1
|
Worm M, Demoly P, Okamoto Y, Vidal C, Daghildjian K, Yan K, Casale TB, Bergmann KC. Safety of 300IR house dust mite sublingual tablet from pooled clinical trial and post-marketing data. World Allergy Organ J 2024; 17:100924. [PMID: 39035788 PMCID: PMC11259958 DOI: 10.1016/j.waojou.2024.100924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Revised: 05/13/2024] [Accepted: 06/05/2024] [Indexed: 07/23/2024] Open
Abstract
Background The 300IR house dust mite (HDM) sublingual immunotherapy (SLIT) tablet is approved for treatment of HDM-induced allergic rhinitis (AR). To provide a comprehensive review of the 300IR HDM-SLIT tablet safety profile based on randomized controlled trial (RCT) pooled data and post-marketing (PM) pharmacovigilance data. Methods Subjects (5-65 years) with confirmed HDM-AR with or without controlled asthma were treated with 300IR or placebo in 8 RCTs. Reported treatment-emergent adverse events (TEAEs) were pooled and analyzed descriptively in subsets of adults/adolescents and children. Adverse reactions (ADRs) collected from spontaneous reporting and PM studies through a pharmacovigilance system since the first marketing authorization were also analyzed. Results Across RCTs, 1853 subjects were treated with the 300IR HDM-SLIT tablet and 1846 with placebo. In both subsets of adults/adolescents and children whichever their asthma status, treatment-related TEAEs of higher incidence in active groups vs placebo were mostly consistent with mild or moderate local application-site reactions. They were mainly reported on the first days of treatment and decreased over time. 4 severe laryngopharyngeal reactions (2 requiring adrenaline/epinephrine) and 1 moderate eczema considered serious rapidly resolved with medications; no anaphylaxis was reported. In PM settings, ADRs reported in more than 235,000 patients were in line with RCT findings. Severe systemic reactions occurred rarely; 12 anaphylactic reactions resolved safely (5 with adrenaline). No new safety signal was raised. Conclusion Safety data from RCTs and more than 7 years of real-life experience confirmed the favorable safety profile of 300IR HDM-SLIT tablet in patients across different regions, regardless of age and asthma status. Clinical trial registrations NCT00674700; Retrospectively registered 06 May 2008.NCT01199133; Retrospectively registered 09 September 2010.NCT01527188; Retrospectively registered 01 February 2012.NCT02443805; Registered 29 April 2015/EudraCT 2014-004223-46; Registered 16 September 2015.jRCT2080221872/JapicCTI-121917; Registered 01 August 2012.jRCT2080222929/JapicCTI-15298; Registered 04 August 2015.
Collapse
Affiliation(s)
- Margitta Worm
- Division of Allergy and Immunology, Department of Dermatology and Allergology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Pascal Demoly
- Division of Allergy, Department of Pulmonology, Hôpital Arnaud de Villeneuve, University Hospital of Montpellier and IDESP UMR UA11, University of Montpellier - Inserm, Montpellier, France
| | - Yoshitaka Okamoto
- Department of Otorhinolaryngology-Head and Neck Surgery, Graduate School of Medicine, Chiba University and Chiba Rosai Hospital, Chiba, Japan
| | - Carmen Vidal
- Allergy Department, Complejo Hospitalario Universitario de Santiago, Faculty of Medicine, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Katia Daghildjian
- Global Medical Affairs Department, Stallergenes Greer, Antony, France
| | - Kwok Yan
- Department of Respiratory Medicine, Royal Prince Alfred Hospital, Sydney, Australia
| | - Thomas B. Casale
- Division of Allergy and Immunology, University of South Florida, Tampa, FL, USA
| | | |
Collapse
|
2
|
Lu Q, Schulz PJ, Chang A. Medication safety perceptions in China: Media exposure, healthcare experiences, and trusted information sources. PATIENT EDUCATION AND COUNSELING 2024; 123:108209. [PMID: 38367304 DOI: 10.1016/j.pec.2024.108209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 01/01/2024] [Accepted: 02/12/2024] [Indexed: 02/19/2024]
Abstract
OBJECTIVE Amid ongoing medication safety concerns in China and limited research on public perceptions, this study investigates the correlations between media exposure, healthcare experiences, and individuals' perceptions of medication safety. It also examines individuals' reliance on information sources during safety crises. METHODS A multistage stratified random sampling was employed with the gross sample containing 3090 Chinese adults aged 18-60 years. Data were analyzed using multiple linear regression. RESULTS Social media exposure was found to negatively correlate with perceptions of current medication safety and its perceived improvement, while exposure to television and print media showed positive correlations. Positive healthcare experiences were associated with improved medication safety perceptions. Among various information sources, healthcare professionals were deemed most trustworthy during medication safety incidents. CONCLUSIONS Media exposure and personal healthcare experiences significantly shape individuals' perceptions of medication safety in China, with healthcare professionals playing a crucial role in this context. Practiceimplications: Effective health crisis communication in China needs to be multifaceted, integrating traditional media and social media platforms to disseminate accurate information broadly. Additionally, healthcare professionals should be actively involved in crisis communication. Their role as trusted sources can be leveraged to clarify misconceptions, and reassure the public during medication safety incidents.
Collapse
Affiliation(s)
- Qianfeng Lu
- Faculty of Communication, Culture and Society, Università della Svizzera italiana (USI), Lugano, Switzerland
| | - Peter J Schulz
- Faculty of Communication, Culture and Society, Università della Svizzera italiana (USI), Lugano, Switzerland; Department of Communication & Media, Ewha Womans University, Seoul, South Korea.
| | - Angela Chang
- Faculty of Social Sciences, University of Macau, Macau, China
| |
Collapse
|
3
|
Muñoz CE, Pham-Huy A, Pernica JM, Boucher FD, De Serres G, Vaudry W, Constantinescu C, Sadarangani M, Bettinger JA, Tapiéro B, Morris SK, McConnell A, Noya F, Halperin SA, Top KA. Factors associated with intention for revaccination among patients with adverse events following immunization. Vaccine 2023; 41:6239-6247. [PMID: 37666696 DOI: 10.1016/j.vaccine.2023.08.067] [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: 05/19/2023] [Revised: 08/17/2023] [Accepted: 08/24/2023] [Indexed: 09/06/2023]
Abstract
OBJECTIVES Individuals and healthcare providers may be uncertain about the safety of revaccination after an adverse event following immunization (AEFI). We identified factors associated with physician recommendation for revaccination and participant intention to be revaccinated among patients with adverse events following immunization (AEFIs) assessed in the Canadian Special Immunization Clinic (SIC) Network from 2013 to 2019. METHODS This prospective observational study included patients assessed in the Canadian Special Immunization Clinic Network from 2013 to 2019 for an AEFI who required additional doses of the vaccine temporally associated with their AEFI. Participants underwent standardized assessment and data collection. Physician recommendations regarding revaccination and participant intent for revaccination were recorded. AEFI impact on daily activities and need for medical attention was captured as low, moderate, high impact and serious (e.g., requiring hospitalization). Multivariable logistic regression analysis identified factors associated with physician recommendation and participant intention for revaccination, controlling for province of assessment. RESULTS Physician recommendation was significantly associated with the type of AEFI and AEFI impact. Compared to large local reaction, physician recommendation for revaccination was reduced for immediate hypersensitivity (aOR: 0.24 [95% CI: 0.08-0.76]) and new onset autoimmune disease (aOR: 0.16; 95% CI: 0.04-0.69). Compared to low impact AEFIs, physician recommendation was reduced for moderate (aOR: 0.22 [95% CI: 0.07-0.65]), high impact (aOR: 0.08 [95% CI: 0.02-0.30]), and serious AEFIs (aOR: 0.11 [95% CI: 0.03-0.37]). Participant intention for revaccination was significantly associated with AEFI impact, with reduced odds for high versus low impact AEFIs (aOR: 0.12 [95% CI: 0.04-0.42]). CONCLUSION Physicians appear to use AEFI type and impact to guide recommendations while patients use primarily AEFI impact to form intentions for revaccination. The findings may help inform counselling for patients with AEFIs.
Collapse
Affiliation(s)
- Caroline E Muñoz
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada; Canadian Center for Vaccinology, IWK Health, Nova Scotia Health, and Dalhousie University, Halifax, Nova Scotia, Canada
| | - Anne Pham-Huy
- Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, Ontario, Canada
| | - Jeffrey M Pernica
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
| | - François D Boucher
- Centre hospitalier universitaire de Québec-Université Laval, Québec, Québec, Canada
| | - Gaston De Serres
- Centre hospitalier universitaire de Québec-Université Laval, Québec, Québec, Canada
| | - Wendy Vaudry
- Stollery Children's Hospital, University of Alberta, Edmonton, Alberta, Canada
| | - Cora Constantinescu
- Alberta Children's Hospital, University of Calgary, Calgary, Alberta, Canada
| | - Manish Sadarangani
- Vaccine Evaluation Center, BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada; Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada
| | - Julie A Bettinger
- Vaccine Evaluation Center, BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada; Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada
| | - Bruce Tapiéro
- Division of Infectious Diseases, CHU Sainte Justine, Université de Montréal, Montréal QC, Canada
| | - Shaun K Morris
- Division of Infectious Diseases, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Athena McConnell
- Jim Pattison Children's Hospital, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Francisco Noya
- Division of Allergy and Immunology and Division of Infectious Diseases, Montreal Children's Hospital-McGill University Health Centre, Montreal, QC, Canada
| | - Scott A Halperin
- Canadian Center for Vaccinology, IWK Health, Nova Scotia Health, and Dalhousie University, Halifax, Nova Scotia, Canada; Department of Pediatrics, Dalhousie University, Canada
| | - Karina A Top
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada; Canadian Center for Vaccinology, IWK Health, Nova Scotia Health, and Dalhousie University, Halifax, Nova Scotia, Canada; Department of Pediatrics, Dalhousie University, Canada.
| |
Collapse
|
4
|
Dudley MZ, Omer SB, O'Leary ST, Limaye RJ, Ellingson MK, Spina CI, Brewer SE, Bednarczyk RA, Chamberlain AT, Malik F, Frew PM, Church-Balin C, Riley LE, Ault KA, Orenstein WA, Halsey NA, Salmon DA. MomsTalkShots, tailored educational app, improves vaccine attitudes: a randomized controlled trial. BMC Public Health 2022; 22:2134. [PMID: 36411403 PMCID: PMC9676851 DOI: 10.1186/s12889-022-14498-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 10/13/2022] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Many pregnant women and parents have concerns about vaccines. This analysis examined the impact of MomsTalkShots, an individually tailored educational application, on vaccine attitudes of pregnant women and mothers. METHODS MomsTalkShots was the patient-level component of a multi-level intervention to improve maternal and infant vaccine uptake that also included provider- and practice-level interventions. The impact of these interventions was studied using a two-by-two factorial design, randomizing at both the patient- and the practice-level. Study staff recruited pregnant women from a diverse set of prenatal care practices in Colorado and Georgia between June 2017 and July 2018. All participants (n = 2087) received a baseline survey of maternal and infant vaccine intentions and attitudes, and two follow-up surveys at least 1 month and 1 year after their infant's birth, respectively. Half of participants (n = 1041) were randomly assigned to receive educational videos through MomsTalkShots, algorithmically tailored to their vaccine intentions, attitudes, and demographics. Since the practice/provider intervention did not appear impactful, this analysis focused on MomsTalkShots regardless of the practice/provider intervention. RESULTS By 1 month post-birth, MomsTalkShots increased perceived risk of maternal influenza disease (61% among MomsTalkShots recipients vs 55% among controls; Odds Ratio: 1.61, 95% Confidence Interval: 1.23-2.09), confidence in influenza vaccine efficacy (73% vs 63%; OR: 1.97, 95%CI: 1.47-2.65), and perceived vaccine knowledge (55% vs 48%; OR: 1.39, 95%CI: 1.13-1.72). Among those intending not to vaccinate at baseline, MomsTalkShots increased perceived risk of maternal influenza disease (38% vs 32%; OR: 2.07, 95%CI: 1.15-3.71) and confidence in influenza vaccine efficacy (44% vs 28%; OR: 2.62, 95%CI: 1.46-4.69). By 1 year post-birth, MomsTalkShots increased perceived vaccine knowledge (62% vs 50%; OR: 1.74, 95%CI: 1.36-2.24) and trust in vaccine information from obstetricians and pediatricians (64% vs 55%; OR: 1.53, 95%CI: 1.17-2.00). Among those uncertain about vaccinating at baseline, MomsTalkShots increased perceived vaccine knowledge (47% vs 12%; OR: 6.89, 95%CI: 1.52-31.25) and reduced infant vaccine safety concerns (71% vs 91%; OR: 0.24, 95%CI: 0.06-0.98). CONCLUSIONS MomsTalkShots improved pregnant women's and mothers' knowledge and perceptions of maternal and infant vaccines and the diseases they prevent, and offers a scalable tool to address vaccine hesitancy. TRIAL REGISTRATION Registered at Clinicaltrials.gov on 13/09/2016 (registration number: NCT02898688).
Collapse
Affiliation(s)
- Matthew Z Dudley
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, 615 N Wolfe St, W5041, Baltimore, MD, 21205, USA.
- Institute for Vaccine Safety, Johns Hopkins University Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA.
| | - Saad B Omer
- Yale Institute for Global Health, Yale School of Medicine, New Haven, USA
- Department of Infectious Diseases, Yale School of Medicine, New Haven, USA
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, USA
- Department of Health Policy and Management, Yale School of Public Health, New Haven, USA
| | - Sean T O'Leary
- Adult and Child Center for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus and Children's Hospital Colorado, 1890 N Revere Ct. Mailstop F443, Aurora, CO, 80045, USA
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, 13123 E 16th Ave, Aurora, CO, 80045, USA
| | - Rupali J Limaye
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, 615 N Wolfe St, W5041, Baltimore, MD, 21205, USA
- Institute for Vaccine Safety, Johns Hopkins University Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA
- International Vaccine Access Center, Johns Hopkins University Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA
- Present address: Merck & Co., Inc., (at Emory University and the University of Nevada - not Merck - when work was performed), NJ, Kenilworth, USA
| | - Mallory K Ellingson
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, USA
| | - Christine I Spina
- Adult and Child Center for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus and Children's Hospital Colorado, 1890 N Revere Ct. Mailstop F443, Aurora, CO, 80045, USA
| | - Sarah E Brewer
- Adult and Child Center for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus and Children's Hospital Colorado, 1890 N Revere Ct. Mailstop F443, Aurora, CO, 80045, USA
- Department of Family Medicine, University of Colorado Anschutz Medical Campus, 13001 E 17th Pl, Aurora, CO, 80045, USA
| | - Robert A Bednarczyk
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, 1518 Clifton Rd. NE, Atlanta, GA, 30322, USA
- Department of Epidemiology, Rollins School of Public Health, Emory University, 1518 Clifton Rd. NE, Atlanta, GA, 30322, USA
- Emory Vaccine Center, Emory University, 201 Dowman Drive, Atlanta, GA, 30322, USA
| | - Allison T Chamberlain
- Department of Epidemiology, Rollins School of Public Health, Emory University, 1518 Clifton Rd. NE, Atlanta, GA, 30322, USA
| | - Fauzia Malik
- Department of Health Policy and Management, Yale School of Public Health, 60 College Street, New Haven, CT, 06520-0834, USA
| | - Paula M Frew
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, 1518 Clifton Rd. NE, Atlanta, GA, 30322, USA
- Division of Infectious Diseases, Department of Medicine, School of Medicine, Emory University, 2015 Uppergate Dr, Atlanta, GA, 30322, USA
- School of Public Health; School of Medicine; Population Health & Health Equity Initiative, Office of Research and Economic Development, University of Nevada, 4505 S. Maryland Pkwy, Las Vegas, NV, 89154, USA
- Present address: Merck & Co., Inc., (at Emory University and the University of Nevada - not Merck - when work was performed), NJ, Kenilworth, USA
| | - Cathy Church-Balin
- Center for Communication Programs, Johns Hopkins University Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA
| | - Laura E Riley
- Department of Obstetrics and Gynecology, Weill Cornell Medicine, 525 East 68th Street, New York, NY, 10065, USA
| | - Kevin A Ault
- Department of Obstetrics and Gynecology, University of Kansas School of Medicine, 3901 Rainbow Boulevard, Kansas City, KS, 66160, USA
| | - Walter A Orenstein
- Emory Vaccine Center, Emory University, 201 Dowman Drive, Atlanta, GA, 30322, USA
- Division of Infectious Diseases, Department of Medicine, School of Medicine, Emory University, 2015 Uppergate Dr, Atlanta, GA, 30322, USA
- Department of Pediatrics, School of Medicine, Emory University, 2015 Uppergate Dr, Atlanta, GA, 30322, USA
| | - Neal A Halsey
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, 615 N Wolfe St, W5041, Baltimore, MD, 21205, USA
- Institute for Vaccine Safety, Johns Hopkins University Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA
| | - Daniel A Salmon
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, 615 N Wolfe St, W5041, Baltimore, MD, 21205, USA
- Institute for Vaccine Safety, Johns Hopkins University Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA
- Department of Health, Behavior and Society, Johns Hopkins University Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA
| |
Collapse
|
5
|
Muñoz CE, MacDonald B, Pham-Huy A, Vaudry W, Pernica JM, Boucher FD, Constantinescu C, Sadarangani M, Bettinger JA, Tapiéro B, Morris SK, McConnell A, Cowan J, Zafack J, Upton J, Abdurrahman Z, McHenry M, Hildebrand KJ, Noya F, De Serres G, Halperin SA, Top KA. Revaccination and Adverse Event Recurrence in Patients with Adverse Events following Immunization. J Pediatr 2022; 250:45-53.e3. [PMID: 35948192 DOI: 10.1016/j.jpeds.2022.07.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Revised: 07/11/2022] [Accepted: 07/20/2022] [Indexed: 10/15/2022]
Abstract
OBJECTIVES To estimate the risk of recurrence of adverse events following immunization (AEFIs) upon revaccination and to determine among patients with suspected vaccine allergy whether allergy skin test positivity was associated with AEFI recurrence. STUDY DESIGN This prospective observational study included patients assessed in the Canadian Special Immunization Clinic Network from 2013 to 2019 with AEFIs who required revaccination with the vaccine temporally associated with their AEFI. Participants underwent standardized assessment and data collection. Special Immunization Clinic physicians used guidelines to inform their recommendations. Participants were followed up after revaccination to capture AEFI recurrences. Data were transferred to a central database for descriptive analysis. RESULTS Overall, 588 participants were assessed for 627 AEFIs; 570 (91%) AEFIs occurred in children <18 years of age. AEFIs included immediate hypersensitivity (130/627; 21%), large local reactions (110/627; 18%), nonurticarial rash (51/627; 8%), seizures (26/627; 4%), and thrombocytopenia (11/627; 2%). Revaccination was recommended to 513 of 588 (87%) participants. Among participants recommended and due for revaccination during the study period, 63% (299/477) were revaccinated. AEFI recurrence was 10% (31/299) overall, 31% (15/49) for large local reactions, and 7% (5/66) for immediate hypersensitivity. No recurrence was serious. Among 92 participants with suspected vaccine allergy who underwent skin testing and were revaccinated, the negative predictive value of skin testing for AEFI recurrence was 96% (95% CI 92.5%-99.5%). CONCLUSIONS Most individuals with AEFIs were safely revaccinated. Among those with suspected vaccine allergy, skin testing may help determine the safety of revaccination.
Collapse
Affiliation(s)
- Caroline E Muñoz
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada; Canadian Center for Vaccinology, IWK Health, Nova Scotia Health, and Dalhousie University, Halifax, Nova Scotia, Canada
| | - Beth MacDonald
- Canadian Center for Vaccinology, IWK Health, Nova Scotia Health, and Dalhousie University, Halifax, Nova Scotia, Canada; Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Anne Pham-Huy
- Division of Infectious Diseases, Immunology and Allergy, Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, Ontario, Canada
| | - Wendy Vaudry
- Stollery Children's Hospital, University of Alberta, Edmonton, Alberta, Canada
| | - Jeffrey M Pernica
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
| | - François D Boucher
- Centre hospitalier universitaire de Québec-Université Laval, Québec, Canada
| | - Cora Constantinescu
- Alberta Children's Hospital, University of Calgary, Calgary, Alberta, Canada
| | - Manish Sadarangani
- Vaccine Evaluation Center, BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada; Department of Pediatrics, Faculty of Medicine, University of British Columbia and BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada
| | - Julie A Bettinger
- Vaccine Evaluation Center, BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada; Department of Pediatrics, Faculty of Medicine, University of British Columbia and BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada
| | - Bruce Tapiéro
- Division of Infectious Diseases, CHU Sainte Justine, Université de Montréal, Montréal, Québec, Canada
| | - Shaun K Morris
- Division of Infectious Diseases, Hospital for Sick Children & Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Athena McConnell
- Jim Pattison Children's Hospital, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Juthaporn Cowan
- The Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Ontario, Canada
| | | | - Julia Upton
- Division of Infectious Diseases, Hospital for Sick Children & Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Zainab Abdurrahman
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
| | - Mary McHenry
- Department of Pediatrics, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Kyla J Hildebrand
- Department of Pediatrics, Faculty of Medicine, University of British Columbia and BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada
| | - Francisco Noya
- Division of Allergy and Immunology and Division of Infectious Diseases, Montreal Children's Hospital-McGill University Health Centre, Montreal, Quebec, Canada
| | - Gaston De Serres
- Centre hospitalier universitaire de Québec-Université Laval, Québec, Canada
| | - Scott A Halperin
- Canadian Center for Vaccinology, IWK Health, Nova Scotia Health, and Dalhousie University, Halifax, Nova Scotia, Canada; Department of Pediatrics, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Karina A Top
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada; Canadian Center for Vaccinology, IWK Health, Nova Scotia Health, and Dalhousie University, Halifax, Nova Scotia, Canada; Department of Pediatrics, Dalhousie University, Halifax, Nova Scotia, Canada.
| | | |
Collapse
|
6
|
Yigit E, Boz G, Gokce A, Aslan M, Ozer A. Knowledge, attitudes and behaviors of Inonu University faculty members regarding childhood vaccine refusal. Hum Vaccin Immunother 2021; 17:5191-5195. [PMID: 34905472 PMCID: PMC8903989 DOI: 10.1080/21645515.2021.2008711] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
INTRODUCTION Although there is a lot of scientific evidence that the benefits of vaccines outweigh their risks, hesitancy about the safety of vaccines can occur in every segment of the community. In this study, we aimed to determine the knowledge, attitudes, and associated factors of vaccine hesitancy among Inonu University faculty members regarding childhood vaccinations. METHOD This is a cross-sectional study, and 258 faculty members were included in the study. The questionnaire used in the study explored the sociodemographic characteristics of the faculty members and their knowledge, attitudes and behaviors regarding childhood vaccination. A chi-square test and a fisher exact test were used for statistical analysis. RESULTS Of the faculty members, 31.8% were hesitant about childhood vaccines, 51.9% stated that there were studies reporting the side effects of vaccines, 48.1% did not agree with giving booster doses of vaccines, 35.7% stated that vaccines could cause autism due to the chemicals contained in the vaccines. The most important information sources of university faculty regarding childhood vaccines members are scientific publications and health professionals. CONCLUSIONS Faculty members level of hesitancy about vaccines was high and since health professionals and scientific articles are the most important information sources of faculty members, misinformation here may affect their knowledge, attitudes and behaviors about vaccination.
Collapse
Affiliation(s)
- Esra Yigit
- Department of Forensic Medicine, Republic of Turkey Ministry of Justice Forensic Medicine Institute, Istanbul, Turkey
| | - Gulseda Boz
- Department of Public Health, Medical Faculty, Inonu University, Malatya, Turkey
| | - Ayse Gokce
- Department of Public Health, Bingol Provincial Health Directorate, Bingol, Turkey,CONTACT Ayse Gokce Bingol Provincial Health Directorate, Yenişehir district, Guldiken street no:11, Bingol12000, Turkey
| | - Mehmet Aslan
- Department of Pediatrics, Medical Faculty, Inonu University, Malatya, Turkey
| | - Ali Ozer
- Department of Public Health, Medical Faculty, Inonu University, Malatya, Turkey
| |
Collapse
|
7
|
CELLA PAOLA, VOGLINO GIANLUCA, BARBERIS ILARIA, ALAGNA ENRICO, ALESSANDRONI CLAUDIA, CUDA ALESSANDRO, D’ALOISIO FRANCESCO, DALLAGIACOMA GIULIA, DE NITTO SARA, DI GASPARE FRANCESCA, GALLIPOLI ORIANA, GENTILE LEANDRO, KUNDISOV LUCIA, NAVARO MONICA, PROVENZANO SANDRO, SANTANGELO OMARENZO, STEFANIZZI PASQUALE, GIANFREDI VINCENZA. Resources for assessing parents' vaccine hesitancy: a systematic review of the literature. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2020; 61:E340-E373. [PMID: 33150224 PMCID: PMC7595070 DOI: 10.15167/2421-4248/jpmh2020.61.3.1448] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Accepted: 07/22/2020] [Indexed: 11/17/2022]
Abstract
The concept of Vaccine Hesitancy has begun to appear in the scientific landscape, referring to the reluctance of a growing proportion of people to accept the vaccination offer. A variety of factors were identified as being associated with vaccine hesitancy but there was no universal algorithm and currently there aren’t any established metrics to assess either the presence or impact of vaccine hesitancy. The aim of this study was to systematically review the published questionnaires evaluating parental vaccine hesitancy, to highlight the differences among these surveys and offer a general overview on this matter. This study offers a deeper perspective on the available questionnaires, helping future researches to identify the most suitable one according to their own aim and study setting.
Collapse
Affiliation(s)
- PAOLA CELLA
- Post Graduate School of Hygiene and Preventive Medicine, Department of Medicine and Surgery, University of Parma, Italy
| | - GIANLUCA VOGLINO
- Post Graduate School of Hygiene and Preventive Medicine, Department of Public Health, University of Turin, Italy
| | - ILARIA BARBERIS
- Health Science Department, University of Genoa, Italy
- Correspondence: Ilaria Barberis, Health Science Department, University of Genoa, largo Rosanna Benzi 10, Pad. 3 San Martino Hospital, Italy - Tel./Fax +39 010 3538502 - E-mail:
| | - ENRICO ALAGNA
- Post Graduate School of Hygiene and Preventive Medicine, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties “G. D’Alessandro”, University of Palermo, Italy
| | - CLAUDIA ALESSANDRONI
- Post Graduate School of Hygiene and Preventive Medicine, University of Rome Tor Vergata, Rome, Italy
| | - ALESSANDRO CUDA
- Post Graduate School of Hygiene and Preventive Medicine, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Italy
| | - FRANCESCO D’ALOISIO
- Post Graduate School of Hygiene and Preventive Medicine, Department of Life, Health and Environmental Sciences, University of L’Aquila, Italy
| | - GIULIA DALLAGIACOMA
- Post Graduate School of Hygiene and Preventive Medicine, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Italy
| | - SARA DE NITTO
- Post Graduate School of Hygiene and Preventive Medicine, Department of Biomedical Science and Human Oncology, University of Bari Aldo Moro, Italy
| | - FRANCESCA DI GASPARE
- Post Graduate School of Hygiene and Preventive Medicine, University of Rome Tor Vergata, Rome, Italy
| | - ORIANA GALLIPOLI
- Post Graduate School of Hygiene and Preventive Medicine, Department of Life, Health and Environmental Sciences, University of L’Aquila, Italy
| | - LEANDRO GENTILE
- Post Graduate School of Hygiene and Preventive Medicine, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Italy
| | - LUCIA KUNDISOV
- Post Graduate School of Public Health, University of Siena, Italy
| | - MONICA NAVARO
- Post Graduate School of Hygiene and Preventive Medicine, Department of Experimental Medicine, University of Campania “L. Vanvitelli”, Italy
| | - SANDRO PROVENZANO
- Post Graduate School of Hygiene and Preventive Medicine, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties “G. D’Alessandro”, University of Palermo, Italy
| | - OMAR ENZO SANTANGELO
- Post Graduate School of Hygiene and Preventive Medicine, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties “G. D’Alessandro”, University of Palermo, Italy
| | - PASQUALE STEFANIZZI
- Post Graduate School of Hygiene and Preventive Medicine, Department of Biomedical Science and Human Oncology, University of Bari Aldo Moro, Italy
| | - VINCENZA GIANFREDI
- Post Graduate School of Hygiene and Preventive Medicine, Department of Experimental Medicine, University of Perugia, Italy
- School of Medicine, University Vita-Salute San Raffaele, Milan, Italy
| |
Collapse
|
8
|
Sarti L, Lezmi G, Mori F, Giovannini M, Caubet JC. Diagnosis and management of hypersensitivity reactions to vaccines. Expert Rev Clin Immunol 2020; 16:883-896. [PMID: 32838592 DOI: 10.1080/1744666x.2020.1814745] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
INTRODUCTION Many countries in Europe now recommend and enforce mandatory vaccinations to improve vaccination coverage. Thus, the number of adverse events following immunization (AEFI) may show an increase. Among these events, severe hypersensitivity reactions to vaccines are rare. However, it is important that they be identified and recognized so that they may be adequately managed. AREAS COVERED The literature search was undertaken through PubMed and Embase to identify English-language papers focusing on hypersensitivity to vaccines. EXPERT OPINION Hypersensitivity reactions following vaccinations are rare and are classified according to their chronology and extension: immediate when they occur within the first 4 hours following administration and non-immediate when they occur later. Local reactions are the most common adverse event following injection of vaccines and generally do not require any allergy workup. Immediate reactions, however, are potentially IgE-mediated and require an allergy workup. In general, a previously known food allergy (i.e., egg or milk) is not a contraindication to immunizations. Patients with a known allergy to gelatin, yeast, latex, antibiotics, or other specific components of vaccines require an allergy workup before administration of the vaccine.
Collapse
Affiliation(s)
- Lucrezia Sarti
- Allergy Unit, Department of Pediatrics, Anna Meyer Children's University Hospital , Florence, Italy
| | - Guillaume Lezmi
- Service de Pneumologie et Allergologie Pédiatriques, Hôpital Necker-Enfants Malades , Paris, France.,Faculty of Medicine, Université Paris Descartes , Paris, France
| | - Francesca Mori
- Allergy Unit, Department of Pediatrics, Anna Meyer Children's University Hospital , Florence, Italy
| | - Mattia Giovannini
- Allergy Unit, Department of Pediatrics, Anna Meyer Children's University Hospital , Florence, Italy
| | - Jean-Christoph Caubet
- Division of Pediatric Allergy, Department of Pediatrics, University Hospitals of Geneva , Geneva, Switzerland
| |
Collapse
|
9
|
McDonald C, Leask J, Chad N, Danchin M, Fethney J, Trevena L. A Consent Support Resource with Benefits and Harms of Vaccination Does Not Increase Hesitancy in Parents-An Acceptability Study. Vaccines (Basel) 2020; 8:vaccines8030500. [PMID: 32887503 PMCID: PMC7565597 DOI: 10.3390/vaccines8030500] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 08/14/2020] [Accepted: 08/25/2020] [Indexed: 11/30/2022] Open
Abstract
It is unclear whether information given about the benefits and risks of routine childhood vaccination during consent may cue parental vaccine hesitancy. Parents were surveyed before and after reading vaccine consent information at a public expo event in Sydney, Australia. We measured vaccine hesitancy with Parent Attitudes about Childhood Vaccine Short Scale (PACV-SS), informed decision-making with Informed Subscale of the Decisional Conflict Scale (DCS-IS), items from Stage of Decision Making, Positive Attitude Assessment, Vaccine Safety and Side Effect Concern, and Vaccine Communication Framework (VCF) tools. Overall, 416 parents showed no change in vaccine hesitancy (mean PACV-SS score pre = 1.97, post = 1.94; diff = −0.02 95% CI −0.10 to 0.15) but were more informed (mean DCS-IS score pre = 29.05, post = 7.41; diff = −21.63 95% CI −24.17 to −18.56), were more positive towards vaccination (pre = 43.8% post = 50.4%; diff = 6.5% 95% CI 3.0% to 10.0%), less concerned about vaccine safety (pre = 28.5%, post = 23.0%, diff = −5.6% 95% CI −2.3% to −8.8%) and side effects (pre = 37.0%, post = 29.0%, diff = −8.0% 95% CI −4.0% to −12.0%) with no change in stage of decision-making or intention to vaccinate. Providing information about the benefits and risks of routine childhood vaccination increases parents’ informed decision-making without increasing vaccine hesitancy.
Collapse
Affiliation(s)
- Ciara McDonald
- Faculty of Medicine and Health, School of Medicine, University of Sydney, Sydney 2006, Australia;
- ASK NHMRC Centre for Research Excellence, University of Sydney, Sydney 2006, Australia;
| | - Julie Leask
- ASK NHMRC Centre for Research Excellence, University of Sydney, Sydney 2006, Australia;
- Faculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, University of Sydney, Sydney 2006, Australia;
| | - Nina Chad
- Faculty of Medicine and Health, School of Public Health, University of Sydney, Sydney 2006, Australia;
| | - Margie Danchin
- Department of General Medicine, Department of Pediatrics, The Royal Children’s Hospital, Victoria 3052 Australia;
- Vaccine Uptake Group, Murdoch Children’s Research Institute Victoria, University of Melbourne, Victoria 3052, Australia
| | - Judith Fethney
- Faculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, University of Sydney, Sydney 2006, Australia;
| | - Lyndal Trevena
- ASK NHMRC Centre for Research Excellence, University of Sydney, Sydney 2006, Australia;
- Faculty of Medicine and Health, School of Public Health, University of Sydney, Sydney 2006, Australia;
- Correspondence: ; Tel.: +61-293517788
| |
Collapse
|
10
|
Smith LE, Webster RK, Rubin GJ. A systematic review of factors associated with side-effect expectations from medical interventions. Health Expect 2020; 23:731-758. [PMID: 32282119 PMCID: PMC7495066 DOI: 10.1111/hex.13059] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Revised: 03/17/2020] [Accepted: 03/19/2020] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Fear of side-effects can result in non-adherence to medical interventions, such as medication and chemotherapy. Side-effect expectations have been identified as strong predictors of later perception of side-effects. However, research investigating predictors of side-effect expectations is disparate. OBJECTIVE To identify factors associated with side-effect expectations. SEARCH STRATEGY We systematically searched Embase, Ovid MEDLINE, Global Health, PsycARTICLES, PsycINFO, Web of Science and Scopus. INCLUSION CRITERIA Studies were included if they investigated associations between any predictive factor and expectations of side-effects from any medical intervention. DATA EXTRACTION AND SYNTHESIS We extracted information about participant characteristics, medication, rates of side-effects expected and predictors of side-effect expectations. Data were narratively synthesized. MAIN RESULTS We identified sixty-four citations, reporting on seventy-two studies. Predictors fell into five categories: personal characteristics, clinical characteristics, psychological traits and state, presentation format of information, and information sources used. Using verbal risk descriptors (eg 'common') compared to numerical descriptors (eg percentages), having lower quality of life or well-being, and currently experiencing symptoms were associated with increased side-effect expectations. DISCUSSION AND CONCLUSIONS Decreasing unrealistic side-effect expectations may lead to decreased experience of side-effects and increased adherence to medical interventions. Widespread communications about medical interventions should describe the incidence of side-effects numerically. Evidence suggests that clinicians should take particular care with patients with lower quality of life, who are currently experiencing symptoms and who have previously experienced symptoms from treatment. Further research should investigate different clinical populations and aim to quantify the impact of the media and social media on side-effect expectations.
Collapse
Affiliation(s)
- Louise E Smith
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | | | - G James Rubin
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| |
Collapse
|
11
|
LaCour M, Davis T. Vaccine skepticism reflects basic cognitive differences in mortality-related event frequency estimation. Vaccine 2020; 38:3790-3799. [DOI: 10.1016/j.vaccine.2020.02.052] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 02/16/2020] [Accepted: 02/18/2020] [Indexed: 11/30/2022]
|
12
|
Dudley MZ, Halsey NA, Omer SB, Orenstein WA, O'Leary ST, Limaye RJ, Salmon DA. The state of vaccine safety science: systematic reviews of the evidence. THE LANCET. INFECTIOUS DISEASES 2020; 20:e80-e89. [PMID: 32278359 DOI: 10.1016/s1473-3099(20)30130-4] [Citation(s) in RCA: 61] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Revised: 02/14/2020] [Accepted: 02/20/2020] [Indexed: 11/24/2022]
Abstract
This Review updates the scientific evidence assessing possible causal associations of adverse events following immunisation (AEFI) compiled in the 2012 report from the Institute of Medicine and the 2014 report from the Agency for Healthcare Research and Quality. For 12 of 46 AEFI examined, a causal relationship has been established with at least one vaccine currently routinely recommended to the general USA population: anaphylaxis, arthralgia or arthritis (mild, acute, and transient, not chronic), deltoid bursitis (when vaccine is administered improperly), disseminated varicella infection (in immune deficient individuals for whom the varicella vaccine is contraindicated), encephalitis, febrile seizures, Guillain-Barré syndrome, hepatitis (in immune deficient individuals for whom the varicella vaccine is contraindicated), herpes zoster, immune thrombocytopenic purpura, meningitis, and syncope. Other than mild acute and transient arthralgia or arthritis, which is very common in adult women after rubella vaccine, these adverse reactions are rare or very rare. Vaccines have an excellent safety profile overall and provide protection against infectious diseases to individuals and the general population.
Collapse
Affiliation(s)
- Matthew Z Dudley
- Department of International Health, Johns Hopkins University, Baltimore, MD, USA; Institute of Vaccine Safety, Johns Hopkins University, Baltimore, MD, USA
| | - Neal A Halsey
- Department of International Health, Johns Hopkins University, Baltimore, MD, USA; Institute of Vaccine Safety, Johns Hopkins University, Baltimore, MD, USA; Department of Pediatrics, Johns Hopkins University School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Saad B Omer
- Epidemiology of Microbial Diseases, Yale School of Public Health, Yale School for Global Health, and Yale School of Medicine, New Haven, CT, USA
| | - Walter A Orenstein
- Department of Pediatrics and Emory Vaccine Center, School of Medicine, Emory University, Atlanta, GA, USA
| | - Sean T O'Leary
- Adult and Child Consortium for Health Outcomes Research and Delivery Science and Department of Pediatrics, Anschutz Medical Campus and Children's Hospital, University of Colorado, Aurora, CO, USA
| | - Rupali J Limaye
- Department of International Health, Johns Hopkins University, Baltimore, MD, USA; Institute of Vaccine Safety, Johns Hopkins University, Baltimore, MD, USA; Department of Health, Behavior & Society, Johns Hopkins University, Baltimore, MD, USA; Department of Epidemiology, Johns Hopkins University, Baltimore, MD, USA; International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Daniel A Salmon
- Department of International Health, Johns Hopkins University, Baltimore, MD, USA; Institute of Vaccine Safety, Johns Hopkins University, Baltimore, MD, USA; Department of Health, Behavior & Society, Johns Hopkins University, Baltimore, MD, USA.
| |
Collapse
|
13
|
Stone CA, Rukasin CR, Beachkofsky TM, Phillips EJ. Immune-mediated adverse reactions to vaccines. Br J Clin Pharmacol 2019; 85:2694-2706. [PMID: 31472022 PMCID: PMC6955412 DOI: 10.1111/bcp.14112] [Citation(s) in RCA: 126] [Impact Index Per Article: 25.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2018] [Revised: 07/26/2019] [Accepted: 08/14/2019] [Indexed: 02/06/2023] Open
Abstract
Vaccination continues to be the single most important and successful public health intervention, due to its prevention of morbidity and mortality from prevalent infectious diseases. Severe immunologically mediated reactions are rare and less common with the vaccine than the true infection. However, these events can cause public fearfulness and loss of confidence in the safety of vaccination. In this paper, we perform a systematic literature search and narrative review of immune-mediated vaccine adverse events and their known and proposed mechanisms, and outline directions for future research. Improving our knowledge base of severe immunologically mediated vaccine reactions and their management drives better vaccine safety and efficacy outcomes.
Collapse
Affiliation(s)
- Cosby A. Stone
- Division of Allergy, Pulmonary and Critical Care Medicine, Department of MedicineVanderbilt University School of MedicineNashvilleTennesseeUSA
| | - Christine R.F. Rukasin
- Division of Allergy, Pulmonary and Critical Care Medicine, Department of MedicineVanderbilt University School of MedicineNashvilleTennesseeUSA
| | | | - Elizabeth J. Phillips
- Department of MedicineVanderbilt University Medical CenterNashvilleTennesseeUSA
- Vanderbilt University Medical SchoolNashvilleTennessee
| |
Collapse
|
14
|
Barański K, Gajda M, Braczkowska B, Kowalska M. Parental Declaration of Adverse Event Following Immunization in a Cross-Sectional Study in Poland. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16204038. [PMID: 31652499 PMCID: PMC6843965 DOI: 10.3390/ijerph16204038] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 10/13/2019] [Accepted: 10/15/2019] [Indexed: 11/16/2022]
Abstract
Vaccines are a well-known and effective preventive measure in communicable diseases. However, like any medical product, vaccines can cause some adverse effects. With increasing population awareness, the number of reported events related to vaccination has increased. Aim: The aim of the study was to assess the frequency and type of reported adverse events following childhood immunization (AEFI), and to recognize the determinant of their occurrence related with a socio-demographic situation, parental knowledge, and/or opinions on vaccinations. Material and Methods: The self-administrated questionnaire was distributed to a group of 3000 random parents or legal guardians living in the Silesian Voivodship (the southern part of Poland) in 2016. The response rate was eventually 41.3% from 1239 participants. Both, the number of children and the percentage of vaccinations given in the studied region, was representative for Poland as a whole. Results: Approximately one-third (32%) of surveyed parents declared the occurrence of AEFI in their children. The most frequently declared AEFIs were: redness, pain, swelling at the injection site (27%), and fever (24.9%). The frequency of reported AEFI was associated with a higher level of parental education and the number of vaccinations given. A negative attitude toward vaccination and the belief that vaccination is unsafe were associated with a higher number of reported AEFI. Conclusions: The results obtained confirmed that the number of declared mild and moderate AEFI is related to a lower parental educational level and is associated with a better experience as a consequence of a higher number of vaccinations given. Frequent AEFI reporters represent negative attitudes toward vaccinations. Further investigation with the exact surveillance system is needed to improve parental trust in vaccination safety.
Collapse
Affiliation(s)
- Kamil Barański
- Department of Epidemiology, School of Medicine in Katowice, Medical University of Silesia, 40-752 Katowice, Poland.
| | - Maksymilian Gajda
- Department of Epidemiology, School of Medicine in Katowice, Medical University of Silesia, 40-752 Katowice, Poland.
| | - Bogumiła Braczkowska
- Department of Epidemiology, School of Medicine in Katowice, Medical University of Silesia, 40-752 Katowice, Poland.
| | - Małgorzata Kowalska
- Department of Epidemiology, School of Medicine in Katowice, Medical University of Silesia, 40-752 Katowice, Poland.
| |
Collapse
|
15
|
Souliotis K, Golna C, Kotsopoulos N, Kapaki V, Dalucas C. Meningitis B vaccination: knowledge and attitudes of pediatricians and parents in Greece. Heliyon 2018; 4:e00902. [PMID: 30426102 PMCID: PMC6222974 DOI: 10.1016/j.heliyon.2018.e00902] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Revised: 07/30/2018] [Accepted: 10/29/2018] [Indexed: 01/06/2023] Open
Abstract
Bexsero®, a meningitis B vaccine, was recently included in the National Immunization Programme (NIP) in Greece, with restricted access to high risk groups only. To map the need to expand coverage, this study assessed pediatricians and parents' perceptions and attitudes towards meningitis B, inclusion of Bexsero® in the NIP and vaccination uptake. We analyzed data from 201 private practice pediatricians questionnaires and 1003 parents phone interviews. Both (pediatricians 64.7%, parents 88.5%) considered meningitis B a critical challenge. 77.6% of pediatricians would prioritize meningitis B vaccination in the NIP and 90.3% would recommend Bexsero® to parents. Of those who would not, 47% feared civil liability challenges and 11.8% hesitated to impose vaccine cost on parents. Only 28.9% of parents had their child vaccinated. Non-reimbursement constituted a major access hurdle. It is critical to expand immunization coverage in Greece through expanded access in the NIP, in line with pediatrician recommendations.
Collapse
Affiliation(s)
- K Souliotis
- Faculty of Social and Political Sciences, University of Peloponnese, Corinth, Greece.,Health Policy Institute, Athens, Greece
| | - C Golna
- Policy Change, Innowth Ltd, Cyprus
| | | | - V Kapaki
- Health Policy Institute, Athens, Greece
| | | |
Collapse
|
16
|
Social differentiation of vaccine hesitancy among French parents and the mediating role of trust and commitment to health: A nationwide cross-sectional study. Vaccine 2018; 36:7666-7673. [DOI: 10.1016/j.vaccine.2018.10.085] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Revised: 09/17/2018] [Accepted: 10/25/2018] [Indexed: 11/17/2022]
|
17
|
Costa-Pinto JC, Willaby HW, Leask J, Hoq M, Schuster T, Ghazarian A, O'Keefe J, Danchin MH. Parental Immunisation Needs and Attitudes Survey in paediatric hospital clinics and community maternal and child health centres in Melbourne, Australia. J Paediatr Child Health 2018; 54:522-529. [PMID: 29168910 DOI: 10.1111/jpc.13790] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Revised: 09/12/2017] [Accepted: 09/25/2017] [Indexed: 11/29/2022]
Abstract
AIM Despite Australia's high vaccination rates, an estimated 3.3% of children are under-vaccinated due to vaccine refusal and the proportion of parents with concerns is unclear. Amongst Australian parents, we aimed to determine the prevalence of vaccine concerns, resources and health-care providers (HCPs) accessed and satisfaction with these resources in two different settings. We also aimed to identify relationships between the level of vaccine concern, socio-economic status and vaccine uptake. METHODS Parents of children under 5 years attending general paediatric clinics in a tertiary paediatric hospital (n = 301/398, 76%) and children under 19 months attending community maternal child health centres (n = 311/391, 81%) completed the survey. Vaccination status was obtained from the Australian Childhood Immunisation Register. RESULTS Despite high support for vaccination (98%, confidence interval (CI) 97-99), 43% of parents reported vaccine concerns (CI 40-47) including the number of vaccines given in the first 2 years (25%, CI 22 to 29), vaccine ingredients (22%, CI 19-25), allergies (18%, CI 15-21), weakening of the immune system (17%, CI 14-20) and autism (11%, CI 8-13). HCPs were the most commonly accessed and trusted information source. In all, 23% of parents reported insufficient knowledge to make good vaccination decisions (CI 20-26). There was little evidence of an association between parental vaccine acceptance or socio-economic status and vaccination status. CONCLUSIONS Despite high support for vaccines, nearly half of Australian parents have some concerns and a quarter lack vaccine decision-making confidence regarding childhood vaccines. Parents frequently access and report high trust in HCPs, who are best placed to address parental vaccine concerns through provision of clear information, using effective communication strategies. Further research in more highly hesitant populations is required to determine the relationship between the level and nature of vaccination concerns and vaccine uptake.
Collapse
Affiliation(s)
- Jessica C Costa-Pinto
- Department of General Medicine, Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Harold W Willaby
- School of Public Health, University of Sydney, Sydney Medical School, Sydney, New South Wales, Australia
| | - Julie Leask
- School of Public Health, University of Sydney, Sydney Medical School, Sydney, New South Wales, Australia
| | - Monsurul Hoq
- Clinical Epidemiology and Biostatistics Unit, Murdoch Childrens Research Institute, Melbourne, Victoria, Australia
| | - Tibor Schuster
- Clinical Epidemiology and Biostatistics Unit, Murdoch Childrens Research Institute, Melbourne, Victoria, Australia
| | - Alice Ghazarian
- Centre for Community Child Health, Murdoch Childrens Research Institute, Melbourne, Victoria, Australia
| | - Jacinta O'Keefe
- Vaccine and Immunisation Research Group, Murdoch Childrens Research Institute, Melbourne, Victoria, Australia
| | - Margie H Danchin
- Department of General Medicine, Royal Children's Hospital, Melbourne, Victoria, Australia.,Vaccine and Immunisation Research Group, Murdoch Childrens Research Institute, Melbourne, Victoria, Australia.,Department of Paediatrics and School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| |
Collapse
|
18
|
Zhang K, Lu B, Liu H, Zhao J, Zheng H, Liu X. Adverse Effects of Inactivated Foot-and-Mouth Disease Vaccine—Possible Causes Analysis and Countermeasures. ACTA ACUST UNITED AC 2018. [DOI: 10.4236/wjv.2018.84007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
19
|
Bocquier A, Ward J, Raude J, Peretti-Watel P, Verger P. Socioeconomic differences in childhood vaccination in developed countries: a systematic review of quantitative studies. Expert Rev Vaccines 2017; 16:1107-1118. [PMID: 28914112 DOI: 10.1080/14760584.2017.1381020] [Citation(s) in RCA: 71] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
INTRODUCTION The reasons for vaccine hesitancy and its relation to individual socioeconomic status (SES) must be better understood. Areas covered: This review focused on developed countries with programs addressing major financial barriers to vaccination access. We systematically reviewed differences by SES in uptake of publicly funded childhood vaccines and in cognitive determinants (beliefs, attitudes) of parental decisions about vaccinating their children. Using the PRISMA statement to guide this review, we searched three electronic databases from January 2000 through April 2016. We retained 43 articles; 34 analyzed SES differences in childhood vaccine uptake, 7 examined differences in its cognitive determinants, and 2 both outcomes. Expert commentary: Results suggest that barriers to vaccination access persist among low-SES children in several settings. Vaccination programs could be improved to provide all mandatory and recommended vaccines 100% free of charge, in both public organizations and private practices, and to reimburse vaccine administration. Multicomponent interventions adapted to the context could also be effective in reducing these inequalities. For specific vaccines (notably for measles, mumps, and rubella), in UK and Germany, uptake was lowest among the most affluent. Interventions carefully tailored to respond to specific concerns of vaccine-hesitant parents, without reinforcing hesitancy, are needed.
Collapse
Affiliation(s)
- Aurélie Bocquier
- a Aix Marseille Univ, INSERM, IRD, SESSTIM, Economics and Social Sciences Applied to Health & Analysis of Medical Information , Marseille , France.,b ORS PACA, Southeastern Health Regional Observatory , Marseille , France
| | - Jeremy Ward
- a Aix Marseille Univ, INSERM, IRD, SESSTIM, Economics and Social Sciences Applied to Health & Analysis of Medical Information , Marseille , France.,c UMR 8236 (LIED) , Université Paris Diderot , Paris , France
| | - Jocelyn Raude
- d UMR "Emergence des Pathologies Virales" (EPV: Aix-Marseille University - IRD 190 - Inserm 1207 - EHESP) , Marseille , France.,e UMR PIMIT, INSERM 1187, CNRS 9192, IRD 249. Plateforme Technologique CYROI , Université de La Réunion , Réunion , France
| | - Patrick Peretti-Watel
- a Aix Marseille Univ, INSERM, IRD, SESSTIM, Economics and Social Sciences Applied to Health & Analysis of Medical Information , Marseille , France.,b ORS PACA, Southeastern Health Regional Observatory , Marseille , France
| | - Pierre Verger
- a Aix Marseille Univ, INSERM, IRD, SESSTIM, Economics and Social Sciences Applied to Health & Analysis of Medical Information , Marseille , France.,b ORS PACA, Southeastern Health Regional Observatory , Marseille , France
| |
Collapse
|
20
|
O'Leary ST, Maldonado YA. Adverse Events Following Immunization: Will It Happen Again? Pediatrics 2017; 140:peds.2017-1760. [PMID: 28847983 DOI: 10.1542/peds.2017-1760] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/01/2017] [Indexed: 11/24/2022] Open
Affiliation(s)
- Sean T O'Leary
- Children's Hospital Colorado, Denver, Colorado; .,Division of Infectious Diseases, Department of Pediatrics, University of Colorado Denver, Denver, Colorado; and
| | - Yvonne A Maldonado
- Division of Infectious Diseases, Department of Pediatrics, Stanford University, Stanford, California
| |
Collapse
|
21
|
Anderson MM, Arvidson C. Childhood vaccine status and correlation with common nonvaccine-preventable illnesses. J Am Assoc Nurse Pract 2017; 29:415-423. [PMID: 28466584 DOI: 10.1002/2327-6924.12464] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Revised: 03/10/2017] [Accepted: 03/10/2017] [Indexed: 11/06/2022]
Abstract
BACKGROUND AND PURPOSE Current trends in parental decision making involve alteration from vaccine schedules in children, citing concerns for altered immune function. The purpose of this study was to determine if there is a difference in incidence of common childhood illnesses dependent on vaccination status. METHODS An investigator-designed survey was administered to parents of children aged 12 months to 7 years. Participants were separated into one of three groups: fully vaccinated, partially vaccinated, and unvaccinated. There were 111 total participants. Power analysis indicated a minimum of 30 participants per group to detect an 80% effect. Descriptive statistics were applied to variables with chi-square for group comparison. CONCLUSIONS The results indicated a statistically significant difference between all three groups in the categories of ear infections, influenza, and common colds. Fully immunized group had significantly more ear infections than partial or unimmunized. The unimmunized group had significantly more colds and flu. IMPLICATIONS FOR PRACTICE Nurse practitioner practice implications relate directly to further education of parents, support, and trust building. Many parents question the possible association between childhood vaccines and immune function and have a distrust of current research. This study showed that most common childhood illnesses are equitable across the population and not dependent on vaccine status.
Collapse
Affiliation(s)
| | - Cathy Arvidson
- School of Nursing, Idaho State University at Pocatello, Idaho
| |
Collapse
|
22
|
Clothier HJ, Crawford NW, Russell M, Kelly H, Buttery JP. Evaluation of ‘SAEFVIC’, A Pharmacovigilance Surveillance Scheme for the Spontaneous Reporting of Adverse Events Following Immunisation in Victoria, Australia. Drug Saf 2017; 40:483-495. [DOI: 10.1007/s40264-017-0520-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
23
|
Immunizing Patients With Adverse Events After Immunization and Potential Contraindications to Immunization: A Report From the Special Immunization Clinics Network. Pediatr Infect Dis J 2016; 35:e384-e391. [PMID: 27626920 DOI: 10.1097/inf.0000000000001323] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND For patients who have experienced adverse events following immunization (AEFI) or who have specific medical conditions, there is limited evidence regarding the best approach to immunization. The Special Immunization Clinics (SICs) Network was established to standardize patient management and assess outcomes after reimmunization. The study objective was to describe the first 2 years of the network's implementation. METHODS Twelve SICs were established across Canada by infectious diseases specialists and allergists. Inclusion criteria were as follows: local reaction ≥ 10 cm, allergic symptoms < 24 hours postimmunization, neurologic symptoms and other AEFI or medical conditions of concern. Eligible patients underwent a standardized evaluation, causality assessment was performed, immunization recommendations were made by expert physicians and patients were followed up to capture AEFI. After individual consent, data were transferred to a central database for analysis. RESULTS From June 2013 to May 2015, 151 patients were enrolled. Most were referred for prior AEFI (132/151, 87%): 42 (32%) for allergic-like reactions, 31 (23%) for injection-site reactions, 20 (15%) for neurologic symptoms and 39 (30%) for other systemic symptoms. Nineteen patients (13%) were seen for underlying conditions that complicated immunization. Reimmunization was recommended for 109 patients, 60 of whom (55%) were immunized and followed up. Eleven patients (18%) experienced recurrence of their AEFI; none were serious (eg, resulting in hospitalization, permanent disability or death). CONCLUSIONS The most frequent reasons for referral to a SIC were allergic-like events and injection site reactions. Reimmunization was safe in most patients. Larger studies are needed to determine outcomes for specific types of AEFI.
Collapse
|
24
|
Ateudjieu J, Stoll B, Nguefack-Tsague G, Yakum MN, Mengouo MN, Genton B. Incidence and types of adverse events during mass vaccination campaign with the meningococcal a conjugate vaccine (MENAFRIVAC™) in Cameroon. Pharmacoepidemiol Drug Saf 2016; 25:1170-1178. [PMID: 27174237 DOI: 10.1002/pds.4027] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Revised: 02/10/2016] [Accepted: 04/11/2016] [Indexed: 11/10/2022]
Affiliation(s)
| | - Beat Stoll
- Adamawa Health Region and North West Health Region; Cameroon
| | | | | | | | - Blaise Genton
- Adamawa Health Region and North West Health Region; Cameroon
| |
Collapse
|
25
|
Thomson A, Watson M. Vaccine hesitancy: A vade mecum v1.0. Vaccine 2016; 34:1989-92. [PMID: 26776469 DOI: 10.1016/j.vaccine.2015.12.049] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2015] [Revised: 12/11/2015] [Accepted: 12/21/2015] [Indexed: 10/22/2022]
|
26
|
Clothier HJ, Selvaraj G, Easton ML, Lewis G, Crawford NW, Buttery JP. Consumer reporting of adverse events following immunization. Hum Vaccin Immunother 2015; 10:3726-30. [PMID: 25483686 DOI: 10.4161/hv.34369] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Surveillance of adverse events following immunisation (AEFI) is an essential component of vaccine safety monitoring. The most commonly utilized passive surveillance systems rely predominantly on reporting by health care providers (HCP). We reviewed adverse event reports received in Victoria, Australia since surveillance commencement in July 2007, to June 2013 (6 years) to ascertain the contribution of consumer (vaccinee or their parent/guardian) reporting to vaccine safety monitoring and to inform future surveillance system development directions. Categorical data included were: reporter type; serious and non-serious AEFI category; and, vaccinee age group. Chi-square test and 2-sample test of proportions were used to compare categories; trend changes were assessed using linear regression. Consumer reporting increased over the 6 years, reaching 21% of reports received in 2013 (P<0.001), most commonly for children aged less than 7 years. Consumer reports were 5% more likely to describe serious AEFI than HCP (P=0.018) and 10% more likely to result in specialist clinic attendance (P<0.001). Although online reporting increased to 32% of all report since its introduction in 2010, 85% of consumers continued to report by phone. Consumer reporting of AEFI is a valuable component of vaccine safety surveillance in addition to HCP reporting. Changes are required to AEFI reporting systems to implement efficient consumer AEFI reporting, but may be justified for their potential impact on signal detection sensitivity.
Collapse
Affiliation(s)
- Hazel J Clothier
- SAEFVIC; Murdoch Childrens Research Institute; Melbourne; School of Population & Global Health; University of Melbourne; Melbourne, Victoria, Australia
| | | | | | | | | | | |
Collapse
|
27
|
Manthiram K, Edwards K, Hassan A. Sustaining motivation to immunize: exchanging lessons between India and the United States. Hum Vaccin Immunother 2015; 10:2930-4. [PMID: 25483676 DOI: 10.4161/hv.29871] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
In our recent study on vaccine uptake and parental attitudes toward immunizations in urban South India, we found strong support for vaccination due to fear of vaccine-preventable diseases and confidence in the recommendations made by health care professionals. In this commentary, we will characterize the reasons behind strong parental motivation to immunize in South India and consider ways these motivators can be enhanced in the United States, where vaccine hesitancy has led to outbreaks of vaccine-preventable disease. In addition, we will also discuss lessons that can be learned from the hesitancy movements in the United States and applied in India to maintain strong support for vaccination.
Collapse
Affiliation(s)
- Kalpana Manthiram
- a Vanderbilt Vaccine Research Program; Division of Pediatric Infectious Diseases ; Vanderbilt University Medical Center ; Nashville , TN US
| | | | | |
Collapse
|
28
|
Awareness and utilization of reporting pathways for adverse events following immunization: online survey among pediatricians in Russia and Germany. Paediatr Drugs 2014; 16:321-30. [PMID: 24849291 DOI: 10.1007/s40272-014-0075-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVES Vaccine safety surveillance is highly dependent on accurate reporting of adverse events following immunization (AEFI). An online survey was conducted to assess the utilization of AEFI reporting standards and pathways among pediatricians in Germany, and in Russia where pediatric specialization begins in medical school. METHODS In May 2011, a 31-item online questionnaire was sent to members of the German Professional Association for Pediatricians (BVKJ) and the Union of Pediatricians of Russia (UPR), capturing information on vaccine safety training, awareness of AEFI reporting pathways, and use of standardized case definitions for the ascertainment of AEFI. A convenience sample of 1,632 completed online surveys was analyzed. RESULTS Participating pediatricians reported spending approximately 50 min per 8-hour workday on vaccine safety consultations, but only 42 % (56 % UPR, 26 % BVKJ) have ever received any formal vaccine safety training. Two-thirds reported having observed AEFI in their practice, but only one-third utilized standardized case definitions for case ascertainment. Only 35 % of participants named accurate AEFI reporting pathways. Every second pediatrician would report AEFI to institutions that are not primarily in charge of vaccine safety surveillance; the remaining reports would either be lost or delayed. Pediatricians who had received formal vaccine safety training were significantly more likely to apply international safety standards and to report adequately, both at the p < 0.05 level. CONCLUSION Pediatricians play a key role in the post-marketing surveillance of vaccine safety. The lack of training represents a missed opportunity. There may be a role for professional societies to improve vaccine safety training.
Collapse
|
29
|
Top KA, Zafack J, De Serres G, Halperin SA. Canadian paediatricians' approaches to managing patients with adverse events following immunization: The role of the Special Immunization Clinic network. Paediatr Child Health 2014. [DOI: 10.1093/pch/19.6.310] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
| | - Karina A Top
- Department of Paediatrics, Dalhousie University and Canadian Center for Vaccinology, IWK Health Centre, Halifax, Nova Scotia
| | - Joseline Zafack
- Department of Social and Preventive Medicine, Laval University
| | - Gaston De Serres
- Department of Social and Preventive Medicine, Laval University
- Institut National de Santé Publique du Québec, Québec, Quebec
| | - Scott A Halperin
- Department of Paediatrics, Dalhousie University and Canadian Center for Vaccinology, IWK Health Centre, Halifax, Nova Scotia
| |
Collapse
|
30
|
Ojakaa DI, Jarvis JD, Matilu MI, Thiam S. Acceptance of a malaria vaccine by caregivers of sick children in Kenya. Malar J 2014; 13:172. [PMID: 24886650 PMCID: PMC4022976 DOI: 10.1186/1475-2875-13-172] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2014] [Accepted: 05/01/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Several malaria vaccines are currently in clinical trials and are expected to provide an improved strategy for malaria control. Prior to introduction of a new vaccine, policymakers must consider the socio cultural environment of the region to ensure widespread community approval. This study investigated the acceptance of a malaria vaccine by child caregivers and analysed factors that influence these. METHODS Interviews from a standard questionnaire were conducted with 2,003 caregivers at 695 randomly selected health facilities across Kenya during the Kenya Service Provision Assessment Survey 2010. Multinomial regression of quantitative data was conducted using STATA to analyse determinants of caregivers accepting malaria vaccination of their child. RESULTS Mothers represented 90% of caregivers interviewed who brought their child to the health facility, and 77% of caregivers were 20-34 years old. Overall, 88% of respondents indicated that they would accept a malaria vaccine, both for a child in their community and their own child. Approval for a vaccine was highest in malaria-endemic Nyanza Province at 98.9%, and lowest in the seasonal transmission area of North Eastern Province at 23%. Although 94% of respondents who had attended at least some school reported they would accept the vaccine for a child, only 56% of those who had never attended school would do so. The likelihood of accepting one's own child to be immunized was correlated with province, satisfaction with health care services in the facility attended, age of the caregiver, and level of education. CONCLUSIONS Results from this study indicate a need for targeted messages and education on a malaria vaccine, particularly for residents of regions where acceptance is low, older caregivers, and those with low literacy and school-attendance levels. This study provides critical evidence to inform policy for a new malaria vaccine that will support its timely and comprehensive uptake in Kenya.
Collapse
|
31
|
Tang DCC, Nguyen HH. The Yin-Yang arms of vaccines: disease-fighting power versus tissue-destructive inflammation. Expert Rev Vaccines 2014; 13:417-27. [PMID: 24502690 DOI: 10.1586/14760584.2014.882775] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The disease-fighting power of vaccines has defeated many pathogens and has been credited with global reduction of mortality and morbidity. However, most vaccine developments focus on the enhancement of effector responses with systemic inflammation and the consequences overlooked. Recent evidence shows that systemic inflammatory phenotypes, acute or chronic, are both detrimental and should be avoided if possible. Since noninvasive vaccination by painless delivery of nasal vaccines and skin patch vaccines could elicit potent protective immunity without inducing systemic inflammation, it can be predicted that vaccinology will increasingly see the abandonment of the 'needle-injection' paradigm for vaccine development. The findings that specific viral particles could rapidly remodel the tissue environment postinfection in favor of some pathogens with the capacity to suppress others illustrate the pressing need for a deeper understanding of the underlying mechanisms in order to unlock the full potential of immunological intervention.
Collapse
Affiliation(s)
- De-Chu Christopher Tang
- International Vaccine Institute, SNU Research Park , 1 Gwanak-ro, Gwanak-gu, Seoul 151-742 , Korea
| | | |
Collapse
|
32
|
Parrella A, Gold M, Braunack-Mayer A, Baghurst P, Marshall H. Consumer reporting of adverse events following immunization (AEFI): identifying predictors of reporting an AEFI. Hum Vaccin Immunother 2014; 10:747-54. [PMID: 24406315 DOI: 10.4161/hv.27459] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Passive reporting of adverse events following immunization (AEFI) by consumers or healthcare professionals is the primary mechanism for post-marketing surveillance of vaccine safety. Although recent initiatives have promoted consumer reporting, there is a lack of research concerning consumer reporters. Computer assisted telephone interviews (CATI) were conducted in 2011 of a cross-sectional, random, general population sample of 191 South Australian parents who stated that their children had previously experienced an AEFI. We compared awareness of surveillance, vaccine safety opinions, and demographics of parents reporting an AEFI to either healthcare professionals or surveillance authorities with those who did not report their children's AEFI. Multivariate regression analyses measured: the association between reporting and safety views; and demographic predictors of reporting an AEFI. Reporting an AEFI to a healthcare professional or a surveillance authority was not significantly associated with awareness of a surveillance system. AEFI reporters, when compared with non-reporters, were more likely to be Australian-born (OR = 4.58, [1.64, 12.78], P = 0.004); were associated with the perception that a serious reaction was more likely to occur at their children's last immunization (OR = 2.54 [95%CI 1.22, 5.30], P = 0.013); and were less accepting of the risk of febrile convulsion, (OR = 3.59 [95%CI 1.50, 8.57], P = 0.004). Although reporting an AEFI was not associated with awareness of surveillance or most socio-demographics, the results suggest some difference in safety opinions. Further studies are required to ascertain if these differences pre-date the occurrence of an AEFI or are a consequence of the AEFI and how consumers can contribute further to vaccine safety surveillance.
Collapse
Affiliation(s)
- Adriana Parrella
- Discipline of Paediatrics; School of Paediatrics and Reproductive Health; University of Adelaide; Adelaide, Australia
| | - Michael Gold
- Discipline of Paediatrics; School of Paediatrics and Reproductive Health; University of Adelaide; Adelaide, Australia
| | | | - Peter Baghurst
- Discipline of Paediatrics; School of Paediatrics and Reproductive Health; University of Adelaide; Adelaide, Australia
| | - Helen Marshall
- Discipline of Paediatrics; School of Paediatrics and Reproductive Health; University of Adelaide; Adelaide, Australia
| |
Collapse
|
33
|
Marshall H, Clarke M, Sullivan T. Parental and community acceptance of the benefits and risks associated with meningococcal B vaccines. Vaccine 2014; 32:338-44. [DOI: 10.1016/j.vaccine.2013.11.042] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2013] [Revised: 11/05/2013] [Accepted: 11/11/2013] [Indexed: 11/15/2022]
|
34
|
Hilton S, Patterson C, Smith E, Bedford H, Hunt K. Teenagers' understandings of and attitudes towards vaccines and vaccine-preventable diseases: a qualitative study. Vaccine 2013; 31:2543-50. [PMID: 23602536 PMCID: PMC3679446 DOI: 10.1016/j.vaccine.2013.04.023] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2012] [Revised: 03/11/2013] [Accepted: 04/03/2013] [Indexed: 11/29/2022]
Abstract
Explored understandings of diseases and knowledge and experiences of vaccination. Teenagers had limited knowledge and little direct experience of the diseases. Participants attitudes towards receiving vaccines’ varied. The success of mass immunisation programmes is associated with disease perceptions. Need to engage with teenagers to address misconceptions about vaccines and diseases.
Background To examine immunisation information needs of teenagers we explored understandings of vaccination and vaccine-preventable diseases, attitudes towards immunisation and experiences of immunisation. Diseases discussed included nine for which vaccines are currently offered in the UK (human papillomavirus, meningitis, tetanus, diphtheria, polio, whooping cough, measles, mumps and rubella), and two not currently included in the routine UK schedule (hepatitis B and chickenpox). Methods Twelve focus groups conducted between November 2010 and March 2011 with 59 teenagers (29 girls and 30 boys) living in various parts of Scotland. Results Teenagers exhibited limited knowledge and experience of the diseases, excluding chickenpox. Measles, mumps and rubella were perceived as severe forms of chickenpox-like illness, and rubella was not associated with foetal damage. Boys commonly believed that human papillomavirus only affects girls, and both genders exhibited confusion about its relationship with cancer. Participants considered two key factors when assessing the threat of diseases: their prevalence in the UK, and their potential to cause fatal or long-term harm. Meningitis was seen as a threat, but primarily to babies. Participants explained their limited knowledge as a result of mass immunisation making once-common diseases rare in the UK, and acknowledged immunisation's role in reducing disease prevalence. Conclusions While it is welcome that fewer teenagers have experienced vaccine-preventable diseases, this presents public health advocates with the challenge of communicating benefits of immunisation when advantages are less visible. The findings are timely in view of the Joint Committee on Vaccination and Immunisation's recommendation that a booster of meningitis C vaccine should be offered to teenagers; that teenagers did not perceive meningitis C as a significant threat should be a key concern of promotional information. While teenagers’ experiences of immunisation in school were not always positive, they seemed enthusiastic at the prospect of introducing more vaccines for their age group.
Collapse
Affiliation(s)
- S Hilton
- MRC/CSO Social and Public Health Sciences Unit, 4 Lilybank Gardens, Glasgow G12 8RZ, United Kingdom
| | | | | | | | | |
Collapse
|