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Lucas Ramanathan P, Baldesberger N, Dietrich LG, Speranza C, Lüthy A, Buhl A, Gisin M, Koch R, Nicca D, Suggs LS, Huber BM, Deml MJ, Tarr PE. Health Care Professionals' Interest in Vaccination Training in Switzerland: A Quantitative Survey. Int J Public Health 2022; 67:1604495. [PMID: 36531605 PMCID: PMC9749818 DOI: 10.3389/ijph.2022.1604495] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 11/14/2022] [Indexed: 08/27/2023] Open
Abstract
Objectives: Health care professionals (HCPs) play an important role for patients' vaccination decisions. To counsel patients/clients appropriately, HCPs need current factual knowledge about vaccines and strong communication skills. Methods: We conducted an online survey with physicians, pharmacists, nurses, and midwives in Switzerland (01.11.2020-31.03.2021). We evaluated: 1) interest in vaccination knowledge and counseling training; 2) vaccination recommendation practices; 3) experience with vaccination counseling/administration; 4) comfort level in addressing vaccine hesitancy (VH); 5) perspectives on patient/client VH, delays, and refusals. Results: In total, 1,933 practicing HCPs responded (496 physicians, 226 pharmacists, 607 nurses, 604 midwives). 43% physicians, 31% pharmacists, 15% nurses, and 23% midwives felt comfortable counseling VH patients/clients. 96% physicians, 98% pharmacists, 85% nurses, and 91% midwives were interested in additional vaccination-related training. All professionals mentioned safety, efficacy, and side effects as topics of most interest for additional training. Conclusion: Results demonstrate a high interest among HCPs for additional vaccination-related training. In addition to factual information about vaccination, such training will likely benefit from a communication component, given the low rates of comfort reported by HCPs when counseling VH patients/clients.
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Affiliation(s)
- Pia Lucas Ramanathan
- University Department of Medicine and Infectious Diseases Service, Kantonsspital Baselland, Bruderholz, Switzerland
- University of Basel, Basel, Switzerland
- Pharmaceutical Care Research Group, Basel, Switzerland
| | - Nadja Baldesberger
- University Department of Medicine and Infectious Diseases Service, Kantonsspital Baselland, Bruderholz, Switzerland
- University of Basel, Basel, Switzerland
- Pharmaceutical Care Research Group, Basel, Switzerland
| | - Léna G. Dietrich
- University Department of Medicine and Infectious Diseases Service, Kantonsspital Baselland, Bruderholz, Switzerland
- University of Basel, Basel, Switzerland
| | - Camilla Speranza
- Institute of Public Health, and Institute of Communication and Public Policy, Università della Svizzera italiana, Lugano, Switzerland
| | - Alyssa Lüthy
- University Department of Medicine and Infectious Diseases Service, Kantonsspital Baselland, Bruderholz, Switzerland
- University of Basel, Basel, Switzerland
| | - Andrea Buhl
- University of Basel, Basel, Switzerland
- Swiss Tropical and Public Health Institute (Swiss TPH), Basel, Switzerland
| | - Martina Gisin
- Department of Obstetrics and Gynecology, University Hospital of Basel, Basel, Switzerland
| | | | - Dunja Nicca
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - L. Suzanne Suggs
- Institute of Public Health, and Institute of Communication and Public Policy, Università della Svizzera italiana, Lugano, Switzerland
- Swiss School of Public Health, Zurich, Switzerland
| | - Benedikt M. Huber
- Center for Integrative Pediatrics, Department of Pediatrics, Fribourg Hospital HFR, Fribourg, Switzerland
- Faculty of Science and Medicine, University of Fribourg, Fribourg, Switzerland
| | - Michael J. Deml
- Institute of Sociological Research, Department of Sociology, University of Geneva, Geneva, Switzerland
| | - Philip E. Tarr
- University Department of Medicine and Infectious Diseases Service, Kantonsspital Baselland, Bruderholz, Switzerland
- University of Basel, Basel, Switzerland
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Deml MJ, Buhl A, Huber BM, Burton‐Jeangros C, Tarr PE. Trust, affect, and choice in parents' vaccination decision-making and health-care provider selection in Switzerland. SOCIOLOGY OF HEALTH & ILLNESS 2022; 44:41-58. [PMID: 34747500 PMCID: PMC9299032 DOI: 10.1111/1467-9566.13388] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 08/30/2021] [Accepted: 10/05/2021] [Indexed: 06/01/2023]
Abstract
This article examines the relationships between biomedicine, complementary and alternative medicine (CAM) and parents' vaccination decision-making in Switzerland. Our empirical evidence sheds light on an understudied phenomenon-parents switching from one doctor to another provider (often one offering CAM services) around issues that arise during vaccination consultations. This is important to understand since CAM is used by 25%-50% of the Swiss population and is integrated into the Swiss health-care system when offered by biomedically trained medical doctors with additional CAM training. Qualitative data gathered from in-depth semi-structured interviews with parents (N = 30) and ethnographic observations of vaccination consultations (N = 16 biomedical consultations, N = 18 CAM consultations) demonstrate how there was not always a clear-cut, direct relationship between (non)vaccination and parents' use of CAM and/or biomedicine. Borrowing from Hirschman (Exit, voice, and loyalty: Responses to decline in firms, organizations, and states, Harvard Univ. Press, 1970), we frame our analysis by using the concepts of exit, voice and loyalty to describe parents' provider selection and vaccination decision-making process, although only four families in the sample described switching solely because of vaccination-related issues. Findings add to vaccine decision-making literature by describing and analysing the underdiscussed provider-switching phenomenon and by demonstrating the importance of parents' experiences of trust, affect and choice in vaccination consultations as they pursue the best health outcomes for their children.
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Affiliation(s)
- Michael J. Deml
- Institute of Sociological ResearchDepartment of SociologyUniversity of GenevaGenevaSwitzerland
- Division of Social and Behavioural SciencesSchool of Public Health & Family MedicineUniversity of Cape TownCape TownSouth Africa
| | - Andrea Buhl
- Swiss Tropical and Public Health Institute (Swiss TPH)BaselSwitzerland
- University of BaselBaselSwitzerland
| | - Benedikt M. Huber
- Department of PediatricsFribourg Cantonal HospitalFribourgSwitzerland
| | | | - Philip E. Tarr
- University of BaselBaselSwitzerland
- University Department of MedicineKantonsspital BasellandUniversity of BaselBruderholzSwitzerland
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Abdul Kadir A, Noor NM, Mukhtar AF. Development and validation of the knowledge and attitude regarding childhood vaccination (KACV) questionnaire among healthcare workers: the Malay version. Hum Vaccin Immunother 2021; 17:5196-5204. [PMID: 34714713 DOI: 10.1080/21645515.2021.1989915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
Health care workers play an important role in supporting childhood vaccination as they are the most trusted source of vaccine-related information for parents. However, there is limited validated tools to measure their knowledge and attitude on childhood vaccination. This study aims to develop and validate knowledge and attitude regarding childhood vaccination (KACV) questionnaire among healthcare workers. The questionnaire was developed based on literature reviews and underwent a sequential validation process, including content, face validity and exploratory factor analysis. However, the attitude section is unidimensional and has undergone reliability analysis only. The preliminary knowledge questionnaire contains 33 items and the attitude questionnaire consists of 17 items. The preliminary KACV showed a high item Content Validity Index and Face Validity Index. The final questionnaire consists of 10 items for knowledge and 15 items for attitude. The Cronbach alpha for the knowledge and attitude section were 0.896 and 0.861, respectively. KACV is a valid and reliable tool to measure healthcare workers' knowledge and attitude on childhood vaccination.
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Affiliation(s)
- Azidah Abdul Kadir
- Department of Family Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia.,Department of Family Medicine, Hospital Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Norhayati Mohd Noor
- Department of Family Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia.,Department of Family Medicine, Hospital Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Ahmad Faiq Mukhtar
- Department of Family Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia.,Department of Family Medicine, Hospital Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
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Olarewaju VO, Jafflin K, Deml MJ, Zimmermann C, Sonderegger J, Preda T, Staub H, Kwiatkowski M, Kloetzer A, Huber BM, Merten S, Tarr PE. Application of the Parent Attitudes about Childhood Vaccines (PACV) survey in three national languages in Switzerland: Exploratory factor analysis and Mokken scale analysis. Hum Vaccin Immunother 2021; 17:2652-2660. [PMID: 33760690 PMCID: PMC8475569 DOI: 10.1080/21645515.2021.1894894] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 02/12/2021] [Accepted: 02/19/2021] [Indexed: 01/24/2023] Open
Abstract
Vaccine hesitancy (VH) is a complex and context-specific phenomenon that is linked to under-immunization and poses challenges to immunization programs. The Parent Attitudes about Childhood Vaccines (PACV) is an instrument developed to measure VH. We translated the PACV into three languages (German, French and Italian) and administered it to 1388 Swiss parents. We used exploratory factor analysis (EFA) to confirm the scale sub-domains, Cronbach's alpha to assess internal consistency reliability, and Mokken scale analysis (MSA), to explore unidimensionality of each language version. We determined to construct validity by linking parental PACV score to children's immunization status for the first dose of measles vaccine. For the 15-item PACV, EFA extracted three sub-domains in German and French and four sub-domains in Italian. Cronbach's alpha was >0.8 across the three languages, and MSA produced a 13-item German, 14-item French, and 11-item Italian PACV. EFA and MSA of the short version PACV extracted a single factor and scale with Cronbach's alpha >0.7 in all three language versions. VH was significantly associated with non-timely receipt of the first dose of measles in all languages (odds ratio of 20.7, 21.3, and 8.3 for German, French, and Italian languages, respectively). The translated and revised PACV-15 versions are valid and reliable instruments for VH measurement. The structure and reliability of the short version of the PACV was as good as the long version. Our results suggest that the PACV can be used to measure parental VH outside the US in the validated languages.
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Affiliation(s)
- Victoria O. Olarewaju
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Kristen Jafflin
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Michael J. Deml
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Clara Zimmermann
- University of Basel, Basel, Switzerland
- University Department of Medicine, University of Basel, Bruderholz, Switzerland
| | - Joanna Sonderegger
- University of Basel, Basel, Switzerland
- University Department of Medicine, University of Basel, Bruderholz, Switzerland
| | - Thierry Preda
- University of Basel, Basel, Switzerland
- University Department of Medicine, University of Basel, Bruderholz, Switzerland
| | - Hanna Staub
- University of Basel, Basel, Switzerland
- University Department of Medicine, University of Basel, Bruderholz, Switzerland
| | - Marek Kwiatkowski
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Andrea Kloetzer
- University of Basel, Basel, Switzerland
- University Department of Medicine, University of Basel, Bruderholz, Switzerland
| | - Benedikt M. Huber
- Department of Pediatrics, HFR Fribourg Cantonal Hospital, Fribourg, Switzerland
| | - Sonja Merten
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Philip E. Tarr
- University of Basel, Basel, Switzerland
- University Department of Medicine, University of Basel, Bruderholz, Switzerland
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Pires C. What Is the State-of-the-Art in Clinical Trials on Vaccine Hesitancy 2015-2020? Vaccines (Basel) 2021; 9:348. [PMID: 33916427 PMCID: PMC8065658 DOI: 10.3390/vaccines9040348] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 03/30/2021] [Accepted: 04/02/2021] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Vaccine hesitancy is related to a delay in acceptance or refusal of vaccination. AIM to perform a systematic review of clinical trials on vaccine hesitancy (2015-2020). METHODS a systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses criteria (PRISMA). Five databases were screened-PubMed, Cochrane Library, DOAJ, SciELO and b-on-which comprise multiple resources. KEYWORDS "Vaccine hesitancy" and ("randomized controlled trial" or "clinical trial"). INCLUSION CRITERIA trials about "vaccine hesitancy" enrolling patients and/or health professionals (2015-2020). EXCLUSION CRITERIA studies about other topics, repeated and qualitative studies, reviews and papers written in languages other than English, Portuguese, French or Spanish. RESULTS a total of 35 trials out of 90 were selected (19 PubMed, 14 Cochrane Library, 0 DOAJ, 0 SciELO and 2 b-on). Selected trials were classified into five topics: children/pediatric (n = 5); online or electronic information (n = 5); vaccination against a specific disease (n = 15) (e.g., influenza or COVID-2019); miscellaneous (n = 4); and educational strategies (n = 6). CONCLUSION the provision of online or electronic information (e.g., through virtual reality, social websites of experts, or apps), communication-based interventions and training of health professionals, residents or subjects seemed to improve vaccine hesitancy.
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Affiliation(s)
- Carla Pires
- Research Center for Biosciences and Health Technologies, CBIOS-Universidade Lusófona de Humanidades e Tecnologias-Escola de Ciências e Tecnologias da Saúde, Campo Grande 376, 1740-024 Lisboa, Portugal
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‘Problem patients and physicians’ failures': What it means for doctors to counsel vaccine hesitant patients in Switzerland. Soc Sci Med 2020; 255:112946. [DOI: 10.1016/j.socscimed.2020.112946] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 03/16/2020] [Accepted: 03/19/2020] [Indexed: 02/03/2023]
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Dicé F, Dolce P, Maiello A, Freda MF. Exploring emotions in dialog between health provider, parent and child. An observational study in pediatric primary care. PRAT PSYCHOL 2020. [DOI: 10.1016/j.prps.2018.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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First year allopathic medical student attitudes about vaccination and vaccine hesitancy. Vaccine 2019; 38:808-814. [PMID: 31791810 DOI: 10.1016/j.vaccine.2019.10.094] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Revised: 10/24/2019] [Accepted: 10/29/2019] [Indexed: 01/07/2023]
Abstract
First year medical students at an allopathic medical school regional campus were asked to complete a 10-question survey at both the beginning and the conclusion of a required course on immunology, hematology and oncology. The survey was designed to solicit student attitudes about vaccination and the students' level of comfort with and exposure to vaccine hesitant patients. Surveys were administered to five consecutive classes from 2013 to 2017. Total response rate for completion of both surveys was 58.0% (178/307). Pre- and post-course surveys were administered to assess whether curricular experiences altered the students' perceptions about vaccinations and their ability to counsel vaccine hesitant patients. Curricular elements were presented in several different formats aimed at increasing student knowledge about vaccinations and student capacity to work with vaccine hesitant patients and families (problem-based learning, didactic lecture and interactive panel discussion). In the pre-survey, the majority of students reported having already encountered people who decline vaccinations (78.8%). Additionally, in the pre-survey the majority of medical students expressed strong support for vaccination (99.6% agreed with the statement that Vaccinations are a great public health accomplishment) and strong disagreement with both of the assertions that childhood vaccines cause autism and vaccine preservatives cause adverse health effects. In response to questions about comfort level while talking with patients about vaccine choices, baseline responses demonstrated a moderately high level of comfort. Post-course surveys revealed a statistically significant increase in student-rated comfort level in talking with patients about vaccine choices (pre-survey 79.2% report comfort versus post 97.8%; p < 0.001). Though this study is limited to student self-reporting, survey responses suggest that targeted curricular elements can improve medical student confidence in counseling patients about vaccinations. Future curricular elements designed to directly observe student performance could provide verification of counseling skill acquisition.
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Williamson L, Glaab H. Addressing vaccine hesitancy requires an ethically consistent health strategy. BMC Med Ethics 2018; 19:84. [PMID: 30355355 PMCID: PMC6201581 DOI: 10.1186/s12910-018-0322-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Accepted: 10/04/2018] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Vaccine hesitancy is a growing threat to public health. The reasons are complex but linked inextricably to a lack of trust in vaccines, expertise and traditional sources of authority. Efforts to increase immunization uptake in children in many countries that have seen a fall in vaccination rates are two-fold: addressing hesitancy by improving healthcare professional-parent exchange and information provision in the clinic; and, secondly, public health strategies that can override parental concerns and values with coercive measures such as mandatory and presumptive vaccination. MAIN TEXT It is argued that such conflicting, parallel approaches seriously risk undermining trust that is crucial for sustaining herd immunity. Although public health strategies can be ethically justified in limiting freedoms, a parent-centered approach seldom acknowledges how it is impacted by contemporaneous coercive measures. In addition, the clinical encounter is not well suited to helping parents consider the public dimensions of vaccination, despite these being important for trust formation and informed decision-making. Efforts to address vaccine hesitancy require more consistent engagement of parental and citizen views. Along with evidence-based information, debates need to be informed by ethical support that equips parents and professionals to respond to the private and public dimensions of vaccination in a more even-handed, transparent manner. CONCLUSION Efforts to address vaccine hesitancy need to avoid simple reliance on either parental values or coercive public policies. To do this effectively requires increasing citizen engagement on vaccination to help inform a parent-centered approach and legitimize public policy measures. In addition, cultivating a more ethically consistent strategy means moving beyond the current silos of health ethics - clinical and public health ethics.
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Affiliation(s)
- Laura Williamson
- Biobehavioral Health Department, Pennsylvania State University, University Park, USA.
| | - Hannah Glaab
- Biobehavioral Health Department, Pennsylvania State University, University Park, USA
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Head KJ, Biederman E, Sturm LA, Zimet GD. A retrospective and prospective look at strategies to increase adolescent HPV vaccine uptake in the United States. Hum Vaccin Immunother 2018; 14:1626-1635. [PMID: 29359986 PMCID: PMC6067847 DOI: 10.1080/21645515.2018.1430539] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Revised: 12/20/2017] [Accepted: 01/15/2018] [Indexed: 01/06/2023] Open
Abstract
The HPV vaccine debuted more than ten years ago in the United States and many strategies have been evaluated to increase HPV vaccination rates, which include not only improving current vaccination behaviors but also sustaining these behaviors. Researchers and practitioners from a variety of backgrounds have engaged in this work, which has included efforts directed at public health and government policies, health education and health promotion programs, and clinical and patient-provider approaches, as well as work aimed to respond to and combat anti-HPV vaccination movements in society. Using a previously developed conceptual model to organize and summarize each of these areas, this paper also highlights the need for future HPV vaccine promotion work to adopt a multi-level and, when possible, integrated approach in order to maximize impact on vaccination rates.
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Affiliation(s)
- Katharine J. Head
- Department of Communication Studies, Indiana University-Purdue University Indianapolis, Indianapolis, IN, USA
| | | | - Lynne A. Sturm
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Gregory D. Zimet
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA
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