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What Matters to Parents Regarding Immunization of Their Children: Systematic Analysis of Expert Advice to Parents in an Internet Forum. Pediatr Infect Dis J 2020; 39:157-163. [PMID: 31725113 DOI: 10.1097/inf.0000000000002509] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND World Health Organization announced vaccine hesitancy among the top 10 threats to global health in 2019. While the number of persons looking for information on health topics on the internet is increasing, information regarding immunization on the internet is often inaccurate and misleading. We aimed to determine the kind of information parents seek on the internet for decision-making regarding immunizations for their children. METHODS We investigated threads of an internet vaccine forum, where parents can get personalized advice from a vaccine expert, with regard to the types of vaccines and content of the questions. One thousand six hundred twenty consultations (4896 questions) between September 2001 and December 2018 were examined. Of these, 1386, including 4000 questions, were related to immunizations of the user's child. Date of consultation, user gender and country of residence, age of the child; kind of vaccine(s), and topic of the question according to the following categories were analyzed: Vaccination schedule, safety, effectiveness, necessity, vaccine application, serology, exchangeability of different vaccine types and brands, maternally acquired immunity, reimbursement, and vaccine product related. RESULTS Most questions concerned infants (47.7%) and regarded measles-component (28.9%) and diphtheria-tetanus-pertussis combination vaccines (25.3%). Parents were mainly interested in vaccination schedule (33.8%), safety (26.6%), and effectiveness (17.8%) of vaccines. Over time, safety-related questions decreased, and effectiveness related questions increased. Disease outbreaks or newly introduced vaccines and vaccinations temporarily raised interest. From 2011 onwards, most questions regarded measles-component vaccines. CONCLUSIONS Our findings will assist health care professionals and policy makers in preparing targeted information campaigns to address questions and counteract vaccine hesitancy.
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Asturias EJ, Wharton M, Pless R, MacDonald NE, Chen RT, Andrews N, Salisbury D, Dodoo AN, Hartigan-Go K, Zuber PLF. Contributions and challenges for worldwide vaccine safety: The Global Advisory Committee on Vaccine Safety at 15 years. Vaccine 2016; 34:3342-9. [PMID: 27195758 PMCID: PMC5085263 DOI: 10.1016/j.vaccine.2016.05.018] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Revised: 05/04/2016] [Accepted: 05/08/2016] [Indexed: 11/23/2022]
Abstract
In 1999, the Global Advisory Committee on Vaccine Safety (GACVS) was established by the World Health Organization (WHO) to provide independent scientific advice on issues relating to the safety of vaccines and immunization. Fifteen years onward, we conducted a multi-faceted review to evaluate the impact, reach and challenges facing GACVS, including the role GACVS plays in informing global, regional and WHO member state vaccine policy. The methods included measures of organizational structure, citation impact, themes approached, and a discussion by previous and current members to evaluate past, present and future challenges. Given the increasing range of data sources and the deployment of many new vaccines, the Committee is facing the complex task of identifying the best available evidence for recommendations on vaccine safety. To help meet the increased demand for public transparency in decision making, GACVS-structured methodology for evidence-based decisions is evolving. GACVS also promotes best practices and capacity building for timely and accurate risk assessment; risk communications; outreach to help countries maintain and, if needed, rebuild public trust in vaccines; and advocacy for bridging the major gaps in vaccine safety capacity globally.
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Affiliation(s)
- Edwin J Asturias
- Center for Global Health, Colorado School of Public Health, Aurora, CO, USA; Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, USA.
| | - Melinda Wharton
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Robert Pless
- Communicable Disease Surveillance, Public Health Agency of Canada, Canada
| | - Noni E MacDonald
- Department of Pediatrics, Dalhousie University, Halifax, NS, Canada
| | - Robert T Chen
- National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Nicholas Andrews
- Statistics, Modelling and Economics Department, Public Health England, London, UK
| | - David Salisbury
- Centre for Global Health Security, Chatham House, London, UK
| | - Alexander N Dodoo
- WHO Collaborating Centre for Advocacy and Training in Pharmacovigilance, School of Medicine and Dentistry, University of Ghana Medical School, Ghana
| | - Kenneth Hartigan-Go
- Center for Development Management, Asian Institute of Management, Philippines
| | - Patrick L F Zuber
- Department of Essential Medicines and Health Products, World Health Organization, Geneva, Switzerland
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Mackey TK, Nayyar G. Digital danger: a review of the global public health, patient safety and cybersecurity threats posed by illicit online pharmacies. Br Med Bull 2016; 118:110-26. [PMID: 27151957 PMCID: PMC5127424 DOI: 10.1093/bmb/ldw016] [Citation(s) in RCA: 73] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/23/2016] [Indexed: 11/13/2022]
Abstract
BACKGROUND Amidst the rise of e-commerce, there has been a proliferation of illicit online pharmacies that threaten global patient safety by selling drugs without a prescription directly to the consumer. Despite this clear threat, little is known about the key risk characteristics, central challenges and current legal, regulatory and law enforcement responses. SOURCES OF DATA A review was conducted of the English literature with search terms 'online pharmacies', 'Internet pharmacies', 'cyber pharmacies', 'rogue pharmacies', and 'e-pharmacies' using PubMed, JSTOR, and Google Scholar from 1999-2005. AREAS OF AGREEMENT Illicit online pharmacies are a rapidly growing public health threat and are characterized by a number of complex and interrelated risk factors. AREAS OF CONTROVERSY Solutions are varied and are of questionable utility in the face of evolving technology that enables this form of transnational cybercrime. GROWING POINTS Legal, regulatory and technology solutions must address the entire illicit online pharmacy ecosystem in order to be effective. AREAS TIMELY FOR DEVELOPING RESEARCH There is a critical need to build international consensus, conduct additional research and develop technology to combat illicit online pharmacies.
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Affiliation(s)
- Tim K Mackey
- Department of Anesthesiology, University of California San Diego School of Medicine, San Diego, California, USA Global Health Policy Institute, San Diego, California, USA Division of Global Public Health, University of California San Diego School of Medicine, San Diego, California, USA
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Bednarek A. Parents’ decisions regarding vaccines and professional education about vaccinations. PIELEGNIARSTWO XXI WIEKU / NURSING IN THE 21ST CENTURY 2015. [DOI: 10.12923/p21w-2015-4/42] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
Introduction. Parents make decisions about the implementation of vaccination in children mainly relying on education provided by the medical staff. At the same time, they benefit from other sources of knowledge about infectious diseases and vaccines, including most commonly the Internet. An important factor influencing parents’ approaches to immunization includes also the experiences related with the implementation of immunoprophylaxis in their own offspring.
Aim. An attempt to assess the relationship between the number of children in a family and making decisions about the importance of vaccination as well as identification of the influence of sources of information on the parents’ view on immunization.
Material and methods. The pilot study comprised 156 mothers of the first child and 112 mothers giving birth to the subsequent child in the Department of Obstetrics and Pathology of Pregnancy, Teaching Hospital No. 1 in Lublin, in 2014. The method used was a diagnostic survey, using the author’s questionnaire, which included 16 questions related to the theme of the paper.
Results. The willingness to implement vaccination was confirmed by 98.1% of the mothers of the first and 100% of the subsequent child. The use of combined vaccines was declared by significantly more mothers expecting subsequent child (66.9%; p<0.001). Only mothers expecting their first child in the majority did not take a decision as to the form of immunoprophylaxis (24.11%; p<0.001). The recommended vaccinations are used more often by mothers of the subsequent child (28.57%; p<0.05). Education by medical staff contributed to the decision concerning implementation of the vaccination in 71.8% of mothers of the first and 43.8% of the subsequent child.
Conclusion. Different sources of knowledge about children’s vaccinations and mothers’ experience positively shape their vaccinology decisions. The combined vaccines – according to the declarations of the respondents - are most often used in mandatory immunoprophylaxis.
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Affiliation(s)
- Anna Bednarek
- Katedra i Zakład Pielęgniarstwa Pediatrycznego, Wydział Nauk o Zdrowiu, Uniwersytet Medyczny w Lublinie
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The Technological Growth in eHealth Services. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2015; 2015:894171. [PMID: 26146515 PMCID: PMC4469784 DOI: 10.1155/2015/894171] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Accepted: 04/27/2015] [Indexed: 12/31/2022]
Abstract
The infusion of information communication technology (ICT) into health services is emerging as an active area of research. It has several advantages but perhaps the most important one is providing medical benefits to one and all irrespective of geographic boundaries in a cost effective manner, providing global expertise and holistic services, in a time bound manner. This paper provides a systematic review of technological growth in eHealth services. The present study reviews and analyzes the role of four important technologies, namely, satellite, internet, mobile, and cloud for providing health services.
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Grant L, Hausman BL, Cashion M, Lucchesi N, Patel K, Roberts J. Vaccination persuasion online: a qualitative study of two provaccine and two vaccine-skeptical websites. J Med Internet Res 2015; 17:e133. [PMID: 26024907 PMCID: PMC4468570 DOI: 10.2196/jmir.4153] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2014] [Revised: 03/24/2015] [Accepted: 04/14/2015] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Current concerns about vaccination resistance often cite the Internet as a source of vaccine controversy. Most academic studies of vaccine resistance online use quantitative methods to describe misinformation on vaccine-skeptical websites. Findings from these studies are useful for categorizing the generic features of these websites, but they do not provide insights into why these websites successfully persuade their viewers. To date, there have been few attempts to understand, qualitatively, the persuasive features of provaccine or vaccine-skeptical websites. OBJECTIVE The purpose of this research was to examine the persuasive features of provaccine and vaccine-skeptical websites. The qualitative analysis was conducted to generate hypotheses concerning what features of these websites are persuasive to people seeking information about vaccination and vaccine-related practices. METHODS This study employed a fully qualitative case study methodology that used the anthropological method of thick description to detail and carefully review the rhetorical features of 1 provaccine government website, 1 provaccine hospital website, 1 vaccine-skeptical information website focused on general vaccine safety, and 1 vaccine-skeptical website focused on a specific vaccine. The data gathered were organized into 5 domains: website ownership, visual and textual content, user experience, hyperlinking, and social interactivity. RESULTS The study found that the 2 provaccine websites analyzed functioned as encyclopedias of vaccine information. Both of the websites had relatively small digital ecologies because they only linked to government websites or websites that endorsed vaccination and evidence-based medicine. Neither of these websites offered visitors interactive features or made extensive use of the affordances of Web 2.0. The study also found that the 2 vaccine-skeptical websites had larger digital ecologies because they linked to a variety of vaccine-related websites, including government websites. They leveraged the affordances of Web 2.0 with their interactive features and digital media. CONCLUSIONS By employing a rhetorical framework, this study found that the provaccine websites analyzed concentrate on the accurate transmission of evidence-based scientific research about vaccines and government-endorsed vaccination-related practices, whereas the vaccine-skeptical websites focus on creating communities of people affected by vaccines and vaccine-related practices. From this personal framework, these websites then challenge the information presented in scientific literature and government documents. At the same time, the vaccine-skeptical websites in this study are repositories of vaccine information and vaccination-related resources. Future studies on vaccination and the Internet should take into consideration the rhetorical features of provaccine and vaccine-skeptical websites and further investigate the influence of Web 2.0 community-building features on people seeking information about vaccine-related practices.
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Affiliation(s)
- Lenny Grant
- Vaccination Research Group, Department of English, Virginia Tech, Blacksburg, VA, United States.
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García-Basteiro AL, Álvarez-Pasquín MJ, Mena G, Llupià A, Aldea M, Sequera VG, Sanz S, Tuells J, Navarro-Alonso JA, de Arísteguí J, Bayas JM. A public-professional web-bridge for vaccines and vaccination: User concerns about vaccine safety. Vaccine 2012; 30:3798-805. [DOI: 10.1016/j.vaccine.2011.10.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2011] [Revised: 09/06/2011] [Accepted: 10/03/2011] [Indexed: 11/30/2022]
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Liang BA, Mackey TK. Vaccine shortages and suspect online pharmacy sellers. Vaccine 2011; 30:105-8. [PMID: 22094281 DOI: 10.1016/j.vaccine.2011.11.016] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2011] [Revised: 10/24/2011] [Accepted: 11/03/2011] [Indexed: 11/28/2022]
Abstract
Vaccines represent half the products on the FDA Biologics Product Shortages list. As a result, providers and patients may purchase them online, a process rife with patient safety risks. We examined vaccine online availability by assessing up to 5 identified online sellers. We determined if sites were accredited by the National Association of Boards of Pharmacy (NABP) VIPPS program, listed as US or international, employed social media linking to suspect online pharmacies, and if they were on the NABP Not Recommended list. All vaccines were advertised by online pharmacies and through data aggregation and social media sites, none were VIPPS-accredited, and most were on the NABP Not Recommended list. We found some online sellers advertising vaccines as over-the-counter. We extended our analysis to WHO Essential Medicines List vaccines and found all are also available online from suspect, non-VIPPS accredited sellers. Stakeholders should be aware of these online patient safety dangers.
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Affiliation(s)
- Bryan A Liang
- Institute of Health Law Studies, California Western School of Law, 350 Cedar Street, San Diego, CA 92101, USA.
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Comparison of quality of internet pages on human papillomavirus immunization in Italian and in English. J Adolesc Health 2010; 46:83-9. [PMID: 20123262 DOI: 10.1016/j.jadohealth.2009.05.006] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2009] [Revised: 05/14/2009] [Accepted: 05/18/2009] [Indexed: 11/22/2022]
Abstract
PURPOSE Information available on the Internet about immunizations may influence parents' perception about human papillomavirus (HPV) immunization and their attitude toward vaccinating their daughters. We hypothesized that the quality of information on HPV available on the Internet may vary with language and with the level of knowledge of parents. To this end we compared the quality of a sample of Web pages in Italian with a sample of Web pages in English. METHODS Five reviewers assessed the quality of Web pages retrieved with popular search engines using criteria adapted from the Good Information Practice Essential Criteria for Vaccine Safety Web Sites recommended by the World Health Organization. Quality of Web pages was assessed in the domains of accessibility, credibility, content, and design. Scores in these domains were compared through nonparametric statistical tests. RESULTS We retrieved and reviewed 74 Web sites in Italian and 117 in English. Most retrieved Web pages (33.5%) were from private agencies. Median scores were higher in Web pages in English compared with those in Italian in the domain of accessibility (p < .01), credibility (p < .01), and content (p < .01). The highest credibility and content scores were those of Web pages from governmental agencies or universities. Accessibility scores were positively associated with content scores (p < .01) and with credibility scores (p < .01). A total of 16.2% of Web pages in Italian opposed HPV immunization compared with 6.0% of those in English (p < .05). CONCLUSIONS Quality of information and number of Web pages opposing HPV immunization may vary with the Web site language. High-quality Web pages on HPV, especially from public health agencies and universities, should be easily accessible and retrievable with common Web search engines.
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Abstract
PURPOSE OF REVIEW This review highlights recent publications on the use of the Internet as it relates to pediatric primary care, including its application to the pediatrician, teen, pediatric patient, and patients' parents. A brief overview of early work is introduced. RECENT FINDINGS The Internet has become a tool to expand the reach of preventive interventions, including school-based online pediatric health education. Although research continues to describe barriers to the adoption of online resources, recent reports highlight newer applications, including user-generated content (i.e. social networking sites), and the impact on teens and their health. There are concerns and benefits of Web 2.0 and the teen population, with adolescents at risk online yet also learning about their health online. Internet referrals, prescriptions for information, and online assessment methods have had varied success to date. There have been some studies of e-learning and online continuing medical education having an impact on clinical decision making, but there is a need for more research on the electronic medical record as it relates to the practicing pediatrician and the Internet at the point of care. SUMMARY The Internet is more than an information repository and continues to affect the lives and health of the pediatric population, parents, and providers. The growth of and changes to the Internet over time bring online innovations that have yet to be studied.
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Global safety of vaccines: strengthening systems for monitoring, management and the role of GACVS. Expert Rev Vaccines 2009; 8:705-16. [PMID: 19485752 DOI: 10.1586/erv.09.40] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Vaccines have contributed enormously in reducing the impact of many infectious diseases, and the expanded use of new and existing vaccines provides unprecedented potential for further reducing the global burden of infectious diseases. Yet, as with the deployment of other technologies, their use may also sometimes be associated with undesirable effects that need to be identified rapidly, understood and minimized. In this article, we review the models and systems that have been developed to monitor and respond to concerns regarding vaccine safety and we give illustrative examples of real or perceived vaccine safety issues. The Global Advisory Committee on Vaccine Safety (GACVS) was set up 10 years ago and charged to provide the WHO with independent advice on vaccine safety issues. The role of the GACVS is both to analyze and to interpret reports of the adverse effects of vaccines that impact on global vaccination programs and strategies, and to foster the development of improved surveillance systems to detect any adverse effects of vaccines, particularly in low- and middle-income countries. It also monitors the development of new vaccines during clinical testing and advises on the safe use of vaccines in immunization programs. As success is achieved with reducing the burden of vaccine-preventable diseases, there will be increasing attention focused on potential adverse effects, on the development of effective surveillance systems to detect adverse effects, and on improved methods to manage and control any harmful consequences of vaccination.
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