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Pang Y, Li B, Li T, Yang T, Deng J, Deng W. Factors Influencing the Intention of Chinese Adults to Recommend COVID-19 Vaccination for Specific or Non-Specific Groups. Healthcare (Basel) 2024; 12:1377. [PMID: 39057520 PMCID: PMC11276595 DOI: 10.3390/healthcare12141377] [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: 05/22/2024] [Revised: 07/05/2024] [Accepted: 07/07/2024] [Indexed: 07/28/2024] Open
Abstract
The widespread availability of vaccines has profound implications for sustainable public health. Positive recommendation on vaccination is one of the most effective ways to increase the willingness to vaccinate against COVID-19. This study aims to investigate the factors influencing the intentions to recommend COVID-19 vaccination for specific groups (IRCVSG) and the intentions to recommend COVID-19 vaccination for non-specific groups (IRCVNSG) in China and explore the mediating role of vaccine hesitancy and perception of vaccination information. This study conducted a cross-sectional anonymous online survey of adults (N = 903) in 28 provincial-level administrative regions in China in May 2022. The prevalence of IRCVSG and IRCVNSG was 60.5% and 93.0%, respectively. Health information literacy has a significant direct and indirect impact on IRCVSG through safety hesitancy and the perceived adequacy and usefulness of vaccination information. The relationship between health information literacy and IRCVNSG is entirely mediated via hesitation about the effectiveness and perceived usefulness of vaccination information. Special attention should be paid to the safety hesitation of COVID-19 vaccination for specific groups. This study tests these effects from both theoretical and practical perspectives, helping to address barriers to promoting the vaccination of specific groups for COVID-19 in clinical practice, improving health and sustainability.
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Affiliation(s)
- Yuxin Pang
- School of Management, Beijing Institute of Technology, Beijing 100081, China; (Y.P.); (B.L.); (T.Y.); (J.D.)
- Sustainable Development Research Institute for Economy and Society of Beijing, Beijing 100081, China
- Yangtze River Delta Research Institute, Beijing Institute of Technology, Jiaxing 314003, China
| | - Bowen Li
- School of Management, Beijing Institute of Technology, Beijing 100081, China; (Y.P.); (B.L.); (T.Y.); (J.D.)
- Sustainable Development Research Institute for Economy and Society of Beijing, Beijing 100081, China
- Yangtze River Delta Research Institute, Beijing Institute of Technology, Jiaxing 314003, China
| | - Tongyao Li
- Macquarie Business School, Macquarie University, Sydney, NSW 2109, Australia;
| | - Tianan Yang
- School of Management, Beijing Institute of Technology, Beijing 100081, China; (Y.P.); (B.L.); (T.Y.); (J.D.)
- Sustainable Development Research Institute for Economy and Society of Beijing, Beijing 100081, China
- Yangtze River Delta Research Institute, Beijing Institute of Technology, Jiaxing 314003, China
| | - Jianwei Deng
- School of Management, Beijing Institute of Technology, Beijing 100081, China; (Y.P.); (B.L.); (T.Y.); (J.D.)
- Sustainable Development Research Institute for Economy and Society of Beijing, Beijing 100081, China
- Yangtze River Delta Research Institute, Beijing Institute of Technology, Jiaxing 314003, China
| | - Wenhao Deng
- School of Management, Beijing Institute of Technology, Beijing 100081, China; (Y.P.); (B.L.); (T.Y.); (J.D.)
- Sustainable Development Research Institute for Economy and Society of Beijing, Beijing 100081, China
- Yangtze River Delta Research Institute, Beijing Institute of Technology, Jiaxing 314003, China
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Al Bashir L, Ismail A, Aljunid SM. Parents' and healthcare professionals' perception toward the introduction of a new fully liquid hexavalent vaccine in the Malaysian national immunization program: a cross-sectional study instrument development and its application. Front Immunol 2023; 14:1052450. [PMID: 37180162 PMCID: PMC10172506 DOI: 10.3389/fimmu.2023.1052450] [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: 09/26/2022] [Accepted: 04/04/2023] [Indexed: 05/15/2023] Open
Abstract
A newly developed fully liquid hexavalent vaccine that comprises six antigens for Diphtheria, Tetanus, acellular Pertussis, Inactivated Poliomyelitis, Haemophilus Influenza type b., and Hepatitis B, is proposed to be introduced in the Malaysian national immunization program, instead of the non-fully liquid pentavalent vaccine and monovalent Hepatitis B vaccine that is currently employed in the immunization schedule. Although the introduction of new vaccines is a necessary intervention, it still needs to be accepted by parents and healthcare professionals. Hence, this study aimed to develop three structured questionnaires and to investigate the participants' perception and acceptability toward the incorporation of the new fully liquid hexavalent vaccine. A cross-sectional study was conducted among a sample of 346 parents, 100 nurses, and 50 physicians attending twenty-two primary health care centers in the states of Selangor and the Federal Territory of Kuala Lumpur and Putrajaya during 2019-2020. The study found that Cronbach's alpha coefficients for the study instruments ranged from 0.825 to 0.918. Principal components analysis produced a good fit with KMO>0.6. For the parents' perception questionnaire, the only extracted factor explained 73.9 % of the total variance; for the nurses' perception toward a non-fully and fully liquid combined vaccine, there was a sole extracted factor that explained 65.2 % and 79.2% of the total variance, respectively. Whereas for the physicians' perception, there was one factor extracted that explains 71.8 % of the total variance. The median score for all the questionnaire items ranged from 4 to 5 (Q1 and Q3 vary between 3-5). Parents' ethnicity was significantly associated (P-value ≤ 0.05) with the perception that the new hexavalent vaccine would reduce their transportation expenses. Moreover, a significant association (P-value ≤ 0.05) was found between physicians' age and the perception of the hexavalent vaccine's ability to decrease patient overcrowding in primary healthcare centers. The instruments used in this study were valid and reliable. Parents of Malay ethnicity were the most concerned about transportation expenses since they have the lowest income and are more concentrated in rural areas compared to other races. Younger physicians were concerned about reducing patient crowding and hence reducing their workload and burnout.
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Affiliation(s)
- Lama Al Bashir
- Department of Community Health, Faculty of Medicine, University Kebangsaan Malaysia (UKM), Kuala Lumpur, Malaysia
- International Centre for Casemix and Clinical Coding, Faculty of Medicine, UKM Medical Centre, National University of Malaysia, Kuala Lumpur, Malaysia
| | - Aniza Ismail
- Department of Community Health, Faculty of Medicine, University Kebangsaan Malaysia (UKM), Kuala Lumpur, Malaysia
- Malaysian Health Economic Association (MAHEA), International Centre for Casemix and Clinical Coding, UKM Medical Centre, National University of Malaysia, Kuala Lumpur, Malaysia
- *Correspondence: Aniza Ismail,
| | - Syed Mohamed Aljunid
- International Centre for Casemix and Clinical Coding, Faculty of Medicine, UKM Medical Centre, National University of Malaysia, Kuala Lumpur, Malaysia
- Malaysian Health Economic Association (MAHEA), International Centre for Casemix and Clinical Coding, UKM Medical Centre, National University of Malaysia, Kuala Lumpur, Malaysia
- Department of Health Policy and Management, College of Public Health, Health Science Center, Kuwait University, Kuwait City, Kuwait
- Department of Community Medicine, School of Medicine, International Medical University, Kuala Lumpur, Malaysia
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Bayır T, Kılıç B, Durmaz Y. The mediating role of product judgment and country of origin effect on health literacy and behavioral intention: A study on COVID-19 vaccines perception of Turkish consumers. Hum Vaccin Immunother 2022; 18:2107838. [PMID: 35930732 DOI: 10.1080/21645515.2022.2107838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
This study is conducted on people in Turkey who had at least one dose of vaccination and it evaluates their differences in attitude in terms of health literacy, product judgment, the country of origin, intention to recommend and motivation to boycott. The 393 vaccine consumers were selected through convenient sampling and the data was collected through online questionnaires. The data was later analyzed by SPSS and AMOS. Normality, reliability tests and frequency analysis were conducted on the data. Afterward, a correlation was calculated using factor loadings to determine the relationship between the variables. The last was conducting the PATH analysis. Some consumers are prejudiced toward COVID-19 vaccines due to perceived distrust, hesitation, and lack of product information. Determining the prejudices of consumers, underlying causes and making inferences will provide more useful information on COVID-19 vaccines to health institutions, vaccine manufacturers, consumers and other organizations.
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Affiliation(s)
- Talha Bayır
- Department of Production Management and Marketing, Şırnak University, Şırnak, Turkey
| | - Burhan Kılıç
- Department of Administration and Organization, Şırnak University, Şırnak, Turkey
| | - Yakup Durmaz
- Department of Marketing, Hasan Kalyoncu University, Gaziantep, Turkey
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Wiysonge CS, Alobwede SM, de Marie C Katoto P, Kidzeru EB, Lumngwena EN, Cooper S, Goliath R, Jackson A, Shey MS. COVID-19 vaccine acceptance and hesitancy among healthcare workers in South Africa. Expert Rev Vaccines 2022; 21:549-559. [PMID: 34990311 DOI: 10.1080/14760584.2022.2023355] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 12/23/2021] [Indexed: 12/16/2022]
Abstract
BACKGROUND We assessed willingness to accept vaccination against coronavirus disease 2019 (COVID-19) among healthcare workers(HCWs) at the start of South Africa's vaccination roll-out. RESEARCH DESIGN AND METHODS We conducted a cross-sectional survey among HCWs in Cape Town in March-May 2021 and assessed predictors of vaccination intentions. RESULTS We recruited 395 participants; 64% women, 49% nurses, and 13% physicians. Of these, 233(59.0%) would accept and 163 (41.0%) were vaccine hesitant i.e. would either refuse or were unsure whether they would accept COVID-19 vaccination. People who did not trust that COVID-19 vaccines are effective were the most hesitant (p = 0.038). Older participants and physicians were more likely to accept vaccination than younger participants (p < 0.01) and other HCWs (p = 0.042) respectively. Other predictors of vaccine acceptance were trust that vaccines are compatible with religion (p < 0.001), consideration of benefits and risks of vaccination (p < 0.001), willingness to be vaccinated to protect others (p < 0.001), and viewing vaccination as a collective action for COVID-19 control (p = 0.029). CONCLUSIONS COVID-19 vaccine hesitancy is high among HCWs in Cape Town. Reducing this would require trust-building interventions, including tailored education.
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Affiliation(s)
- Charles S Wiysonge
- Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa
- School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
- Department of Global Health, Stellenbosch University, Cape Town, South Africa
| | - Samuel M Alobwede
- Department of Medicine, Faculty of Health Sciences and Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa
| | - Patrick de Marie C Katoto
- Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa
- Francie van Zijl Drive, Stellenbosch University, Tygerberg, Cape Town, South Africa
| | - Elvis B Kidzeru
- Hair and Skin Research Laboratory, Division of Dermatology, Department of Medicine, Faculty of Health Sciences and Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa
- The Medical Research Centre (CRM), Institute of Medical Research and Medicinal Plant Studies (Impm), Ministry of Scientific Research and Innovation, Yaoundé, Cameroon
| | - Evelyn N Lumngwena
- Institute of Infectious Disease and Molecular Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
- Cape Heart Institute, Department of Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
- Centre for the Study of Emerging and Re-emerging Infections (CREMER), Institute of Medical Research and Medicinal Plant Studies (Impm), Ministry of Scientific Research and Innovation, Yaoundé, Cameroon
| | - Sara Cooper
- Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa
- School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Rene Goliath
- Wellcome Centre for Infectious Disease Research in Africa (Cidri-africa), University of Cape Town, Cape Town, South Africa
| | - Amanda Jackson
- Wellcome Centre for Infectious Disease Research in Africa (Cidri-africa), University of Cape Town, Cape Town, South Africa
| | - Muki S Shey
- Department of Medicine, Faculty of Health Sciences and Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa
- Institute of Infectious Disease and Molecular Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
- Wellcome Centre for Infectious Disease Research in Africa (Cidri-africa), University of Cape Town, Cape Town, South Africa
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An Independent Study to Compare Compliance, Attitudes, Knowledge, and Sources of Knowledge about Pneumococcal Vaccinations among an Italian Sample of Older Adults. Vaccines (Basel) 2022; 10:vaccines10040490. [PMID: 35455239 PMCID: PMC9030078 DOI: 10.3390/vaccines10040490] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 03/16/2022] [Accepted: 03/17/2022] [Indexed: 02/07/2023] Open
Abstract
Background: Streptococcus pneumoniae is one of the leading causes of pneumoniae deaths, especially among elderly individuals, with the vaccine being the primary prevention instrument. However, information on national vaccine coverage among the elderly population is scarce and sparse. Methods: A survey involved a representative sample of Italians older than 65 years (n = 600), who agreed to participate in the study through a phone interview. Participants’ self-reported pneumococcal vaccination status, vaccine literacy, information source, and risk perception related to the infection and to vaccines-adverse reactions were assessed. Results: The reported vaccination status is very low (11.2%), with respondents largely uninformed about vaccination opportunities. The results also show that the predominant (and most effective) source of information is healthcare providers, with vaccine hesitancy being positively linked to risk perception related to disease and negatively linked to risk perception of vaccine adverse reactions. Conclusions: This study suggests the need to collect data to systematically monitor vaccination coverage and calls for information campaigns to improve elderly literacy to increase vaccination uptake.
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Souza FDO, Werneck GL, Pinho PDS, Teixeira JRB, Lua I, Araújo TMD. [Influenza vaccine hesitancy among health workers, Bahia State, Brazil]. CAD SAUDE PUBLICA 2022; 38:e00098521. [PMID: 35107509 DOI: 10.1590/0102-311x00098521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 07/29/2021] [Indexed: 08/19/2023] Open
Abstract
The World Health Organization acknowledges vaccine hesitancy as one of the ten most serious global health threats. The study investigated the association between confidence, convenience, and complacency and influenza vaccine hesitancy among male and female health workers. The study included 453 workers in primary and medium-complexity health services in a medium-sized city in the state of Bahia, Brazil. Vaccine-hesitant individuals were defined as those who had not received an influenza vaccine in 2019. Structural equation models were used to assess interrelations between target predictive variables and vaccine hesitancy. One-fourth of the workers (25.4%) hesitated to be vaccinated for influenza. Lower confidence (standardized coefficient - SC = 0.261; p = 0.044) and higher complacency (SC = 0.256; p < 0.001) were significantly associated with vaccine hesitancy. Convenience was not associated with vaccine hesitancy. Workers not involved in patient care, workers in medium-complexity services, and male workers reported less receptiveness from the health professional administering the vaccines. Fear of needles was associated with both lower confidence and greater vaccine hesitancy. History of vaccine reactions was not associated directly with vaccine hesitancy, but it was associated with greater complacency, that is, less perception of risk from vaccine-preventable diseases. Since annual influenza vaccination is recommended, influenza vaccine hesitancy can increase the burden of this disease in the population. The data back the hypothesis that factors related to confidence and complacency produce harms in this vaccine´s acceptance and should be considered in the development of strategies and actions for greater adherence to vaccination.
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Affiliation(s)
- Fernanda de Oliveira Souza
- Universidade Federal do Recôncavo da Bahia, Feira de Santana, Brasil.,Universidade Estadual de Feira de Santana, Feira de Santana, Brasil
| | | | | | | | - Iracema Lua
- Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, Brasil
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7
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Lin C, Mullen J, Smith D, Kotarba M, Kaplan SJ, Tu P. Healthcare Providers' Vaccine Perceptions, Hesitancy, and Recommendation to Patients: A Systematic Review. Vaccines (Basel) 2021; 9:vaccines9070713. [PMID: 34358132 PMCID: PMC8310254 DOI: 10.3390/vaccines9070713] [Citation(s) in RCA: 60] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 06/09/2021] [Accepted: 06/16/2021] [Indexed: 12/13/2022] Open
Abstract
Despite vaccines' effectiveness in reducing the rate of preventable diseases, vaccine hesitancy has threatened public health and economies worldwide. Healthcare providers' (HCP) communications and behavior strongly influence patient receptivity and uptake. The goal of this review was to examine HCP vaccine perceptions, knowledge, and reservations and how these attitudes affect their recommendations and vaccination practices. Primary research studies published by 16 September 2020 were searched in PubMed, Web of Science, Embase, CINAHL, and PsycINFO. A 14-item scale was developed for survey study and risk of bias appraisal (SSRBA). In total, 96 papers from 34 countries were included, covering 17 vaccines (HPV and influenza vaccines the most studied). Recommendation was positively associated with provider knowledge and experience, beliefs about disease risk, and perceptions of vaccine safety, necessity, and efficacy. HCP vaccination attitudes and practices varied across specialties, vaccines, and countries; demographic impact was inconclusive. Barriers included anticipation of patient/parental concerns or refusal, lacking clear guidelines, time constraints, and cost. For HPV, vaccines were more often recommended to older, female adolescents and by physicians who discussed sexual health. HCPs are vital advocates for patients and the public, but studies indicated a prevalence of provider hesitancy pertaining to inadequate knowledge, low vaccine confidence, and suboptimal uptake themselves. Improving HCP knowledge and assuring their access to information they deem trustworthy are essential to supporting HCPs' role as "trusted messengers" to promote vaccine acceptance.
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Affiliation(s)
- Cheryl Lin
- Policy and Organizational Management Program, Duke University, Durham, NC 27705, USA; (C.L.); (D.S.); (M.K.)
| | - Jewel Mullen
- Dell Medical School, The University of Texas at Austin, Austin, TX 78712, USA;
| | - Danielle Smith
- Policy and Organizational Management Program, Duke University, Durham, NC 27705, USA; (C.L.); (D.S.); (M.K.)
| | - Michaela Kotarba
- Policy and Organizational Management Program, Duke University, Durham, NC 27705, USA; (C.L.); (D.S.); (M.K.)
| | - Samantha J. Kaplan
- Medical Center Library and Archives, Duke University, Durham, NC 27710, USA;
| | - Pikuei Tu
- Policy and Organizational Management Program, Duke University, Durham, NC 27705, USA; (C.L.); (D.S.); (M.K.)
- Correspondence:
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8
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Pullagura GR, Violette R, Houle SKD, Waite NM. Exploring influenza vaccine hesitancy in community pharmacies: Knowledge, attitudes and practices of community pharmacists in Ontario, Canada. Can Pharm J (Ott) 2020; 153:361-370. [PMID: 33282027 DOI: 10.1177/1715163520960744] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Background Vaccine hesitancy (VH) remains a prime contributor to poor influenza vaccine uptake. This study explores the knowledge, attitudes and practices of community pharmacists toward influenza VH, including their personal influenza immunization attitudes and behaviours. Methods A web-based cross-sectional survey questionnaire was administered to community pharmacists practising in Ontario, Canada. A 38-question survey tool explored 5 domains, including pharmacists' personal attitudes and behaviour toward influenza immunization, their self-reported knowledge of influenza, its vaccine and vaccine hesitancy, and their attitudes, practices and experiences with influenza VH at the community pharmacy. The data were analyzed descriptively. Results A total of 5530 survey invitations were e-mailed, and 885 responses were collected (response rate 16%). Two-thirds (n = 568, 65.7%) of the respondents reported receiving the influenza vaccine in the preceding season. The most frequent reasons for personal influenza immunization were prevention of disease transmission to patients, friends and family, and contribution to herd immunity. In addition to their confidence and perceived ability to identify and address influenza VH, respondents' self-reported knowledge across a 15-item Likert questionnaire was high. Respondents reported coming across an average of 16 (SD 28) individuals hesitant to receive the influenza vaccine each week. Regular workload (n = 419, 65.6%) and insufficient time (n = 406, 65.3%) were reported as the most limiting barriers to engagement in influenza vaccine conversations. Conclusion Facilitating optimal practice scope for pharmacists, and capitalizing on the convenience and accessibility of the community pharmacy setting, presents a promising means to address influenza VH. However, barriers to pharmacist-initiated engagement on influenza vaccine must be explored and addressed. Can Pharm J (Ott) 2020;153:xx-xx.
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Affiliation(s)
| | | | | | - Nancy M Waite
- School of Pharmacy, University of Waterloo, Kitchener, Ontario
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9
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Thanh Thi Le X, Ishizumi A, Thi Thu Nguyen H, Thi Duong H, Thi Thanh Dang H, Manh Do C, Thi Pham Q, Thi Le H, Iijima M, Tohme RA, Patel P, Abad N. Social and behavioral determinants of attitudes towards and practices of hepatitis B vaccine birth dose in Vietnam. Vaccine 2020; 38:8343-8350. [PMID: 33221065 DOI: 10.1016/j.vaccine.2020.11.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 10/11/2020] [Accepted: 11/03/2020] [Indexed: 01/01/2023]
Abstract
BACKGROUND Hepatitis B virus (HBV) infection is a significant public health issue in Vietnam. Our goal was to understand the determinants of attitudes towards and practices of hepatitis B vaccine birth dose (HepB-BD) in certain regions of Vietnam. METHOD A rapid qualitative assessment was conducted in three geographically diverse provinces that reported low coverage (<50%) of HepB-BD. Using purposive sampling of participants, 29 focus group discussions and 20 in-depth interviews were held with caregivers (n = 96), healthcare providers (n = 75), and healthcare administrators (n = 16). Summary notes from these were translated, and inductive coding was used to derive themes. The SAGE Vaccine Hesitancy Determinants Matrix was used as a theoretical framework to organize barriers and facilitators associated with the themes into three levels of influence. RESULTS At the individual and group level, caregivers who had higher levels of knowledge about HepB-BD sought the vaccine proactively, while others with lower knowledge faced barriers to the vaccine. Some caregivers reported a negative attitude toward health services because of a language barrier or had generalized concerns about HepB-BD due to media reporting of the past adverse events. Distress arising from potential adverse events was equally common among healthcare providers. At the contextual level, the physical environment made it difficult for caregivers to access healthcare facilities and for providers to conduct outreach. Home births posed a challenge for timely administration of HepB-BD, while health facility births facilitated it. Vaccination-specific barriers included misinterpretation of pre-vaccination screening criteria and asking for the consent of caregivers. Inadequate resources for service delivery negatively influenced HepB-BD attitudes and practices. CONCLUSION Given the diversity of barriers associated with attitudes towards and practices of HepB-BD in the three provinces, tailored interventions will be necessary for both demand- and supply-side factors. Rural areas, often with more home births and geographic barriers, may require focused attention.
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Affiliation(s)
- Xuan Thanh Thi Le
- Hanoi Medical University, No 1 Ton That Tung-Dong Da, Hanoi 116001, Viet Nam
| | - Atsuyoshi Ishizumi
- ORISE Fellow, Global Immunization Division, US Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30329, USA.
| | | | - Hong Thi Duong
- Expanded Program on Immunization, National Institute of Hygiene and Epidemiology, So 1 pho Yec Xanh, Pham Dinh Ho, Hai Ba Trung, Hanoi 100000, Viet Nam
| | - Huyen Thi Thanh Dang
- Expanded Program on Immunization, National Institute of Hygiene and Epidemiology, So 1 pho Yec Xanh, Pham Dinh Ho, Hai Ba Trung, Hanoi 100000, Viet Nam
| | - Cuong Manh Do
- Hai Phong Centers for Disease Control, Hai Phong, Viet Nam
| | - Quan Thi Pham
- Hanoi Medical University, No 1 Ton That Tung-Dong Da, Hanoi 116001, Viet Nam
| | - Huong Thi Le
- Hanoi Medical University, No 1 Ton That Tung-Dong Da, Hanoi 116001, Viet Nam
| | - Makiko Iijima
- World Health Organization Representative Office for Vietnam, P.O. Box 52, Hanoi, Viet Nam
| | - Rania A Tohme
- Global Immunization Division, US Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30329, USA
| | - Palak Patel
- ORISE Fellow, Global Immunization Division, US Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30329, USA
| | - Neetu Abad
- Global Immunization Division, US Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30329, USA
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10
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Amadori F, Terracciano E, Gennaio I, Mita V, Gargano D, Zaratti L, Franco E, Arigliani R. Opinions and attitudes of Italian healthcare workers towards recommended but not compulsory rotavirus vaccination. Hum Vaccin Immunother 2020; 17:497-502. [PMID: 32614732 PMCID: PMC7899670 DOI: 10.1080/21645515.2020.1776546] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Rotaviruses (RVs) are a leading cause of viral gastroenteritis among children younger than 5. The incidence of RV disease can be reduced through the widespread use of vaccination, but coverage is low in many countries, including Italy. This fact reflects the poor consideration given to the RV vaccine, both by the population and by healthcare workers. Peoples’ opinions are strictly dependent on the attitude of doctors and nurses. The aim of this work is the evaluation of healthcare workers’ knowledge, attitudes and opinions regarding RV vaccination. The results of two surveys were compared; the first was carried out in 2017, soon after the Italian National Immunization Plan introduced the recommendation for the RV vaccine. The second was performed at the end of 2018, approximately 1 year after the adoption of a Law that introduced new compulsory vaccinations, not including the RV vaccine. In 2017, 182 questionnaires were collected, and 111 in 2018. An increase was observed in the percentage of participants who reported recommending the RV vaccine and a significant increase was found in the coverage the participants claimed to reach. Education of healthcare workers after the introduction of compulsory vaccination may prompt them to actively offer also recommended vaccines.
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Affiliation(s)
- F Amadori
- Specialization School for Hygiene and Preventive Medicine, University of Rome Tor Vergata , Rome, Italy
| | - E Terracciano
- Specialization School for Hygiene and Preventive Medicine, University of Rome Tor Vergata , Rome, Italy
| | - I Gennaio
- Department of Biomedicine and Prevention, University of Rome Tor Vergata , Rome, Italy
| | - V Mita
- Department of Biomedicine and Prevention, University of Rome Tor Vergata , Rome, Italy
| | - D Gargano
- Nursing Service, Bambino Gesù Children's Hospital, Rome, Italy
| | - L Zaratti
- Department of Biomedicine and Prevention, University of Rome Tor Vergata , Rome, Italy
| | - E Franco
- Department of Biomedicine and Prevention, University of Rome Tor Vergata , Rome, Italy
| | - R Arigliani
- School of Counselling, Italian Medical Research Institute , Benevento, Italy
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De Wals P. Epidemiology and Control of Meningococcal Disease in Canada: A Long, Complex, and Unfinished Story. THE CANADIAN JOURNAL OF INFECTIOUS DISEASES & MEDICAL MICROBIOLOGY = JOURNAL CANADIEN DES MALADIES INFECTIEUSES ET DE LA MICROBIOLOGIE MEDICALE 2019; 2019:8901847. [PMID: 31885753 PMCID: PMC6899262 DOI: 10.1155/2019/8901847] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Revised: 09/30/2019] [Accepted: 10/26/2019] [Indexed: 12/02/2022]
Abstract
The epidemiology of meningococcal disease in Canada has been punctuated by outbreaks caused by serogroup A strains in the 1940s, virulent serogroup C clones from 1985 to 2001, a serogroup B clone in Quebec from 2003 to 2014, and more recently a W clone in British Columbia. Region- and province-wide immunization campaigns have been implemented to control these outbreaks using meningococcal C polysaccharide and conjugate vaccines, a quadrivalent ACWY conjugate vaccine, and a serogroup B protein-based vaccine. Meningococcal C conjugate vaccines have been included in routine immunization programs for children, and ACWY conjugate vaccines have been included in school-based programs for adolescents in most jurisdictions. In contrast, serogroup B protein-based vaccines were only recommended and used for high-risk individuals and to control outbreaks. Currently, the immunization schedules adopted in provinces and territories are not uniform. This is not explained by notable epidemiologic differences. Publicly funded immunization programs are the result of a complex decision-making process. Political factors including public opinion, media attention, interest groups' advocacy campaigns, decision-makers' priorities and budgetary constraints have played important roles in shaping meningococcal programs in Canada, and this should be recognized. As the recent occurrence of outbreaks caused by virulent W clones shows, continued investments in epidemiological surveillance at both the provincial and national levels are necessary, so there can be early warning and informed decisions can be made.
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Affiliation(s)
- Philippe De Wals
- Department of Social and Preventive Medicine, Laval University, Quebec City, Canada
- Centre de Recherche de l'Institut de Cardiologie et de Pneumologie de Québec, Quebec City, Canada
- Centre de Recherche du Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Canada
- Institut National de Santé Publique du Québec, Quebec City, Canada
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Tomboloni C, Tersigni C, de Martino M, Dini D, González-López JR, Festini F, Neri S, Ciofi D. Knowledge, attitude and disinformation regarding vaccination and immunization practices among healthcare workers of a third-level paediatric hospital. Ital J Pediatr 2019; 45:104. [PMID: 31426830 PMCID: PMC6701138 DOI: 10.1186/s13052-019-0684-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Accepted: 07/17/2019] [Indexed: 11/22/2022] Open
Abstract
Background Vaccination represents one of the most effective means of preventing infections for the population and for the public health in general. Recently there has been a decline in vaccinations, also among healthcare workers (HCWs). The aim of the study is to detect the knowledge, skills, attitudes and barriers of HCWs regarding vaccinations in a tertiary children’s hospital in order to support clinical management in immunisation practices. Methods An observational study was conducted on 255 subjects over a period of 8 months. The 31-item questionnaire considered profession, level of instruction and different ages. It included questions taken from a questionnaire used for a Canadian research and one used by the Bellinzona hospital. A 4-point Likert scale and closed-ended questions were used. A confidence interval of 95%, p value ≤ 0.05, Chi-square, ANOVA and the Kruskal-Wallis test were considered. Results In the last 5 years less than one third of the sample were vaccinated against flu. 77.8% (n.130) of nurses and 45.8% (n.19) of doctors were not vaccinated (p < 0.0001). As for risk perception, 51.5% of nurses and 90.6% of doctors believe that their risk of contracting influenza is greater than that of the general population. In relation to the injection site, in all the age ranges there was a high level of knowledge except for those aged over 61 who responded incorrectly. Doctors were more prepared (p < 0.0001). 50% of the sample used internet only as a source of information for vaccines. Generally, scientific sources were used infrequently. The higher the education level, the more frequent the utilisation of trustworthy scientific resources and literature. (p = 0.0002). Conclusions In line with the attitude observed in recent years, nurses are not inclined to get vaccinated themselves although they agree to having their children vaccinated. HCWs have a good level of knowledge about vaccines and immunisation practices. With the nurses we found that the higher the education level, the greater the knowledge about vaccines which leads to the conclusion that low levels of adherence are not due to a lack of knowledge, but rather, to a low perception of risks. Hence the need to strengthen the vaccination strategies inside the companies.
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Affiliation(s)
- Carlotta Tomboloni
- Oxford University Hospital NHS Foundation Trust, Collaborator of the Italian Science Society of Paediatric Nursing, Oxford, UK
| | - Chiara Tersigni
- Department of Health Sciences, University of Florence, Florence, Italy
| | - Maurizio de Martino
- Department of Health Sciences, Anna Meyer Children's Hospital, University of Florence, Florence, Italy.
| | - Donata Dini
- Anna Meyer Children's Hospital, Florence, Italy
| | - José Rafael González-López
- Faculty of Nursing, Physiotherapy and Podiatry, Nursing Department, Universidad de Sevilla, Seville, Spain
| | - Filippo Festini
- Department of Health Sciences, Anna Meyer Children's Hospital, University of Florence, Florence, Italy
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Dybsand LL, Hall KJ, Carson PJ. Immunization attitudes, opinions, and knowledge of healthcare professional students at two Midwestern universities in the United States. BMC MEDICAL EDUCATION 2019; 19:242. [PMID: 31266481 PMCID: PMC6604347 DOI: 10.1186/s12909-019-1678-8] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Accepted: 06/19/2019] [Indexed: 05/14/2023]
Abstract
BACKGROUND In addition to administering vaccinations, healthcare professionals (HCPs) also play a crucial role in providing education and advocacy to the public regarding immunizations. Yet, many current and future HCPs are unprepared or reluctant to address the vaccine conversation with hesitant patients. Doctors, pharmacists, and nurses are all recognized as the most trusted sources of vaccine information. By comparing future HCPs in these three distinct programs, we can better understand where potential gaps may lie in their training and education. With insight from students, potential changes to curriculum can improve future HCPs ability to address vaccine hesitancy in their respective careers. The objective of this study was to assess and compare the knowledge, attitudes, and opinions of HCP students on the topic of immunization. METHODS A cross-sectional survey was conducted in 2017 to assess students in nursing, medical, and pharmacy programs at two universities in the state of North Dakota in the United States. The survey assessed six key themes: 1) demographic information; 2) basic vaccine knowledge; 3) vaccine hesitancy; 4) likelihood to recommend vaccines; 5) confidence in addressing vaccine-related topics with patients; 6) an appraisal of the education they have received on vaccinations. RESULTS The survey was completed by 223 participants (overall response rate = 23.7%). Results indicated that vaccine-related knowledge varied greatly by program; high knowledge scores were achieved by 74.3% of medical students, 62.7% of pharmacy students, 57.1% of doctor of nursing practice (DNP) students, and 24.7% of bachelor of science in nursing (BSN) students. Over a third (34.2%) of BSN students believed that the current recommended immunization schedule places undue burden on a child's immune system, versus only 4.3% of medical students. Additionally, 54.2% of participants believed that spreading out recommended vaccines over several visits was an appropriate means of reducing parental stress about vaccinating. CONCLUSIONS Participant responses suggest that negative attitudes, lack of knowledge, and general discomfort exist across all programs, but especially among nursing students, regarding vaccination. Our findings indicate potential areas where targeted interventions could be implemented to better equip future HCPs in their ability to discuss and educate the public regarding vaccination. TRIAL REGISTRATION #PH17173.
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Affiliation(s)
- Lauren L. Dybsand
- Center for Immunization Research and Education, Department of Public Health, North Dakota State University, Dept 2662, PO Box 6050, Fargo, ND 58108-6050 USA
| | - Kylie J. Hall
- Center for Immunization Research and Education, Department of Public Health, North Dakota State University, Dept 2662, PO Box 6050, Fargo, ND 58108-6050 USA
| | - Paul J. Carson
- Center for Immunization Research and Education, Department of Public Health, North Dakota State University, Dept 2662, PO Box 6050, Fargo, ND 58108-6050 USA
- Sanford Health, Fargo, ND 58104 USA
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RICCÒ M, CATTANI S, VERONESI L, COLUCCI ME. Knowledge, attitudes, beliefs and practices of construction workers towards tetanus vaccine in Northern Italy. INDUSTRIAL HEALTH 2016; 54:554-563. [PMID: 27251030 PMCID: PMC5136613 DOI: 10.2486/indhealth.2015-0249] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/11/2015] [Accepted: 05/09/2016] [Indexed: 05/26/2023]
Abstract
Construction workers (CWs) are both more exposed to tetanus and at higher risk to be inadequately immunized. Our aim was to evaluate tetanus immunization status and knowledge/attitudes towards tetanus vaccination in CWs in Italy. In this field report, the immunization status of 554 unskilled CWs (i.e. labourers). Immunization status was assessed recalling immunization booklets/certificates. Attitudes and knowledge were collected through a standardized questionnaire. In 240/554 CWs, immunization status was inadequate/not documented: in 184 subjects (33.2%), the last vaccination shot was older than 10 years, whereas basal immunization was incomplete in 20 cases, more frequently in foreign-born people (FBP) than in Italian born (IBP) (OR=7.116). In 198 cases (35.7%), an Occupational Physician (OPh) performed last booster, usually with monovalent (T, n=173) vaccine. The main reason for inadequate immunization was having forgotten the periodic booster (148/554; 26.7%), whereas 42 subjects (7.6%) deliberately avoided tetanus vaccine because of personal/religious beliefs, more frequently in FBP than in IBP (OR=3.182). In summary, the prevalence of inadequate immunization status was relatively high (43.4%): the high prevalence of "forgotten boosters" enlightens the key role of OPh in recalling and promoting vaccination policies. Moreover, the inappropriate use of Td vaccine points out the opportunity for educational campaigns in OPh.
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Affiliation(s)
- Matteo RICCÒ
- Azienda Provinciale per i Servizi Sanitari della Provincia Autonoma di Trento Unità Operativa di Prevenzione e Sicurezza degli Ambienti di Lavoro, Italy
| | - Silvia CATTANI
- Department of Clinical Surgery, General Surgery and Surgical Therapy, School of Nursing Sciences, Parma University Hospital, Italy
| | - Licia VERONESI
- Department of Biomedical, Biotechnological, and Translational Sciences (SBiBiT), University of Parma, Italy
| | - Maria Eugenia COLUCCI
- Department of Biomedical, Biotechnological, and Translational Sciences (SBiBiT), University of Parma, Italy
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Paterson P, Meurice F, Stanberry LR, Glismann S, Rosenthal SL, Larson HJ. Vaccine hesitancy and healthcare providers. Vaccine 2016; 34:6700-6706. [PMID: 27810314 DOI: 10.1016/j.vaccine.2016.10.042] [Citation(s) in RCA: 488] [Impact Index Per Article: 61.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Revised: 10/05/2016] [Accepted: 10/17/2016] [Indexed: 11/29/2022]
Abstract
While most people vaccinate according to the recommended schedule, this success is challenged by individuals and groups who delay or refuse vaccines. The aim of this article is to review studies on vaccine hesitancy among healthcare providers (HCPs), and the influences of their own vaccine confidence and vaccination behaviour on their vaccination recommendations to others. The search strategy was developed in Medline and then adapted across several multidisciplinary mainstream databases including Embase Classic & Embase, and PschInfo. All foreign language articles were included if the abstract was available in English. A total of 185 articles were included in the literature review. 66% studied the vaccine hesitancy among HCPs, 17% analysed concerns, attitudes and/or behaviour of HCPs towards vaccinating others, and 9% were about evaluating intervention(s). Overall, knowledge about particular vaccines, their efficacy and safety, helped to build HCPs own confidence in vaccines and their willingness to recommend vaccines to others. The importance of societal endorsement and support from colleagues was also reported. In the face of emerging vaccine hesitancy, HCPs still remain the most trusted advisor and influencer of vaccination decisions. The capacity and confidence of HCPs, though, are stretched as they are faced with time constraints, increased workload and limited resources, and often have inadequate information or training support to address parents' questions. Overall, HCPs need more support to manage the quickly evolving vaccine environment as well as changing public, especially those who are reluctant or refuse vaccination. Some recommended strategies included strengthening trust between HCPs, health authorities and policymakers, through more shared involvement in the establishment of vaccine recommendations.
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Affiliation(s)
- Pauline Paterson
- London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, United Kingdom.
| | - François Meurice
- GSK Vaccines, Avenue Fleming 20, Parc de la Noire Epine, B-1300 Wavre, Belgium.
| | - Lawrence R Stanberry
- Columbia University College of Physicians and Surgeons and New York-Presbyterian/Morgan Stanley Children's Hospital, New York, NY, USA.
| | - Steffen Glismann
- GSK Vaccines, Avenue Fleming 20, Parc de la Noire Epine, B-1300 Wavre, Belgium.
| | - Susan L Rosenthal
- Columbia University College of Physicians and Surgeons and New York-Presbyterian/Morgan Stanley Children's Hospital, New York, NY, USA.
| | - Heidi J Larson
- London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, United Kingdom; Department of Global Health, University of Washington, Seattle, USA.
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Halcomb E, Hickman L. Attitudes and immunisation practices of Australian general practice nurses. Contemp Nurse 2016; 52:440-446. [DOI: 10.1080/10376178.2016.1216754] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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MacDougall DM, Halperin BA, Langley JM, MacKinnon-Cameron D, Li L, Halperin SA. Knowledge, attitudes, beliefs, and behaviors of parents and healthcare providers before and after implementation of a universal rotavirus vaccination program. Vaccine 2015; 34:687-695. [PMID: 26458809 DOI: 10.1016/j.vaccine.2015.09.089] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Revised: 09/25/2015] [Accepted: 09/28/2015] [Indexed: 10/22/2022]
Abstract
OBJECTIVE In Canada, rotavirus vaccine is recommended for all infants, but not all provinces/territories have publicly funded programs. We compared public and healthcare provider (HCP) knowledge, attitudes, beliefs, and behaviors in a province with a public health nurse-delivered, publicly funded rotavirus vaccination program to a province with a publicly funded, physician-delivered program. A third province with no vaccination program acted as a control. DESIGN Information about knowledge, attitudes, beliefs, and behaviors of parents whose children were eligible for the universal program and healthcare providers responsible for administering the vaccine were collected through the use of two validated surveys distributed in public health clinics, physicians' offices, and via e-mail. Early and postvaccine-program survey results were compared. RESULTS A total of 722 early implementation and 709 postimplementation parent surveys and 180 early and 141 postimplementation HCP surveys were analyzed. HCP and public attitudes toward rotavirus vaccination were generally positive and didn't change over time. More parents postprogram were aware of the NACI recommendation and the vaccination program and reported that their healthcare provider discussed rotavirus infection and vaccine with them. Prior to the program across all sites, more physicians than nurses were aware of the national recommendation regarding rotavirus vaccine. In the postprogram survey, however, more nurses were aware of the national recommendation and their provincial universal rotavirus vaccination program. Nurses had higher knowledge scores than physicians in the postprogram survey (p<0.001). Parents of young infants were also more knowledgeable about rotavirus and rotavirus vaccine in the two areas where universal programs were in place (p<0.001). CONCLUSIONS Implementation of a universal rotavirus vaccination program was associated with an increase in knowledge and more positive attitudes toward rotavirus vaccine amongst parents of eligible infants. Nurses involved in a public health-delivered vaccination program were more knowledgeable and had more positive attitudes toward the vaccine than physicians in a jurisdiction where vaccine was physician-delivered.
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Affiliation(s)
- Donna M MacDougall
- Canadian Center for Vaccinology, Dalhousie University, IWK Health Centre, and the Nova Scotia Health Authority, Halifax, NS, Canada; School of Nursing, St. Francis Xavier University, Antigonish, NS, Canada
| | - Beth A Halperin
- Canadian Center for Vaccinology, Dalhousie University, IWK Health Centre, and the Nova Scotia Health Authority, Halifax, NS, Canada; School of Nursing, Dalhousie University, Halifax, NS, Canada; Department of Pediatrics, Dalhousie University, Halifax, NS, Canada
| | - Joanne M Langley
- Canadian Center for Vaccinology, Dalhousie University, IWK Health Centre, and the Nova Scotia Health Authority, Halifax, NS, Canada; Department of Pediatrics, Dalhousie University, Halifax, NS, Canada; Department of Community Health and Epidemiology, Dalhousie University, Halifax, NS, Canada
| | - Donna MacKinnon-Cameron
- Canadian Center for Vaccinology, Dalhousie University, IWK Health Centre, and the Nova Scotia Health Authority, Halifax, NS, Canada
| | - Li Li
- Canadian Center for Vaccinology, Dalhousie University, IWK Health Centre, and the Nova Scotia Health Authority, Halifax, NS, Canada
| | - Scott A Halperin
- Canadian Center for Vaccinology, Dalhousie University, IWK Health Centre, and the Nova Scotia Health Authority, Halifax, NS, Canada; Department of Pediatrics, Dalhousie University, Halifax, NS, Canada; Department of Microbiology & Immunology, Dalhousie University, Halifax, NS, Canada.
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Philips L, Young J, Williams LA, Cooke M, Rickard C. Opportunistic immunisation in the emergency department: A survey of staff knowledge, opinion and practices. ACTA ACUST UNITED AC 2014; 17:44-50. [DOI: 10.1016/j.aenj.2013.12.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2013] [Revised: 12/18/2013] [Accepted: 12/20/2013] [Indexed: 10/25/2022]
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Larson HJ, Jarrett C, Eckersberger E, Smith DMD, Paterson P. Understanding vaccine hesitancy around vaccines and vaccination from a global perspective: a systematic review of published literature, 2007-2012. Vaccine 2014; 32:2150-9. [PMID: 24598724 DOI: 10.1016/j.vaccine.2014.01.081] [Citation(s) in RCA: 1181] [Impact Index Per Article: 118.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2013] [Revised: 01/18/2014] [Accepted: 01/28/2014] [Indexed: 12/11/2022]
Abstract
Vaccine "hesitancy" is an emerging term in the literature and discourse on vaccine decision-making and determinants of vaccine acceptance. It recognizes a continuum between the domains of vaccine acceptance and vaccine refusal and de-polarizes previous characterization of individuals and groups as either anti-vaccine or pro-vaccine. The primary aims of this systematic review are to: 1) identify research on vaccine hesitancy; 2) identify determinants of vaccine hesitancy in different settings including its context-specific causes, its expression and its impact; and 3) inform the development of a model for assessing determinants of vaccine hesitancy in different settings as proposed by the Strategic Advisory Group of Experts Working Group (SAGE WG) for dealing with vaccine hesitancy. A broad search strategy, built to capture multiple dimensions of public trust, confidence and hesitancy around vaccines, was applied across multiple databases. Peer-reviewed studies were selected for inclusion if they focused on childhood vaccines [≤ 7 years of age], used multivariate analyses, and were published between January 2007 and November 2012. Our results show a variety of factors as being associated with vaccine hesitancy but they do not allow for a complete classification and confirmation of their independent and relative strength of influence. Determinants of vaccine hesitancy are complex and context-specific - varying across time, place and vaccines.
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Affiliation(s)
- Heidi J Larson
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, United Kingdom.
| | - Caitlin Jarrett
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, United Kingdom.
| | - Elisabeth Eckersberger
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, United Kingdom.
| | - David M D Smith
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, United Kingdom.
| | - Pauline Paterson
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, United Kingdom.
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Morin A, Lemaître T, Farrands A, Carrier N, Gagneur A. Maternal knowledge, attitudes and beliefs regarding gastroenteritis and rotavirus vaccine before implementing vaccination program: Which key messages in light of a new immunization program? Vaccine 2012; 30:5921-7. [DOI: 10.1016/j.vaccine.2012.07.050] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2012] [Revised: 07/16/2012] [Accepted: 07/23/2012] [Indexed: 11/29/2022]
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Dubé E, Gilca V, Sauvageau C, Bettinger JA, Boucher FD, McNeil S, Gemmill I, Lavoie F, Ouakki M, Boulianne N. Clinicians' opinions on new vaccination programs implementation. Vaccine 2012; 30:4632-7. [PMID: 22580354 DOI: 10.1016/j.vaccine.2012.04.100] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2012] [Accepted: 04/27/2012] [Indexed: 12/25/2022]
Abstract
In Canada, several new vaccines were recently approved for clinical use or are expected to be soon. Decision-makers are faced with the choice whether or not to include these vaccines in publicly funded vaccination programs. The aim of this study was to assess Canadian pediatricians' and family physicians' opinions regarding 7 new vaccines, and perceived priority for the introduction of new programs. A self-administered, anonymous, mail-based questionnaire was sent during fall 2009 to a random sample of 1182 family physicians and to all 1852 Canadian pediatricians. Responses to 8 statements regarding frequency and severity of the diseases, efficacy and safety of the vaccines as well as feasibility of immunization programs were used to calculate priority scores to rank the 7 potential new vaccination programs (calculated scores ranging from 0 to 100). Overall response rate was 43%. The majority of respondents perceived the health and economic burden of diseases prevented by the seven new vaccines as important and considered new vaccines to be safe and effective. More than 90% of physicians strongly agreed or agreed that the new vaccines would be or are currently well accepted by the public and by the health professionals who administer vaccines, except for the HPV and rotavirus vaccines (respectively 30% and 29% strongly agreed or agreed). Mean priority scores were: 77.4 out of 100 for the measles, mumps, rubella and varicella (MMRV) combined vaccine; 75.6 for the hexavalent (DTaP-IPV-Hib-HBV) vaccine; 73.1 for the new pneumococcal conjugate vaccines; 69.8 for the meningococcal ACYW135; 68.9 for the combined hepatitis A and B; 63.5 for the human papillomavirus vaccine and 56.9 for the rotavirus vaccine. Health professionals' opinion is an important element to consider in the decision-making process regarding implementation of new immunization programs. Without health professional support, the introduction of a new vaccination program may be unsuccessful. In this study, the MMRV and the hexavalent (DTaP-IPV-Hib-HBV) vaccines received the highest ratings.
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Affiliation(s)
- E Dubé
- Institut national de santé publique du Québec, 2400 d'Estimauville, Québec, Québec, Canada.
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Dubé E, Gilca V, Sauvageau C, Bradet R, Bettinger J, Boulianne N, Boucher F, McNeil S, Gemmill I, Lavoie F. Canadian paediatricians’ opinions on rotavirus vaccination. Vaccine 2011; 29:3177-82. [DOI: 10.1016/j.vaccine.2011.02.044] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2010] [Revised: 02/08/2011] [Accepted: 02/15/2011] [Indexed: 10/18/2022]
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Couverture vaccinale des professionnels de santé dans un service d’infectiologie. Med Mal Infect 2011; 41:135-9. [DOI: 10.1016/j.medmal.2010.11.018] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2010] [Revised: 09/22/2010] [Accepted: 11/19/2010] [Indexed: 11/17/2022]
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Dubé E, Gilca V, Sauvageau C, Boulianne N, Boucher FD, Bettinger JA, McNeil S, Gemmill I, Lavoie F, Ouakki M. Canadian family physicians' and paediatricians' knowledge, attitudes and practices regarding A(H1N1) pandemic vaccine. BMC Res Notes 2010; 3:102. [PMID: 20398265 PMCID: PMC2864287 DOI: 10.1186/1756-0500-3-102] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2009] [Accepted: 04/14/2010] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND One of the main determinants of public immunization success is health professionals' support and recommendations. Little is known about the physicians' level of support and intentions regarding A(H1N1) pandemic influenza vaccination. The aim of this survey was to document Canadian family physicians' and paediatricians' knowledge, attitudes and practices (KAP) as well as their intentions regarding A(H1N1) pandemic influenza vaccines right before the beginning of the largest immunization campaign in Canadian history. FINDINGS A self-administered, anonymous, mail-based questionnaire was sent to a random sample of family physicians and to all paediatricians practicing in Canada. All 921 questionnaires received by October 29 2009 were included in the analysis. Between 72% and 92% of respondents agreed with the statements regarding vaccine safety, effectiveness and acceptability. More than 75% of respondents intended to recommend the A(H1N1) pandemic influenza vaccine to their patients and to get vaccinated themselves. The most significant factors associated with the intention to recommend A(H1N1) pandemic vaccines were physicians' intention to be vaccinated against influenza themselves and the perceived acceptability of the vaccine by the vaccinators. CONCLUSIONS Most Canadian family physicians and paediatricians surveyed were supportive of the A(H1N1) pandemic influenza vaccination before its implementation and large media coverage.
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Affiliation(s)
- Eve Dubé
- Centre de recherche du CHUL-CHUQ, Centre Hospitalier de l'Université Laval, Québec, Canada.
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