront during the fight against the COVID-19 pandemic. This review explores the etiology of anti-vaccination beliefs among travelers and draws conclusions about their impact on public health and society in general. For this purpose, a purposeful search for data on the causative factors of vaccine hesitancy and their impact on people's health was conducted. A descriptive analysis of the findings and conclusions regarding possible implications in health policy and clinical practice are presented. A fear of side effects, lack of credence in the necessity of vaccines, and mistrust of medical authorities are important causative factors. Their interplay shapes hesitancy towards vaccines. However, anti-vaccination beliefs can also be an aspect of a more general unconventional stance of life. Health care professionals and organizations must be ready to tackle vaccine hesitancy by making the necessary interventions. Correcting misconceptions about vaccinations is a prerequisite for ensuring personal and public health, especially in the context of a pandemic or epidemic. Moreover, ensuring the efficacy and safety of vaccines, especially in cases of modern technology applications, is a fundamental factor in addressing people's concerns about vaccines. For this purpose, medical authorities and organizations must provide accurate and clear information on vaccines so as to eliminate misinformation. Furthermore, clinicians should cultivate their communication skills in order to convey the appropriate messages to prospective recipients of vaccinations.

The predictive role of parental attitudes toward COVID-19 vaccines and child vulnerability: A multi-country study on the relationship between parental vaccine hesitancy and financial well-being

Background and purpose

Recent new mutations and increases in transmission of COVID-19 among adolescents and children highlight the importance of identifying which factors influence parental decisions regarding vaccinating their children. The current study aims to explore whether child vulnerability and parents' attitudes toward vaccines mediate the association between perceived financial well-being and vaccine hesitancy among parents.

Method

A predictive, cross-sectional, multi-country online questionnaire was administered with a convenience sample of 6,073 parents (Australia, 2,734; Iran, 2,447; China, 523; Turkey, 369). Participants completed the Parent Attitude About Child Vaccines (PACV), the Child Vulnerability Scale (CVS), a Financial Well-being (FWB) measure, and Parental Vaccine Hesitancy (PVH) questionnaire.

Results

The current study revealed that perceived financial well-being had significant and negative associations with parents' attitudes toward COVID-19 vaccines and child vulnerability among the Australian sample. Contrary to the Australian findings, results from Chinese participants indicated that financial well-being had significant and positive predictive effects on parent attitudes toward vaccines, child vulnerability, and parental vaccine hesitancy. The results of the Iranian sample revealed that parents' attitudes toward vaccines and child vulnerability significantly and negatively predicted parental vaccine hesitancy.

Conclusion

The current study revealed that a parents' perceived financial well-being had a significant and negative relationship with parental attitudes about vaccines and child vulnerability; however, it did not significantly predict parental vaccine hesitancy among Turkish parents as it did for parents in Australia, Iran, and China. Findings of the study have policy implications for how certain countries may tailor their vaccine-related health messages to parents with low financial wellbeing and parents with vulnerable children.

Parental childhood vaccine hesitancy and predicting uptake of vaccinations: a systematic review

Aim:

This review aims are to (1) identify relevant quantitative research on parental childhood vaccine hesitancy with vaccine uptake and vaccination intention being relevant outcomes and (2) map the gaps in knowledge on vaccine hesitancy to develop suggestions for further research and to guide interventions in this field.

Background:

Vaccine hesitancy recognises a continuum between vaccine acceptance and vaccine refusal, de-polarising past anti-vaccine, and pro-vaccine categorisations of individuals and groups. Vaccine hesitancy poses a serious challenge to international efforts to lessen the burden of vaccine-preventable diseases. Potential vaccination barriers must be identified to inform initiatives aimed at increasing vaccine awareness, acceptance, and uptake.

Methods:

Five databases were searched for peer-reviewed articles published between 1998 and 2020 in the fields of medicine, nursing, public health, biological sciences, and social sciences. Across these datasets, a comprehensive search technique was used to identify multiple variables of public trust, confidence, and hesitancy about vaccines. Using PRISMA guidelines, 34 papers were included so long as they focused on childhood immunisations, employed multivariate analysis, and were published during the time frame. Significant challenges to vaccine uptake or intention were identified in these studies. Barriers to vaccination for the target populations were grouped using conceptual frameworks based on the Protection Motivation Theory and the World Health Organization’s Strategic Advisory Group of Experts on Immunization Working Group model and explored using the 5C psychological antecedents of vaccination.

Findings:

Although several characteristics were shown to relate to vaccine hesitancy, they do not allow for a thorough classification or proof of their individual and comparative level of influence. Understudied themes were also discovered during the review. Lack of confidence, complacency, constraints, calculation, and collective responsibility have all been highlighted as barriers to vaccination uptake among parents to different degrees.

Heterogeneity thwarts autism explanatory power: A proposal for endophenotypes

Many researchers now believe that autism heterogeneity is likely to include many disorders, but most research is based on samples defined by the DSM-5 Autism Spectrum Disorder (ASD) criteria. However, individuals diagnosed with autism have complex and varied biological causes for their symptoms. Therefore, autism is not a unitary biological entity. And although autism is significantly different from typical development, autism is not a unitary clinical disorder because diagnosed individuals vary in symptom patterns, comorbidities, biomarkers, and gene variants. The DSM-5 ASD criteria were designed to reduce heterogeneity, and there have been many other efforts to reduce autism heterogeneity including using more stringent clinical criteria, dividing autism into low and high functioning groups, creating subgroups, and by studying larger samples. However, to date these efforts have not been successful. Heterogeneity is extensive and remains unexplained, and no autism pathophysiology has been discovered. Most importantly, heterogeneity has hindered the explanatory power of the autism diagnosis to discover drug regimens and effective behavioral treatments. The paper proposes that possible transdiagnostic endophenotypes may reduce autism heterogeneity. Searching for transdiagnostic endophenotypes requires exploring autism symptoms outside of the framework of the DSM-5 autism diagnosis. This paper proposes that researchers relax diagnostic criteria to increase the range of phenotypes to support the search for transdiagnostic endophenotypes. The paper proposes possible candidates for transdiagnostic endophenotypes. These candidates are taken from DSM-5 ASD criteria, from concepts that have resulted from researched theories, and from symptoms that are the result of subtyping. The paper then sketches a possible basis for a future transdiagnostic endophenotypes screening tool that includes symptoms of autism and other neurodevelopmental disorders.