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How Public Health Professionals View Mandatory Vaccination in Italy-A Cross-Sectional Survey. Vaccines (Basel) 2021; 9:vaccines9060580. [PMID: 34205959 PMCID: PMC8228801 DOI: 10.3390/vaccines9060580] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 05/26/2021] [Accepted: 05/27/2021] [Indexed: 11/17/2022] Open
Abstract
In response to the decline in child vaccination coverage and the subsequent occurrence of large vaccine-preventable disease outbreaks, in 2017 Italy introduced a new law that made ten vaccines mandatory for children aged 0-16 years. The policy change initiated an ongoing debate among the general public, as well as in the political arena and the scientific community, over this major public health concern. Hence, we conducted a survey aimed at assessing Italian public health professionals' attitudes towards and opinions on mandatory vaccination. A validated online questionnaire was administered to 1350 members of the Italian Society of Hygiene, Preventive Medicine and Public Health. Among the 1044 responders (response rate 77%), a large majority were in favour of the Italian mandatory vaccination law (91%) and against its repeal (74%). Nevertheless, according to our sample, maintaining a high level of vaccination coverage without the need to mandate would be preferable, and thus efforts to promote vaccine confidence and proactive vaccine uptake are still needed.
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Rauh LD, Lathan HS, Masiello MM, Ratzan SC, Parker RM. A Select Bibliography of Actions to Promote Vaccine Literacy: A Resource for Health Communication. JOURNAL OF HEALTH COMMUNICATION 2020; 25:843-858. [PMID: 33719890 DOI: 10.1080/10810730.2021.1878312] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
In this bibliography, the researchers provide an introduction to the available evidence base of actions to promote vaccine literacy. The research team organized interventions to create a tool that can inform health communicators and practitioners seeking a resource focused on strategy and implementation design for actions that support vaccine literacy. This scoping bibliography is honed specifically to respond to the urgency of the current pandemic, when supporting and increasing vaccine literacy offers promise for achieving the critically needed high levels of vaccination. Over the course of the coming months and year, this bibliography will be a dynamic and "living" document hosted and maintained on vaccineliteracy.com.
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Affiliation(s)
- Lauren D Rauh
- Department of Community Health and Social Sciences, City University of New York Graduate School of Public Health and Health Policy, New York, NY, USA
| | - Hannah S Lathan
- Department of Community Health and Social Sciences, City University of New York Graduate School of Public Health and Health Policy, New York, NY, USA
| | | | - Scott C Ratzan
- Department of Community Health and Social Sciences, City University of New York Graduate School of Public Health and Health Policy, New York, NY, USA
| | - Ruth M Parker
- Division of General Medicine, Emory University School of Medicine, Atlanta, GA, USA
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Abstract
Most vaccines protect both the vaccinated individual and the society by reducing the transmission of infectious diseases. In order to eliminate infectious diseases, individuals need to consider social welfare beyond mere self-interest-regardless of ethnic, religious, or national group borders. It has therefore been proposed that vaccination poses a social contract in which individuals are morally obliged to get vaccinated. However, little is known about whether individuals indeed act upon this social contract. If so, vaccinated individuals should reciprocate by being more generous to a vaccinated other. On the contrary, if the other doesn't vaccinate and violates the social contract, generosity should decline. Three preregistered experiments investigated how a person's own vaccination behavior, others' vaccination behavior, and others' group membership influenced a person's generosity toward respective others. The experiments consistently showed that especially compliant (i.e., vaccinated) individuals showed less generosity toward nonvaccinated individuals. This effect was independent of the others' group membership, suggesting an unconditional moral principle. An internal metaanalysis (n = 1,032) confirmed the overall social contract effect. In a fourth experiment (n = 1,212), this pattern was especially pronounced among vaccinated individuals who perceived vaccination as a moral obligation. It is concluded that vaccination is a social contract in which cooperation is the morally right choice. Individuals act upon the social contract, and more so the stronger they perceive it as a moral obligation. Emphasizing the social contract could be a promising intervention to increase vaccine uptake, prevent free riding, and, eventually, support the elimination of infectious diseases.
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Mathieu P, Gautier A, Raude J, Goronflot T, Launay T, Debin M, Guerrisi C, Turbelin C, Hanslik T, Jestin C, Colizza V, Blanchon T, Rossignol L. Population perception of mandatory childhood vaccination programme before its implementation, France, 2017. Euro Surveill 2019; 24:1900053. [PMID: 31241041 PMCID: PMC6593904 DOI: 10.2807/1560-7917.es.2019.24.25.1900053] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
BackgroundVaccination policy in France was previously characterised by the coexistence of eight recommended and three mandatory vaccinations for children younger than 2 years old. These 11 vaccines are now mandatory for all children born after 1 January 2018.AimTo study the French population's opinion about this new policy and to assess factors associated with a positive opinion during this changing phase.MethodsA cross-sectional survey about vaccination was conducted from 16 November-19 December 2017 among the GrippeNet.fr cohort. Data were weighted for age, sex and education according to the French population. Univariate and multivariate analyses were performed to identify factors associated with a favourable opinion on mandatory vaccines' extension and defined in the '3Cs' model by the World Health Organization Strategic Advisory Group of Experts working group on vaccine hesitancy.ResultsOf the 3,222 participants (response rate 50.5%) and after adjustment, 64.5% agreed with the extension of mandatory vaccines. It was considered a necessary step by 68.7% of the study population, while 33.8% considered it unsafe for children and 56.9% saw it as authoritarian. Factors associated with a positive opinion about the extension of mandatory vaccines were components of the confidence, complacency and convenience dimensions of the '3Cs' model.ConclusionsIn our sample, two thirds of the French population was in favour of the extension of mandatory vaccines for children. Perception of vaccine safety and benefits were major predictors for positive and negative opinions about this new policy.
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Affiliation(s)
- Pauline Mathieu
- Sorbonne Universités, INSERM, Institut Pierre Louis d’épidémiologie et de Santé Publique (IPLESP), F-75012, Paris, France
| | | | - Jocelyn Raude
- EHESP Rennes, Université Sorbonne Paris Cité, France
| | - Thomas Goronflot
- Sorbonne Universités, INSERM, Institut Pierre Louis d’épidémiologie et de Santé Publique (IPLESP), F-75012, Paris, France
| | - Titouan Launay
- Sorbonne Universités, INSERM, Institut Pierre Louis d’épidémiologie et de Santé Publique (IPLESP), F-75012, Paris, France
| | - Marion Debin
- Sorbonne Universités, INSERM, Institut Pierre Louis d’épidémiologie et de Santé Publique (IPLESP), F-75012, Paris, France
| | - Caroline Guerrisi
- Sorbonne Universités, INSERM, Institut Pierre Louis d’épidémiologie et de Santé Publique (IPLESP), F-75012, Paris, France
| | - Clément Turbelin
- Sorbonne Universités, INSERM, Institut Pierre Louis d’épidémiologie et de Santé Publique (IPLESP), F-75012, Paris, France
| | - Thomas Hanslik
- Sorbonne Universités, INSERM, Institut Pierre Louis d’épidémiologie et de Santé Publique (IPLESP), F-75012, Paris, France,Université de Versailles Saint-Quentin-en-Yvelines, UVSQ, UFR de Médecine, FR-78000, Versailles, France,Service de Médecine Interne, Hôpital Ambroise Paré, Assistance Publique - Hôpitaux de Paris, APHP, FR-92100, Boulogne Billancourt, France
| | | | - Vittoria Colizza
- Sorbonne Universités, INSERM, Institut Pierre Louis d’épidémiologie et de Santé Publique (IPLESP), F-75012, Paris, France
| | - Thierry Blanchon
- Sorbonne Universités, INSERM, Institut Pierre Louis d’épidémiologie et de Santé Publique (IPLESP), F-75012, Paris, France
| | - Louise Rossignol
- Sorbonne Universités, INSERM, Institut Pierre Louis d’épidémiologie et de Santé Publique (IPLESP), F-75012, Paris, France
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Attwell K, Navin MC, Lopalco PL, Jestin C, Reiter S, Omer SB. Recent vaccine mandates in the United States, Europe and Australia: A comparative study. Vaccine 2018; 36:7377-7384. [PMID: 30337171 DOI: 10.1016/j.vaccine.2018.10.019] [Citation(s) in RCA: 72] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Revised: 10/03/2018] [Accepted: 10/04/2018] [Indexed: 11/17/2022]
Abstract
BACKGROUND In response to recent outbreaks of vaccine-preventable diseases and concerns around vaccine refusal, several high-income countries have adopted or reformed vaccine mandate policies. While all make it more difficult for parents to refuse vaccines, the nature and scope of 'mandatory vaccination' is heterogeneous, and there has been no attempt to develop a detailed, comparative systematic account of the possible forms mandates can take. METHODS We compare the construction, introduction/amendment, and operation of six new high profile vaccine mandates in Australia, France, Germany, Italy, California, and Washington. We rank these policies in order of their relative restrictiveness and analyze other differences between them. RESULTS New mandate instruments differ in their effects on behavior, and with regard to their structure, exemptions, target populations, consequences and enforcement. We identify diverse means by which vaccine mandates can restrict behaviors, various degrees of severity, and different gradations of intensity in enforcement. CONCLUSION We suggest that politico-cultural context and vaccine policy history are centrally important factors for vaccine mandate policymakers to consider. It matters whether citizens trust their governments to limit individual freedom in the name of public health, and whether citizens have previously been subjected to vaccine mandates. Furthermore, political communities must consider the diverse mechanisms by which they may construct vaccine mandate policies; whether through emergency decrees or ordinary statutes, and how (or whether) to involve various stakeholder groups in developing and implementing new vaccine mandate policies.
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Affiliation(s)
- Katie Attwell
- Political Science and International Relations, University of Western Australia, 35 Stirling Highway, Crawley 6009, Australia.
| | - Mark C Navin
- Department of Philosophy, Oakland University, 146 Library Drive, Rochester, MI 48309-4479, USA
| | - Pier Luigi Lopalco
- Department of Translational Research on New Technologies in Medicine and Surgery, University of Pisa, Lungarno Antonio Pacinotti, 43, 56126 Pisa Pl, Italy
| | - Christine Jestin
- Sante Publique France, 12 rue du Val d'Osne, 94415 Saint-Maurice Cedex, France
| | - Sabine Reiter
- Infectious Diseases, Antimicrobial Resistance, Hygiene, Vaccination Federal Ministry of Health, Bundesministerium für Gesundheit Referat, 322 Friedrichstraße 108, 10117 Berlin, Germany
| | - Saad B Omer
- Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Atlanta, GA 20211, USA
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Thomas S, Cashman P, Islam F, Baker L, Clark K, Leask J, Butler R, Durrheim DN. Tailoring immunisation service delivery in a disadvantaged community in Australia; views of health providers and parents. Vaccine 2018; 36:2596-2603. [PMID: 29631887 DOI: 10.1016/j.vaccine.2018.03.072] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Revised: 02/23/2018] [Accepted: 03/27/2018] [Indexed: 10/17/2022]
Abstract
In 2014 the Australian immunisation target was raised from 90% to 95% of children to be fully immunised. A national priority is to identify geographic areas of low coverage and implement strategies to improve immunisation rates. Using The World Health Organization's Tailoring Immunization Programmes (TIP) Guidelines, the aim of this study was to identify areas of low immunisation coverage for children in the Hunter New England Local Health District, New South Wales, and to gain a deeper understanding of the factors influencing immunisation in those areas in order to develop tailored strategies for increasing immunisation coverage. Data from the Australian Immunisation Register was used to identify geographic areas of low coverage. Data from interviews and focus groups with parents and service providers were used to gain a deeper understanding of the factors influencing immunisation in those areas. The regional city of Maitland in New South Wales was identified as having a persistently high number and relatively high proportion of children not fully immunised (n = 427, 15.4% in 2016). Themes from 59 stakeholder interviews and focus groups included; (i) limited engagement with health services unless the need is urgent, (ii) multi-dimensional access barriers to immunisation services in Maitland, (iii) a flexible, supportive family centred, primary health care approach, utilising strong partnerships, is most likely to be effective in increasing childhood immunisation rates in Maitland, (iv) data can be used more effectively to inform service providers about trends and individual children not fully immunised. TIP guidelines proved useful for identifying areas of low coverage and providing an understanding of determining factors and the strategies most likely to be effective. Understanding the complex problems many parents face and the access barriers that contribute to low immunisation coverage is essential in developing appropriate solutions. Finding ways to support parents and remove those barriers can contribute to higher coverage. In Maitland, targeted outreach and home visiting has been implemented in consultation with community and health service representatives to ensure that the children from socially disadvantaged populations identified do not miss out on vaccination.
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Affiliation(s)
- Susan Thomas
- University of Newcastle, School of Medicine and Public Health, Newcastle, NSW, Australia.
| | - Patrick Cashman
- Hunter New England Local Health District, Population Health, Wallsend, NSW, Australia
| | - Fakhrul Islam
- Hunter New England Local Health District, Population Health, Wallsend, NSW, Australia
| | - Loretta Baker
- Hunter New England Local Health District, East Maitland Community Health Centre, Maitland, NSW, Australia
| | - Katrina Clark
- Hunter New England Local Health District, Population Health, Wallsend, NSW, Australia
| | - Julie Leask
- University of Sydney, Faculty of Nursing and Midwifery and School of Public Health, Faculty of Medicine, Sydney, NSW, Australia
| | - Robb Butler
- World Health Organization Regional Office for Europe, Division of Health Emergencies and Communicable Diseases, Amsterdam, The Netherlands
| | - David N Durrheim
- University of Newcastle, School of Medicine and Public Health, Newcastle, NSW, Australia; Hunter New England Local Health District, Population Health, Wallsend, NSW, Australia
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