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Araujo-Chaveron L, Olivier C, Pellissier G, Bouvet E, Mueller JE. Analyzing the 7C psychological antecedents of vaccine acceptance throughout the COVID-19 pandemic among healthcare sector workers in France: A repeated cross-sectional study (CappVac-Cov). Vaccine 2024:S0264-410X(24)00744-8. [PMID: 38972764 DOI: 10.1016/j.vaccine.2024.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2024] [Revised: 07/01/2024] [Accepted: 07/02/2024] [Indexed: 07/09/2024]
Abstract
BACKGROUND Across various stages of the COVID-19 pandemic and related vaccine recommendations in France, we assessed the association of the 7C-psychological antecedents with vaccine uptake/intention for booster vaccination among healthcare-sector workers (HCSWs). We also assessed whether 7C-antecedent profiles changed over time. METHODOLOGY The Research Group for the Prevention of Occupational Infections in Healthcare Workers (GERES) conducted three repeated web-surveys which were disseminated by email chain-referral among HCSWs throughout France. The questionnaires waves took place: July-November 2021, February-March 2022 and January-March 2023 (P2, P3 and P4). We also reanalysed data from a prior similar study conducted late 2020-early 2021 (Moirangthem et al. (2022)) (P1). To evaluate the association of 7C-items with vaccine uptake-intention for future vaccination, we estimated adjusted prevalence ratios (aPR) using robust variance Poisson regression. We report the 7C-item population attributable loss in vaccine intention. RESULTS The four surveys (P1-P4) encompassed 5234, 339, 351 and 437 participants. At earlier stages of the vaccine campaign, the principal antecedents of vaccine intention were favorable perception of vaccination benefit-risk-balance (BRB) (vs. unfavorable, aPR: 2.32), reactance to employer encouragement for vaccination (motivates vs. dissuades-me, aPR:2.23), vaccine confidence (vs. not-being-confident, aPR: 1.71) and social conformism towards vaccination (favorable vs. skeptical opinion in private environment, aPR: 1.33). Under a vaccine mandate for HCSWs, only perceiving vaccination as a collective action was associated with current vaccine status (agree vs. disagree, aPR: 2.19). At later stages of the epidemic, hypothetical booster vaccine intentions were strongly associated with BRB perception (favorable vs. unfavorable, aPR: 2.07) and perceiving vaccination as a collective action (agree vs. disagree, aPR: 1.69). Fearing a severe side effect from vaccination decreased population vaccine intention by 26.2 %. CONCLUSION Our results suggest that both 7C-antecedents and their association with vaccine behaviour can change over time, and underscore the importance of assuring confidence in vaccine safety.
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Affiliation(s)
- Lucia Araujo-Chaveron
- EHESP French School of Public Health, Paris, France; Institut Pasteur, Paris, France
| | - Cyril Olivier
- Research Group for the Prevention of Occupational Infections in Healthcare Workers (GERES), Paris, France
| | - Gérard Pellissier
- Research Group for the Prevention of Occupational Infections in Healthcare Workers (GERES), Paris, France
| | - Elisabeth Bouvet
- Research Group for the Prevention of Occupational Infections in Healthcare Workers (GERES), Paris, France
| | - Judith E Mueller
- EHESP French School of Public Health, Paris, France; Institut Pasteur, Paris, France; Univ. Rennes, EHESP, CNRS, Inserm, Arènes - UMR 6051, RSMS (Recherche sur les Services et Management en Santé) - U 1309, F-35000 Rennes, France.
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Kaufman J, Rak A, Vasiliadis S, Brar N, Atif E, White J, Danchin M, Durrheim DN. The Case for Assessing the Drivers of Measles Vaccine Uptake. Vaccines (Basel) 2024; 12:692. [PMID: 38932421 PMCID: PMC11209301 DOI: 10.3390/vaccines12060692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Revised: 06/18/2024] [Accepted: 06/19/2024] [Indexed: 06/28/2024] Open
Abstract
Global measles cases are on the rise following disruptions to routine immunisation programs during the COVID-19 pandemic, with devastating consequences. According to the World Health Organization, the behavioural and social drivers of vaccination include what people think and feel about vaccines, social processes, motivation to vaccinate and practical barriers to vaccination. However, the drivers of measles vaccine uptake are not necessarily the same as those for other childhood vaccines, and we lack data on how these drivers specifically have changed during and since the COVID-19 pandemic. Without accurately measuring the behavioural and social drivers for measles vaccination, and ideally measuring them serially over time, countries cannot design, target and implement interventions that effectively increase and sustain measles vaccine coverage. This paper outlines what is and is not known about the behavioural and social drivers of measles vaccination and provides recommendations for improving their post-pandemic assessment.
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Affiliation(s)
- Jessica Kaufman
- Vaccine Uptake Group, Murdoch Children’s Research Institute, Melbourne, VIC 3052, Australia; (A.R.); (S.V.); (M.D.)
- Department of Paediatrics, The University of Melbourne, Melbourne, VIC 3052, Australia
| | - Ashleigh Rak
- Vaccine Uptake Group, Murdoch Children’s Research Institute, Melbourne, VIC 3052, Australia; (A.R.); (S.V.); (M.D.)
| | - Sophia Vasiliadis
- Vaccine Uptake Group, Murdoch Children’s Research Institute, Melbourne, VIC 3052, Australia; (A.R.); (S.V.); (M.D.)
| | - Navrit Brar
- Melbourne Medical School, The University of Melbourne, Melbourne, CIV 3052, Australia; (N.B.); (E.A.)
| | - Eeman Atif
- Melbourne Medical School, The University of Melbourne, Melbourne, CIV 3052, Australia; (N.B.); (E.A.)
| | - Jennifer White
- Health Protection, Hunter New England Local Health District, Booth Building, Wallsend Health Services Longworth Avenue, Newcastle, NSW 2287, Australia; (J.W.); (D.N.D.)
- School of Medicine and Public Health, University of Newcastle, Newcastle, NSW 2308, Australia
| | - Margie Danchin
- Vaccine Uptake Group, Murdoch Children’s Research Institute, Melbourne, VIC 3052, Australia; (A.R.); (S.V.); (M.D.)
- Department of Paediatrics, The University of Melbourne, Melbourne, VIC 3052, Australia
- Department of General Medicine, The Royal Children’s Hospital, Melbourne, VIC 3052, Australia
| | - David N. Durrheim
- Health Protection, Hunter New England Local Health District, Booth Building, Wallsend Health Services Longworth Avenue, Newcastle, NSW 2287, Australia; (J.W.); (D.N.D.)
- School of Medicine and Public Health, University of Newcastle, Newcastle, NSW 2308, Australia
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Allen J, Watts DJ, Rand DG. Quantifying the impact of misinformation and vaccine-skeptical content on Facebook. Science 2024; 384:eadk3451. [PMID: 38815040 DOI: 10.1126/science.adk3451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 04/17/2024] [Indexed: 06/01/2024]
Abstract
Low uptake of the COVID-19 vaccine in the US has been widely attributed to social media misinformation. To evaluate this claim, we introduce a framework combining lab experiments (total N = 18,725), crowdsourcing, and machine learning to estimate the causal effect of 13,206 vaccine-related URLs on the vaccination intentions of US Facebook users (N ≈ 233 million). We estimate that the impact of unflagged content that nonetheless encouraged vaccine skepticism was 46-fold greater than that of misinformation flagged by fact-checkers. Although misinformation reduced predicted vaccination intentions significantly more than unflagged vaccine content when viewed, Facebook users' exposure to flagged content was limited. In contrast, unflagged stories highlighting rare deaths after vaccination were among Facebook's most-viewed stories. Our work emphasizes the need to scrutinize factually accurate but potentially misleading content in addition to outright falsehoods.
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Affiliation(s)
- Jennifer Allen
- Sloan School of Management, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Duncan J Watts
- Department of Computer and Information Science, University of Pennsylvania, Philadelphia, PA, USA
- Annenberg School for Communication, University of Pennsylvania, Philadelphia, PA, USA
- Operations, Information, and Decisions Department, University of Pennsylvania, Philadelphia, PA, USA
| | - David G Rand
- Sloan School of Management, Massachusetts Institute of Technology, Cambridge, MA, USA
- Institute for Data, Systems, and Society, Massachusetts Institute of Technology, Cambridge, MA, USA
- Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, Cambridge, MA, USA
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Okyay RA, Kaya E, Erdoğan A. Vaccine refusal in pregnant women in Kahramanmaraş: a community-based study from Türkiye. PeerJ 2024; 12:e17409. [PMID: 38784396 PMCID: PMC11114108 DOI: 10.7717/peerj.17409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Accepted: 04/26/2024] [Indexed: 05/25/2024] Open
Abstract
Background The global health landscape is increasingly challenged by the rejection of childhood vaccines. This study investigates vaccination reservations and refusal among pregnant women. Methods A cross-sectional study was conducted in Kahramanmaraş, Türkiye, spanning January to March 2019, entailing face to face interviews with 938 pregnant women. The questionnaire collected sociodemographic data and probed vaccination attitudes. The decision to vaccinate the baby was treated as the dependent variable, analyzed alongside sociodemographic factors and other variables. Data underwent evaluation via descriptive analysis, the Chi-square test, and binary logistic regression. Results Participants had a mean age of 27.6 years. Among them 20 (2.1%) expressed intent to either abstain from or partially vaccinate their babies, with 70% citing apprehensions regarding potential vaccine-related harm. Statistical analysis unveiled that higher economic income, elevated parental education level, fewer than two children, reliance on the Internet for vaccination information, and a lack of trust in physicians significantly correlated with vaccine refusal among pregnant women (p < 0.05). Conclusions The study concludes that dissemination of vaccination information by the healthcare professionals, complemented by the enactment of pro-vaccine internet policies holds promise in shaping vaccination behavior.
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Affiliation(s)
| | - Erhan Kaya
- Faculty of Medicine, Department of Public Health, Kahramanmaraş Sütçü İmam University, Kahramanmaraş, Türkiye
| | - Ayşegül Erdoğan
- Faculty of Medicine, Department of Public Health, Kahramanmaraş Sütçü İmam University, Kahramanmaraş, Türkiye
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Smith SE, Sivertsen N, Lines L, De Bellis A. Exploring social media influences on vaccine decision-making in parents: a netnography. Ther Adv Vaccines Immunother 2024; 12:25151355241249607. [PMID: 38726045 PMCID: PMC11080448 DOI: 10.1177/25151355241249607] [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: 07/09/2023] [Accepted: 03/28/2024] [Indexed: 05/12/2024] Open
Abstract
Background Immunization is one of the most significant health initiatives of recent times. Despite this, vaccine hesitancy is increasing and was listed as one of the top 10 threats to global health by the World Health Organization in 2019. A major factor associated with vaccine hesitancy is thought to be the viral spread of misinformation by a small but active anti-vaccination movement. Objectives The purpose of this study was to explore the influences of social media on vaccine decision-making in parents. Design This study is part of a larger body of research that explored vaccine decision-making in parents. Other methods included were an online survey and semi-structured interviews. This study investigated the influence of cyberculture on parents in an online environment. Method This study employed netnography, a form of qualitative inquiry with its roots in ethnography as methodology and a purpose-designed Facebook page as the means of exploring a purpose-designed online community with a particular focus on the culture, belief systems and influences present. Both manual and computer-assisted thematic analyses were used to analyse the data obtained. Results Three key themes were identified in this study. These included vaccine safety concerns, the emotional debate and COVID-19-specific issues. The results indicated the presence of strong anti-vaccination sentiment combined with an 'infodemic' of conspiracy theories, misinformation and vitriol with the potential to negatively impact parents seeking immunization information. Conclusion Given the popularity and accessibility of social media and the ready access to misinformation present online, it is evident that parental vaccine decision-making may be impacted adversely. Therefore, it is important that healthcare professionals are aware of this and provide adequate and timely education prior to parents seeking information on social media.
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Affiliation(s)
- Susan E. Smith
- College of Nursing and Health Science, Flinders University, P.O. Box 573, Stirling, SA 5154, Australia
| | - Nina Sivertsen
- College of Nursing and Health Science, Flinders University, Adelaide, SA, Australia
- Rural and Remote Arctic Health, UiT The Arctic University of Norway, Tromsø, Norway
| | - Lauren Lines
- College of Nursing and Health Science, Flinders University, Adelaide, SA, Australia
| | - Anita De Bellis
- College of Nursing and Health Science, Flinders University, Adelaide, SA, Australia
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Berhie S, Kacanek D, Lee J, Jao J, Powis K, Salomon L, Siddiqui D, Yee LM. Routine Vaccination During Pregnancy Among People Living With HIV in the United States. JAMA Netw Open 2024; 7:e249531. [PMID: 38696165 PMCID: PMC11066702 DOI: 10.1001/jamanetworkopen.2024.9531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 02/28/2024] [Indexed: 05/05/2024] Open
Abstract
Importance Pregnancy represents a window of opportunity for vaccination due to established maternal and fetal benefits of vaccination. Little is known about receipt of routinely recommended vaccines in pregnancy, specifically tetanus, diphtheria, plus acellular pertussis (Tdap) and influenza, among pregnant people living with HIV (PLHIV). Objective To estimate prevalence of vaccination receipt among pregnant people with HIV (PLHIV) and identify demographic and clinical characteristics associated with vaccination. Design, Setting, and Participants This multicenter cohort study included women participating in Women's Health Study (WHS) of the Surveillance Monitoring for ART Toxicities (SMARTT) Study of the Pediatric HIV/AIDS Cohort Study. The network has been enrolling pregnant PLHIV at 22 US sites since 2007. Participants for this study enrolled between December 2017 and July 2019. Data analysis was conducted from October 2021 to March 2022. Exposure Data on vaccination in pregnancy were collected through medical record abstraction. Main Outcomes and Measures Vaccination receipt was defined as Tdap vaccination received at less than 36 weeks' gestation and influenza vaccination at any gestational age, based on current guidelines. Log-binomial and modified Poisson regression models with generalized estimating equations were fit to identify factors associated with successful receipt of (1) Tdap, (2) influenza, and (3) both vaccinations. Results A total of 310 pregnancies among 278 people participating in the WHS were included (mean [SD] age, 29.5 [6.1] years; 220 [71%] Black, 77 [25%] Hispanic, and 77 [25%] race and ethnicity other than Black; 64 [21%] with perinatally acquired HIV). Less than one-third of pregnancies were vaccinated as recommended (Tdap, 32.6% [95% CI, 27.4%-38.1%]; influenza, 31.6% [95% CI, 26.5%-37.1%]; both, 22.6% [95% CI, 18.0%-27.6%]). People living with perinatally acquired HIV, those who did not identify as Black, or those who were multiparous had adjusted risk ratios (aRRs) less than 1, while older PLHIV had aRRs greater than 1, but these differences did not reach statistical significance (perinatally acquired HIV: adjusted risk ratio [aRR], 0.46; 95% CI, 0.21-1.02; race other than Black: aRR, 0.53; 95% CI, 0.26-1.08; multiparous: aRR, 0.59; 95% CI, 0.35-1.00; age 24-29 years: aRR, 2.03; 95% CI, 0.92-4.48). Conclusions and Relevance In this diverse, multicenter cohort of pregnant PLHIV, receipt of recommended vaccinations was low. Identifying and addressing barriers to vaccination receipt is urgently needed for pregnant people with HIV.
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Affiliation(s)
- Saba Berhie
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Brigham and Women’s Hospital, Boston, Massachusetts
| | - Deborah Kacanek
- Center for Biostatistics in AIDS Research, Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Jessica Lee
- Center for Biostatistics in AIDS Research, Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Jennifer Jao
- Division of Infectious Diseases, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Kathleen Powis
- Departments of Internal Medicine and Pediatrics, Massachusetts General Hospital, Boston, Massachusetts
- Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Liz Salomon
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Danish Siddiqui
- American University of Integrative Sciences, St Michael, Barbados
| | - Lynn M. Yee
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
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Arcaro P, Nachira L, Pattavina F, Campo E, Mancini R, Pascucci D, Damiani G, Carducci B, Spadea A, Lanzone A, Bruno S, Laurenti P. Assessing the Impact of the COVID-19 Pandemic on Pregnant Women's Attitudes towards Childhood Vaccinations: A Cross-Sectional Study. Vaccines (Basel) 2024; 12:473. [PMID: 38793724 PMCID: PMC11126003 DOI: 10.3390/vaccines12050473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Revised: 04/15/2024] [Accepted: 04/24/2024] [Indexed: 05/26/2024] Open
Abstract
The COVID-19 pandemic has globally disrupted immunisation practices, impacting vulnerable populations such as pregnant women (PW), who harbour concerns about future children's immunisations. This study aimed to assess the pandemic's impact on PW's attitudes towards childhood vaccinations. During three consecutive flu seasons from October 2019 to January 2022, a cross-sectional study was conducted in a large Italian teaching hospital using a questionnaire. The chi-square test was performed to compare each season. Across the 2019-2020 to 2021-2022 seasons, course attendance by PW surged from 105 to 340. Significant shifts in vaccination intentions were noted, including a 7.5% decrease in measles vaccination intent (p = 0.02) and a 10% decrease in that of pertussis (p = 0.004) from 2019-2020 to 2020-2021. While perceived contagion risk decreased, disease severity perceptions increased, with few significant differences. A statistically significant reduction was noted in the proportion of participants suspecting economic motives behind NHS workers' promotion of childhood vaccinations. Furthermore, the pandemic period saw an increase in the perceived utility of non-institutional websites and the advice of physicians outside the NHS. These findings will help develop evidence-based, tailored interventions and communication strategies to address vaccine hesitancy and ensure optimal vaccination coverage among children born during and after the pandemic.
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Affiliation(s)
- Paola Arcaro
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (P.A.); (L.N.); (E.C.); (R.M.); (G.D.); (S.B.); (P.L.)
| | - Lorenza Nachira
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (P.A.); (L.N.); (E.C.); (R.M.); (G.D.); (S.B.); (P.L.)
| | - Fabio Pattavina
- Women, Children and Public Health Sciences Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (B.C.); (A.L.)
| | - Enrica Campo
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (P.A.); (L.N.); (E.C.); (R.M.); (G.D.); (S.B.); (P.L.)
| | - Rossella Mancini
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (P.A.); (L.N.); (E.C.); (R.M.); (G.D.); (S.B.); (P.L.)
| | - Domenico Pascucci
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (P.A.); (L.N.); (E.C.); (R.M.); (G.D.); (S.B.); (P.L.)
- Health Management, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
| | - Gianfranco Damiani
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (P.A.); (L.N.); (E.C.); (R.M.); (G.D.); (S.B.); (P.L.)
- Women, Children and Public Health Sciences Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (B.C.); (A.L.)
| | - Brigida Carducci
- Women, Children and Public Health Sciences Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (B.C.); (A.L.)
| | | | - Antonio Lanzone
- Women, Children and Public Health Sciences Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (B.C.); (A.L.)
| | - Stefania Bruno
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (P.A.); (L.N.); (E.C.); (R.M.); (G.D.); (S.B.); (P.L.)
- Women, Children and Public Health Sciences Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (B.C.); (A.L.)
| | - Patrizia Laurenti
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (P.A.); (L.N.); (E.C.); (R.M.); (G.D.); (S.B.); (P.L.)
- Women, Children and Public Health Sciences Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (B.C.); (A.L.)
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O'Leary ST, Opel DJ, Cataldi JR, Hackell JM. Strategies for Improving Vaccine Communication and Uptake. Pediatrics 2024; 153:e2023065483. [PMID: 38404211 DOI: 10.1542/peds.2023-065483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/19/2023] [Indexed: 02/27/2024] Open
Abstract
Vaccines have led to a significant decrease in rates of vaccine-preventable diseases and have made a significant impact on the health of children. However, some parents express concerns about vaccine safety and the necessity of vaccines. The concerns of parents range from hesitancy about some immunizations to refusal of all vaccines. This clinical report provides information about the scope and impact of the problem, the facts surrounding common vaccination concerns, and the latest evidence regarding effective communication techniques for the vaccine conversation. After reading this clinical report, readers can expect to: Understand concepts and underlying determinants of vaccine uptake and vaccine hesitancy.Understand the relationship between vaccine hesitancy and costs of preventable medical care.Recognize and address specific concerns (eg, vaccine safety) with caregivers when hesitancy is present.
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Affiliation(s)
- Sean T O'Leary
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado; Adult and Child Center for Outcomes Research and Delivery Science (ACCORDS), University of Colorado School of Medicine/Children's Hospital Colorado, Aurora, Colorado
| | - Douglas J Opel
- Treuman Katz Center for Pediatric Bioethics and Palliative Care, Seattle Children's Research Institute; Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington
| | - Jessica R Cataldi
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado; Adult and Child Center for Outcomes Research and Delivery Science (ACCORDS), University of Colorado School of Medicine/Children's Hospital Colorado, Aurora, Colorado
| | - Jesse M Hackell
- Department of Pediatrics, New York Medical College, Valhalla, New York
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Anraad C, van Empelen P, Ruiter RAC, Rijnders M, van Groessen K, van Keulen HM. Promoting informed decision making about maternal pertussis vaccination: the systematic development of an online tailored decision aid and a centering-based group antenatal care intervention. Front Public Health 2024; 12:1256337. [PMID: 38425460 PMCID: PMC10902124 DOI: 10.3389/fpubh.2024.1256337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 01/23/2024] [Indexed: 03/02/2024] Open
Abstract
Introduction Maintaining and enhancing vaccine confidence continues to be a challenge. Making an informed decision not only helps to avoid potential future regret but also reduces susceptibility to misinformation. There is an urgent need for interventions that facilitate informed decision-making about vaccines. This paper describes the systematic development of two interventions designed to promote informed decision making and indirectly, acceptance of maternal pertussis vaccination (MPV) in the Netherlands. Materials and methods The 6-step Intervention Mapping (IM) protocol was used for the development of an online tailored decision aid and Centering Pregnancy-based Group Antenatal Care (CP) intervention. A needs assessment was done using empirical literature and conducting a survey and focus groups (1), intervention objectives were formulated at the behavior and determinants levels (2), theoretical methods of behavior change were selected and translated into practical applications (3), which were further developed into the two interventions using user-centered design (4). Finally, plans were developed for implementation (5), and evaluation (6) of the interventions. Results The needs assessment showed that pregnant women often based their decision about MPV on information sourced online and conversations with their partners, obstetric care providers, and peers. Responding to these findings, we systematically developed two interactive, theory-based interventions. We created an online tailored decision aid, subjecting it to four iterations of testing among pregnant women, including those with low literacy levels. Participants evaluated prototypes of the intervention positively on relevance and usability. In addition, a CP intervention was developed with midwives. Conclusion Using IM resulted in the creation of an online decision aid and CP intervention to promote informed decision making regarding MPV. This description of the systematic development of the interventions not only serves to illustrate design rationales, it will also aid the interpretation of the evaluation of the interventions, the development of future interventions promoting informed decision and acceptance of vaccines, and comparisons with other interventions.
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Affiliation(s)
- Charlotte Anraad
- Department of Work and Social Psychology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands
- TNO Child Health, Netherlands Organization for Applied Scientific Research, Leiden, Netherlands
| | - Pepijn van Empelen
- TNO Child Health, Netherlands Organization for Applied Scientific Research, Leiden, Netherlands
| | - Robert A. C. Ruiter
- Department of Work and Social Psychology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands
| | - Marlies Rijnders
- TNO Child Health, Netherlands Organization for Applied Scientific Research, Leiden, Netherlands
| | | | - Hilde M. van Keulen
- TNO Child Health, Netherlands Organization for Applied Scientific Research, Leiden, Netherlands
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Skirrow H, Foley K, Bedford H, Lewis C, Whittaker E, Costelloe C, Saxena S. Impact of pregnancy vaccine uptake and socio-demographic determinants on subsequent childhood Measles, Mumps and Rubella vaccine uptake: A UK birth cohort study. Vaccine 2024; 42:322-331. [PMID: 38072757 DOI: 10.1016/j.vaccine.2023.11.063] [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: 10/09/2023] [Revised: 11/21/2023] [Accepted: 11/30/2023] [Indexed: 01/01/2024]
Abstract
BACKGROUND We examined the association between socio-demographic determinants and uptake of childhood Measles, Mumps & Rubella (MMR) vaccines and the association between pregnant women's pertussis vaccine uptake and their children's MMR vaccine uptake. METHODS We used nationally-representative linked mother-baby electronic records from the United Kingdom's Clinical-Practice-Research-Datalink. We created a birth cohort of children born between 01.01.2000 and 12.12.2020. We estimated the proportion vaccinated with first MMR vaccine by age 2 years and first and second MMR vaccines by age 5 years. We used survival-analysis and Cox proportional hazard models to examine the association between deprivation, ethnicity and maternal age and pertussis vaccination in pregnancy and children's MMR uptake. RESULTS Overall, 89.4 % (710,797/795,497) of children had first MMR by age 2 years and 92.6 % (736,495/795,497) by age 5 years. Among children still in the cohort when second MMR was due, 85.9 % (478,480/557,050) had two MMRs by age 5 years. Children from the most-deprived areas, children of Black ethnicity and children of mothers aged < 20 years had increased risk of being unvaccinated compared with children from the least-deprived areas, White children and children of mothers aged 31-40 years: first MMR by 5 years, adjusted Hazard Ratios (HR):0.86 (CI:0.85-0.87), HR:0.87 (CI:0.85-0.88) & HR:0.89 (CI:0.88-0.90) respectively. Deprivation was the determinant associated with the greatest risk of missed second MMR: adjusted HR:0.82 (CI:0.81-0.83). Children of mothers vaccinated in pregnancy were more likely than children of unvaccinated mothers to have MMR vaccines after adjusting for ethnicity, deprivation, and maternal age (First and Second MMRs adjusted HRs:1.43 (CI:1.41-1.45), 1.49 (CI:1.45-1.53). CONCLUSION Children from most-deprived areas are less likely to have MMR vaccines compared with children from least-deprived areas. Mothers who take up pregnancy vaccines are more likely to have their children vaccinated with MMR. Healthcare services should promote and facilitate access to both maternal and childhood vaccines during pregnancy.
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Affiliation(s)
- H Skirrow
- School of Public Health, Imperial College London, United Kingdom.
| | - K Foley
- School of Public Health, Imperial College London, United Kingdom
| | - H Bedford
- Population, Policy and Practice, Great Ormond Street Institute of Child Health, University College London, United Kingdom
| | - C Lewis
- Population, Policy and Practice, Great Ormond Street Institute of Child Health, University College London, United Kingdom; London North Genomic Laboratory Hub, Great Ormond Street Hospital, London, United Kingdom
| | - E Whittaker
- Section of Paediatric Infectious Diseases, Imperial College London, United Kingdom; Department of Paediatric Infectious Diseases, Imperial College Healthcare NHS Trust, United Kingdom
| | - C Costelloe
- School of Public Health, Imperial College London, United Kingdom; Institute of Cancer Research, London, United Kingdom
| | - S Saxena
- School of Public Health, Imperial College London, United Kingdom
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Smith SE, Sivertsen N, Lines L, De Bellis A. Pushed to the Fringe - The Impact of Vaccine Hesitancy on Children and Families. Compr Child Adolesc Nurs 2023; 46:262-276. [PMID: 37318539 DOI: 10.1080/24694193.2023.2222815] [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: 03/06/2023] [Accepted: 05/19/2023] [Indexed: 06/16/2023]
Abstract
Vaccine hesitancy has been described as any delay or refusal of vaccines despite their availability and is increasing in Australia and other middle to high-income countries. The aim of this study is to gain a deep understanding of the experiences and influences on vaccine hesitant children and their families. A qualitative interview approach was undertaken with vaccine hesitant parents and pregnant women (n = 12). Semi-structured interviews were conducted by telephone. Inductive thematic analysis was undertaken on data obtained using the guidelines of Braun and Clarke. Three main themes were identified in this study, including Pushed to the fringe; A culture of Distrust; and Coerced choices. The study revealed that vaccine hesitant parents felt isolated and pushed to the fringe of society. They also expressed dissatisfaction with the Australian "No Jab - No Pay" and "No Jab - No Play" legislation. This contributed to feelings of marginalization. Participants also cited a breakdown in the therapeutic relationships, which impacted their child's health. Additionally, a lack of sufficient information was received to achieve informed consent. These results suggest that there is a need for enhanced education for some health-care professionals, many of whom have reported being confronted by conversations with vaccine hesitant parents.
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Affiliation(s)
- Susan E Smith
- College of Nursing and Health Science, Flinders University, Adelaide, South Australia
| | - Nina Sivertsen
- Rural and Remote Arctic Health, Campus Hammersfest, Flinders University and Arctic University of Norway, Adelaide, South Australia
| | - Lauren Lines
- Flinders University, Bedford Park, South Australia
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12
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Anraad C, van Empelen P, Ruiter RAC, van Keulen H. Effects of an online tailored decision aid to promote informed decision making about maternal pertussis vaccination in the Netherlands: A randomized controlled trial. Vaccine 2023; 41:7348-7358. [PMID: 37977943 DOI: 10.1016/j.vaccine.2023.10.068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 06/30/2023] [Accepted: 10/26/2023] [Indexed: 11/19/2023]
Abstract
INTRODUCTION In 2019, maternal pertussis vaccination (MPV) during pregnancy was introduced in the Netherlands. New interventions to promote informed decision making (IDM) about vaccinations are highly needed, especially for new vaccinations. Decision aids (DAs) have the potential to support IDM. This study evaluates the effects of an online DA on IDM and MPV uptake. METHODS Pregnant individuals, recruited for the randomized controlled trial (RCT), who gave informed consent (N = 1,236) were randomly assigned to the control (N = 650; no information) or intervention condition (N = 586; DA at 18 weeks pregnancy). MPV uptake and IDM were primary outcomes, decisional certainty and psychological determinants of MPV uptake were secondary outcomes. Measures were taken at 18 weeks of pregnancy (baseline) and at 20 weeks of pregnancy (post-test); intervention use was logged. Data were analysed using intention-to-treat analyses, logistic regression, and linear mixed regression models. RESULTS Uptake of MPV was high in our sample (92.3 %). No significant effect of the DA condition on MPV uptake was found compared to the control condition. We found that the DA increased IDM (β = 0.24, p < .004) and one of its components level of knowledge about MPV (β = 0.31, p < .004). We also found an increase in decisional certainty (β = 0.24, p < .004), perceived susceptibility (β = 0.24, p < .004), severity of pertussis (β = 0.41, p < .004), and positive affect about MPV (β = 0.15, p < .004). There was a positive association between dose of the intervention and MPV uptake (β = 0.05, p < .004). DISCUSSION The DA seemed effective in promoting IDM about and determinants of MPV uptake. No main effect was found on MPV uptake, but MPV uptake was related to the level of exposure to the DA. People with high intentions towards MPV were overrepresented in the sample. However, effects on IDM were consistent among participants with different levels of MPV intention at baseline.
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Affiliation(s)
- Charlotte Anraad
- Department of Work & Social Psychology, Faculty of Psychology and Neuroscience, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands; TNO Child Health, Netherlands Organization for Applied Scientific Research, P.O. Box 3005, 2316 ZL Leiden, The Netherlands.
| | - Pepijn van Empelen
- TNO Child Health, Netherlands Organization for Applied Scientific Research, P.O. Box 3005, 2316 ZL Leiden, The Netherlands
| | - Robert A C Ruiter
- Department of Work & Social Psychology, Faculty of Psychology and Neuroscience, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands
| | - Hilde van Keulen
- TNO Child Health, Netherlands Organization for Applied Scientific Research, P.O. Box 3005, 2316 ZL Leiden, The Netherlands
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Smith SE, Sivertsen N, Lines L, De Bellis A. Netnography: A novel methodology for nursing research. J Adv Nurs 2023; 79:4207-4217. [PMID: 37464735 DOI: 10.1111/jan.15798] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 06/19/2023] [Accepted: 07/03/2023] [Indexed: 07/20/2023]
Abstract
AIM The aim of this paper is to critically reflect on our team's experience of using netnography to explore vaccine-hesitant parents and pregnant women, a group who have traditionally been difficult to recruit to research studies and a methodology that is underutilized in nursing research. DESIGN This paper takes the form of a discussion paper that will utilize data obtained from a qualitative netnographic study. Relevant literature was searched including 2015-2023. METHOD This paper utilized data obtained from a qualitative study that used netnography as methodology and an online minable data source. Netnography is a relatively new methodology that uses the online environment to explore digital cultures and study networked society. It pays particular attention to cultural insights and conditions that impact the human experience. This methodology is particularly relevant to nursing research which is often humanistic and always conducted to ensure optimal patient outcomes. RESULTS Using netnography for the first time has resulted in four main insights. These include the adaptability of the process; the creativity involved in designing the site; the ready acceptance of the site by participants and the co-creation knowledge that resulted. CONCLUSIONS Netnography is a creative methodology that was successful in accessing and engaging the vaccine-hesitant community, a group who are often marginalized. Netnography has the advantage of using a platform that is familiar and safe for many people and provides access to an extensive minable data source.
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Affiliation(s)
- Susan E Smith
- College of Nursing and Health Science, Flinders University, Adelaide, South Australia, Australia
| | - Nina Sivertsen
- Caring Futures Institute, College of Nursing and Health Science, Flinders University, Adelaide, South Australia, Australia
- University and UIT Arctic University of Norway, Rural and Remote Arctic health, Campus Hammersfest, Tromsø, Norway
| | - Lauren Lines
- College of Nursing and Health Science, Flinders University, Adelaide, South Australia, Australia
| | - Anita De Bellis
- College of Nursing and Health Science, Flinders University, Adelaide, South Australia, Australia
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14
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Fenta ET, Tiruneh MG, Delie AM, Kidie AA, Ayal BG, Limenh LW, Astatkie BG, Workie NK, yigzaw ZA, Bogale EK, Anagaw TF. Health literacy and COVID-19 vaccine acceptance worldwide: A systematic review. SAGE Open Med 2023; 11:20503121231197869. [PMID: 37823070 PMCID: PMC10563502 DOI: 10.1177/20503121231197869] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Accepted: 08/11/2023] [Indexed: 10/13/2023] Open
Abstract
Objective Health literacy helps an individual to have the capacity to obtain, process, and understand basic health information to make appropriate health decisions. This study aimed to review the association between health literacy and COVID-19 vaccine acceptance. Method This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses steps. Databases including PubMed/MEDLINE, Web of Science, Scopus, EMBASE, World Health Organization libraries, and Google Scholar were used to search all published articles in the area of health literacy and COVID-19 vaccine acceptance until August 1, 2022. Result In this review, 1348 articles were retrieved. Finally, 13 articles were included in the review after the removal of duplicates that did not meet our inclusion criteria. In all, 10 articles showed that health literacy was significantly associated with COVID-19 vaccine acceptance. This review also showed that positive perception of the vaccine, vaccine hesitancy, adverse reaction from vaccines, residence, socioeconomic status, level of education, younger age, being a health worker, and positive belief have associations with health literacy and COVID-19 vaccine acceptance. There was significant heterogeneity in the study population and measurement tools used for health literacy and COVID-19 vaccine acceptance. Conclusion This systematic review provides comprehensive evidence on health literacy and COVID-19 vaccine acceptance globally. There was significant heterogeneity in the study population and measurement tools used for health literacy and COVID-19 vaccine acceptance. Most studies reported that health literacy is significantly associated with COVID-19 vaccine acceptance. Therefore, investing in health literacy using different vaccine promotion strategies may improve COVID-19 vaccine acceptance and health decision-making to decrease the impact of the COVID-19 pandemic.
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Affiliation(s)
- Eneyew Talie Fenta
- Department of Public Health, College Medicine Health Science, Injibara University, Injibara, Ethiopia
| | - Misganaw Guadie Tiruneh
- Department of Public Health, College Medicine Health Science, Woldia University, Woldia, Ethiopia
| | - Amare Mebrate Delie
- Department of Public Health, College Medicine Health Science, Injibara University, Injibara, Ethiopia
| | - Atitegeb Abera Kidie
- Department of Public Health, College Medicine Health Science, Woldia University, Woldia, Ethiopia
| | - Birtukan Gizachew Ayal
- Department of Public Health, College Medicine Health Science, Woldia University, Woldia, Ethiopia
| | - Liknaw Workie Limenh
- Department of Public Health, Gamby Medical and Business College, Bahir Dar, Ethiopia
- Department of Pharmaceutics, University of Gondar, Gondar, Ethiopia
| | | | - Nigus Kassie Workie
- Department of Public Health, College of Medicine and Health Science, Dire Dawa University, Dire Dawa, Ethiopia
| | - Zeamanuel Anteneh yigzaw
- Department of Health Promotion and Behavioral Science, School of Public Health, College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia
| | - Eyob ketema Bogale
- Department of Health Promotion and Behavioral Science, School of Public Health, College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia
| | - Tadele Fentabil Anagaw
- Department of Health Promotion and Behavioral Science, School of Public Health, College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia
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Surti MS, Amarbayan MM, McNeil DA, Hayden KA, Donald M, Patey AM, Bruce M, Castillo E. Resources available for parent-provider vaccine communication in pregnancy in Canada: a scoping review. BMJ Open 2023; 13:e072473. [PMID: 37607800 PMCID: PMC10445382 DOI: 10.1136/bmjopen-2023-072473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 08/08/2023] [Indexed: 08/24/2023] Open
Abstract
OBJECTIVE Vaccination in pregnancy (VIP) is a protective measure for pregnant individuals and their babies. Healthcare provider's (HCP) recommendations are important in promoting VIP. However, a lack of strong recommendations and accessible resources to facilitate communication impact uptake. This study sought to determine the extent of and characterise the resources available for parent-provider vaccine communication in pregnancy in Canada using a behavioural theory-informed approach. DESIGN Scoping review. METHODS In accordance with the JBI methodology, nine disciplinary and interdisciplinary databases were searched, and a systematic grey literature search was conducted in March and January 2022, respectively. Eligible studies included resources available to HCPs practising in Canada when discussing VIP, and resources tailored to pregnant individuals. Two reviewers piloted a representative sample of published and grey literature using inclusion-exclusion criteria and the Authority, Accuracy, Coverage, Objectivity, Date, Significance guidelines (for grey literature only). Sixty-five published articles and 1079 grey reports were screened for eligibility, of which 19 articles and 166 reports were included, respectively. RESULTS From the 19 published literature articles and 166 grey literature reports, 95% were driven by the 'Knowledge' domain of the Theoretical Domains Framework, while n=34 (18%) addressed the 'Skills' domain. Other gaps included a lack of VIP-specific tools to address hesitancy and a lack of information on culturally safe counselling practices. CONCLUSION The study suggests a need for resources in Canada to improve VIP communication skills and improve access to vaccination information for HCPs and pregnant individuals. The absence of such resources may hinder VIP uptake.
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Affiliation(s)
- Monica Santosh Surti
- Department of Medicine, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada
| | | | - Deborah A McNeil
- Faculty of Nursing, University of Calgary, Calgary, Alberta, Canada
- Maternal, Newborn, Child and Youth Strategic Clinical Network, Alberta Health Services, Edmonton, Alberta, Canada
| | - K Alix Hayden
- Libraries and Cultural Resources, University of Calgary, Calgary, Alberta, Canada
| | - Maoliosa Donald
- Department of Medicine, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada
| | - Andrea M Patey
- Centre for Implementation Research, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
- School of Rehabilitation Therapy, Queen's University, Kingston, Ontario, Canada
| | - Marcia Bruce
- Department of Medicine, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada
| | - Eliana Castillo
- Department of Medicine, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada
- Maternal, Newborn, Child and Youth Strategic Clinical Network, Alberta Health Services, Edmonton, Alberta, Canada
- Department of Obstetrics and Gynaecology, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada
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16
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Negash BT, Tediso Y, Yoseph A. Predictors of timeliness of vaccination among children of age 12-23 months in Boricha district, Sidama region Ethiopia, in 2019. BMC Pediatr 2023; 23:409. [PMID: 37598170 PMCID: PMC10439539 DOI: 10.1186/s12887-023-04234-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 08/07/2023] [Indexed: 08/21/2023] Open
Abstract
BACKGROUND Traditional measurement of vaccine coverage can mask the magnitude of timely uptake of vaccine. Hence, the optimal measurement of timeliness is unclear due to variations in vaccine schedule among countries in the world. In Ethiopia, Oral Polio Virus (OPV), Pentavalent, Tetanus, H. influenza type B, Hepatitis B, and Pneumonia-Conjugate Vaccine (PCV) are basic vaccines which are taken at birth, six weeks, ten weeks, and fourteen weeks respectively. Despite its importance, information is scarce about on-time vaccination in the study area. Therefore, this study aimed to assess prevalence and factors associated with on-time vaccination among children of age 12-23 months in Boricha district, Sidama Ethiopia, in 2019. METHODS A community based survey was conducted in Boricha district, Sidama region Ethiopia from January 1-30 in 2019. Study participants were selected using stratified multistage sampling technique. Kebeles were stratified based on residence. First, Kebeles were selected using random sampling. Then, systematic random sampling was employed to reach each household. Data were collected using structured and interviewer administered questionnaire. Logistic regression analysis was employed to identify factors associated with timely vaccination. Then, independent variables with p-value < 0.25 in COR were fitted further into multivariate logistic regression analysis model to control the possible cofounders. AOR with 95% CI and p-value < 0.05 was computed and reported as the level of statistical significance. RESULTS From a total of 614 study participants, only 609 study participants have responded to questions completely making a response rate of 99.2%. Prevalence of timeliness of vaccination was 26.8% (95% CI: 25, 28) in this study. Factors like children of women with formal education (AOR = 5.3, 95%CI,2.7, 10.4), absence of antenatal care visit (AOR = 4.2,95%CI, 1.8,9.8), home delivery (AOR = 6.2,95%CI,4.0,9.3), lack of postnatal care (AOR = 3.7,95%CI,1.1,13.3), and lack of information about when vaccines completion date (AOR = 2.0, 95% CI,1.13,3.8) were factors influences timely vaccination among children of age 12-23 months. CONCLUSION Prevalence of on-time vaccination among children of age 12-23 months is lower than national threshold. Therefore, sustained health education on vaccination schedule and reminder strategies should be designed and implemented. Furthermore, maternal and child health care services should be enhanced and coordinated to improve on-time uptake of vaccine.
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Affiliation(s)
- Berhan Tsegaye Negash
- Department of Midwifery, College Medicine and Health Science, Hawassa University, Hawassa, Sidama Ethiopia
| | - Yoseph Tediso
- Department of Public Health, College of Medicine and Health Science, Hawassa University, Hawassa, Sidama Ethiopia
| | - Amanuel Yoseph
- Department of Public Health, College of Medicine and Health Science, Hawassa University, Hawassa, Sidama Ethiopia
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Di Martino G, Mazzocca R, Camplone L, Cedrone F, Di Giovanni P, Staniscia T. Attitudes and Beliefs towards Rotavirus Vaccination in a Sample of Italian Women: A Cross-Sectional Study. Vaccines (Basel) 2023; 11:1041. [PMID: 37376430 DOI: 10.3390/vaccines11061041] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 05/15/2023] [Accepted: 05/25/2023] [Indexed: 06/29/2023] Open
Abstract
(1) Background: Rotavirus is the leading cause of severe diarrhea and dehydration in infants and young children worldwide. Despite the proven benefits of vaccination, vaccine hesitancy and refusal remains a significant barrier to achieving high vaccination coverage in many countries, such as Italy. (2) Methods: An online survey was conducted among women aged between 18 and 50 years from Abruzzo Region, Italy. The survey was composed of two main sections: demographic characteristics and attitudes and knowledge about rotavirus vaccination, based on a five-point Likert scale. Logistic regression analysis was performed to evaluate factors associated with willingness to get the rotavirus vaccination. (3) Results: A total of 414 women were enrolled in the study. Women who were unaware of rotavirus more frequently had a lower education level (university degree 62.5% vs. 78.7%, p = 0.004) and reported having no children (p < 0.001). About half of the enrolled women thought that rotavirus infection is dangerous (190, 55.6%) and that rotavirus can cause a serious illness (201, 58.8%). Regarding associated factors, women informed by a physician were more likely get a vaccination compared to women informed by friends or relatives (OR 34.35, 95% CI 7.12-98.98, p < 0.001). (4) Conclusions: The present study showed low levels of knowledge and attitudes towards rotavirus vaccination. These results highlight the need for developing and improving additional public education programs for parents.
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Affiliation(s)
- Giuseppe Di Martino
- Department of Medicine and Ageing Sciences, "G. d'Annunzio" University of Chieti-Pescara, 66100 Chieti, Italy
- Unit of Hygiene, Epidemiology and Public Health, Local Health Authority of Pescara, 65100 Pescara, Italy
| | - Riccardo Mazzocca
- School of Hygiene and Preventive Medicine, University of L'Aquila, 67100 L'Aquila, Italy
| | - Laura Camplone
- School of Hygiene and Preventive Medicine, University of L'Aquila, 67100 L'Aquila, Italy
| | - Fabrizio Cedrone
- Hospital Management, Local Health Authority of Pescara, 65100 Pescara, Italy
| | - Pamela Di Giovanni
- Department of Pharmacy, "G. d'Annunzio" University of Chieti-Pescara, 66100 Chieti, Italy
| | - Tommaso Staniscia
- Department of Medicine and Ageing Sciences, "G. d'Annunzio" University of Chieti-Pescara, 66100 Chieti, Italy
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Gavaruzzi T, Caserotti M, Bonaiuti R, Bonanni P, Crescioli G, Di Tommaso M, Lombardi N, Lotto L, Ravaldi C, Rubaltelli E, Tasso A, Vannacci A, Girardi P. The Interplay of Perceived Risks and Benefits in Deciding to Become Vaccinated against COVID-19 While Pregnant or Breastfeeding: A Cross-Sectional Study in Italy. J Clin Med 2023; 12:jcm12103469. [PMID: 37240575 DOI: 10.3390/jcm12103469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 05/10/2023] [Accepted: 05/11/2023] [Indexed: 05/28/2023] Open
Abstract
The present study examined the role of the perception of risks and benefits for the mother and her babies in deciding about the COVID-19 vaccination. In this cross-sectional study, five hypotheses were tested using data from a convenience sample of Italian pregnant and/or breastfeeding women (N = 1104, July-September 2021). A logistic regression model estimated the influence of the predictors on the reported behavior, and a beta regression model was used to evaluate which factors influenced the willingness to become vaccinated among unvaccinated women. The COVID-19 vaccination overall risks/benefits tradeoff was highly predictive of both behavior and intention. Ceteris paribus, an increase in the perception of risks for the baby weighed more against vaccination than a similar increase in the perception of risks for the mother. Additionally, pregnant women resulted in being less likely (or willing) to be vaccinated in their status than breastfeeding women, but they were equally accepting of vaccination if they were not pregnant. COVID-19 risk perception predicted intention to become vaccinated, but not behavior. In conclusion, the overall risks/benefits tradeoff is key in predicting vaccination behavior and intention, but the concerns for the baby weigh more than those for the mother in the decision, shedding light on this previously neglected aspect.
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Affiliation(s)
- Teresa Gavaruzzi
- Department of Medical and Surgical Sciences, University of Bologna, 40126 Bologna, Italy
- Department of Developmental Psychology and Socialization, University of Padova, 35122 Padova, Italy
| | - Marta Caserotti
- Department of Developmental Psychology and Socialization, University of Padova, 35122 Padova, Italy
| | - Roberto Bonaiuti
- PeaRL Perinatal Research Laboratory, CiaoLapo Foundation for Perinatal Health, Department of Neurosciences, Psychology, Drug Research and Child Health, University of Firenze, 50139 Firenze, Italy
| | - Paolo Bonanni
- Department of Health Science, University of Firenze, 50121 Firenze, Italy
| | - Giada Crescioli
- PeaRL Perinatal Research Laboratory, CiaoLapo Foundation for Perinatal Health, Department of Neurosciences, Psychology, Drug Research and Child Health, University of Firenze, 50139 Firenze, Italy
| | | | - Niccolò Lombardi
- PeaRL Perinatal Research Laboratory, CiaoLapo Foundation for Perinatal Health, Department of Neurosciences, Psychology, Drug Research and Child Health, University of Firenze, 50139 Firenze, Italy
| | - Lorella Lotto
- Department of Developmental Psychology and Socialization, University of Padova, 35122 Padova, Italy
| | - Claudia Ravaldi
- PeaRL Perinatal Research Laboratory, CiaoLapo Foundation for Perinatal Health, Department of Neurosciences, Psychology, Drug Research and Child Health, University of Firenze, 50139 Firenze, Italy
| | - Enrico Rubaltelli
- Department of Developmental Psychology and Socialization, University of Padova, 35122 Padova, Italy
| | - Alessandra Tasso
- Department of Humanities, University of Ferrara, 44121 Ferrara, Italy
| | - Alfredo Vannacci
- PeaRL Perinatal Research Laboratory, CiaoLapo Foundation for Perinatal Health, Department of Neurosciences, Psychology, Drug Research and Child Health, University of Firenze, 50139 Firenze, Italy
| | - Paolo Girardi
- Department of Environmental Sciences, Informatics and Statistics, Ca' Foscari University of Venezia, 30123 Venezia, Italy
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Piltch-Loeb R, James R, Albrecht SS, Buttenheim AM, Dowd JB, Kumar A, Jones M, Leininger LJ, Simanek A, Aronowitz S. What Were the Information Voids? A Qualitative Analysis of Questions Asked by Dear Pandemic Readers between August 2020-August 2021. JOURNAL OF HEALTH COMMUNICATION 2023; 28:25-33. [PMID: 37390014 DOI: 10.1080/10810730.2023.2214986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/02/2023]
Abstract
In the current infodemic, how individuals receive information (channel), who it is coming from (source), and how it is framed can have an important effect on COVID-19 related mitigation behaviors. In light of these challenges presented by the infodemic, Dear Pandemic (DP) was created to directly address persistent questions related to COVID-19 and other health topics in the online environment. This is a qualitative analysis of 3806 questions that were submitted by DP readers to a question box on the Dear Pandemic website between August 30, 2020 and August 29, 2021. Analyses resulted in four themes: the need for clarification of other sources; lack of trust in information; recognition of possible misinformation; and questions on personal decision-making. Each theme reflects an unmet informational need of Dear Pandemic readers, which may be reflective of the broader informational gaps in our science communication efforts.This study highlights the role of an ad hoc risk communication platform in the current environment and uses questions submitted to the Dear Pandemic question box to identify informational needs of DP readers over the course of the COVID-19 pandemic. These findings may help clarify how organizations addressing health misinformation in the digital space can contribute to timely, responsive science communication and improve future communication efforts.
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Affiliation(s)
- Rachael Piltch-Loeb
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- DearPandemic.org, Madison, Philadelphia, PA, USA
| | | | - Sandra S Albrecht
- DearPandemic.org, Madison, Philadelphia, PA, USA
- Department of Epidemiology, Mailman School of Public Health at Columbia University, New York, NY, USA
| | - Alison M Buttenheim
- DearPandemic.org, Madison, Philadelphia, PA, USA
- Department of Family and Community Health, University of Pennsylvania School of Nursing, Philadelphia, PA, USA
| | - Jennifer Beam Dowd
- DearPandemic.org, Madison, Philadelphia, PA, USA
- Leverhulme Centre for Demographic Science, University of Oxford, Oxford, UK
| | - Aparna Kumar
- DearPandemic.org, Madison, Philadelphia, PA, USA
- Thomas Jefferson University College of Nursing, Philadelphia, PA, USA
| | - Malia Jones
- DearPandemic.org, Madison, Philadelphia, PA, USA
- Department of Community & Environmental Sociology, University of Wisconsin-Madison, Madison, WI, USA
| | - Lindsey J Leininger
- DearPandemic.org, Madison, Philadelphia, PA, USA
- Tuck School of Business at Dartmouth College, Hanover, NH, USA
| | - Amanda Simanek
- DearPandemic.org, Madison, Philadelphia, PA, USA
- Department of Foundational Sciences, Chicago Medical School and Michael Reese Foundation Center for Health Equity Research, Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA
| | - Shoshana Aronowitz
- DearPandemic.org, Madison, Philadelphia, PA, USA
- Department of Family and Community Health, University of Pennsylvania School of Nursing, Philadelphia, PA, USA
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20
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Zhou F, Lindley MC, Lee JT, Jatlaoui TC. Association Between Influenza Vaccination During Pregnancy and Infant Influenza Vaccination. Obstet Gynecol 2023; 141:563-569. [PMID: 36728080 PMCID: PMC11259230 DOI: 10.1097/aog.0000000000005101] [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: 11/28/2022] [Accepted: 12/22/2022] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To examine the association between influenza vaccination during pregnancy and infant influenza vaccination. METHODS We conducted a retrospective analysis of individuals aged 15-49 years who were continually privately insured from August 2017 to May 2019 and had singleton live births between September 2017 and February 2018 and their infants. Influenza vaccination coverage was assessed for pregnant people during the 2017-2018 influenza season and for their infants during the 2018-2019 season using the 2017-2019 MarketScan data. Multivariate log-binomial regressions were conducted to examine the association between influenza vaccination during pregnancy and infant influenza vaccination. RESULTS Of the 34,919 pregnant people in this analysis, 14,168 (40.6%) received influenza vaccination during pregnancy. Of the infants born to people vaccinated during pregnancy, 90.0% received at least one dose of influenza vaccine during the 2018-2019 season and 75.5% received at least two doses. Of the infants born to those not vaccinated during pregnancy, 66.3% received at least one dose of influenza vaccine and 51.8% received at least two doses. At-least-one-dose coverage was 35.7% higher (adjusted risk ratio [aRR] 1.34, 95% CI 1.33-1.36) and at-least-two-dose coverage was 45.8% higher (aRR 1.43, 95% CI 1.41-1.46) for infants born to people who received influenza vaccination during pregnancy compared with infants born to people who did not. CONCLUSION Our results show a positive and statistically significant relationship between influenza vaccination during pregnancy and infant influenza vaccination status in their first season eligible for vaccination. Interventions to increase influenza vaccination coverage among pregnant people may also increase infant influenza vaccination coverage, offering greater protection against serious complications of influenza in both vulnerable populations.
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Affiliation(s)
- Fangjun Zhou
- Immunization Service Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
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21
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Young A, Charania NA, Gauld N, Norris P, Turner N, Willing E. Informing women about maternal vaccination in Aotearoa New Zealand: Is it effective? Midwifery 2023; 120:103636. [PMID: 36827756 DOI: 10.1016/j.midw.2023.103636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 02/06/2023] [Accepted: 02/14/2023] [Indexed: 02/20/2023]
Affiliation(s)
- Amber Young
- School of Pharmacy, University of Otago, PO Box 56, Dunedin 9054, New Zealand.
| | - Nadia A Charania
- Department of Public Health, School of Public Health and Interdisciplinary Studies, Auckland University of Technology, 90 Akoranga Drive, Northcote, Auckland 0627, New Zealand
| | - Natalie Gauld
- Department of Paediatrics: Child and Youth Health, University of Auckland, Private Bag 92019, Auckland 1142, New Zealand; School of Pharmacy, University of Auckland, Private Bag 92019, Auckland 1142, New Zealand
| | - Pauline Norris
- Va'a o Tautai-Centre for Pacific Health, University of Otago, PO Box 56, Dunedin 9054, New Zealand
| | - Nikki Turner
- Immunisation Advisory Centre, University of Auckland, Grafton Campus, Building 507, Level 3, 22-30 Park Avenue, Grafton, Auckland 1023, New Zealand
| | - Esther Willing
- Kōhatu-Centre for Hauora Māori, Otago Medical School, University of Otago, PO Box 56, Dunedin 9054, New Zealand
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22
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Uttekar S, MacDonald N, Orenstein WA, Danchin M, Blaser V, Thomson A, Menning L, Shimp L, Rath B, Limaye R, Esangbedo D, Abeyesekera S, Malue Nielsen S, Mackay S, Purnat T, Duraisamy K, Karthickeyan V, Siddique A, Thacker N. Empowering Health Workers to Build Public Trust in Vaccination: Experience from the International Pediatric Association's Online Vaccine Trust Course, 2020-2021. Vaccine 2023; 41:435-443. [PMID: 36470688 DOI: 10.1016/j.vaccine.2022.11.061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 11/22/2022] [Accepted: 11/23/2022] [Indexed: 12/03/2022]
Abstract
BACKGROUND The quality of interactions between health workers (HWs) and caregivers is key in vaccine acceptance. To optimize this, HWs need knowledge about best vaccine communication practices in person and on social media. Most pre-service curricula do not include such approaches. COVID-19 necessitated the International Pediatric Association (IPA) to shift from in-person train the trainer workshops to developing an online Vaccine Trust Course to address these gaps. METHOD The seven-module, 8-hour Vaccine Trust Course was offered online in seven languages and promoted globally. Course outcomes for participants between September 1, 2020 and September 30, 2021 were assessed using enrollment, participation, and completion data; pre-and post-training surveys of attitudes, knowledge, and practice skills; and follow-up practice surveys 3 months post course completion. RESULTS Of the 4,926 participants across 137 countries who registered; 2,381 (48.3 %) started the course, with 1,217 (51.1 %) completing. The majority were 25 - 39 years (57 %), female (57 %), and in pediatrics (70 %); 31 % came from India. 62 % of completers rated course structure/design as excellent, 36 % as good. Over 80 % rated the content as the most valuable aspect. Three months post training, 61 % HWs reported increased empathy towards caregivers, confidence while counseling and increased vaccine acceptance amongst their patients. 21 % identified the course as the only factor in these positive changes. CONCLUSION Shifting from face-to-face to online training due to the COVID-19 pandemic helped increase the global reach of HWs course engagement and uptake. Trained HWs reported increased empathy towards caregivers and confidence while counseling and increased patient vaccine acceptance.
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Affiliation(s)
| | - Noni MacDonald
- Department of Pediatrics, Dalhousie University, IWK Health Centre, 5850/5980 University Ave, Halifax, Nova Scotia B3K 6R8, Canada
| | | | - Margie Danchin
- Murdoch Children's Research Institute, Flemington Road, Parkville, Victoria 3052, Australia; The University of Melbourne, Parkville, Victoria, Australia; Royal Children's Hospital, Parkville, Victoria, Australia
| | - Vince Blaser
- Sabin Vaccine Institute, Washington, DC 20037, United States
| | | | | | - Lora Shimp
- John Snow, Inc., 2733 Crystal Drive, 4th Floor, Arlington, VA 22202, United States
| | - Barbara Rath
- Vaccine Safety Initiative, Berlin, Germany; Université de Bourgogne Franche Comté, 32 Av. de l'Observatoire, 25000 Besançon, France
| | - Rupali Limaye
- International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St., E5521, Baltimore, MD 21205, United States
| | | | | | - Siff Malue Nielsen
- World Health Organization Regional Office for Europe, Marmorvej 51, DK-2100 Copenhagen Ø, Denmark
| | | | - Tina Purnat
- World Health Organization, Geneva, Switzerland
| | | | | | - Aninda Siddique
- University of Toronto, 27 King's College Cir, Toronto, ON M5S 1A1, Canada
| | - Naveen Thacker
- International Pediatric Association, Gandhidham, Gujarat, India; Deep Child Hospital and Research Centre, Plot No. 208, Sector 1A, Gandhidham, Gujarat, India.
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Bourque SL, Weikel BW, Palmer C, Cataldi JR, Blackwell S, Hwang SS. Prevalence and Predictors of Pediatric COVID-19 Vaccine Acceptance. Am J Perinatol 2023; 40:106-114. [PMID: 35554887 DOI: 10.1055/a-1850-3199] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVE As pediatric COVID-19 vaccine eligibility expands, understanding predictors of vaccine intent is critical to effectively address parental concerns. Objectives included: (1) Evaluate maternal COVID-19 vaccine intent for child(ren) and associated predictors of stated intent; (2) Describe attitudes related to hypothetical vaccination policies; (3) Summarize themes associated with intention to vaccinate child(ren) for COVID-19. STUDY DESIGN Mothers enrolled in Heath eMoms, a longitudinal survey project, were recruited for this electronic COVID-19 survey. Chi-square analysis was used to compare proportions of respondent characteristics based on vaccination intent. Population survey logistic regression was used for multivariable modeling to assess the independent association between vaccine intent and demographics. RESULTS The response rate was 65.3% (n = 1884); 44.2% would choose vaccination, 20.3% would not choose vaccination, and 35.5% are unsure whether to have their child(ren) vaccinated for COVID-19. Black mothers (AOR 0.26, 95% CI 0.13, 0.54), respondents with less than high school education (AOR 0.26, 95% 0.12, 0.56) and those in rural areas (AOR 0.28, 95% CI 0.16, 0.48) were less likely to choose vaccination. Commonly cited reasons for vaccine hesitancy include the belief that the vaccine was not tested enough, is not safe, and there are concerns regarding its side effects. CONCLUSION Over 50% of respondents do not intend or are unsure about their intent to vaccinate their child(ren) for COVID-19 with variability noted by demographics. Opportunities exist for perinatal and pediatric providers to educate pregnant people, parents, and caregivers with a focus on addressing concerns regarding vaccine safety and efficacy. KEY POINTS · COVID-19 vaccination rates remain suboptimal, especially in the pediatric population, with variation across states.. · We found that the prevalence of vaccine acceptance for young children is low.. · We highlight opportunities for providers to educate parents, focusing on addressing vaccine safety and efficacy..
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Affiliation(s)
- Stephanie L Bourque
- Department of Pediatrics, Section of Neonatology, University of Colorado School of Medicine, Aurora, Colorado, United States
| | - Blair W Weikel
- Department of Pediatrics, Section of Neonatology, University of Colorado School of Medicine, Aurora, Colorado, United States
| | - Claire Palmer
- Department of Pediatrics, Section of Neonatology, University of Colorado School of Medicine, Aurora, Colorado, United States
| | - Jessica R Cataldi
- Department of Pediatrics, Section of Infectious Diseases, University of Colorado School of Medicine, Aurora, Colorado, United States.,Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, Colorado, United States
| | - Sarah Blackwell
- Colorado Department of Public Health and Environment, Aurora, Colorado, United States
| | - Sunah S Hwang
- Department of Pediatrics, Section of Neonatology, University of Colorado School of Medicine, Aurora, Colorado, United States
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24
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Narasimhan S, Perry TL, Johnson LC. "I was having an internal conflict with myself." COVID-19 vaccination decision-making processes among pregnant women. WOMEN'S HEALTH (LONDON, ENGLAND) 2023; 19:17455057231218211. [PMID: 38130103 DOI: 10.1177/17455057231218211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2023]
Abstract
BACKGROUND Vaccination serves as an efficient primary means of control for infectious diseases. However, in the case of the COVID-19 pandemic, pregnant women within the United States had the lowest rates of COVID-19 vaccination and reported the lowest intent to vaccinate. OBJECTIVES To explore the decision-making process for COVID-19 vaccination for people pregnant during the pandemic. DESIGN A secondary analysis of data from a mixed-methods study that examined the impact of COVID-19 on experiences of prenatal care, birth support, and delivery in the Southern United States. METHODS This study used a descriptive phenomenological approach to thematically analyze in-depth interviews (n = 20) with adult women who were pregnant by January 2020 and had their prenatal care and delivery during the pandemic beginning in March 2020. The transcripts were de-identified, coded, and thematically analyzed to saturation to identify drivers of COVID-19 vaccine decision-making based on COVID-19 vaccination status and timing. Comparative analyses were conducted to assess differences in decision-making processes based on race/ethnicity and parity. Participants also completed a sociodemographic survey that included their COVID-19 vaccination status. RESULTS Two themes emerged, the weighing of parallel risks and priorities from different sources resulting in vaccine decisional conflict and the need to reconcile that conflict via multiple strategies. All participants weighed priorities and risks from multiple areas of their lives and described internal conflict around vaccination. Participants described tailoring decisions to household dynamics, reconciling public and private values around vaccination, and the impact of their identities on the decision-making process. While many described concerns over vaccine safety and fetal health, uniquely, many highlighted weighing the impact of prior pregnancy loss history, with some choosing other preventive measures like social distancing or mask-wearing, which they deemed less risky. CONCLUSION Pregnant people make complex COVID-19 vaccination decisions, which must be considered in future vaccine messaging and advocacy for this group.
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Affiliation(s)
- Subasri Narasimhan
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
- Center for Reproductive Health Research in the Southeast, Emory University, Atlanta, GA, USA
| | - Tahira L Perry
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Leslie Cm Johnson
- Department of Family and Preventive Medicine, Emory University School of Medicine, Atlanta, GA, USA
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25
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Lalot F, Abrams D, Heering MS, Babaian J, Ozkececi H, Peitz L, Davies Hayon K, Broadwood J. Distrustful Complacency and the COVID-19 Vaccine: How Concern and Political Trust Interact to Affect Vaccine Hesitancy. POLITICAL PSYCHOLOGY 2022; 44:POPS12871. [PMID: 36718283 PMCID: PMC9878109 DOI: 10.1111/pops.12871] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
We test the hypothesis that COVID-19 vaccine hesitancy is attributable to distrustful complacency-an interactive combination of low concern and low trust. Across two studies, 9,695 respondents from different parts of Britain reported their level of concern about COVID-19, trust in the UK government, and intention to accept or refuse the vaccine. Multilevel regression analysis, controlling for geographic area and relevant demographics, confirmed the predicted interactive effect of concern and trust. Across studies, respondents with both low trust and low concern were 10%-22% more vaccine hesitant than respondents with either high trust or high concern, and 26%-29% more hesitant than respondents with both high trust and high concern. Results hold equally among White, Black, and Muslim respondents, consistent with the view that regardless of mean-level differences, a common process underlies vaccine hesitancy, underlining the importance of tackling distrustful complacency both generally and specifically among unvaccinated individuals and populations.
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26
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Vasudevan L, Stinnett SS, Hart L, Gomez Altamirano P, Gonzalez A, Weaver K, Gray B, Bartlett J. Pregnant individuals' information needs and intention to vaccinate their children with routine and COVID-19 vaccines: Findings from a cross-sectional survey. Int J Gynaecol Obstet 2022:10.1002/ijgo.14571. [PMID: 36353745 PMCID: PMC9877590 DOI: 10.1002/ijgo.14571] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Revised: 10/26/2022] [Accepted: 11/09/2022] [Indexed: 11/11/2022]
Abstract
OBJECTIVE The current study assessed pregnant individuals' intention to accept routine and COVID-19 vaccines for their baby after birth, and to identify key demographic (e.g., age) and nondemographic characteristics (e.g., prior birth) associated with vaccination intention. METHODS The authors conducted a cross-sectional survey with pregnant individuals attending prenatal practices affiliated with a large academic medical center and two rural county health departments in the southeastern United States. The survey included 11 questions and was self-administered by pregnant individuals in clinic settings. The final analysis included responses from 443 pregnant individuals. RESULTS Only 67% of pregnant individuals planned to vaccinate their baby with all recommended routine vaccines; an additional 22% reported having questions about recommendations. Only 35% of pregnant individuals said they would vaccinate their baby as soon as possible with a COVID-19 vaccine. Younger pregnant individuals and those identifying as Black or African American had lower routine and COVID-19 vaccination intention. Routine vaccination, but not COVID-19 vaccination intention, was associated with familiarity with routine vaccination schedule, trimester of pregnancy, Hispanic ethnicity, history of prior birth, and having access to a computer. CONCLUSION Study findings support differential tailoring of future interventions targeting pregnant individuals to promote routine and COVID-19 vaccines for children.
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Affiliation(s)
- Lavanya Vasudevan
- Department of Family Medicine and Community HealthDuke University School of MedicineDurhamNorth CarolinaUSA,Duke Global Health InstituteDurhamNorth CarolinaUSA,Hubert Department of Global HealthRollins School of Public Health, Emory UniversityAtlantaGeorgiaUSA
| | - Sandra S. Stinnett
- Department of Biostatistics and BioinformaticsDuke University School of MedicineDurhamNorth CarolinaUSA
| | - Lauren Hart
- Department of Family Medicine and Community HealthDuke University School of MedicineDurhamNorth CarolinaUSA
| | - Pedro Gomez Altamirano
- Department of Family Medicine and Community HealthDuke University School of MedicineDurhamNorth CarolinaUSA
| | - Angel Gonzalez
- Department of Family Medicine and Community HealthDuke University School of MedicineDurhamNorth CarolinaUSA
| | - Kristin Weaver
- Department of Obstetrics and GynecologyDuke University School of MedicineDurhamNorth CarolinaUSA
| | - Beverly Gray
- Department of Obstetrics and GynecologyDuke University School of MedicineDurhamNorth CarolinaUSA
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27
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Smith SE, Sivertsen N, Lines L, De Bellis A. Decision making in vaccine hesitant parents and pregnant women - An integrative review. INTERNATIONAL JOURNAL OF NURSING STUDIES ADVANCES 2022; 4:100062. [PMID: 38745627 PMCID: PMC11080481 DOI: 10.1016/j.ijnsa.2022.100062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 01/03/2022] [Accepted: 01/14/2022] [Indexed: 12/01/2022] Open
Abstract
Objectives : Vaccine refusal is increasing in Australia and is a major concern in high- and middle-income countries. There is evidence to suggest that some parents, even those who elect to immunise, may be vaccine hesitant with some manipulating the schedule by excluding or delaying some vaccines. The aim of this review was to gain an understanding of factors that influence vaccine decision-making in pregnant women and parents of children. Design : An integrative review approach was used to produce an analysis of existing literature on vaccine decision-making in pregnancy and parents. As the broadest of review methods, an integrative review can include a range of experimental and non-experimental research, thereby ensuring the inclusion of data from multiple perspectives. Data Sources : Online databases were searched for research related to vaccine decision-making in pregnant women and parents. Original and review articles were sought that were published in English between 2015 and 2021. Reviewed articles included qualitative and quantitative studies and systematic reviews. No mixed methods papers were located or excluded from this review. Review methods : The review method was an integrative review informed by Coughlan. Results : Papers from thirteen predominantly high- and middle-income countries were selected for this review. A total of 31 articles fit the inclusion/exclusion criteria, including qualitative, quantitative and review articles. Three main themes were identified including the role of healthcare professionals, vaccine safety concerns and alternative influences. Alternative influences included: social media, friends and family, religion, conspiracy theories and salutogenic parenting. Findings suggest that high levels of anxiety are involved in vaccine decision-making with parents seeking information from multiple sources including healthcare professionals, friends and family and social media. Conclusions : Pregnancy is an ideal time to provide education on both pregnancy and childhood vaccinations. However, some parents reported dissatisfaction in their therapeutic relationships with healthcare professionals. As a result, parents can resort to their own information seeking, in the main via social media which has been linked to vaccine refusal. Additionally, some healthcare professionals report feeling inadequately prepared for the role of immunisation promotion and provision. Parental information seeking from non-traditional sources has been shown to result in the acquisition of misinformation, exposure to conspiracy theories, the inevitable loss of vaccine confidence and subsequent vaccine refusal.
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Affiliation(s)
- Susan E Smith
- Flinders University College of nursing and health science, Australia
| | - Nina Sivertsen
- Flinders University College of nursing and health science, Australia
- Arctic University of Norway, Rural and Remote Arctic Health, Campus Hammersfest
| | - Lauren Lines
- Flinders University College of nursing and health science, Australia
| | - Anita De Bellis
- Flinders University College of nursing and health science, Australia
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28
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Bussink-Voorend D, Hautvast JLA, Vandeberg L, Visser O, Hulscher MEJL. A systematic literature review to clarify the concept of vaccine hesitancy. Nat Hum Behav 2022; 6:1634-1648. [PMID: 35995837 DOI: 10.1038/s41562-022-01431-6] [Citation(s) in RCA: 60] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 07/13/2022] [Indexed: 11/25/2022]
Abstract
Vaccine hesitancy (VH) is considered a top-10 global health threat. The concept of VH has been described and applied inconsistently. This systematic review aims to clarify VH by analysing how it is operationalized. We searched PubMed, Embase and PsycINFO databases on 14 January 2022. We selected 422 studies containing operationalizations of VH for inclusion. One limitation is that studies of lower quality were not excluded. Our qualitative analysis reveals that VH is conceptualized as involving (1) cognitions or affect, (2) behaviour and (3) decision making. A wide variety of methods have been used to measure VH. Our findings indicate the varied and confusing use of the term VH, leading to an impracticable concept. We propose that VH should be defined as a state of indecisiveness regarding a vaccination decision.
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Affiliation(s)
- Daphne Bussink-Voorend
- Radboud University Medical Center, Radboud Institute for Health Sciences, Primary and Community Care, Nijmegen, the Netherlands.
| | - Jeannine L A Hautvast
- Radboud University Medical Center, Radboud Institute for Health Sciences, Primary and Community Care, Nijmegen, the Netherlands
| | - Lisa Vandeberg
- Behavioural Science Institute, Radboud University, Nijmegen, the Netherlands
| | - Olga Visser
- Radboud University Medical Center, Radboud Institute for Health Sciences, Primary and Community Care, Nijmegen, the Netherlands
| | - Marlies E J L Hulscher
- Radboud University Medical Center, Radboud Institute for Health Sciences, IQ Healthcare, Nijmegen, the Netherlands
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29
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Paul R, Raghuraman N, Carter EB, Odibo AO, Kelly JC, Foeller ME, Perez MJ. COVID Vaccine Information Sources Utilized by Female Healthcare Workers. Am J Obstet Gynecol MFM 2022; 4:100704. [PMID: 35931368 PMCID: PMC9345656 DOI: 10.1016/j.ajogmf.2022.100704] [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: 05/23/2022] [Revised: 07/13/2022] [Accepted: 07/28/2022] [Indexed: 12/02/2022]
Abstract
BACKGROUND Clinical trials of the messenger RNA COVID-19 vaccines excluded individuals with active reproductive needs (attempting to conceive, currently pregnant, and/or lactating). Women comprise three-quarters of healthcare workers in the United States-an occupational field among the first to receive the vaccine. Professional medical and government organizations have encouraged shared decision-making and access to vaccination among those with active reproductive needs. OBJECTIVE This study aimed to characterize the information sources used by pregnancy-capable healthcare workers for information about the COVID-19 vaccines and to compare the self-reported "most important" source by the respondents' active reproductive needs, if any. STUDY DESIGN This was a web-based national survey of female, US-based healthcare workers in January 2021. Recruitment was done using social media and subsequent sharing via word of mouth. We classified the respondents into 6 groups on the basis of self-reported reproductive needs as follows: (1) preventing pregnancy, (2) attempting pregnancy, (3) currently pregnant, (4) lactating, (5) attempting pregnancy and lactating, and (6) currently pregnant and lactating. We provided respondents with a list of information sources (friends, family, obstetrician-gynecologists, pediatrician, news, social media, government organizations, their employer, and "other") and asked respondents which source(s) they used when looking for information about the vaccine and their most important source. We used descriptive statistics to characterize the information sources and compared the endorsement of government organizations and obstetrician-gynecologists, which were the most important information source between reproductive groups, using the chi-square test. The effect size was calculated using Cramér V. RESULTS Our survey had 11,405 unique respondents: 5846 (51.3%) were preventing pregnancy, 955 (8.4%) were attempting pregnancy, 2196 (19.3%) were currently pregnant, 2250 (19.7%) were lactating, 67 (0.6%) were attempting pregnancy and lactating, and 91 (0.8%) were currently pregnant and lactating. The most endorsed information sources were government organizations (88.7%), employers (48.5%), obstetrician-gynecologists (44.9%), and social media (39.6%). Considering the most important information source, the distribution of respondents endorsing government organizations was different between reproductive groups (P<.001); it was most common among respondents preventing pregnancy (62.6%) and least common among those currently pregnant (31.5%). We observed an inverse pattern among the respondents endorsing an obstetrician-gynecologist as the most important source; the source was most common among currently pregnant respondents (51.4%) and least common among those preventing pregnancy (5.8%), P<.001. The differences in the endorsement of social media as an information source between groups were significant but had a small effect size. CONCLUSION Healthcare workers use government and professional medical organizations for information. Respondents attempting pregnancy and those pregnant and/or lactating are more likely to use social media and an obstetrician-gynecologist as information sources for vaccine decision-making. These data can inform public health messaging and counseling for clinicians.
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Affiliation(s)
- Rachel Paul
- Divisions of Maternal-Fetal Medicine & Clinical Research, Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, MO (R. Paul and Drs Raghuraman, Carter, Odibo, Kelly, and Perez)
| | - Nandini Raghuraman
- Divisions of Maternal-Fetal Medicine & Clinical Research, Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, MO (R. Paul and Drs Raghuraman, Carter, Odibo, Kelly, and Perez)
| | - Ebony B Carter
- Divisions of Maternal-Fetal Medicine & Clinical Research, Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, MO (R. Paul and Drs Raghuraman, Carter, Odibo, Kelly, and Perez)
| | - Anthony O Odibo
- Divisions of Maternal-Fetal Medicine & Clinical Research, Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, MO (R. Paul and Drs Raghuraman, Carter, Odibo, Kelly, and Perez)
| | - Jeannie C Kelly
- Divisions of Maternal-Fetal Medicine & Clinical Research, Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, MO (R. Paul and Drs Raghuraman, Carter, Odibo, Kelly, and Perez)
| | - Megan E Foeller
- Maternal-Fetal Medicine, Saint Alphonsus Medical Center, Boise, ID (Dr Foeller)
| | - Marta J Perez
- Divisions of Maternal-Fetal Medicine & Clinical Research, Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, MO (R. Paul and Drs Raghuraman, Carter, Odibo, Kelly, and Perez).
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30
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Homer CSE, Javid N, Wilton K, Bradfield Z. Vaccination in pregnancy: The role of the midwife. Front Glob Womens Health 2022; 3:929173. [PMID: 36353468 PMCID: PMC9637860 DOI: 10.3389/fgwh.2022.929173] [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: 04/26/2022] [Accepted: 10/07/2022] [Indexed: 11/14/2022] Open
Abstract
Midwives are the front-line workers providing maternity care for women in many countries. The role of the midwife includes providing information about, and recommendations for, maternal vaccination in pregnancy and for the baby in the postnatal period. Vaccinations recommended in pregnancy include those to prevent influenza, pertussis, tetanus and now COVID-19. Vaccinations for the newborn baby include hepatitis B. Healthcare professionals play an important role in influencing decision-making around vaccination and midwives are key in supporting vaccination uptake. Midwives are strong influencer in women's decisions around vaccination for themselves and their babies. The COVID-19 vaccination programs have shone a light on vaccination in pregnancy especially as SARS-COV-2 infection has significant adverse effects in pregnancy. COVID-19 vaccination has been shown to be safe and effective in pregnancy. Despite this, there is vaccine hesitancy from pregnant women in many countries. Midwives play a unique role in the provision of care to women and families but they need specific support and information regarding vaccination in pregnancy. Targeted education, supportive mentoring and supervision and opportunities to lead innovative ways of ensuring vaccine access is logistically easy and possible are all needed. This Commentary outlines the key vaccinations recommended in pregnancy including COVID-19 vaccination and highlights some strategies to scale-up vaccination programs in pregnancy with a particular focus on the role of midwives.
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Affiliation(s)
- Caroline S. E. Homer
- Maternal, Child and Adolescent Health Program, Burnet Institute, Melbourne, VIC, Australia,Faculty of Health, Universityof Technology Sydney, Sydney, NSW, Australia,Correspondence: Caroline S. E. Homer
| | - Nasrin Javid
- Faculty of Health, Universityof Technology Sydney, Sydney, NSW, Australia,Nursing and Midwifery Research Alliance, South West Sydney Local Health District, Liverpool, NSW, Australia
| | - Kellie Wilton
- Australian College of Midwives, Canberra, ACT, Australia
| | - Zoe Bradfield
- Faculty of Health Sciences, King Edward Memorial Hospital and Curtin University, Perth, WA, Australia
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Gorgui J, Atallah A, Boucoiran I, Gomez YH, Bérard A. SARS-CoV-2 vaccine uptake and reasons for hesitancy among Canadian pregnant people: a prospective cohort study. CMAJ Open 2022; 10:E1034-E1043. [PMID: 36735245 PMCID: PMC9744265 DOI: 10.9778/cmajo.20210273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Several vaccines against SARS-CoV-2 have been developed and approved at an unparalleled speed. Given that SARS-CoV-2 vaccines are recommended to pregnant people, our aim was to quantify vaccination uptake, and describe vaccination hesitancy and behavioural attitudes surrounding SARS-CoV-2 vaccination in pregnancy in Canada. METHODS The CONCEPTION study is an ongoing international study started in June 2020, evaluating the impact of the COVID-19 pandemic on the health of pregnant people and their children. For this study, pregnant people recruited from Apr. 20, 2021, to Feb. 8, 2022, and residing in Canada were invited to complete a Web-based survey. In addition to all CONCEPTION variables, data on vaccine uptake as well as personal knowledge of COVID-19 severity in pregnancy and of SARS-CoV-2 vaccine safety and efficacy were collected. Marginal risk differences and adjusted odds ratios (ORs) were calculated to assess determinants of SARS-CoV-2 vaccination during pregnancy. RESULTS From Apr. 20, 2021, to Feb. 8, 2022, 603 pregnant people were recruited and gave consent, of which 83.7% (n = 505) were vaccinated and 16.3% (n = 98) were not vaccinated against SARS-CoV-2. Uptake of the influenza vaccine in 2020/21 was a significant predictor of being vaccinated against SARS-CoV-2 or intention to be vaccinated (marginal risk difference 3.2%, 95% confidence interval [CI] 3.0% to 3.3%, adjusted OR 4.43, 95% CI 2.32 to 9.25), and being employed (marginal risk difference 11.2%, 95% CI 10.6% to 11.9%, adjusted OR 2.17, 95% CI 1.03 to 4.35) increased the likelihood of being vaccinated against SARS-CoV-2. Self-assessed knowledge of COVID-19 severity and vaccine efficacy was not associated with vaccine uptake. INTERPRETATION Among the Canadian pregnant people who responded to this study, vaccine uptake against SARS-CoV-2 was high. However, our results underscore the importance of improving knowledge transfer about the efficacy of SARS-CoV-2 vaccines in pregnancy to guide vaccination efforts.
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Affiliation(s)
- Jessica Gorgui
- Centre hospitalier universitaire Sainte-Justine Research Centre (Gorgui, Bérard, Gomez); Faculty of Pharmacy (Gorgui, Bérard), Université de Montréal; Mother and Children's Infectious Diseases Centre (Atallah, Boucoiran), CHU Sainte-Justine, Université de Montréal, Montréal, Que.; Hospices Civils de Lyon (Atallah), Hôpital Femme Mère Enfant, Department of Prenatal Diagnosis, Université Claude Bernard Lyon 1, Lyon, France; Department of Obstetrics and Gynecology (Atallah), and School of Public Health (Boucoiran), Université de Montréal, Montréal, Que.; Faculty of Medicine (Boucoiran, Bérard), Université Claude Bernard Lyon 1, Lyon, France
| | - Anthony Atallah
- Centre hospitalier universitaire Sainte-Justine Research Centre (Gorgui, Bérard, Gomez); Faculty of Pharmacy (Gorgui, Bérard), Université de Montréal; Mother and Children's Infectious Diseases Centre (Atallah, Boucoiran), CHU Sainte-Justine, Université de Montréal, Montréal, Que.; Hospices Civils de Lyon (Atallah), Hôpital Femme Mère Enfant, Department of Prenatal Diagnosis, Université Claude Bernard Lyon 1, Lyon, France; Department of Obstetrics and Gynecology (Atallah), and School of Public Health (Boucoiran), Université de Montréal, Montréal, Que.; Faculty of Medicine (Boucoiran, Bérard), Université Claude Bernard Lyon 1, Lyon, France
| | - Isabelle Boucoiran
- Centre hospitalier universitaire Sainte-Justine Research Centre (Gorgui, Bérard, Gomez); Faculty of Pharmacy (Gorgui, Bérard), Université de Montréal; Mother and Children's Infectious Diseases Centre (Atallah, Boucoiran), CHU Sainte-Justine, Université de Montréal, Montréal, Que.; Hospices Civils de Lyon (Atallah), Hôpital Femme Mère Enfant, Department of Prenatal Diagnosis, Université Claude Bernard Lyon 1, Lyon, France; Department of Obstetrics and Gynecology (Atallah), and School of Public Health (Boucoiran), Université de Montréal, Montréal, Que.; Faculty of Medicine (Boucoiran, Bérard), Université Claude Bernard Lyon 1, Lyon, France
| | - Yessica-Haydee Gomez
- Centre hospitalier universitaire Sainte-Justine Research Centre (Gorgui, Bérard, Gomez); Faculty of Pharmacy (Gorgui, Bérard), Université de Montréal; Mother and Children's Infectious Diseases Centre (Atallah, Boucoiran), CHU Sainte-Justine, Université de Montréal, Montréal, Que.; Hospices Civils de Lyon (Atallah), Hôpital Femme Mère Enfant, Department of Prenatal Diagnosis, Université Claude Bernard Lyon 1, Lyon, France; Department of Obstetrics and Gynecology (Atallah), and School of Public Health (Boucoiran), Université de Montréal, Montréal, Que.; Faculty of Medicine (Boucoiran, Bérard), Université Claude Bernard Lyon 1, Lyon, France
| | - Anick Bérard
- Centre hospitalier universitaire Sainte-Justine Research Centre (Gorgui, Bérard, Gomez); Faculty of Pharmacy (Gorgui, Bérard), Université de Montréal; Mother and Children's Infectious Diseases Centre (Atallah, Boucoiran), CHU Sainte-Justine, Université de Montréal, Montréal, Que.; Hospices Civils de Lyon (Atallah), Hôpital Femme Mère Enfant, Department of Prenatal Diagnosis, Université Claude Bernard Lyon 1, Lyon, France; Department of Obstetrics and Gynecology (Atallah), and School of Public Health (Boucoiran), Université de Montréal, Montréal, Que.; Faculty of Medicine (Boucoiran, Bérard), Université Claude Bernard Lyon 1, Lyon, France
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Yalçin SS, Kömürlüoğlu A, Topaç O. Rates of childhood vaccine refusal in Turkey during 2016-2017: Regional causes and solutions. Arch Pediatr 2022; 29:594-598. [PMID: 36167616 DOI: 10.1016/j.arcped.2022.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Revised: 04/22/2022] [Accepted: 06/18/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Vaccine hesitancy is a growing problem globally. This study aimed to detect the rates of vaccine refusal (VR) during childhood in each province and region of Turkey from 2016 to 2017 and to evaluate the experiences of Expanded Programme on Immunization (EPI) managers regarding childhood VR and opinions to solve and reduce vaccine hesitancy in Turkey. METHODS VR was defined as the refusal to vaccinate for at least one vaccine in children aged 0-23 months. In this descriptive study, information on notified VR cases and recommended solutions from every province in Turkey was accessed by the local EPI manager for the period 2016-2017. The VR rates were calculated. RESULTS From 80 provinces, 8977 VR cases were detected in 2016 (VR rate 3.5‰) and 14,779 cases in 2017 (VR rate 5.9‰; p<0.001). One quarter of Family Health Units reported at least one case of VR. The highest VR rate in children aged under 2 years was in East Marmara (8.4‰) in 2016, and the West Anatolia Region (10.9‰) and East Marmara region (10.9‰) in 2017. Concerns about the vaccine content, harmfulness, and fears about adverse effects were the most common reasons underlying VR. Educating healthcare workers about vaccines and interpersonal communication skills, increasing patient information with informative brochures, and preventing anti-vaccination publications in the media were the most frequent recommendations to solve VR. CONCLUSIONS In Turkey, VR cases continue to increase. Correct and adequate information, effective communication, and trust between healthcare workers and parents can help reduce VR.
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Affiliation(s)
- Siddika Songül Yalçin
- Hacettepe University, Faculty of Medicine, Department of Pediatrics, Division of Social Pediatrics, Ankara, Turkey.
| | - Ayça Kömürlüoğlu
- Sivas Cumhuriyet University, Faculty of Medicine, Department of Pediatrics, Sivas, Turkey
| | - Osman Topaç
- Ankara Health Directorate Public Health Presidency, Ankara, Turkey
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Pringle W, Greyson D, Graham JE, Dubé È, Mitchell H, Trottier MÈ, Berman R, Russell ML, MacDonald SE, Bettinger JA. Suitable but requiring support: How the midwifery model of care offers opportunities to counsel the vaccine hesitant pregnant population. Vaccine 2022; 40:5594-5600. [PMID: 35989134 DOI: 10.1016/j.vaccine.2022.07.055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 06/02/2022] [Accepted: 07/27/2022] [Indexed: 11/28/2022]
Abstract
Uptake of vaccination during pregnancy in Canada is lower than comparator countries. A recommendation from a trusted perinatal healthcare provider is a key opportunity to promote vaccine uptake and improve confidence. This study aims to identify barriers and opportunities to vaccination in midwifery care. Seventeen semi-structured telephone interviews with practicing midwives, educators and public health professionals with immunization training experiences were conducted. Documents pertaining to the midwifery profession (approx. 50) were reviewed. Inductive thematic analysis identified logistical, interprofessional, and information barriers preventing Canadian midwives from administering vaccines and counseling clients about vaccination, as well as opportunities to address each barrier. Key interventions at the level of logistics, training, and client information materials would help address barriers to the integration of midwives into the provision and recommendation of vaccines in perinatal care across Canada.
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Affiliation(s)
- Wendy Pringle
- Vaccine Evaluation Center, University of British Columbia, 950 W 28th Ave, Vancouver, British Columbia V5Z 4H4, Canada.
| | - Devon Greyson
- Department of Communication, University of Massachusetts Amherst, Integrative Learning Center, 650 N Pleasant St, Amherst, Massachusetts 01003, USA; School of Population and Public Health, University of British Columbia, 2206 East Mall, Vancouver, British Columbia V6T 1Z3, Canada.
| | - Janice E Graham
- Department of Pediatrics, Dalhousie University, 5849 University Ave, C-309, P.O. Box 15000, Halifax, Nova Scotia B3H 4H7, Canada.
| | - Ève Dubé
- Quebec National Institute of Public Health, 945, av Wolfe, Quebec City, Quebec G1V 5B3, Canada.
| | - Hana Mitchell
- Vaccine Evaluation Center, University of British Columbia, 950 W 28th Ave, Vancouver, British Columbia V5Z 4H4, Canada; Department of Pediatrics, UBC Faculty of Medicine, Rm 2D19, 4480 Oak Street, BC Children's Hospital, Vancouver, BC V6H 3V4, Canada.
| | - Marie-Ève Trottier
- Quebec National Institute of Public Health, 945, av Wolfe, Quebec City, Quebec G1V 5B3, Canada.
| | - Robyn Berman
- Ottawa Birth and Wellness Centre, 2260 Walkley Rd, Ottawa, Ontario K1G 6A8, Canada.
| | - Margaret L Russell
- Cumming School of Medicine, University of Calgary, 3330 Hospital Dr NW, Calgary, Alberta T2N 4N1, Canada.
| | - Shannon E MacDonald
- Faculty of Nursing, University of Alberta, Level 3, Edmonton Clinic Health Academy, 11405-87 Ave, Edmonton, Alberta T6G 1C9, Canada.
| | - Julie A Bettinger
- Vaccine Evaluation Center, University of British Columbia, 950 W 28th Ave, Vancouver, British Columbia V5Z 4H4, Canada; Department of Pediatrics, UBC Faculty of Medicine, Rm 2D19, 4480 Oak Street, BC Children's Hospital, Vancouver, BC V6H 3V4, Canada.
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Bruno S, Nachira L, Villani L, Beccia V, Di Pilla A, Pascucci D, Quaranta G, Carducci B, Spadea A, Damiani G, Lanzone A, Federico B, Laurenti P. Knowledge and beliefs about vaccination in pregnant women before and during the COVID-19 pandemic. Front Public Health 2022; 10:903557. [PMID: 35991061 PMCID: PMC9386522 DOI: 10.3389/fpubh.2022.903557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 07/11/2022] [Indexed: 11/18/2022] Open
Abstract
Introduction Vaccine hesitancy threatens the health of populations and challenges Public Health professionals. Strategies to reduce it aim to improve people's risk perception about vaccine-preventable diseases, fill knowledge gaps about vaccines and increase trust in healthcare providers. During pregnancy, educational interventions can provide a proper knowledge about safety and efficacy of maternal and childhood vaccinations. Fighting hesitancy and clarifying doubts is fundamental during the COVID-19 pandemic, which may have affected people's knowledge and beliefs toward vaccination. This study aimed at assessing if the advent of the pandemic was associated with changes in pregnant women's knowledge and beliefs toward vaccination, and trust in healthcare services. Methods A repeated cross-sectional study was conducted through self-reported questionnaires in a Roman teaching hospital, where educational classes about vaccinations are routinely held as part of a birthing preparation course. Data were collected on a sample of pregnant women before and during the pandemic. Free-of-charge flu vaccinations were offered to all course participants and adherence to flu vaccination was assessed. Results The proportion of pregnant women reporting that vaccines have mild side effects and that are sufficiently tested increased from 78.6 to 92.0% (p = 0.001) and from 79.4 to 93.2% (p = 0.001), respectively. There was a reduction from 33.0 to 23.3% (p = 0.065) in the proportion of those declaring that healthcare workers (HCWs) give information only on the benefits and not on the risks of vaccines, and a reduction from 27.3 to 12.1% (p = 0.001) in those reporting that vaccines are an imposition and not a free choice of mothers. Trust in National Health Service (NHS) operators slightly decreased. Among participants, the monthly flu vaccination adherence ranged from 50.0% in November to 29.2% January for 2019–20 flu season, and from 56.3% in September to 14.5% in January for 2020–21 flu season, showing a higher vaccination acceptance in the earlier months of 2020-21 flu season. Conclusions The pandemic may have positively affected pregnant women's knowledge and opinions about vaccinations and trust in HCWs, despite a possible negative impact on their perceptions about NHS operators. This should inspire Public Health professionals to rethink their role as health communicators.
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Affiliation(s)
- Stefania Bruno
- Women, Children and Public Health Sciences Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Lorenza Nachira
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
- *Correspondence: Lorenza Nachira
| | - Leonardo Villani
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Viria Beccia
- Medical Oncology, Comprehensive Cancer Center, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Andrea Di Pilla
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
- Clinical Governance, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Domenico Pascucci
- Women, Children and Public Health Sciences Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Gianluigi Quaranta
- Women, Children and Public Health Sciences Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Brigida Carducci
- Women, Children and Public Health Sciences Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | | | - Gianfranco Damiani
- Women, Children and Public Health Sciences Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Antonio Lanzone
- Women, Children and Public Health Sciences Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Bruno Federico
- Department of Human Sciences, Society and Health, University of Cassino and Southern Lazio, Cassino, Frosinone, Italy
| | - Patrizia Laurenti
- Women, Children and Public Health Sciences Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
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de Munter AC, Hautvast JL, Ruijs WL, Henri Spaan D, Hulscher ME, Ruiter RA. Deciding about maternal pertussis vaccination: associations between intention, and needs and values in a vaccine-hesitant religious group. Vaccine 2022; 40:5213-5222. [DOI: 10.1016/j.vaccine.2022.07.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 07/02/2022] [Accepted: 07/20/2022] [Indexed: 10/16/2022]
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Krishnamoorthy Y, Rehman T. Impact of antenatal care visits on childhood immunization: a propensity score-matched analysis using nationally representative survey. Fam Pract 2022; 39:603-609. [PMID: 34564727 DOI: 10.1093/fampra/cmab124] [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] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Evidence has suggested a relationship between antenatal care (ANC) visits and childhood immunization coverage. However, evaluating its impact using observational data suffers from the problem of selection bias. Hence, we adopted propensity score-matched (PSM) analysis for studying the impact of ANC visits on childhood immunization. METHODS Data regarding ANC visits and childhood immunization were collected from a nationally representative survey, National Family Health Survey-4 (NFHS-4). We performed PSM analysis with logit model using the psmatch2 command package in STATA to find the average treatment effect on the population (ATE), treated (ATT), and untreated (ATU). RESULTS In total, 5,430 participants were included in the analysis. Radius matching with caliper width of 0.01 was used to match the groups. The ATT values in the intervention and control groups were 0.71 and 0.47, respectively, indicating that the immunization coverage was increased by 24% because of ANC visits. The ATU values in the intervention and control groups were 0.40 and 0.65, respectively. This indicates that for the women who did not make the ANC visits, the chance of getting their children immunized would have increased by 25% if they had made four or more visits. The final ATE estimate was 0.25 among the study participants. Quality of matching was good with no significant difference in characteristics between the two groups. CONCLUSION Findings from our study imply that policymakers in India should focus on further improving the ANC coverage as it has a significant impact on improving childhood immunization coverage.
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Affiliation(s)
- Yuvaraj Krishnamoorthy
- Department of Community Medicine, ESIC Medical College & PGIMSR, K.K. Nagar, Chennai, Tamil Nadu, India
| | - Tanveer Rehman
- Department of Preventive and Social Medicine, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
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Young A, Charania NA, Gauld N, Norris P, Turner N, Willing E. Knowledge and decisions about maternal immunisation by pregnant women in Aotearoa New Zealand. BMC Health Serv Res 2022; 22:779. [PMID: 35698133 PMCID: PMC9192336 DOI: 10.1186/s12913-022-08162-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 06/07/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Maternal vaccinations for influenza and pertussis are recommended in New Zealand to protect mothers and their infant from infection. However, maternal immunisation coverage in New Zealand is suboptimal. Furthermore, there is unacceptable inequitable maternal immunisation rates across the country with Māori and Pacific women having significantly lower maternal immunisation rates than those of other New Zealanders. METHODS This research set out to explore what pregnant/recently pregnant Māori and Pacific women knew about immunisation during pregnancy and what factors influenced their decision to be vaccinated. A semi-structured interview guide was developed with questions focusing on knowledge of pertussis and influenza vaccination during pregnancy and decision-making. Māori and Pacific women aged over 16 years were purposively sampled and interviewed in Dunedin and Gisborne, New Zealand between May and August 2021. Interviews were analysed following a directed qualitative content approach. Data were arranged into coding nodes based on the study aims (deductive analysis) informed by previous literature and within these participant experiences were inductively coded into themes and subthemes. RESULTS Not all women were aware of maternal vaccine recommendations or they diseases they protected against. Many underestimated how dangerous influenza and pertussis could be and some were more concerned about potential harms of the vaccine. Furthermore, understanding potential harms of infection and protection provided by vaccination did not necessarily mean women would choose to be vaccinated. Those who decided to vaccinate felt well-informed, had vaccination recommended by their healthcare provider, and did so to protect their and their infant's health. Those who decided against vaccination were concerned about safety of the vaccines, lacked the information they needed, were not offered the vaccine, or did not consider vaccination a priority. CONCLUSIONS There is a lack of understanding about vaccine benefits and risks of vaccine-preventable diseases which can result in the reinforcement of negative influences such as the fear of side effects. Furthermore, if vaccine benefits are not understood, inaccessibility of vaccines and the precedence of other life priorities may prevent uptake. Being well-informed and supported to make positive decisions to vaccinate in pregnancy is likely to improve vaccine coverage in Māori and Pacific Island New Zealanders.
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Affiliation(s)
- Amber Young
- Division of Health Sciences , Kōhatu-Centre for Hauora Māori, Otago Medical School, University of Otago, PO Box 56 , 9054, Dunedin, New Zealand.
| | - Nadia A Charania
- Department of Public Health, School of Public Health and Interdisciplinary Studies, Auckland University of Technology, Auckland, New Zealand
| | - Natalie Gauld
- Department of Paediatrics: Child and Youth Health, University of Auckland, Auckland, New Zealand.,School of Pharmacy, University of Auckland, Auckland, New Zealand
| | - Pauline Norris
- Va'a o Tautai - Centre for Pacific Health, University of Otago, Dunedin, New Zealand
| | - Nikki Turner
- Immunisation Advisory Centre, Department of General Practice and Primary Care, University of Auckland, Auckland, New Zealand
| | - Esther Willing
- Division of Health Sciences , Kōhatu-Centre for Hauora Māori, Otago Medical School, University of Otago, PO Box 56 , 9054, Dunedin, New Zealand
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How Were Healthcare Workers after Anti-SARS-CoV-2 Vaccination? A Study of the Emotional Side Effects of Vaccination. Vaccines (Basel) 2022; 10:vaccines10060854. [PMID: 35746462 PMCID: PMC9229046 DOI: 10.3390/vaccines10060854] [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: 03/18/2022] [Revised: 05/17/2022] [Accepted: 05/18/2022] [Indexed: 02/04/2023] Open
Abstract
Anti-SARS-CoV-2 vaccines appear to be the only escape from the COVID-19 pandemic. As healthcare workers were among the first in society to be vaccinated, understanding their emotional status post-vaccination is fundamental to the promotion of COVID-19 vaccines among the rest of society. The aims of this study were to investigate the predictors of positive and negative emotions experienced by healthcare workers after being vaccinated and to understand whether those emotions were related to the modalities of vaccine promotion within the community. A cohort of 5790 Italian healthcare workers completed an original online survey regarding their experience with anti-SARS-CoV-2 vaccines and reported on a series of personal and environmental factors. The data obtained show that increased risk perception of COVID-19, vaccine confidence and receipt of greater quantities of information regarding vaccines are predictors of a more positive emotional state post-vaccination. Predictors of a more negative emotional state are older age, lower education, lower confidence and receipt of smaller quantities of information, in addition to neurotic personality traits and high risk perception of COVID-19. Importantly, vaccination promotion may be favoured by a happy emotional status after vaccination. This study can serve as a source of guidelines for the promotion of COVID-19 vaccination among healthcare workers and laypeople.
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Alrabadi N, Bany-Melhem S, Alzoubi KH, Alzoubi OO, Masadeh M, Abuhammad S, Harun SN. COVID-19 Vaccination Hesitancy: A Review of the Literature and Recommendations. Curr Rev Clin Exp Pharmacol 2022; 19:CRCEP-EPUB-123426. [PMID: 35549859 DOI: 10.2174/2772432817666220512112913] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 01/24/2022] [Accepted: 01/24/2022] [Indexed: 11/22/2022]
Abstract
Vaccines are important to improve immunity against pathogens and diseases. The current COVID-19 disease is rapidly evolving and spreading among people; therefore, it is important to utilize a proper vaccination strategy against it. Currently, many approved vaccines are available and accessible; however, there is a reported hesitancy against taking them among the public and even the health care workers. Mainly, this is attributed to the fear of the possible side effects and complications. Moreover, inaccurate knowledge disseminated through the media/social media especially by those who lack proper expertise adds confusion and more fear that affects the vaccination decision. For such reasons, it is essential to find strategies to increase the acceptability of vaccines and to enhance confidence in the vaccination process. This should be accompanied by sufficient efforts and proper clinical studies to confirm the value and the safety of the vaccines. Those strategies are important to avoid the further spread of the COVID-19 disease and to abort the pandemic worldwide, especially when considering the likely approach towards a COVID-19 booster vaccination program, in which booster vaccines are re-taken along intervals to adequately contain the rapidly evolving nature of the virus. This review article highlights the factors influencing the acceptability of the COVID-19 vaccination and enrollment in clinical trials among the public and some specific populations. Furthermore, it summarizes the suggested strategies and recommendations that can improve the attitudes towards COVID-19 vaccination programs.
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Affiliation(s)
- Nasr Alrabadi
- Department of Pharmacology, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan, 22110
| | - Shouq Bany-Melhem
- Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan, 22110
| | - Karem H Alzoubi
- Department of Pharmacy Practice and Pharmacotherapeutics, University of Sharjah, Sharjah, UAE
- Deparment of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan, 22110
| | - Osama O Alzoubi
- Faculty of Medicine, The University of Jordan, Amman, Jordan
| | - Majd Masadeh
- Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan, 22110
| | - Sawsan Abuhammad
- Department of Maternal and Child Health Nursing, Faculty of Nursing, Jordan University of Science and Technology, Irbid, Jordan, 22110
| | - Sabariah Noor Harun
- Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, 11800, Penang, Malaysia
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Yarnall JN, Seashore C, Phillipi CA, Hatch JE, King B, Hart C, Lohr JA. Timing of Vaccine Decision-Making Among First-Time Parents. Acad Pediatr 2022; 22:551-558. [PMID: 34748968 DOI: 10.1016/j.acap.2021.10.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 10/04/2021] [Accepted: 10/19/2021] [Indexed: 11/01/2022]
Abstract
OBJECTIVE Decreased childhood vaccination can lead to local outbreaks of vaccine-preventable disease. In a pilot study from our group, 72% of parents of newborns reported initiating their vaccine decision-making for that child prior to conception. Since a sound understanding of the timing of parental vaccine decision-making is needed to direct educational efforts, we surveyed a national cohort of first-time parents to extend our preliminary findings. METHODS From March 2019 to March 2020, first-time parents of newborns in mother-baby units of the Better Outcomes through Research for Newborns (BORN) network completed the Vaccine Preference Development Survey (VPDS). The VPDS measures intent to vaccinate, timing of vaccine decision-making, and sources of influence. Univariate and multivariate analyses explored associations between intent to vaccinate and timing of vaccine decision-making with demographic variables. RESULTS Twenty-three sites provided surveys through site-specific nonrandom systemic sampling; 91% (1393/1524) of surveys were used in the analysis. Most parents planned to fully vaccinate (1191/1380, 86.3%) and started vaccine decision-making prior to conception (850/1378, 61.7%). Maternal age, race and ethnicity, relationship status, and education were all significantly associated with planning to fully vaccinate and preconception decision-making (P < .001). Preconception decision-making correlated strongly with intent to fully vaccinate (P < .001). Parents influenced by personal education, medical professionals, and family/friends were more likely to endorse preconception decision-making; those strongly influenced by internet/social media were less likely to allow all vaccines or start decision-making prior to conception. CONCLUSIONS Vaccine decision-making occurs preconception for most new parents. Initiating vaccine discussions during the birth hospitalization may be too late.
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Affiliation(s)
- J Nathan Yarnall
- Emory University School of Medicine (JN Yarnall), Atlanta, Ga; Children's Healthcare of Atlanta (JN Yarnall), Atlanta, Ga.
| | - Carl Seashore
- University of North Carolina School of Medicine (C Seashore, JE Hatch, C Hart, and JA Lohr), Chapel Hill, NC; UNC Health - Children's (C Seashore, C Hart), Chapel Hill, NC
| | | | - Joseph E Hatch
- University of North Carolina School of Medicine (C Seashore, JE Hatch, C Hart, and JA Lohr), Chapel Hill, NC
| | - Beth King
- Academic Pediatric Association (B King), McLean, Va
| | - Chayla Hart
- University of North Carolina School of Medicine (C Seashore, JE Hatch, C Hart, and JA Lohr), Chapel Hill, NC; UNC Health - Children's (C Seashore, C Hart), Chapel Hill, NC
| | - Jacob A Lohr
- University of North Carolina School of Medicine (C Seashore, JE Hatch, C Hart, and JA Lohr), Chapel Hill, NC
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Januszek S, Siwiec N, Januszek R, Kluz M, Lebed R, Toś P, Góra T, Plens K, Dąbrowski K, Sidorowicz M, Szcześniewska A, Barnaś E, Kalandyk-Osinko K, Darmochwal-Kolarz D, Kluz T. Approach of Pregnant Women from Poland and the Ukraine to COVID-19 Vaccination—The Role of Medical Consultation. Vaccines (Basel) 2022; 10:vaccines10020255. [PMID: 35214718 PMCID: PMC8880363 DOI: 10.3390/vaccines10020255] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2021] [Revised: 02/03/2022] [Accepted: 02/03/2022] [Indexed: 12/14/2022] Open
Abstract
There are many arguments for the safety and efficacy of COVID-19 vaccines in pregnancy. The aim of this study is to describe the level of vaccination acceptance, to find the factors that most influence the decision to vaccinate, and to describe the scale of changes in vaccination acceptance influenced by medical information on the safety, efficacy, and benefits of vaccination among pregnant women. A total of 300 patients completed the questionnaire, including 150 in Poland and 150 in the Ukraine. The level of vaccination acceptance was assessed before and after medical consultation. There were 53 (35.3%) patients with the intention to get vaccinated in Poland and 25 (16.7%) in the Ukraine. After consultation with a physician, this increased to 109 (72.6%) in Poland and 69 (46%) in the Ukraine. The main factors influencing the acceptance of vaccinations were the fear of harming the foetus (OR-0.119, CI-0.039–0.324 p < 0.001), complications in pregnancy (OR-0.073 CI-0.023–0.197 p < 0.001), and limitations in the vaccination programme (OR-0.026 CI-0.001–0.207 p < 0.001). Medical information about the safety, effectiveness and benefits of vaccinations among pregnant women, provided during a medical visit, may increase the acceptance of vaccinations by 105.6%, as among Polish patients, and by 176%, as among pregnant women from the Ukraine.
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Affiliation(s)
- Sławomir Januszek
- Department of Gynecology, Oncology and Obstetrics, Fryderyk Chopin University Hospital No. 1, 35-055 Rzeszów, Poland; (N.S.); (K.K.-O.); (T.K.)
- Department of Gynecology and Obstetrics, Institute of Medical Sciences, Medical College of Rzeszów University, 35-316 Rzeszów, Poland; (E.B.); (D.D.-K.)
- Correspondence: ; Tel.: +48-535860429
| | - Natalia Siwiec
- Department of Gynecology, Oncology and Obstetrics, Fryderyk Chopin University Hospital No. 1, 35-055 Rzeszów, Poland; (N.S.); (K.K.-O.); (T.K.)
| | - Rafał Januszek
- Department of Cardiology and Cardiovascular Interventions, University Hospital, 30-688 Kraków, Poland;
| | - Marta Kluz
- Department of Pathology, Fryderyk Chopin University Hospital No. 1, 35-055 Rzeszów, Poland;
| | - Roman Lebed
- Khmelnytsky Regional Perinatal Centre, 29-016 Khmelnytskyi, Ukraine;
| | - Paweł Toś
- Department of Gynecology and Obstetrics, University Hospital No. 2, 35-301 Rzeszów, Poland;
| | - Tomasz Góra
- Department of Gynecology and Obstetrics, Jan Paweł II Hospital, 35-241 Rzeszów, Poland;
- Department of Obstetrics and Perinatology, Medical College, Jagiellonian University, 31-501 Kraków, Poland
| | | | - Krzysztof Dąbrowski
- Department of Perinatology, City Hospital in Ruda Śląska, Gynecology and Obstetrics, 41-717 Ruda Śląska, Poland; (K.D.); (M.S.)
| | - Marcin Sidorowicz
- Department of Perinatology, City Hospital in Ruda Śląska, Gynecology and Obstetrics, 41-717 Ruda Śląska, Poland; (K.D.); (M.S.)
| | - Aleksandra Szcześniewska
- Departament of Perinatology and Gynecology, Polish Mother’s Memorial Hospital Research Institute, 93-338 Łodź, Poland;
| | - Edyta Barnaś
- Department of Gynecology and Obstetrics, Institute of Medical Sciences, Medical College of Rzeszów University, 35-316 Rzeszów, Poland; (E.B.); (D.D.-K.)
| | - Katarzyna Kalandyk-Osinko
- Department of Gynecology, Oncology and Obstetrics, Fryderyk Chopin University Hospital No. 1, 35-055 Rzeszów, Poland; (N.S.); (K.K.-O.); (T.K.)
- Department of Gynecology and Obstetrics, Institute of Medical Sciences, Medical College of Rzeszów University, 35-316 Rzeszów, Poland; (E.B.); (D.D.-K.)
| | - Dorota Darmochwal-Kolarz
- Department of Gynecology and Obstetrics, Institute of Medical Sciences, Medical College of Rzeszów University, 35-316 Rzeszów, Poland; (E.B.); (D.D.-K.)
- Department of Gynecology and Obstetrics, University Hospital No. 2, 35-301 Rzeszów, Poland;
| | - Tomasz Kluz
- Department of Gynecology, Oncology and Obstetrics, Fryderyk Chopin University Hospital No. 1, 35-055 Rzeszów, Poland; (N.S.); (K.K.-O.); (T.K.)
- Department of Gynecology and Obstetrics, Institute of Medical Sciences, Medical College of Rzeszów University, 35-316 Rzeszów, Poland; (E.B.); (D.D.-K.)
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Rubincam C, Greyson D, Haselden C, Saunders R, Bettinger JA. Is the pre-natal period a missed opportunity for communicating with parents about immunizations? Evidence from a longitudinal qualitative study in Victoria, British Columbia. BMC Public Health 2022; 22:237. [PMID: 35123432 PMCID: PMC8817524 DOI: 10.1186/s12889-022-12658-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 01/27/2022] [Indexed: 11/29/2022] Open
Abstract
Background Growing evidence shows that many parents begin the decision-making process about infant vaccination during pregnancy and these decisions – once established – may be resistant to change. Despite this, many interventions targeting vaccination are focused on communicating with parents after their baby is born. This suggests that the prenatal period may constitute a missed opportunity for communicating with expectant parents about infant vaccination. Methods Using a longitudinal qualitative design, we conducted two interviews (prepartum and postpartum) with women (n = 19) to explore the optimal timing of vaccination information. The data were analyzed thematically, and examined across all sets of pre- and post-partum interviews as well as within each individual participant to draw out salient themes. Results Most participants formed their intentions to vaccinate before the baby was born and indicated that they would welcome information about vaccination from their maternity care providers. However, few individuals recalled their maternity care providers initiating vaccination-related conversations with them. Conclusion The prenatal period is an important time to begin conversations with expectant parents about vaccinating their infants, particularly if these conversations are initiated by trusted maternity care providers. More information is needed on how maternity care providers can be better supported to have these conversations with their patients.
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Weighing up the risks — Vaccine decision-making in pregnancy and parenting. Women Birth 2022; 35:547-552. [DOI: 10.1016/j.wombi.2022.02.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 02/04/2022] [Accepted: 02/11/2022] [Indexed: 11/23/2022]
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Foo D, Sarna M, Pereira G, Moore HC, Regan AK. Longitudinal, population-based cohort study of prenatal influenza vaccination and influenza infection in childhood. Vaccine 2022; 40:656-665. [PMID: 35000794 DOI: 10.1016/j.vaccine.2021.11.084] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 11/21/2021] [Accepted: 11/28/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Influenza vaccination is recommended to protect mothers and their infants from influenza infection. Few studies have evaluated the health impacts of in utero exposure to influenza vaccine among children more than six months of age. METHODS We used probabilistically linked administrative health records to establish a mother-child cohort to evaluate the risk of influenza and acute respiratory infections associated with maternal influenza vaccination. Outcomes were laboratory-confirmed influenza (LCI) and hospitalization for influenza or acute respiratory infection (ARI). Adjusted hazard ratios (aHRs) accounted for child's Aboriginal status and were weighted by the inverse-probability of treatment. RESULTS 14,396 (11.5%) children were born to vaccinated mothers. Maternally vaccinated infants aged < 6 months had lower risk of LCI (aHR: 0.33; 95% CI: 0.13, 0.85), influenza-associated hospitalization (aHR: 0.39; 95% CI: 0.16, 0.94) and ARI-associated hospitalization (aHR: 0.85; 95% CI: 0.77, 0.94) compared to maternally unvaccinated infants. With the exception of an increased risk of LCI among children aged 6 months to < 2 years old following first trimester vaccination (aHR: 2.28; 95% CI: 1.41, 3.69), there were no other differences in the risk of LCI, influenza-associated hospitalization or ARI-associated hospitalization among children aged > 6 months. CONCLUSION Study results show that maternal influenza vaccination is effective in preventing influenza in the first six months and had no impact on respiratory infections after two years of age.
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Affiliation(s)
- Damien Foo
- Curtin School of Population Health, Curtin University, Perth, Western Australia, Australia; Wesfarmers Centre of Vaccines & Infectious Diseases, Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia.
| | - Mohinder Sarna
- Curtin School of Population Health, Curtin University, Perth, Western Australia, Australia; Wesfarmers Centre of Vaccines & Infectious Diseases, Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia
| | - Gavin Pereira
- Curtin School of Population Health, Curtin University, Perth, Western Australia, Australia; Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway; enAble Institute, Curtin University, Perth, Western Australia, Australia
| | - Hannah C Moore
- Curtin School of Population Health, Curtin University, Perth, Western Australia, Australia; Wesfarmers Centre of Vaccines & Infectious Diseases, Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia
| | - Annette K Regan
- Curtin School of Population Health, Curtin University, Perth, Western Australia, Australia; Wesfarmers Centre of Vaccines & Infectious Diseases, Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia; School of Nursing and Health Professions, University of San Francisco, San Francisco, California, United States; Fielding School of Public Health, University of California Los Angeles, Los Angeles, California, United States
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Skirrow H, Barnett S, Bell S, Riaposova L, Mounier-Jack S, Kampmann B, Holder B. Women's views on accepting COVID-19 vaccination during and after pregnancy, and for their babies: a multi-methods study in the UK. BMC Pregnancy Childbirth 2022; 22:33. [PMID: 35030996 PMCID: PMC8759061 DOI: 10.1186/s12884-021-04321-3] [Citation(s) in RCA: 95] [Impact Index Per Article: 47.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 11/29/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND COVID-19 vaccines are advised for pregnant women in the United Kingdom (UK) however COVID-19 vaccine uptake among pregnant women is inadequate. METHODS An online survey and semi-structured interviews were used to investigate pregnant women's views on COVID-19 vaccine acceptability for themselves when pregnant, not pregnant and for their babies. One thousand one hundred eighty-one women, aged over 16 years, who had been pregnant since 23rd March 2020, were surveyed between 3rd August-11th October 2020. Ten women were interviewed. RESULTS The majority of women surveyed (81.2%) reported that they would 'definitely' or were 'leaning towards' accepting a COVID-19 vaccine when not pregnant. COVID-19 vaccine acceptance was significantly lower during pregnancy (62.1%, p < 0.005) and for their babies (69.9%, p < 0.005). Ethnic minority women were twice as likely to reject a COVID-19 vaccine for themselves when not pregnant, pregnant and for their babies compared to women from White ethnic groups (p < 0.005). Women from lower-income households, aged under 25-years, and from some geographic regions were more likely to reject a COVID-19 vaccine when not pregnant, pregnant and for their babies. Multivariate analysis revealed that income and ethnicity were the main drivers of the observed age and regional differences. Women unvaccinated against pertussis in pregnancy were over four times more likely to reject COVID-19 vaccines when not pregnant, pregnant and for their babies. Thematic analysis of the survey freetext responses and interviews found safety concerns about COVID-19 vaccines were common though wider mistrust in vaccines was also expressed. Trust in vaccines and the health system were also reasons women gave for accepting COVID-19 vaccines. CONCLUSION Safety information on COVID-19 vaccines must be clearly communicated to pregnant women to provide reassurance and facilitate informed pregnancy vaccine decisions. Targeted interventions to promote COVID-19 vaccine uptake among ethnic minority and lower-income women may be needed.
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Affiliation(s)
- Helen Skirrow
- Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, UK
| | - Sara Barnett
- Department of Metabolism, Digestion and Reproduction, Institute of Reproductive and Developmental Biology, Imperial College London, London, UK
| | - Sadie Bell
- Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Lucia Riaposova
- Department of Metabolism, Digestion and Reproduction, Institute of Reproductive and Developmental Biology, Imperial College London, London, UK
| | - Sandra Mounier-Jack
- Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Beate Kampmann
- The Vaccine Centre, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK
- Vaccines and Immunity Theme, MRC Unit The Gambia at London School of Hygiene and Tropical Medicine, Banjul, The Gambia
| | - Beth Holder
- Department of Metabolism, Digestion and Reproduction, Institute of Reproductive and Developmental Biology, Imperial College London, London, UK.
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Sabahelzain MM, Moukhyer M, Bosma H, van den Borne B. Determinants of Measles Vaccine Hesitancy among Sudanese Parents in Khartoum State, Sudan: A Cross-Sectional Study. Vaccines (Basel) 2021; 10:vaccines10010006. [PMID: 35062667 PMCID: PMC8780692 DOI: 10.3390/vaccines10010006] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 12/07/2021] [Accepted: 12/20/2021] [Indexed: 11/20/2022] Open
Abstract
Determinants of vaccine hesitancy are not yet well understood. This study aims to assess measles vaccine hesitancy and characterize its determinants among Sudanese parents in Omdurman in Khartoum State. A community-based cross-sectional quantitative study was conducted in Khartoum State in February 2019. The Parent Attitudes about Childhood Vaccination (PACV) was used to measure measles vaccine hesitancy. Questions about the sociodemographic characteristics of the family, the perception of the parents about the measles vaccine, and the parental exposure to information were asked. Proportions of vaccine hesitancy and coefficients of linear regression were computed. Five hundred parents were recruited for the study. We found that a significant proportion of participants (about 1 in 5 parents) had hesitations regarding the measles vaccine. Significant predictors of measles vaccine hesitancy were parental exposure to anti-vaccination information or materials (β = −0.478, p-value < 0.001), the parents’ perception of the effectiveness of measles vaccines (β = 0.093, p-value = 0.020), the age of the mother (β = 0.112, p-value = 0.017), the birth rank of the child (β = −0.116, p-value = 0.015), and the total number of the children in the family (β = 0.098, p-value = 0.013). Vaccination access issues were the common justification for parental vaccination hesitancy. Our findings indicate that investment in vaccine communication as well as addressing access issues might be an effective intervention for improving measles vaccine acceptance and, ultimately, measles vaccine coverage.
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Affiliation(s)
- Majdi M. Sabahelzain
- Department of Public Health, School of Health Sciences, Ahfad University for Women, Omdurman P.O. Box 167, Sudan
- Department of Health Promotion, Care and Public Health Research Institute (CAPHRI), Maastricht University, 6211 LK Maastricht, The Netherlands;
- Correspondence:
| | - Mohamed Moukhyer
- Education Development and Quality Unit, College of Applied Medical Sciences, Jazan University, Jazan 45142, Saudi Arabia;
- Public Health Programmes, School of Medicine, University of Limerick, V94 T9PX Limerick, Ireland
| | - Hans Bosma
- Department of Social Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, 6211 LK Maastricht, The Netherlands;
| | - Bart van den Borne
- Department of Health Promotion, Care and Public Health Research Institute (CAPHRI), Maastricht University, 6211 LK Maastricht, The Netherlands;
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Marchetti F, Verazza S, Brambilla M, Restivo V. Rotavirus and the web: analysis of online conversations in Italy during 2020. Hum Vaccin Immunother 2021; 18:2002087. [PMID: 34856884 PMCID: PMC8966986 DOI: 10.1080/21645515.2021.2002087] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Rotavirus is the most common cause of severe diarrhea among children worldwide. In 2017, Italy included rotavirus vaccination in its National Immunization Program. The use of social media monitoring, an efficient tool to understand vaccine hesitancy, has increased in recent years; however, only a few examples of such monitoring are available for Italy. Present study analyzed content on online sources, including social media, to identify factors contributing to Italian parents’ decisions to vaccinate or not their children against rotavirus. Blogmeter Suite was used to search and analyze conversations related to rotavirus in Italian on online sources during 2020. These data were compared with data from 2019. There were 2250 mentions of “rotavirus” recorded; 1080 were related to the rotavirus vaccine. Terms and hashtags used were similar in both years. Facebook was the main source of influence, Instagram dominated the engagement (the sum of interactions related to a post), and Google Trends showed a 5-year upward trend in searches for rotavirus vaccine. Of 1270 sentiment opinions, 60.7% were negative. More parents were familiar with the disease and the vaccine in 2020 compared with 2019. Pediatricians were the most influential healthcare professionals (59.2% of mentions), followed by vaccination staff (33.4%). The most relevant factors for vaccine hesitancy were fear of adverse events, concerns about the vaccination schedule, and COVID-19. Present study represents the first web listening analysis of online discussions about rotavirus. The results can be used to inform targeted communication to counteract misinformation and raise awareness about rotavirus vaccination among parents.
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Affiliation(s)
| | | | | | - Vincenzo Restivo
- Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties "G. D'Alessandro", University of Palermo, Palermo, Italy
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Gilchrist CA, Chelimo C, Tatnell R, Atatoa Carr P, Camargo CA, Morton S, Grant CC. Vaccination information fathers receive during pregnancy and determinants of infant vaccination timeliness. Hum Vaccin Immunother 2021; 17:5214-5225. [PMID: 34797748 DOI: 10.1080/21645515.2021.1932212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
The information fathers receive about infant vaccination may influence their decision to vaccinate. We describe fathers' sources of vaccination information and paternal determinants of timely infant vaccinations. Participants were from a child cohort study in New Zealand. The child cohort was established by enrolling pregnant women and their partners. During pregnancy, fathers (n = 4017) of the cohort children born 2009-2010 described information sources that encouraged or discouraged infant vaccination. The National Immunization Register provided infant vaccination data. Independent associations of the vaccination information received by fathers with the timeliness of their infant's vaccination were determined using multivariable logistic regression. Associations were described using adjusted odds ratios and 95% confidence intervals. One-third of fathers (1430/4017 [36%]) recalled receiving vaccination information, 64% of which encouraged vaccination. Most infants (2900/4017 [72%]) received all their vaccinations on time, however only 58% of Māori infants were vaccinated on time. Paternal determinants of vaccination timeliness were the father receiving discouraging or conflicting information about vaccination, father's ethnicity, father's vaccination hesitancy, and whether the mother received vaccination information. To improve vaccination uptake and timeliness, a vaccination conversation with mothers, fathers and whānau could be included in routine antenatal care, informing and supporting decision-making, and addressing concerns. Vaccination education should address present and historic distrust of the health system. Framing vaccination within a Māori model of health and including fathers and whānau in decision-making will address vaccination inequities in New Zealand.
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Affiliation(s)
- Catherine A Gilchrist
- Department of Paediatrics: Child and Youth Health, The University of Auckland, Auckland, New Zealand
| | - Carol Chelimo
- Department of Paediatrics: Child and Youth Health, The University of Auckland, Auckland, New Zealand
| | - Ryan Tatnell
- General Paediatrics, Starship Children's Health, Auckland, New Zealand
| | - Polly Atatoa Carr
- Growing up in New Zealand, The University of Auckland, Auckland, New Zealand.,National Institute of Demographic and Economic Analysis, University of Waikato, Hamilton, New Zealand
| | - Carlos A Camargo
- Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA, USA.,Harvard Medical School, Harvard University, Boston, MA, USA
| | - Susan Morton
- Growing up in New Zealand, The University of Auckland, Auckland, New Zealand.,Centre for Longitudinal Research - He Ara Ki Mua, The University of Auckland, Auckland, New Zealand
| | - Cameron C Grant
- Department of Paediatrics: Child and Youth Health, The University of Auckland, Auckland, New Zealand.,General Paediatrics, Starship Children's Health, Auckland, New Zealand.,Centre for Longitudinal Research - He Ara Ki Mua, The University of Auckland, Auckland, New Zealand
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Huel C, Harding J, MacKinnon K, Gordon C, MacDonald SE. Parental experiences of caring for their preschool children after declining vaccines: a qualitative systematic review protocol. JBI Evid Synth 2021; 20:196-203. [PMID: 34559698 DOI: 10.11124/jbies-21-00116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
OBJECTIVE This review will explore the experiences of parents after making the decision not to vaccinate their young children. This review aims to help health care providers understand parents' specific care strategies for their under-vaccinated or unvaccinated young children. INTRODUCTION Much of the current qualitative research literature on parents who hesitate or refuse to vaccinate their young children focuses on parental perceptions about the safety and efficacy of vaccines and decision-making. However, limited attention has been paid to measures taken by parents to help their young children avoid contracting communicable diseases, promote resistance, and enhance their children's health. INCLUSION CRITERIA This review will consider qualitative studies that describe parents' experiences of caring for their young children, aged 0 to 6 years, after making the decision not to vaccinate. Studies undertaken in any context will be considered. Studies that focus on young children who are unvaccinated or not fully vaccinated for reasons not related to parental refusal will be excluded. METHODS The JBI methodology for systematic reviews of qualitative evidence will be followed. Databases will be searched from 1998 onwards, and will include Web of Science, MEDLINE, CINAHL, PsycINFO, Google Scholar, and ProQuest Dissertations and Theses, with no language limits. Following critical appraisal, findings that describe parental experiences and the care activities they perform related to their young children will be extracted. The JBI process of meta-aggregation will be used to identify categories and synthesize findings. The ConQual approach will be used to assess confidence in the findings. SYSTEMATIC REVIEW REGISTRATION NUMBER PROSPERO CRD42021241781.
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Affiliation(s)
- Christine Huel
- University of Victoria, Victoria, BC, Canada The University of Victoria (UVic) Centre for Evidence-Informed Nursing and Healthcare (CEiNHC): A JBI Centre of Excellence University of British Columbia, Vancouver, BC, Canada University of Alberta, Edmonton, AB, Canada
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Foley E, Breit S, Marsh C, Ault K, Lydic M. Attitudes toward Rubella and Varicella Vaccination during Preconception Care. Kans J Med 2021; 14:215-219. [PMID: 34540135 PMCID: PMC8415390 DOI: 10.17161/kjm.vol1415205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 05/05/2021] [Indexed: 11/17/2022] Open
Abstract
Introduction Studies of anti-vaccine attitudes in the perinatal time period previously have not paid special attention to the MMR and varicella vaccines. Because both contain live attenuated virus, a contraindication during pregnancy, it is important to assess barriers to vaccination clinically during preconception to avoid the known fetal morbidity associated with congenital rubella or varicella infection. Methods The primary outcome of this study was to determine prevalence of patients with nonimmune status for rubella and varicella in the setting of advanced reproductive care. Secondary outcomes of interest included further understanding nonimmune reproductive-aged women's attitudes toward MMR and varicella vaccination during preconception. Patient records with laboratory orders for rubella or varicella immunoglobulin titers, placed at the KU Advanced Reproductive Care clinic between January 2017 and June 2020, were reviewed (n = 2,217). A cross-sectional survey was administered to patients with a laboratory reported negative titer result. Results Prevalence of nonimmunity to either rubella or varicella represented 6.0% (n = 134) and 3.8% (n = 85) of records, respectively; nineteen records (0.6%) demonstrated nonimmunity to both. The women who did not receive recommended vaccines following a non-immune titer result (n = 19) most commonly cited their rationale was to not delay fertility treatment further (n = 8), a requirement when receiving live attenuated virus vaccines. Conclusions The prevalence of nonimmune persons in the study population fell within the range recognized to be sufficient for herd immunity. The majority of survey respondents indicated that CDC recommended vaccinations were of high personal importance, with strong congruence of thought among those who answered in favor of vaccines when posed with several true or false statements about personal beliefs and vaccine efficacy. The risk/benefit analysis of postponing fertility treatment to achieve adequate levels of immunity should be a focused discussion when establishing fertility treatment goals with patients in the setting of advanced reproductive care.
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Affiliation(s)
- Elise Foley
- University of Kansas School of Medicine-Salina, Salina, KS
| | - Shelby Breit
- University of Kansas School of Medicine-Salina, Salina, KS
| | - Courtney Marsh
- Center for Advanced Reproductive Medicine, University of Kansas Medical Center, Kansas City, KS
| | - Kevin Ault
- Center for Advanced Reproductive Medicine, University of Kansas Medical Center, Kansas City, KS
| | - Michael Lydic
- Center for Advanced Reproductive Medicine, University of Kansas Medical Center, Kansas City, KS
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