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Marvila Garcia É, Lima de Souza E, Penido Matozinhos F, Moreira Ribeiro da Silva T, Alves Waldman E, Sato APS. Associated factors with vaccine hesitancy in mothers of children up to two years old in a Brazilian city. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0002026. [PMID: 37289722 DOI: 10.1371/journal.pgph.0002026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 05/15/2023] [Indexed: 06/10/2023]
Abstract
This study aims to evaluate maternal vaccine hesitancy and its associated factors. This is a cross-sectional study of a probabilistic sample of 450 mothers of children born in 2015, living in a Brazilian city, and who was, at the time of data collection, more than two years old. We used the tool proposed by the World Health Organization (10-item Vaccine Hesitancy Scale). To assess its structure, we performed, exploratory and confirmatory factor analyses. We performed linear regression models to evaluate the factors associated with vaccine hesitancy. The factor analysis showed two components for the vaccine hesitancy scale: lack of confidence in vaccines and risk perception of vaccines. High family income was associated with lower vaccine hesitancy (greater confidence in vaccines and lower risk perception of vaccines), while the presence of other children, regardless of birth order, in the family was associated with lower confidence in vaccines. A good rapport with health professionals, willingness to wait for the vaccination and the getting vaccinated through campaigns were associated with greater confidence in vaccines. The deliberate delay or decision not to vaccinate their children and previous experience with adverse reactions to the vaccine were associated with lower confidence in vaccines and greater risk perception of vaccines. Health care providers, especially nurses, play a relevant role to address vaccine hesitancy, guiding vaccination through a trustworthy rapport.
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Management Options for Ixodes ricinus-Associated Pathogens: A Review of Prevention Strategies. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17061830. [PMID: 32178257 PMCID: PMC7143654 DOI: 10.3390/ijerph17061830] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Revised: 03/03/2020] [Accepted: 03/05/2020] [Indexed: 12/16/2022]
Abstract
Ticks are important human and animal parasites and vectors of many infectious disease agents. Control of tick activity is an effective tool to reduce the risk of contracting tick-transmitted diseases. The castor bean tick (Ixodes ricinus) is the most common tick species in Europe. It is also a vector of the causative agents of Lyme borreliosis and tick-borne encephalitis, which are two of the most important arthropod-borne diseases in Europe. In recent years, increases in tick activity and incidence of tick-borne diseases have been observed in many European countries. These increases are linked to many ecological and anthropogenic factors such as landscape management, climate change, animal migration, and increased popularity of outdoor activities or changes in land usage. Tick activity is driven by many biotic and abiotic factors, some of which can be effectively managed to decrease risk of tick bites. In the USA, recommendations for landscape management, tick host control, and tick chemical control are well-defined for the applied purpose of reducing tick presence on private property. In Europe, where fewer studies have assessed tick management strategies, the similarity in ecological factors influencing vector presence suggests that approaches that work in USA may also be applicable. In this article we review key factors driving the tick exposure risk in Europe to select those most conducive to management for decreased tick-associated risk.
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Fafangel M, Cassini A, Colzani E, Klavs I, Grgič Vitek M, Učakar V, Muehlen M, Vudrag M, Kraigher A. Estimating the annual burden of tick-borne encephalitis to inform vaccination policy, Slovenia, 2009 to 2013. ACTA ACUST UNITED AC 2017; 22:30509. [PMID: 28449731 PMCID: PMC5404479 DOI: 10.2807/1560-7917.es.2017.22.16.30509] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Accepted: 09/09/2016] [Indexed: 12/15/2022]
Abstract
With an annual incidence between 8 and 15 per 100,000 population in the period from 2009 to 2013, Slovenia has one of the highest notified incidences of tick-borne encephalitis (TBE) in Europe. TBE vaccination coverage remains at about 7.3%. To inform vaccination policy, we used surveillance data from 2009 to 2013 to calculate the overall and age- and sex-specific mean annual TBE incidence. We estimated disability-adjusted life years (DALYs) with 95% uncertainty intervals (UI), using the Burden of Communicable Diseases in Europe approach from the European Centre for Disease Prevention and Control. The mean annual incidence was 11.6 per 100,000 population, peaking in older age groups (50-74 years: 18.5/100,000) while relatively lower among children (5-14 years: 10.2/100,000). We estimated an overall 10.95 DALYs per 100,000 population per year (95% UI: 10.25-11.65). In contrast to the TBE incidence, the disease burden in children aged 5-14 years was higher than in adults aged 50-74 years: 17.31 (95% UI: 14.58-20.08) and 11.58 (95% UI: 10.25-12.91) DALYs per 100,000 stratum-specific population, respectively. In a limited resource setting where prioritisation of TBE vaccination strategies is required, vaccination programmes targeting children may have a higher impact on disease burden.
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Affiliation(s)
- Mario Fafangel
- National Institute of Public Health (NIJZ), Ljubljana, Slovenia.,European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Alessandro Cassini
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden.,Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Edoardo Colzani
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden.,Department of Health Science, University of Milano-Bicocca, Monza, Italy
| | - Irena Klavs
- National Institute of Public Health (NIJZ), Ljubljana, Slovenia
| | | | - Veronika Učakar
- National Institute of Public Health (NIJZ), Ljubljana, Slovenia
| | - Marion Muehlen
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Marko Vudrag
- National Institute of Public Health (NIJZ), Ljubljana, Slovenia
| | - Alenka Kraigher
- National Institute of Public Health (NIJZ), Ljubljana, Slovenia
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The International Scientific Working Group on Tick-Borne Encephalitis (ISW TBE): Review of 17 years of activity and commitment. Ticks Tick Borne Dis 2016; 7:399-404. [DOI: 10.1016/j.ttbdis.2015.12.018] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Accepted: 12/21/2015] [Indexed: 12/11/2022]
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Šmit R, Postma MJ. The Burden of Tick-Borne Encephalitis in Disability-Adjusted Life Years (DALYs) for Slovenia. PLoS One 2015; 10:e0144988. [PMID: 26672751 PMCID: PMC4684505 DOI: 10.1371/journal.pone.0144988] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2014] [Accepted: 11/25/2015] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Tick-borne encephalitis (TBE) presents an increasing burden in many parts of Europe, Asian Russia, Siberia, Asian former USSR and Far East. Incidence can be considered as one way to express the burden. A more comprehensive measure concerns disability-adjusted life years (DALYs), better characterizing the full burden of TBE. TBE burden in DALYs has not yet been estimated, nor has it been specified by the Global Burden of Disease (GBD) studies. OBJECTIVE The purpose of the present study is to estimate the burden of TBE in Slovenia, expressed in DALYs, both from the population and individual perspectives. We discuss the impact of TBE burden on public health and potential strategies to reduce this burden in Slovenia. METHODS The burden of TBE is estimated by using the updated DALYs' methodology first introduced in the GBD project. The DALYs᾽ calculations are based on the health outcomes of the natural course of the disease being modelled. Corrections for under-reporting and under-ascertainment are applied. The impact of uncertainty in parameters in the model was assessed using sensitivity analyses. RESULTS From the population perspective, total DALYs amount to 3,450 (167.8 per 100,000 population), while from the individual perspective they amount to 3.1 per case in 2011. Notably, the consequences of TBE present a larger burden than TBE itself. CONCLUSIONS TBE presents a relatively high burden expressed in DALYs compared with estimates for other infectious diseases from the GBD 2010 study for Slovenia. Raising awareness and increasing vaccination coverage are needed to reduce TBE and its consequences.
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Affiliation(s)
- Renata Šmit
- Department of Pharmacy, Unit of PharmacoEpidemiology & PharmacoEconomics (PE2), University of Groningen, Groningen, Netherlands
- Institute for Science in Healthy Aging & healthcaRE (SHARE), University Medical Center Groningen (UMCG), University of Groningen, Groningen, Netherlands
| | - Maarten J. Postma
- Department of Pharmacy, Unit of PharmacoEpidemiology & PharmacoEconomics (PE2), University of Groningen, Groningen, Netherlands
- Institute for Science in Healthy Aging & healthcaRE (SHARE), University Medical Center Groningen (UMCG), University of Groningen, Groningen, Netherlands
- Department of Epidemiology, UMCG, University of Groningen, Groningen, Netherlands
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Slunge D. The Willingness to Pay for Vaccination against Tick-Borne Encephalitis and Implications for Public Health Policy: Evidence from Sweden. PLoS One 2015; 10:e0143875. [PMID: 26641491 PMCID: PMC4671589 DOI: 10.1371/journal.pone.0143875] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2015] [Accepted: 11/10/2015] [Indexed: 12/30/2022] Open
Abstract
The increasing incidence of tick-borne encephalitis (TBE) in Sweden and several other European countries has sparked a discussion about the need for a public vaccination strategy. However, TBE vaccination coverage is incomplete and there is little knowledge about the factors influencing vaccination behavior. Based on a survey of 1,500 randomly selected respondents in Sweden, we estimate vaccination coverage in areas with different TBE risk levels and analyze the role of vaccine price and other factors influencing the demand for vaccination. First, we find that the average rate of TBE vaccination in Sweden is 33% in TBE risk areas and 18% elsewhere. Income, age and risk-related factors such as incidence of TBE in the area of residence, frequency of visits to areas with TBE risk, and experience with tick bites are positively associated with demand for TBE vaccine. Next, using contingent valuation methodology, we estimate the willingness to pay for TBE vaccination among the unvaccinated respondents and the effect of a possible subsidy. Among the unvaccinated respondents in TBE risk areas, we estimate the mean willingness to pay for the recommended three doses of TBE vaccine to be 465 SEK (approximately 46 euros or 40% of the current market price). We project that a subsidy making TBE vaccines free of charge could increase the vaccination rate in TBE risk areas to around 78%, with a larger effect on low-income households, whose current vaccination rate is only 15% in risk areas. However, price is not the only factor affecting demand. We find significant effects on vaccination behavior associated with trust in vaccine recommendations, perceptions about tick bite-related health risks and knowledge about ticks and tick-borne diseases. Hence, increasing knowledge and trust, as well as ease of access to vaccinations, can also be important measures for public health agencies that want to increase the vaccination rate.
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Affiliation(s)
- Daniel Slunge
- Department of Economics, University of Gothenburg, Gothenburg, Sweden
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Kawakatsu Y, Tanaka J, Ogawa K, Ogendo K, Honda S. Effects of three interventions and determinants of full vaccination among children aged 12-59 months in Nyanza province, Kenya. Public Health 2015; 129:1530-8. [PMID: 26278475 DOI: 10.1016/j.puhe.2015.07.008] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2015] [Revised: 07/09/2015] [Accepted: 07/13/2015] [Indexed: 11/19/2022]
Abstract
OBJECTIVES The purpose of this study is to describe the effects of the three main interventions and identify the individual and community determinants of full vaccination coverage among children aged 12-59 months in Nyanza province, Kenya. STUDY DESIGN Cross-sectional study. METHODS We utilized three datasets. One is the Nyanza Province County-based Multiple Indicator Cluster Survey 2011. The other two datasets are the lists of community units and health facilities in Nyanza Province, Kenya. A three-level multilevel logistic regression analysis was performed. RESULTS In the final model, the highest wealth quintile (AOR: 2.49; 95% CI: 1.333-4.642; P = 0.004), the community with high coverage of media devices (AOR: 1.50; 95% CI: 1.029-2.198; P = 0.035), the participation of mass immunization campaigns (AOR: 1.63; 95% CI: 1.153-2.303; P = 0.006) were the significant determinants of complete child vaccination. CONCLUSIONS In conclusion, further implementation of mass immunization campaigns is the recommended intervention to increase the uptake of required vaccinations among children. In addition, further attention to the poor and the low coverage of media devices is necessary, since they are the most vulnerable population in terms of accessibility of vaccination services. Implementation community based activity, such as community health workers, would have a positive impact on vaccination coverage, if their performance is continuously high.
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Affiliation(s)
- Y Kawakatsu
- Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan.
| | - J Tanaka
- Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - K Ogawa
- Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | | | - S Honda
- Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
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Grgič-Vitek M. Estimating vaccination coverage against tick-borne encephalitis: comment on: Košnik IG, Lah AK. A campaign to increase the vaccination rate in a highly endemic tick-borne encephalitis region of Slovenia. Vaccine 2013;31(5):732-4. Vaccine 2013; 32:2944. [PMID: 23747455 DOI: 10.1016/j.vaccine.2013.05.093] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2013] [Revised: 05/20/2013] [Accepted: 05/22/2013] [Indexed: 11/19/2022]
Affiliation(s)
- Marta Grgič-Vitek
- National Institute of Public Health, Trubarjeva 2, 1000 Ljubljana, Slovenia.
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Lantos PM. Lyme disease vaccination: are we ready to try again? THE LANCET. INFECTIOUS DISEASES 2013; 13:643-4. [PMID: 23665340 DOI: 10.1016/s1473-3099(13)70085-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- Paul M Lantos
- Department of Internal Medicine, Duke University School of Medicine, Durham, NC 27710, USA.
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