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Frennesson NF, McQuire C, Aijaz Khan S, Barnett J, Zuccolo L. Evaluating Messaging on Prenatal Health Behaviors Using Social Media Data: Systematic Review. J Med Internet Res 2023; 25:e44912. [PMID: 38117557 PMCID: PMC10765287 DOI: 10.2196/44912] [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: 12/08/2022] [Revised: 10/27/2023] [Accepted: 11/29/2023] [Indexed: 12/21/2023] Open
Abstract
BACKGROUND Social media platforms are increasingly being used to disseminate messages about prenatal health. However, to date, we lack a systematic assessment of how to evaluate the impact of official prenatal health messaging and campaigns using social media data. OBJECTIVE This study aims to review both the published and gray literature on how official prenatal health messaging and campaigns have been evaluated to date in terms of impact, acceptability, effectiveness, and unintended consequences, using social media data. METHODS A total of 6 electronic databases were searched and supplemented with the hand-searching of reference lists. Both published and gray literature were eligible for review. Data were analyzed using content analysis for descriptive data and a thematic synthesis approach to summarize qualitative evidence. A quality appraisal tool, designed especially for use with social media data, was used to assess the quality of the included articles. RESULTS A total of 11 studies were eligible for the review. The results showed that the most common prenatal health behavior targeted was alcohol consumption, and Facebook was the most commonly used source of social media data. The majority (n=6) of articles used social media data for descriptive purposes only. The results also showed that there was a lack of evaluation of the effectiveness, acceptability, and unintended consequences of the prenatal health message or campaign. CONCLUSIONS Social media is a widely used and potentially valuable resource for communicating and evaluating prenatal health messaging. However, this review suggests that there is a need to develop and adopt sound methodology on how to evaluate prenatal health messaging using social media data, for the benefit of future research and to inform public health practice.
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Affiliation(s)
- Nessie Felicia Frennesson
- Tobacco and Alcohol Research Group, School of Psychological Science, University of Bristol, Bristol, United Kingdom
| | - Cheryl McQuire
- Centre for Public Health, Bristol Medical School, University of Bristol, Bristol, United Kingdom
- National Institute for Health and Care Research, School for Public Health Research, Newcastle, United Kingdom
| | - Saher Aijaz Khan
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Julie Barnett
- Department of Psychology, University of Bath, Bath, United Kingdom
| | - Luisa Zuccolo
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
- Health Data Science Centre, Human Technopole, Milan, Italy
- Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom
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2
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McCarron SA, Bradley DT, Hart ND. A scoping review of the reasons for and approaches to non-uptake of pertussis and influenza vaccinations in pregnant women in the United Kingdom and Ireland. BMC Pregnancy Childbirth 2023; 23:857. [PMID: 38087222 PMCID: PMC10717507 DOI: 10.1186/s12884-023-06171-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 12/03/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Pertussis and influenza cause significant morbidity and mortality in pregnancy and the neonatal period. Maternal vaccination in pregnancy would reduce harm, but low vaccine uptake is a concern. This scoping review aimed to understand the reasons for, and approaches, to non-uptake of pertussis and influenza vaccinations in pregnant women in the UK and Ireland. METHODS The inclusion criteria of this scoping review consist of pregnant women who avail of pertussis and influenza vaccines in the UK and Ireland. MEDLINE, EMBASE, Web of Science and CINAHL databases were searched in June 2021 and updated in October 2022. Searches were limited to English language reports published after 2011. We followed the Joanna Briggs Institute guidance on scoping reviews. Data were extracted and charted. RESULTS Five themes emerged from the literature. Acceptability, as well as organisational and awareness issues, were overarching themes regarding reasons for and approaches to non-uptake of the vaccines respectively. Other themes included healthcare professional factors, information interpretation and pregnancy-related factors. CONCLUSIONS Women need clear, comprehensible information, ideally provided by their healthcare professionals, in a way that is meaningful and addresses their circumstances and risk perceptions. This research will serve as a base for future work that aims behaviour science interventions at the wider pregnant population as well as the target groups that have been identified in this review.
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3
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Silva MEP, Skeva R, House T, Jay C. Tracking the structure and sentiment of vaccination discussions on Mumsnet. SOCIAL NETWORK ANALYSIS AND MINING 2023; 13:152. [PMID: 38026264 PMCID: PMC10657328 DOI: 10.1007/s13278-023-01155-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 10/03/2023] [Accepted: 10/10/2023] [Indexed: 12/01/2023]
Abstract
Vaccination is one of the most impactful healthcare interventions in terms of lives saved at a given cost, leading the anti-vaccination movement to be identified as one of the top 10 threats to global health in 2019 by the World Health Organization. This issue increased in importance during the COVID-19 pandemic where, despite good overall adherence to vaccination, specific communities still showed high rates of refusal. Online social media has been identified as a breeding ground for anti-vaccination discussions. In this work, we study how vaccination discussions are conducted in the discussion forum of Mumsnet, a UK-based website aimed at parents. By representing vaccination discussions as networks of social interactions, we can apply techniques from network analysis to characterize these discussions, namely network comparison, a task aimed at quantifying similarities and differences between networks. Using network comparison based on graphlets-small connected network subgraphs-we show how the topological structure of vaccination discussions on Mumsnet differs over time, in particular before and after COVID-19. We also perform sentiment analysis on the content of the discussions and show how the sentiment toward vaccinations changes over time. Our results highlight an association between differences in network structure and changes to sentiment, demonstrating how network comparison can be used as a tool to guide and enhance the conclusions from sentiment analysis.
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Affiliation(s)
- Miguel E. P. Silva
- Department of Computer Science, University of Manchester, Oxford Road, Manchester, M13 9PY England UK
- LIAAD, INESC-TEC, Porto, Portugal
| | - Rigina Skeva
- Department of Computer Science, University of Manchester, Oxford Road, Manchester, M13 9PY England UK
| | - Thomas House
- Department of Mathematics, University of Manchester, Oxford Road, Manchester, M13 9PY England UK
| | - Caroline Jay
- Department of Computer Science, University of Manchester, Oxford Road, Manchester, M13 9PY England UK
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4
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Anderson A. Regional and neighbourhood-based variation in three types of vaccine attitude in Britain. Health Place 2023; 83:103098. [PMID: 37572542 DOI: 10.1016/j.healthplace.2023.103098] [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: 12/07/2022] [Revised: 08/04/2023] [Accepted: 08/07/2023] [Indexed: 08/14/2023]
Abstract
This study investigates the geographic patterning of attitudes towards vaccination in Britain (England, Wales, and Scotland). Using survey data from the 2018 Wellcome Monitor linked to lower super output areas and NUTS2 regions, this study provides evidence that negative attitudes regarding the risk of side-effects from vaccination and regarding the efficacy of vaccination are correlated with higher levels of local deprivation. While previous research has highlighted associations between vaccine uptake and deprivation for a variety of reasons, this study specifically contends that particular individualised types of caution about vaccines also tend to cluster in deprived areas.
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Affiliation(s)
- Alistair Anderson
- School of Sociology and Social Policy, Law and Social Sciences Building, University Park, Nottingham, NG7 2RD, UK.
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5
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Herasimenka A, Au Y, George A, Joynes-Burgess K, Knuutila A, Bright J, Howard PN. The political economy of digital profiteering: communication resource mobilization by anti-vaccination actors. THE JOURNAL OF COMMUNICATION 2023; 73:126-137. [PMID: 37016634 PMCID: PMC10066223 DOI: 10.1093/joc/jqac043] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 11/18/2022] [Accepted: 11/27/2022] [Indexed: 06/19/2023]
Abstract
Contemporary communication requires both a supply of content and a digital information infrastructure. Modern campaigns of misinformation are especially dependent on that back-end infrastructure for tracking and targeting a sympathetic audience and generating revenue that can sustain the campaign financially-if not enable profiteering. However, little is known about the political economy of misinformation, particularly those campaigns spreading misleading or harmful content about public health guidelines and vaccination programs. To understand the political economy of health misinformation, we analyze the content and infrastructure networks of 59 groups involved in communicating misinformation about vaccination programs. With a unique collection of tracker and communication infrastructure data, we demonstrate how the political economy of misinformation depends on platform monetization infrastructures. We offer a theory of communication resource mobilization that advances understanding of the communicative context, organizational interactions, and political outcomes of misinformation production.
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6
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Cheatham S, Kummervold PE, Parisi L, Lanfranchi B, Croci I, Comunello F, Rota MC, Filia A, Tozzi AE, Rizzo C, Gesualdo F. Understanding the vaccine stance of Italian tweets and addressing language changes through the COVID-19 pandemic: Development and validation of a machine learning model. Front Public Health 2022; 10:948880. [PMID: 35968436 PMCID: PMC9372360 DOI: 10.3389/fpubh.2022.948880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 07/11/2022] [Indexed: 11/13/2022] Open
Abstract
Social media is increasingly being used to express opinions and attitudes toward vaccines. The vaccine stance of social media posts can be classified in almost real-time using machine learning. We describe the use of a Transformer-based machine learning model for analyzing vaccine stance of Italian tweets, and demonstrate the need to address changes over time in vaccine-related language, through periodic model retraining. Vaccine-related tweets were collected through a platform developed for the European Joint Action on Vaccination. Two datasets were collected, the first between November 2019 and June 2020, the second from April to September 2021. The tweets were manually categorized by three independent annotators. After cleaning, the total dataset consisted of 1,736 tweets with 3 categories (promotional, neutral, and discouraging). The manually classified tweets were used to train and test various machine learning models. The model that classified the data most similarly to humans was XLM-Roberta-large, a multilingual version of the Transformer-based model RoBERTa. The model hyper-parameters were tuned and then the model ran five times. The fine-tuned model with the best F-score over the validation dataset was selected. Running the selected fine-tuned model on just the first test dataset resulted in an accuracy of 72.8% (F-score 0.713). Using this model on the second test dataset resulted in a 10% drop in accuracy to 62.1% (F-score 0.617), indicating that the model recognized a difference in language between the datasets. On the combined test datasets the accuracy was 70.1% (F-score 0.689). Retraining the model using data from the first and second datasets increased the accuracy over the second test dataset to 71.3% (F-score 0.713), a 9% improvement from when using just the first dataset for training. The accuracy over the first test dataset remained the same at 72.8% (F-score 0.721). The accuracy over the combined test datasets was then 72.4% (F-score 0.720), a 2% improvement. Through fine-tuning a machine-learning model on task-specific data, the accuracy achieved in categorizing tweets was close to that expected by a single human annotator. Regular training of machine-learning models with recent data is advisable to maximize accuracy.
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Affiliation(s)
- Susan Cheatham
- Multifactorial and Complex Diseases Research Area, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | | | - Lorenza Parisi
- Department of Human Sciences, Link Campus University, Rome, Italy
| | - Barbara Lanfranchi
- Multifactorial and Complex Diseases Research Area, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Ileana Croci
- Multifactorial and Complex Diseases Research Area, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Francesca Comunello
- Department of Communication and Social Research, Sapienza University, Rome, Italy
| | - Maria Cristina Rota
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Antonietta Filia
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Alberto Eugenio Tozzi
- Multifactorial and Complex Diseases Research Area, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Caterina Rizzo
- Multifactorial and Complex Diseases Research Area, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
- Department of Translational Research and New Technologies in Medicine and Surgery, Pisa University, Pisa, Italy
- *Correspondence: Caterina Rizzo
| | - Francesco Gesualdo
- Multifactorial and Complex Diseases Research Area, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
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7
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Gesualdo F, Parisi L, Croci I, Comunello F, Parente A, Russo L, Campagna I, Lanfranchi B, Rota MC, Filia A, Tozzi AE, Rizzo C. How the Italian Twitter Conversation on Vaccines Changed During the First Phase of the Pandemic: A Mixed-Method Analysis. Front Public Health 2022; 10:824465. [PMID: 35664110 PMCID: PMC9157769 DOI: 10.3389/fpubh.2022.824465] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 04/06/2022] [Indexed: 11/24/2022] Open
Abstract
In the context of the European Joint Action on Vaccination, we analyzed, through quantitative and qualitative methods, a random sample of vaccine-related tweets published in Italy between November 2019 and June 2020, with the aim of understanding how the Twitter conversation on vaccines changed during the first phase of the pandemic, compared to the pre-pandemic months. Tweets were analyzed by a multidisciplinary team in terms of kind of vaccine, vaccine stance, tone of voice, population target, mentioned source of information. Multiple correspondence analysis was used to identify variables associated with vaccine stance. We analyzed 2,473 tweets. 58.2% mentioned the COVID-19 vaccine. Most had a discouraging stance (38.1%), followed by promotional (32.5%), neutral (22%) and ambiguous (2.5%). The discouraging stance was the most represented before the pandemic (69.6%). In February and March 2020, discouraging tweets decreased intensely and promotional and neutral tweets dominated the conversation. Between April and June 2020, promotional tweets remained more represented (36.5%), followed by discouraging (30%) and neutral (24.3%). The tweets' tone of voice was mainly polemical/complaining, both for promotional and for discouraging tweets. The multiple correspondence analysis identified a definite profile for discouraging and neutral tweets, compared to promotional and ambiguous tweets. In conclusion, the emergence of SARS-CoV-2 caused a deep change in the vaccination discourse on Twitter in Italy, with an increase of promotional and ambiguous tweets. Systematic monitoring of Twitter and other social media, ideally combined with traditional surveys, would enable us to better understand Italian vaccine hesitancy and plan tailored, data-based communication strategies.
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Affiliation(s)
- Francesco Gesualdo
- Multifactorial and Complex Diseases Research Area, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Lorenza Parisi
- Department of Human Sciences, Link Campus University, Rome, Italy
| | - Ileana Croci
- Multifactorial and Complex Diseases Research Area, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Francesca Comunello
- Department of Communication and Social Research, Sapienza University of Rome, Rome, Italy
| | - Andrea Parente
- Department of Communication and Social Research, Sapienza University of Rome, Rome, Italy
| | - Luisa Russo
- Multifactorial and Complex Diseases Research Area, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Ilaria Campagna
- Multifactorial and Complex Diseases Research Area, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Barbara Lanfranchi
- Multifactorial and Complex Diseases Research Area, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Maria Cristina Rota
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Antonietta Filia
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Alberto Eugenio Tozzi
- Multifactorial and Complex Diseases Research Area, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Caterina Rizzo
- Clinical Pathways and Epidemiology Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
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8
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Baïssas T, Boisnard F, Cuesta Esteve I, Garcia Sánchez M, Jones CE, Rigoine de Fougerolles T, Tan L, Vitoux O, Klein C. Vaccination in pregnancy against pertussis and seasonal influenza: key learnings and components from high-performing vaccine programmes in three countries: the United Kingdom, the United States and Spain. BMC Public Health 2021; 21:2182. [PMID: 34844567 PMCID: PMC8628032 DOI: 10.1186/s12889-021-12198-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 11/03/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Pertussis and seasonal influenza are responsible for significant maternal, neonatal, and infant morbidity and mortality, but vaccine coverage rates (VCR) for both pertussis (administered as a tetanus, diphtheria, acellular pertussis [Tdap] vaccination) and seasonal influenza in pregnancy remain generally low. Only a small number of countries, including Spain, the United Kingdom (UK), and the United States (US), have high Tdap and seasonal influenza VCRs in pregnancy. The purpose of this study was to identify the key factors that contributed to the high VCRs observed in these countries. METHODS The experience from both Tdap and seasonal influenza vaccination programmes during pregnancy were documented in Spain, the UK, and the US using a three-step approach. A literature review yielded 157 publications, and a further 117 documents were selected through desk research. A published five-pillar VCR framework for influenza was amended to evaluate the specific contributing factors leading to high Tdap and seasonal influenza VCRs among pregnant women. RESULTS The analysis identified components that contributed to higher VCR in pregnant women across three different healthcare systems in Spain, UK, and US. The combination of several key interventions in each country led to a rapid increase in VCR that reached near-optimal levels (i.e. 75% for seasonal influenza) within a few years. As well as inclusion in national immunisation programme and vaccine reimbursement, key components that were identified included the mobilisation of health authorities, prenatal care Healthcare Professionals (HCP) and scientific societies, the inclusion of vaccination in antenatal medical guidance, the provision of educational material to HCPs, and a strong disease awareness driven by recent pertussis outbreaks in each country. CONCLUSIONS Although there is no simple, universal solution to improving sub-optimal VCRs, the list of components identified in this study from three countries with high-performing Tdap and seasonal influenza vaccination programmes provides a basis for public health and medical stakeholders in other countries to define strategies to successfully implement national vaccination programmes for pregnant women.
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Affiliation(s)
| | | | | | | | - Christine E Jones
- Faculty of Medicine and Institute for Life Sciences University of Southampton and NIHR Southampton Clinical Research Facility and Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | | | - Litjen Tan
- Immunisation Action Coalition, Saint Paul, MN, USA
| | | | - Christina Klein
- Sanofi Pasteur, 14, Espace Henry Vallée, 69007, Lyon, France.
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9
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Karafillakis E, Paterson P, Larson HJ. 'My primary purpose is to protect the unborn child': Understanding pregnant women's perceptions of maternal vaccination and vaccine trials in Europe. Vaccine 2021; 39:5673-5679. [PMID: 34419304 DOI: 10.1016/j.vaccine.2021.07.099] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 07/29/2021] [Accepted: 07/31/2021] [Indexed: 10/20/2022]
Abstract
Despite the important benefits of maternal vaccination for pregnant women and newborns, vaccination uptake is low in many European countries. Differences in vaccination policies and recommendations, as well as concerns about vaccine safety can partly explain inadequate coverage rates and women's hesitancy to get vaccinated during pregnancy. This study aims to explore pregnant women's experiences, decision-making processes and perceptions towards maternal vaccination and maternal vaccine trials in France, Germany, Italy, Spain and the United Kingdom. Qualitative interviews and focus groups were conducted with 258 pregnant women identified through local research panels and snowballing. Topic guides translated in local languages were designed to explore women's awareness and perceptions of maternal vaccination, and willingness to participate in vaccine trials during pregnancy. A thematic analysis was conducted. Pregnant women were found to have low awareness about maternal vaccination, with many reporting not having received a recommendation to vaccinate from their doctors. Strong trust in health professionals indicate that strengthened recommendations could improve vaccination uptake. Vaccination decision-making in pregnancy was described in the context of a highly emotional period, generating anxiety and fears around the safety of vaccines. Pregnancy was also discussed as a period during which women develop nurturing and protective identities. However, depending on the information they received as well as influences from experts, families and peers, women either perceived vaccination as a threat to their babies' safety or as a means to protect them. Attitudes towards maternal vaccine trials were less ambiguous, with most pregnant women strongly rejecting the notion of taking part in trials. While strategies to improve pregnant women's awareness and perceptions of maternal vaccination are needed, it is equally important to understand why healthcare professionals may not be recommending vaccination. More coordinated strategies across Europe could help strengthen communication and trust in maternal vaccination.
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Affiliation(s)
- E Karafillakis
- Department of Infectious Diseases Epidemiology, London School of Hygiene & Topical Medicine, London, United Kingdom.
| | - P Paterson
- Department of Infectious Diseases Epidemiology, London School of Hygiene & Topical Medicine, London, United Kingdom
| | - H J Larson
- Department of Infectious Diseases Epidemiology, London School of Hygiene & Topical Medicine, London, United Kingdom; Department of Health Metrics Sciences, University of Washington, Seattle, WA, USA; Centre for the Evaluation of Vaccination, Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
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10
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Norizuki M, Hori A, Wada K. Factors associated with adults' actions to confirm their own rubella immune status in Japan's drive toward rubella elimination: Cross-sectional online survey of non-healthcare workers in their 20s to 40s. Environ Health Prev Med 2021; 26:77. [PMID: 34380430 PMCID: PMC8356215 DOI: 10.1186/s12199-021-01002-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 07/28/2021] [Indexed: 11/19/2022] Open
Abstract
Background Rubella outbreaks occurred among adults in Japan in 2013-2014 and 2018-2019 due to immunity gaps. In response and aiming at rubella elimination by 2020, the government introduced countermeasures comprising supplementary immunization activities for voluntary testing of adult non-healthcare-related workers and vaccination of susceptible individuals. However, as of October 2020, rubella immunity testing and vaccination rates remained low. This study was conducted to identify factors associated with adults voluntarily confirming their rubella immune status, to help develop effective promotion activities for hard-to-reach and left-behind populations. Methods In this cross-sectional study, a general population sample of non-healthcare workers aged 20-49 years in Japan completed an online survey in November 2020. Univariate analysis was performed to examine associations of specific actions taken to confirm rubella immune status with social background characteristics, knowledge of rubella, and attitude to testing and vaccination. Log binomial regression analysis was performed to explore the associations following adjustment for social background characteristics. Results Among 1,854 respondents (927 men, 927 women), only 23.4% of men and 39.4% of women in their 20s to 40s have taken some action related to rubella prevention. Three major factors were associated with the targeted population having taken voluntary action: (1) knowing about testing for confirmation of immunity status (adjusted odds ratio [AOR] 4.29 men, 2.89 women), the rubella outbreak in 2013 among men in their 20s to 40s (AOR 2.79 men, 1.64 women), and congenital rubella syndrome (AOR 1.89 men, 3.10 women); (2) having acquaintances who were vaccinated against or tested for rubella (AOR 2.98 men, 1.95 women); and (3) having a positive attitude toward influenza vaccination (AOR 2.48 men, 1.83 women). Marriage, desire for pregnancy, and having children were weakly associated with taking action. Conclusions Currently, insufficient voluntary action is being taken by high-risk adult populations to close the identified immunity gaps. In this last mile to rubella elimination, our findings and suggested potential interventions via annual health check-ups and occupational health and public health initiatives could prove helpful in developing further countermeasures that actively promote and implement supplementary immunization activities targeting all adult generations.
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Affiliation(s)
- Masataro Norizuki
- Graduate School of Medicine, International University of Health and Welfare Graduate School, 4-1-26 Akasaka, Minato, Tokyo, 107-8402, Japan.,Bureau of International Health Cooperation, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku, Tokyo, 162-8655, Japan
| | - Ai Hori
- Department of Global Public Health, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, 305-8577, Japan
| | - Koji Wada
- Graduate School of Medicine, International University of Health and Welfare Graduate School, 4-1-26 Akasaka, Minato, Tokyo, 107-8402, Japan.
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11
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The effect of the Internet on decision-making during pregnancy: a systematic review. Arch Womens Ment Health 2021; 24:205-215. [PMID: 32901361 DOI: 10.1007/s00737-020-01065-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Accepted: 09/02/2020] [Indexed: 10/23/2022]
Abstract
The purpose of this review is to explain how the Internet affects decision-making in pregnancy. A systematic review was carried out in accordance with the guidelines developed by the National Institute of Health Research at York University. The PubMed, EBSCOhost, Ulakbim Medical Database, Turkish Medline, Web of Science, and Scopus databases were scanned. Three keywords in the titles, abstracts, and keywords of the articles were searched for in the Medical Subject Headings: "Pregnancy," "Decision-making," and "Internet." A total of 1143 articles were found in the first screening. Duplicate articles were removed. The remaining articles were reviewed according to the inclusion criteria. Only articles about healthy pregnant women were accessed, and only full-text research articles published in English were used. Seventeen articles met the inclusion criteria. The sample size varied between 9 and 7092. Most studies reported that pregnant women use the Internet as a source of information about pregnancy. Pregnancy, development of the fetus, labor, neonatal health, and nutrition were the subjects most researched. It was found that women with a higher education, who were young, nulliparous, and primigravid, looked for more information on the Internet. The Internet affects decisions about the type of delivery, drug use in pregnancy, and physical activity. Using the Internet had a positive effect on the decision-making processes of pregnant women, increased their awareness, and had a visible effect on this process.
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12
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Zhang KC, Fang Y, Cao H, Chen H, Hu T, Chen Y, Zhou X, Wang Z. Behavioral Intention to Receive a COVID-19 Vaccination Among Chinese Factory Workers: Cross-sectional Online Survey. J Med Internet Res 2021; 23:e24673. [PMID: 33646966 PMCID: PMC7945977 DOI: 10.2196/24673] [Citation(s) in RCA: 52] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 12/16/2020] [Accepted: 02/26/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND COVID-19 vaccines will become available in China soon. Understanding communities' responses to the forthcoming COVID-19 vaccines is important. We applied the theory of planned behavior as the theoretical framework. OBJECTIVE This study investigates the prevalence of and factors associated with behavioral intention to receive self-financed or free COVID-19 vaccinations among Chinese factory workers who resumed work during the pandemic. We examined the effects of factors including sociodemographics, perceptions related to COVID-19 vaccination, exposure to information about COVID-19 vaccination through social media, and COVID-19 preventive measures implemented by individuals and factories. METHODS Participants were full-time employees 18 years or older who worked in factories in Shenzhen. Factory workers in Shenzhen are required to receive a physical examination annually. Eligible workers attending six physical examination sites were invited to complete a survey on September 1-7, 2020. Out of 2653 eligible factory workers, 2053 (77.4%) completed the online survey. Multivariate two-level logistic regression models and ordinal logistic regression models were fitted. RESULTS The prevalence of behavioral intention to receive a COVID-19 vaccination was 66.6% (n=1368, conditional on 80% vaccine efficacy and market rate) and 80.6% (n=1655, conditional on 80% vaccine efficacy and free vaccines). After adjusting for significant background characteristics, positive attitudes toward COVID-19 vaccination (adjusted odds ratio [AOR] 1.20, 95% CI 1.15-1.25 and AOR 1.24, 95% CI 1.19-1.30), perceived support from significant others for getting a COVID-19 vaccination (AOR 1.43, 95% CI 1.32-1.55 and AOR 1.37, 95% CI 1.25-1.50), and perceived behavioral control to get a COVID-19 vaccination (AOR 1.51, 95% CI 1.32-1.73 and AOR 1.28, 95% CI 1.09-1.51) were positively associated with both dependent variables (conditional on 80% vaccine efficacy and market rate or free vaccines, respectively). Regarding social media influence, higher frequency of exposure to positive information related to COVID-19 vaccination was associated with a higher intention to receive a COVID-19 vaccination at market rate (AOR 1.53, 95% CI 1.39-1.70) or a free vaccination (AOR 1.52, 95% CI 1.35-1.71). Higher self-reported compliance with wearing a face mask in the workplace (AOR 1.27, 95% CI 1.02-1.58 and AOR 1.67, 95% CI 1.24-2.27) and other public spaces (AOR 1.80, 95% CI 1.42-2.29 and AOR 1.34, 95% CI 1.01-1.77), hand hygiene (AOR 1.21, 95% CI 1.00-1.47 and AOR 1.52, 95% CI 1.19-1.93), and avoiding social gatherings (AOR 1.22, 95% CI 1.01-1.47 and AOR 1.55, 95% CI 1.23-1.95) and crowded places (AOR 1.24, 95% CI 1.02-1.51 and AOR 1.73, 95% CI 1.37-2.18) were also positively associated with both dependent variables. The number of COVID-19 preventive measures implemented by the factory was positively associated with the intention to receive a COVID-19 vaccination under both scenarios (AOR 1.08, 95% CI 1.04-1.12 and AOR 1.06, 95% CI 1.01-1.11). CONCLUSIONS Factory workers in China reported a high behavioral intention to receive a COVID-19 vaccination. The theory of planned behavior is a useful framework to guide the development of future campaigns promoting COVID-19 vaccination.
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Affiliation(s)
- Ke Chun Zhang
- Longhua District Center for Disease Control and Prevention, Shenzhen, China
| | - Yuan Fang
- Department of Early Childhood Education, The Education University of Hong Kong, Hong Kong, China
| | - He Cao
- Longhua District Center for Disease Control and Prevention, Shenzhen, China
| | - Hongbiao Chen
- Longhua District Center for Disease Control and Prevention, Shenzhen, China
| | - Tian Hu
- Longhua District Center for Disease Control and Prevention, Shenzhen, China
| | - Yaqi Chen
- Longhua District Center for Disease Control and Prevention, Shenzhen, China
| | - Xiaofeng Zhou
- Longhua District Center for Disease Control and Prevention, Shenzhen, China
| | - Zixin Wang
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
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Martin S, Kilich E, Dada S, Kummervold PE, Denny C, Paterson P, Larson HJ. "Vaccines for pregnant women…?! Absurd" - Mapping maternal vaccination discourse and stance on social media over six months. Vaccine 2020; 38:6627-6637. [PMID: 32788136 DOI: 10.1016/j.vaccine.2020.07.072] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 07/24/2020] [Accepted: 07/31/2020] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To understand the predominant topics of discussion, stance and associated language used on social media platforms relating to maternal vaccines in 15 countries over a six-month period. BACKGROUND In 2019, the World Health Organisation prioritised vaccine hesitancy as a top ten global health threat and recognized the role of viral misinformation on social media as propagating vaccine hesitancy. Maternal vaccination offers the potential to improve maternal and child health, and to reduce the risk of severe morbidity and mortality in pregnancy. Understanding the topics of discussion, stance and language used around maternal vaccines on social media can inform public health bodies on how to combat vaccine misinformation and vaccine hesitancy. METHODS Social media data was extracted (Twitter, forums, blogs and comments) for six months from 15 countries (Australia, Brazil, Canada, France, Germany, India, Italy, Korea, Mexico, Panama, South Africa, Spain, United Kingdom and United States). We used stance, discourse and topic analysis to provide insight into the most frequent and weighted keywords, hashtags and themes of conversation within and across countries. RESULTS We exported a total of 19,192 social media posts in 16 languages obtained between 1st November 2018 and 30th April 2019. After screening all posts, 16,000 were included in analyses, while excluding retweets, 2,722 were annotated for sentiment. Main topics of discussion were the safety of the maternal influenza and pertussis vaccines. Discouraging posts were most common in Italy (44.9%), and the USA (30.8%). CONCLUSION The content and stance of maternal vaccination posts from November 2018 to April 2019 differed across countries, however specific topics of discussion were not limited to geographical location. These discussions included the promotion of vaccination, involvement of pregnant women in vaccine research, and the trust and transparency of institutions. Future research should examine the relationship between stance (promotional, neutral, ambiguous, discouraging) online and maternal vaccination uptake in the respective regions.
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Affiliation(s)
- Sam Martin
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK.
| | - Eliz Kilich
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Sara Dada
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | | | - Chermain Denny
- Faculty of Science, Vrije University, Amsterdam, Netherlands
| | - Pauline Paterson
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Heidi J Larson
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK; Institute of Health Metrics and Evaluation, University of Washington, Seattle, USA
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14
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Wexler A, Davoudi A, Weissenbacher D, Choi R, O’Connor K, Cummings H, Gonzalez-Hernandez G. Pregnancy and health in the age of the Internet: A content analysis of online "birth club" forums. PLoS One 2020; 15:e0230947. [PMID: 32287266 PMCID: PMC7156049 DOI: 10.1371/journal.pone.0230947] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Accepted: 03/12/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Although studies report that more than 90% of pregnant women utilize digital sources to supplement their maternal healthcare, little is known about the kinds of information that women seek from their peers during pregnancy. To date, most research has used self-report measures to elucidate how and why women to turn to digital sources during pregnancy. However, given that these measures may differ from actual utilization of online health information, it is important to analyze the online content pregnant women generate. OBJECTIVE To apply machine learning methods to analyze online pregnancy forums, to better understand how women seek information from a community of online peers during pregnancy. METHODS Data from seven WhatToExpect.com "birth club" forums (September 2018; January-June 2018) were scraped. Forum posts were collected for a one-year period, which included three trimesters and three months postpartum. Only initial posts from each thread were analyzed (n = 262,238). Automatic natural language processing (NLP) methods captured 50 discussed topics, which were annotated by two independent coders and grouped categorically. RESULTS The largest topic categories were maternal health (45%), baby-related topics (29%), and people/relationships (10%). While pain was a popular topic all throughout pregnancy, individual topics that were dominant by trimester included miscarriage (first trimester), labor (third trimester), and baby sleeping routine (postpartum period). CONCLUSION More than just emotional or peer support, pregnant women turn to online forums to discuss their health. Dominant topics, such as labor and miscarriage, suggest unmet informational needs in these domains. With misinformation becoming a growing public health concern, more attention must be directed toward peer-exchange outlets.
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Affiliation(s)
- Anna Wexler
- Department of Medical Ethics and Health Policy, University of Pennsylvania, Philadelphia, PA, United States of America
| | - Anahita Davoudi
- Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania, Philadelphia, PA, United States of America
| | - Davy Weissenbacher
- Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania, Philadelphia, PA, United States of America
| | - Rebekah Choi
- Department of Medical Ethics and Health Policy, University of Pennsylvania, Philadelphia, PA, United States of America
| | - Karen O’Connor
- Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania, Philadelphia, PA, United States of America
| | - Holly Cummings
- Department of Obstetrics and Gynecology, University of Pennsylvania, Philadelphia, PA, United States of America
| | - Graciela Gonzalez-Hernandez
- Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania, Philadelphia, PA, United States of America
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15
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Wilcox CR, Little P, Jones CE. Current practice and attitudes towards vaccination during pregnancy: a survey of GPs across England. Br J Gen Pract 2020; 70:e179-e185. [PMID: 31988088 PMCID: PMC6988681 DOI: 10.3399/bjgp20x708113] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Accepted: 07/22/2019] [Indexed: 10/31/2022] Open
Abstract
Background Antenatal vaccines are commonly delivered in primary care, yet the views of GPs regarding these programmes have been neglected in research to date. Aim To establish the attitudes and current practice of GPs towards antenatal vaccination and their views on the optimal location for delivery of this service. Design and setting A multicentre online survey questionnaire. Method A questionnaire was sent to GPs across England between December 2018 and January 2019. Results The majority of 1586 responders considered antenatal vaccination safe (96% for influenza, 89% pertussis). GPs were significantly less confident in their knowledge of pertussis compared with influenza vaccination (64% versus 80% were confident, P <0.001), and many desired further education (59% versus 48%, P <0.001). Few (37%) discussed vaccination with pregnant women regularly, but most (80%) felt their recommendation would influence decision making. Those with greater confidence in their knowledge of pertussis and influenza vaccination, and who were >2 years since qualifying, discussed vaccination significantly more often (odds ratio [OR] 3.52, P <0.001; OR 2.34, P = 0.001; OR 1.76, P = 0.003, respectively), regardless of whether they routinely saw pregnant women. Most (83%) reported that antenatal vaccination was GP led in their region, yet only 26% thought it should be primarily GP based. GPs expressed disconnect from antenatal care, and many suggested that midwives and/or secondary care should take greater responsibility for the delivery of antenatal vaccination. Conclusion There is support among GPs to embed vaccination programmes within routine antenatal care. Further educational resources, specifically designed for the needs of GPs, are needed to facilitate opportunistic discussion with pregnant women about vaccination.
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Affiliation(s)
- Christopher R Wilcox
- NIHR Clinical Research Facility, University Hospital Southampton NHS Foundation Trust, Southampton
| | - Paul Little
- Department of Primary Care and Population Sciences, Aldermoor Health Centre, University of Southampton, Southampton
| | - Christine E Jones
- Faculty of Medicine and Institute for Life Sciences, University of Southampton; University Hospital Southampton NHS Foundation Trust, Southampton
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16
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Marchetti F, Vilca LM, Cetin I. Insights and expectations for Tdap vaccination of pregnant women in Italy. J Matern Fetal Neonatal Med 2019; 34:2132-2139. [PMID: 31456459 DOI: 10.1080/14767058.2019.1659240] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Pertussis is a widespread vaccine-preventable disease, associated with an increasing trend to hospitalization among newborns. Pertussis in newborns can be fatal, and the most effective way to prevent it is maternal immunization (MI) with a reduced antigen content tetanus, diphtheria, and acellular pertussis vaccine (Tdap). In Italy, the National Immunization Plan (NIP) 2017-2019 introduced de novo Tdap vaccination during each pregnancy at no cost for the recipient. Despite this, vaccination coverage is suboptimal. This survey of pregnant women across Italy was conducted to investigate their knowledge and expectations of Tdap. METHODS A cross-sectional survey was conducted. Pregnant women up to 28th gestational weeks were interviewed by Telephone using a questionnaire with 16 questions. Statistics were descriptive. RESULTS The final sample recruited 600 respondents evenly distributed across Italy. The average duration of pregnancy at the time of the interview was 20.8 weeks (standard deviation [SD] 6.0). Most women (60.7%) were between 30 and 40 years of age. About half were aware of the risks of pertussis for newborns (54.5%) and the increased risk of hospitalization (59.8%); 47.2% were aware that Tdap MI was offered free of charge under the NIP. Safety information regarding the mother and newborn was considered the most important information in deciding whether to be vaccinated (47.4%), followed by safety information related only to the newborn (29.5%). About half (52.2%) stated that they would "certainly" accept MI, and 25.3% would like to receive more information. Gynecologists were the preferred healthcare providers (HCPs) for the provision of MI information (34.3%), followed by pediatricians (25.5%). Two-thirds of the respondents would prefer to be informed about MI before getting pregnant (66.0%). Vaccines investigated specifically for use in pregnancy were preferred by respondents. Overall, no relevant differences were observed between women pregnant for the first time and those with more than one pregnancy, nor between geographical regions. CONCLUSIONS The results show room for improving the awareness and understanding of the risks of pertussis for infants and the protective role of MI. The pregnant women preferred to receive advice on MI from an HCP, primarily their gynecologist. They were most interested in information on the safety profile of Tdap during pregnancy, on the mother, fetus, and newborn. The potential impact of this study to support clinical practice of Healthcare Providers is highlighted in the Focus on the Patient section. [Formula: see text].
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Affiliation(s)
| | - Luz Maria Vilca
- Department of Pediatrics, Obstetrics and Gynecology and Preventive Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Irene Cetin
- Department of Obstetrics and Gynecology, University of Milano, Milano, Italy
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Rozbroj T, Lyons A, Lucke J. The mad leading the blind: Perceptions of the vaccine-refusal movement among Australians who support vaccination. Vaccine 2019; 37:5986-5993. [PMID: 31451326 DOI: 10.1016/j.vaccine.2019.08.023] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Revised: 07/10/2019] [Accepted: 08/15/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Vaccine refusal is shaped by the social ecology in which it occurs. How people who refuse vaccines are communicated to and treated may affect the nature and strength of their negative vaccine beliefs, and their responsiveness to health promotion messages. Yet little is known about how people who refuse vaccines are perceived by the public. Our research examined perceptions among pro-vaccine Australians of the vaccine-refusal movement. METHODS Descriptions of the vaccine-refusal movement by 2666 pro-vaccine Australians were analysed using thematic discourse analysis. Descriptive themes were identified via inductive, iterative coding. Discourse analysis techniques were then used to interpret latent beliefs about the vaccine-refusal movement. RESULTS Participants had negative and stigmatising perceptions of the vaccine-refusal movement. They believed the movement is dangerous, misinformed, and comprised of charlatans and fools who are unintelligent, selfish, overly emotional, conspiratorial and scientifically illiterate. Discursive analysis showed that these perceptions were underpinned by beliefs that people would have to be defective in some way to believe anti-vaccine rhetoric. Furthermore, perceptions were underpinned by beliefs that the movement spreads not only disease, but also dangerous ideas that were seen to attack the social order, institutions, values and reason. Participants' intensely-negative views related to their inability to imagine why someone would refuse vaccines. CONCLUSIONS This research provides a focused, qualitative account of public perceptions of the vaccine-refusal movement. The findings are concerning: stigma towards vaccine-refusing people may adversely affect their wellbeing and entrench their negative vaccine beliefs. The research suggests that more compassionate, nuanced discussion of vaccine refusal in the public sphere is needed. It also supports the need to systematically examine public attitudes towards vaccine refusal as a determinant of vaccine confidence.
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Affiliation(s)
- T Rozbroj
- Australian Research Centre in Sex, Health and Society, La Trobe University, Bundoora, VIC 3086, Australia.
| | - A Lyons
- Australian Research Centre in Sex, Health and Society, La Trobe University, Bundoora, VIC 3086, Australia
| | - J Lucke
- Australian Research Centre in Sex, Health and Society, La Trobe University, Bundoora, VIC 3086, Australia; School of Public Health, The University of Queensland, St Lucia, QLD 4072, Australia
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Wilcox CR, Bottrell K, Paterson P, Schulz WS, Vandrevala T, Larson HJ, Jones CE. Influenza and pertussis vaccination in pregnancy: Portrayal in online media articles and perceptions of pregnant women and healthcare professionals. Vaccine 2018; 36:7625-7631. [PMID: 30401620 PMCID: PMC6263273 DOI: 10.1016/j.vaccine.2018.10.092] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Revised: 10/05/2018] [Accepted: 10/29/2018] [Indexed: 11/13/2022]
Abstract
Introduction Online media may influence women’s decision to undergo vaccination during pregnancy. The aims of this mixed-methods study were to: (1) examine the portrayal of maternal vaccination in online media and (2) establish the perceived target of vaccine protection as viewed by pregnant women and maternity healthcare professionals (HCPs). Methods Online media articles on maternal vaccination (published July-December 2012 or November 2015-April 2016) were identified through the London School of Hygiene & Tropical Medicine’s Vaccine Confidence Database and thematically analysed. Questionnaires for pregnant women and HCPs were distributed within four English hospitals (July 2017-January 2018). Results Of 203 articles identified, 60% related to pertussis vaccination, 33% to influenza and 6% both. The majority positively portrayed vaccination in pregnancy (97%), but inaccurate, negative articles persist which criticize pertussis vaccination’s safety and efficacy. Positively-worded articles about pertussis tended to focus on infant protection and highlight examples of recent cases, whereas positively-worded articles about influenza focused on maternal protection. These themes were reflected in questionnaire responses from 314 pregnant women and 204 HCPs, who perceived pertussis vaccination as protecting the baby, and influenza vaccination as protecting the mother, or mother and baby equally. A minority of the pregnant women surveyed intended to decline influenza (22%) or pertussis (8%) vaccination. Conclusions The majority of online articles support pertussis and influenza vaccination during pregnancy. The portrayal of pertussis vaccination as primarily benefiting the child, using real-examples, may influence its higher uptake compared with influenza. This approach should be considered by HCPs when recommending vaccination. HCPs should be prepared to provide advice to women hesitant about vaccination, including addressing any negative media, and consider educational strategies to counteract inaccurate information. Future studies should directly assess the influence of media on vaccine decision-making and establish which media platforms are typically used by pregnant women to gather information.
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Affiliation(s)
- Christopher R Wilcox
- NIHR Clinical Research Facility, University Hospital Southampton NHS Foundation Trust, Southampton, UK.
| | - Kathryn Bottrell
- Paediatric Infectious Diseases Research Group, St George's, University of London, UK
| | - Pauline Paterson
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | - William S Schulz
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | | | - Heidi J Larson
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | - Christine E Jones
- Paediatric Infectious Diseases Research Group, St George's, University of London, UK; Faculty of Medicine and Institute for Life Sciences, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
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