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Lan Y, Jin L. Heritage and hesitancy: how preference for traditional Chinese medicine influences vaccine attitudes. Front Public Health 2024; 12:1355720. [PMID: 38566787 PMCID: PMC10985209 DOI: 10.3389/fpubh.2024.1355720] [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: 12/14/2023] [Accepted: 02/29/2024] [Indexed: 04/04/2024] Open
Abstract
Introduction Vaccine hesitancy, amplified by the COVID-19 pandemic, is a pressing public health challenge. This study investigates the association between Traditional Chinese Medicine (TCM) preference and COVID-19 vaccine hesitancy within China. Methods The study uses data from the 2021 Chinese General Social Survey (CGSS) (N = 2,690). Logistic regressions and Karlson-Holm-Breen (KHB) method are employed to analyzed the relationship between TCM preference and vaccine hesitancy. Results The study reaffirms prior findings by revealing a robust and stable association between TCM preference and vaccine hesitancy, which remains unaffected by socioeconomic and demographic confounders, as well as institutional trust dynamics of healthcare system. Contrary to expectations, TCM enthusiasts do not exhibit vaccine hesitancy based on divergent epistemological views concerning vaccine risks and immunity acquisition compared to biomedicine. Discussion This research enriches understandings of the intricate relations between healthcare paradigms and vaccine attitudes, inviting further inquiry into the role of CAM in shaping vaccination behaviors across different cultures and contexts. The insights bear significant public health implications for enhancing vaccine acceptance and coverage, particularly among populations where CAM practices wield substantial influence.
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Affiliation(s)
- Yaxin Lan
- Department of Social Work, School of Sociology and Political Science, Shanghai University, Shanghai, China
- Department of Sociology, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Lei Jin
- Faculty of Social Science, The Chinese University of Hong Kong, Shatin, Hong Kong Region, Hong Kong SAR, China
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Kaur M, Coppeta L, Olesen OF. Vaccine Hesitancy among Healthcare Workers in Europe: A Systematic Review. Vaccines (Basel) 2023; 11:1657. [PMID: 38005989 PMCID: PMC10675787 DOI: 10.3390/vaccines11111657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 10/17/2023] [Accepted: 10/25/2023] [Indexed: 11/26/2023] Open
Abstract
This study analyzes vaccine hesitancy (VH) among healthcare workers (HCWs) in 15 European countries. We have undertaken a systematic review by synthesizing data from 46 articles (between 2015 and 2022) encompassing 55,612 subjects. Despite the heterogeneity of the methods in the various studies, we found that physicians had consistently higher vaccination rates than nurses across different countries and different vaccines. Physicians' average vaccination rate was 79% across a selection of vaccines, while that of nurses was 62%. Concerns regarding vaccine safety, information gaps, and the responsibility of healthcare authorities in managing VH are highlighted by qualitative insights. This research contributes to our comprehension of the ways in which VH among HCWs is impacted by healthcare roles, vaccine types, and regional disparities. The insights gleaned from this analysis can serve as a guide for targeted interventions aimed at increasing vaccine acceptance and coverage in Europe, ultimately strengthening public health.
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Affiliation(s)
- Mandeep Kaur
- European Vaccine Initiative, Universitätsklinikum Heidelberg (Heidelberg University Hospital), Voßstraße 2, 69115 Heidelberg, Germany;
| | - Luca Coppeta
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy;
| | - Ole F. Olesen
- European Vaccine Initiative, Universitätsklinikum Heidelberg (Heidelberg University Hospital), Voßstraße 2, 69115 Heidelberg, Germany;
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Fasce A, Karlsson L, Verger P, Mäki O, Taubert F, Garrison A, Schmid P, Holford DL, Lewandowsky S, Rodrigues F, Betsch C, Soveri A. Endorsement of alternative medicine and vaccine hesitancy among physicians: A cross-sectional study in four European countries. Hum Vaccin Immunother 2023; 19:2242748. [PMID: 37581343 PMCID: PMC10431744 DOI: 10.1080/21645515.2023.2242748] [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: 04/28/2023] [Revised: 07/13/2023] [Accepted: 07/27/2023] [Indexed: 08/16/2023] Open
Abstract
Vaccine hesitancy has become a threat to public health, especially as it is a phenomenon that has also been observed among healthcare professionals. In this study, we analyzed the relationship between endorsement of complementary and alternative medicine (CAM) and vaccination attitudes and behaviors among healthcare professionals, using a cross-sectional sample of physicians with vaccination responsibilities from four European countries: Germany, Finland, Portugal, and France (total N = 2,787). Our results suggest that, in all the participating countries, CAM endorsement is associated with lower frequency of vaccine recommendation, lower self-vaccination rates, and being more open to patients delaying vaccination, with these relationships being mediated by distrust in vaccines. A latent profile analysis revealed that a profile characterized by higher-than-average CAM endorsement and lower-than-average confidence and recommendation of vaccines occurs, to some degree, among 19% of the total sample, although these percentages varied from one country to another: 23.72% in Germany, 17.83% in France, 9.77% in Finland, and 5.86% in Portugal. These results constitute a call to consider health care professionals' attitudes toward CAM as a factor that could hinder the implementation of immunization campaigns.
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Affiliation(s)
- Angelo Fasce
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Linda Karlsson
- Institute of Clinical Medicine, University of Turku, Turku, Finland
| | - Pierre Verger
- Faculté des Sciences Médicales et Paramédicales, Southeastern Health Regional Observatory (Observatoire Régional de la Santé, ORS-PACA), Marseille, France
| | - Otto Mäki
- Department of Psychology and Speech-Language Pathology, University of Turku, Turku, Finland
| | - Frederike Taubert
- Institute for Planetary Health Behavior, University of Erfurt, Erfurt, Germany
- Health Communication Working Group, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
| | - Amanda Garrison
- Faculté des Sciences Médicales et Paramédicales, Southeastern Health Regional Observatory (Observatoire Régional de la Santé, ORS-PACA), Marseille, France
| | - Philipp Schmid
- Institute for Planetary Health Behavior, University of Erfurt, Erfurt, Germany
- Department of Implementation Research, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
| | - Dawn Liu Holford
- School of Psychological Science, University of Bristol, Bristol, UK
| | - Stephan Lewandowsky
- School of Psychological Science, University of Bristol, Bristol, UK
- School of Psychological Science, University of Western Australia, Perth, Australia
- Department of Psychology, University of Potsdam, Postdam, Germany
| | | | - Cornelia Betsch
- Health Communication Working Group, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
| | - Anna Soveri
- Institute of Clinical Medicine, University of Turku, Turku, Finland
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Jacques M, Lorton F, Dufourg MN, Bois C, Launay E, Siméon T, Raude J, Guen CGL, Lévy-Brühl D, Charles MA, Chalumeau M, Scherdel P. Determinants of incomplete vaccination in children at age two in France: results from the nationwide ELFE birth cohort. Eur J Pediatr 2023; 182:1019-1028. [PMID: 36542162 PMCID: PMC9768772 DOI: 10.1007/s00431-022-04733-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 11/18/2022] [Accepted: 11/23/2022] [Indexed: 12/24/2022]
Abstract
Incomplete vaccination in the pediatric population is a growing public health issue in high-income countries, but its determinants are poorly understood. Their identification is necessary to design target actions that can improve vaccination uptake. Our aim was to assess the determinants of incomplete vaccination in two-year-old children in France. Among the 18,329 children included in the 2011 ELFE French nationwide population-based birth cohort, we selected those for whom vaccination status was available at age two years. Incomplete vaccination was defined as ≥ 1 missing dose of recommended vaccines. Potential determinants of incomplete vaccination were identified by using logistic regression, taking into account attrition and missing data. Of the 5,740 (31.3%) children analyzed, 46.5% (95% confidence interval [CI] 44.7-48.0) were incompletely vaccinated. Factors independently associated with incomplete vaccination were having older siblings (adjusted odds ratio 1.18, 95% CI [1.03-1.34] and 1.28 [1.06-1.54] for one and ≥ 2 siblings, respectively, vs. 0), residing in an isolated area (1.92 [1.36-2.75] vs. an urban area), parents not following health recommendations or using alternative medicines (1.81 [1.41-2.34] and 1.23 [1.04-1.46], respectively, vs. parents confident in institutions and following heath recommendations), not being visited by a maternal and child protection service nurse during the child's first two months (1.19 [1.03-1.38] vs. ≥ 1 visit), and being followed by a general practitioner (2.87 [2.52-3.26] vs. a pediatrician). CONCLUSIONS Incomplete vaccination was highly prevalent in the studied pediatric population and was associated with several socio-demographic, parental, and healthcare service characteristics. These findings may help in designing targeted corrective actions. WHAT IS KNOWN • Incomplete vaccination in the pediatric population is a growing public health issue in high-income countries. • The partial understanding of the determinants of incomplete vaccination precludes the design of effective targeted corrective actions. WHAT IS NEW • High prevalence of incomplete vaccination at age two years in France. • Incomplete vaccination was independently associated with several socio-demographic, parental, and healthcare service characteristics.
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Affiliation(s)
- Marianne Jacques
- Obstetrical Perinatal and Pediatric Epidemiology Research Team (EPOPé), Université Paris Cité, Inserm, Center for Research in Epidemiology and StatisticS (CRESS), 75004 Paris, France
- grid.277151.70000 0004 0472 0371Inserm 1413 CIC FEA, Nantes University Hospital, Nantes, France
| | - Fleur Lorton
- Obstetrical Perinatal and Pediatric Epidemiology Research Team (EPOPé), Université Paris Cité, Inserm, Center for Research in Epidemiology and StatisticS (CRESS), 75004 Paris, France
- grid.277151.70000 0004 0472 0371Inserm 1413 CIC FEA, Nantes University Hospital, Nantes, France
- grid.277151.70000 0004 0472 0371Department of Pediatric Emergency Care, Nantes University Hospital, Nantes, France
| | - Marie-Noëlle Dufourg
- grid.7429.80000000121866389French Institute for Demographic Studies (Ined), Inserm, French Blood Agency, ELFE Joint Unit, Aubervilliers, France
| | - Corinne Bois
- grid.7429.80000000121866389French Institute for Demographic Studies (Ined), Inserm, French Blood Agency, ELFE Joint Unit, Aubervilliers, France
| | - Elise Launay
- Obstetrical Perinatal and Pediatric Epidemiology Research Team (EPOPé), Université Paris Cité, Inserm, Center for Research in Epidemiology and StatisticS (CRESS), 75004 Paris, France
- grid.277151.70000 0004 0472 0371Inserm 1413 CIC FEA, Nantes University Hospital, Nantes, France
- grid.277151.70000 0004 0472 0371Department of Pediatric Emergency Care, Nantes University Hospital, Nantes, France
| | - Thierry Siméon
- grid.7429.80000000121866389French Institute for Demographic Studies (Ined), Inserm, French Blood Agency, ELFE Joint Unit, Aubervilliers, France
| | - Jocelyn Raude
- grid.414412.60000 0001 1943 5037EHESP-School of Public Health, Rennes, France
| | - Christèle Gras-Le Guen
- Obstetrical Perinatal and Pediatric Epidemiology Research Team (EPOPé), Université Paris Cité, Inserm, Center for Research in Epidemiology and StatisticS (CRESS), 75004 Paris, France
- grid.277151.70000 0004 0472 0371Inserm 1413 CIC FEA, Nantes University Hospital, Nantes, France
- grid.277151.70000 0004 0472 0371Department of Pediatric Emergency Care, Nantes University Hospital, Nantes, France
| | - Daniel Lévy-Brühl
- grid.493975.50000 0004 5948 8741Santé Publique France, French National Public Health Agency, Saint-Maurice, France
| | - Marie-Aline Charles
- grid.7429.80000000121866389French Institute for Demographic Studies (Ined), Inserm, French Blood Agency, ELFE Joint Unit, Aubervilliers, France
| | - Martin Chalumeau
- Obstetrical Perinatal and Pediatric Epidemiology Research Team (EPOPé), Université Paris Cité, Inserm, Center for Research in Epidemiology and StatisticS (CRESS), 75004 Paris, France
- grid.508487.60000 0004 7885 7602Department of General Pediatrics and Pediatric Infectious Diseases, AP-HP, Necker-Enfants malades hospital, Université Paris Cité, Paris, France
| | - Pauline Scherdel
- Obstetrical Perinatal and Pediatric Epidemiology Research Team (EPOPé), Université Paris Cité, Inserm, Center for Research in Epidemiology and StatisticS (CRESS), 75004 Paris, France
- grid.277151.70000 0004 0472 0371Inserm 1413 CIC FEA, Nantes University Hospital, Nantes, France
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Führer A, Pacolli L, Yilmaz-Aslan Y, Brzoska P. COVID-19 Vaccine Acceptance and Its Determinants among Migrants in Germany-Results of a Cross-Sectional Study. Vaccines (Basel) 2022; 10:1350. [PMID: 36016238 PMCID: PMC9413826 DOI: 10.3390/vaccines10081350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 08/11/2022] [Accepted: 08/17/2022] [Indexed: 11/16/2022] Open
Abstract
Vaccinations are a core element of infection control. Migrants have been reported to have low vaccination rates for many infectious diseases, including COVID-19. Still, determinants of migrants' uptake of COVID-19 vaccinations are not sufficiently clear. The present study addresses this gap and examines the respective influence of three potential determinants: barriers to access, attitude towards vaccinations in general, and towards COVID-19 vaccines. The study uses a cross-sectional online survey among migrants in Germany. The questionnaire assessed the aforementioned determinants using standardized tools. Information on 204 individuals was available. The vaccination rate in the sample was 80%. Vaccinated as compared to unvaccinated respondents reported more often the absence of financial barriers (71% (95%CI: 64-73%) vs. 45% (95%CI: 28-63%)), short waiting times (51% (95%CI: 43-59%) vs. 22% (95%CI: 5-38%)), and the presence of a vaccination center close-by (91.5% (95%CI: 87-96%) vs. 69.7% (95%CI: 54-85%)). Concerning COVID-19 vaccine acceptance, the majority of respondents (68%) agreed that the vaccine is important. Unvaccinated respondents more often feared side effects, were convinced that the vaccine is not safe, and assumed that COVID-19 is not dangerous. Correspondingly, acceptance of vaccinations in general was higher among vaccinated respondents. In line with findings from previous studies, our survey found that all three determinants seem to influence migrants' vaccination status while their overall vaccination rate was comparable to the general population. Hence, migration background per se does not sufficiently explain vaccine acceptance and further research is needed to identify subgroups of migrants that should be specifically addressed to increase their vaccination rate.
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Affiliation(s)
- Amand Führer
- Institute for Medical Epidemiology, Biometrics and Informatics (IMEBI), Interdisciplinary Center for Health Sciences, Medical School of the Martin Luther-University Halle-Wittenberg, 06112 Halle, Germany
| | - Latife Pacolli
- Health Services Research Unit, Faculty of Health, School of Medicine, Witten/Herdecke University, 58448 Witten, Germany
| | - Yüce Yilmaz-Aslan
- Health Services Research Unit, Faculty of Health, School of Medicine, Witten/Herdecke University, 58448 Witten, Germany
- Deptartment of Health Services Research and Nursing, Faculty of Health Sciences, Bielefeld University, 33615 Bielefeld, Germany
| | - Patrick Brzoska
- Health Services Research Unit, Faculty of Health, School of Medicine, Witten/Herdecke University, 58448 Witten, Germany
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Verger P, Botelho-Nevers E, Garrison A, Gagnon D, Gagneur A, Gagneux-Brunon A, Dubé E. Vaccine hesitancy in health-care providers in Western countries: a narrative review. Expert Rev Vaccines 2022; 21:909-927. [PMID: 35315308 DOI: 10.1080/14760584.2022.2056026] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
INTRODUCTION Vaccine hesitancy (VH) is a leading cause of suboptimal vaccine uptake rates worldwide. The interaction between patients and health-care providers (HCPs) is the keystone in addressing VH. However, significant proportions of HCPs, including those who administer vaccines, are personally and professionally vaccine-hesitant. AREAS COVERED This narrative review sought to characterize the nature, extent, correlates, and consequences of VH among HCPs. We included 39 quantitative and qualitative studies conducted in Western countries, published since 2015, that assessed VH among HCPs in general, for several vaccines. Studies were reviewed using the WHO 3Cs model - (lack of) confidence, complacency, and (lack of) convenience. EXPERT OPINION Despite the lack of validated tools and substantial heterogeneity in the methods used to measure VH among HCPs, this review confirms its presence in this population, at frequencies that vary by country, profession type, setting, and level of medical education. Lack of knowledge and mistrust in health authorities/pharmaceutical industry/experts were among its principal drivers. Improving the content about vaccination in HCPs' training programs, facilitating access to reliable information for use during consultations, and developing and validating instruments to measure HCPs' VH and its determinants are key to addressing VH among HCPs.
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Affiliation(s)
- Pierre Verger
- ORS Paca, Southeastern Health Regional Observatory, Marseille, France.,Faculty of Medicine, Aix-Marseille University, Marseille, France
| | - Elisabeth Botelho-Nevers
- Department of Infectious Diseases, University Hospital of Saint-Etienne, Saint-Etienne, France.,CIRI - Centre International de Recherche en Infectiologie, Lyon, France.,Univ Lyon, Jean Monnet University, Saint-Etienne, France.,Chair PreVacCi, Presage Institut, Jean Monnet University, Saint-Etienne, France
| | - Amanda Garrison
- ORS Paca, Southeastern Health Regional Observatory, Marseille, France.,Faculty of Medicine, Aix-Marseille University, Marseille, France
| | - Dominique Gagnon
- Direction des risques biologiques et de la santé au travail, Institut national de santé publique du Québec, Quebec, Canada
| | - Arnaud Gagneur
- Department of Pediatrics, Centre de Recherche du CHUS, Quebec, Canada.,Faculté de médecine et des sciences de la santé, Département de pédiatrie, Université de Sherbrooke-Campus de la Santé, Quebec, Canada
| | - Amandine Gagneux-Brunon
- Department of Infectious Diseases, University Hospital of Saint-Etienne, Saint-Etienne, France.,CIRI - Centre International de Recherche en Infectiologie, Lyon, France.,Univ Lyon, Jean Monnet University, Saint-Etienne, France.,Chair PreVacCi, Presage Institut, Jean Monnet University, Saint-Etienne, France.,CIC INSERM Vaccinology, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - Eve Dubé
- Deptartment of Anthropology, Laval University, Quebec, Canada
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