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Wang X, Zhang T, Gong H, Li J, Wu B, Chen B, Zhao S. Game-theoretic analysis of governance and corruption in China's pharmaceutical industry. Front Med (Lausanne) 2024; 11:1439864. [PMID: 39206179 PMCID: PMC11349649 DOI: 10.3389/fmed.2024.1439864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2024] [Accepted: 07/25/2024] [Indexed: 09/04/2024] Open
Abstract
Introduction With the rapid development of China's pharmaceutical industry, issues of corruption and regulatory effectiveness have become increasingly prominent, posing critical challenges to public health safety and the industry's sustainable development. Methods This paper adopts a bounded rationality perspective and employs a game-theoretic evolutionary approach to establish a tripartite evolutionary game model involving pharmaceutical companies, third-party auditing organizations, and health insurance regulatory agencies. It analyzes the stable strategies of the parties involved and the sensitivity of key parameters within this tripartite game system. Results The study reveals that adherence to health insurance regulations by pharmaceutical companies, refusal of bribes by third-party auditing organizations, and the implementation of lenient regulations by health insurance agencies can form an effective governance equilibrium. This equilibrium state contributes to reducing corruption in the pharmaceutical industry, balancing the interests of all parties, and promoting healthy industry development. Discussion Pharmaceutical companies must balance compliance costs against the risks of non-compliance benefits while maximizing profits; third-party auditing organizations need to choose between fulfilling their duties and accepting bribes, considering their economic benefits and professional reputation; health insurance regulatory agencies adjust their strategies between strict and lenient regulation to maximize social welfare. The paper suggests enhancing policy support, strengthening compliance supervision, improving audit independence, and adjusting regulatory strategies to optimize governance in the pharmaceutical industry. Additionally, the research highlights the role of collaborative efforts among the three parties in achieving sustainable governance. Furthermore, the study conducts a numerical simulation analysis to demonstrate the impact of various parameters on the evolutionary stability of the system, providing practical insights into the implementation of regulatory policies. This research offers new insights for policy formulation and governance in China's pharmaceutical sector, providing significant reference value for guiding the industry's sustainable development.
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Affiliation(s)
- Xi Wang
- Faculty of Humanities and Social Sciences, Macau Polytechnic University, Macau, Macau SAR, China
| | - Tao Zhang
- Faculty of Humanities and Social Sciences, Macau Polytechnic University, Macau, Macau SAR, China
| | - Hanxiang Gong
- The Second Affiliated Hospital, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Jinghua Li
- School of Public Health, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Baoling Wu
- Faculty of Humanities and Social Sciences, Macau Polytechnic University, Macau, Macau SAR, China
| | - Baoxin Chen
- Pingshan Hospital, Southern Medical University, Shenzhen, Guangdong, China
| | - Shufang Zhao
- Faculty of Humanities and Social Sciences, Macau Polytechnic University, Macau, Macau SAR, China
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Ji J, Hu T, Chen M. Impact of COVID-19 Vaccine Persuasion Strategies on Social Endorsement and Public Response on Chinese Social Media. HEALTH COMMUNICATION 2024:1-12. [PMID: 38973185 DOI: 10.1080/10410236.2024.2375478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/09/2024]
Abstract
Persuading the public to get vaccinated against infectious diseases is critical and carries profound implications for preparing for future pandemics. This study examined whether and how persuasion strategies employed in pro-vaccine messages affect social endorsement and audience stance toward the COVID-19 vaccine expressed in comments on Chinese social media. Through manual coding and pre-trained BERT model, we analyzed 1,500 Weibo posts focused on COVID-19 vaccination persuasion and 238,201 associated comments. Results showed that medical experts succeeded in eliciting heightened social endorsement and receiving more pro-vaccine comments. Posts that employed negative emotional appeal were less likely to be liked or receive pro-vaccine comments. Besides, vaccine persuasion messages presented in a narrative format or emphasizing vaccine efficacy garnered significantly more likes but did not significantly receive more pro-vaccine comments. Discussing domestic issues or employing joy appeal received more pro-vaccine comments. These results offer valuable insights for health practitioners and communicators, highlighting more effective persuasion strategies for engaging citizens in vaccine-related discussions on social media. This study underscores the importance of leveraging persuasion tactics on social media to foster vaccination uptake and better prepare us for handling future pandemics.
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Affiliation(s)
- Jiaojiao Ji
- Department of Communication of Science and Technology, University of Science and Technology of China
- Institute for Computational Social Sciences and Media Studies, University of Science and Technology of China
| | - Ting Hu
- Department of Philosophy of Science and Technology, University of Science and Technology of China
| | - Meng Chen
- School of Media and Communication, Shanghai Jiao Tong University
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3
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Lu Q, Schulz PJ, Chang A. Medication safety perceptions in China: Media exposure, healthcare experiences, and trusted information sources. PATIENT EDUCATION AND COUNSELING 2024; 123:108209. [PMID: 38367304 DOI: 10.1016/j.pec.2024.108209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 01/01/2024] [Accepted: 02/12/2024] [Indexed: 02/19/2024]
Abstract
OBJECTIVE Amid ongoing medication safety concerns in China and limited research on public perceptions, this study investigates the correlations between media exposure, healthcare experiences, and individuals' perceptions of medication safety. It also examines individuals' reliance on information sources during safety crises. METHODS A multistage stratified random sampling was employed with the gross sample containing 3090 Chinese adults aged 18-60 years. Data were analyzed using multiple linear regression. RESULTS Social media exposure was found to negatively correlate with perceptions of current medication safety and its perceived improvement, while exposure to television and print media showed positive correlations. Positive healthcare experiences were associated with improved medication safety perceptions. Among various information sources, healthcare professionals were deemed most trustworthy during medication safety incidents. CONCLUSIONS Media exposure and personal healthcare experiences significantly shape individuals' perceptions of medication safety in China, with healthcare professionals playing a crucial role in this context. Practiceimplications: Effective health crisis communication in China needs to be multifaceted, integrating traditional media and social media platforms to disseminate accurate information broadly. Additionally, healthcare professionals should be actively involved in crisis communication. Their role as trusted sources can be leveraged to clarify misconceptions, and reassure the public during medication safety incidents.
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Affiliation(s)
- Qianfeng Lu
- Faculty of Communication, Culture and Society, Università della Svizzera italiana (USI), Lugano, Switzerland
| | - Peter J Schulz
- Faculty of Communication, Culture and Society, Università della Svizzera italiana (USI), Lugano, Switzerland; Department of Communication & Media, Ewha Womans University, Seoul, South Korea.
| | - Angela Chang
- Faculty of Social Sciences, University of Macau, Macau, China
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4
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Bharucha T, Gangadharan B, Clarke R, Fernandez LG, Arman BY, Walsby-Tickle J, Deats M, Mosca S, Lin Q, Stokes R, Dunachie S, Merchant HA, Dubot-Pérès A, Caillet C, McCullagh J, Matousek P, Zitzmann N, Newton PN. Repurposing rapid diagnostic tests to detect falsified vaccines in supply chains. Vaccine 2024; 42:1506-1511. [PMID: 38355318 DOI: 10.1016/j.vaccine.2024.01.019] [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: 03/17/2023] [Revised: 11/21/2023] [Accepted: 01/04/2024] [Indexed: 02/16/2024]
Abstract
Substandard (including degraded) and falsified (SF) vaccines are a relatively neglected issue with serious global implications for public health. This has been highlighted during the rapid and widespread rollout of COVID-19 vaccines. There has been increasing interest in devices to screen for SF non-vaccine medicines including tablets and capsules to empower inspectors and standardise surveillance. However, there has been very limited published research focussed on repurposing or developing new devices for screening for SF vaccines. To our knowledge, rapid diagnostic tests (RDTs) have not been used for this purpose but have important potential for detecting falsified vaccines. We performed a proof-in-principle study to investigate their diagnostic accuracy using a diverse range of RDT-vaccine/falsified vaccine surrogate pairs. In an initial assessment, we demonstrated the utility of four RDTs in detecting seven vaccines. Subsequently, the four RDTs were evaluated by three blinded assessors with seven vaccines and four falsified vaccines surrogates. The results provide preliminary data that RDTs could be used by multiple international organisations, national medicines regulators and vaccine manufacturers/distributors to screen for falsified vaccines in supply chains, aligned with the WHO global 'Prevent, Detect and Respond' strategy.
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Affiliation(s)
- Tehmina Bharucha
- Department of Biochemistry, University of Oxford, Oxford OX1 3QU, UK; Kavli Institute for Nanoscience Discovery, University of Oxford, Oxford OX1 3QU, UK; Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao Democratic People's Republic.
| | - Bevin Gangadharan
- Department of Biochemistry, University of Oxford, Oxford OX1 3QU, UK; Kavli Institute for Nanoscience Discovery, University of Oxford, Oxford OX1 3QU, UK
| | - Rebecca Clarke
- Department of Chemistry, University of Oxford, Oxford OX1 3TA, UK
| | - Laura Gomez Fernandez
- Department of Biochemistry, University of Oxford, Oxford OX1 3QU, UK; Kavli Institute for Nanoscience Discovery, University of Oxford, Oxford OX1 3QU, UK
| | - Benediktus Yohan Arman
- Department of Biochemistry, University of Oxford, Oxford OX1 3QU, UK; Kavli Institute for Nanoscience Discovery, University of Oxford, Oxford OX1 3QU, UK
| | | | - Michael Deats
- Centre for Tropical Medicine & Global Health, Nuffield Department of Medicine, University of Oxford, Oxford OX3 7LG, UK
| | - Sara Mosca
- Central Laser Facility, Research Complex at Harwell, STFC Rutherford-Appleton Laboratory, UKRI, Harwell Campus, Didcot OX11 0QX, UK
| | - Qianqi Lin
- Central Laser Facility, Research Complex at Harwell, STFC Rutherford-Appleton Laboratory, UKRI, Harwell Campus, Didcot OX11 0QX, UK
| | - Robert Stokes
- Agilent Technologies LDA UK, Becquerel Avenue, Didcot OX11 0RA, UK
| | - Susanna Dunachie
- Centre for Tropical Medicine & Global Health, Nuffield Department of Medicine, University of Oxford, Oxford OX3 7LG, UK; Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand; Department of Microbiology and Infectious Diseases, Oxford University Hospitals NHS Foundation Trust, Oxford OX3 9DU, UK
| | - Hamid A Merchant
- Department of Bioscience, School of Health, Sport and Bioscience, University of East London, Water Lane London E15 4LZ, UK; Department of Pharmacy, School of Applied Sciences, University of Huddersfield, Queensgate, Huddersfield HD1 3DH, UK
| | - Audrey Dubot-Pérès
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao Democratic People's Republic; Centre for Tropical Medicine & Global Health, Nuffield Department of Medicine, University of Oxford, Oxford OX3 7LG, UK; Unité Des Virus Emergents (UVE: Aix Marseille Univ, IRD190, INSERM 1207), Marseille, France
| | - Céline Caillet
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao Democratic People's Republic; Centre for Tropical Medicine & Global Health, Nuffield Department of Medicine, University of Oxford, Oxford OX3 7LG, UK; Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand; Infectious Diseases Data Observatory, Nuffield Department of Medicine, University of Oxford, Oxford OX3 7LG, UK
| | - James McCullagh
- Department of Chemistry, University of Oxford, Oxford OX1 3TA, UK
| | - Pavel Matousek
- Centre for Tropical Medicine & Global Health, Nuffield Department of Medicine, University of Oxford, Oxford OX3 7LG, UK; Central Laser Facility, Research Complex at Harwell, STFC Rutherford-Appleton Laboratory, UKRI, Harwell Campus, Didcot OX11 0QX, UK
| | - Nicole Zitzmann
- Department of Biochemistry, University of Oxford, Oxford OX1 3QU, UK; Kavli Institute for Nanoscience Discovery, University of Oxford, Oxford OX1 3QU, UK
| | - Paul N Newton
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao Democratic People's Republic; Centre for Tropical Medicine & Global Health, Nuffield Department of Medicine, University of Oxford, Oxford OX3 7LG, UK; Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand; Infectious Diseases Data Observatory, Nuffield Department of Medicine, University of Oxford, Oxford OX3 7LG, UK.
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5
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Ma W, Zhang L, Ren D, Meng X, Yin J, Sun Q. Parental preferences for rotavirus vaccination for their children under 5 years old in China: A discrete choice experiment. Hum Vaccin Immunother 2023; 19:2179222. [PMID: 36794417 PMCID: PMC10026903 DOI: 10.1080/21645515.2023.2179222] [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: 10/28/2022] [Accepted: 02/05/2023] [Indexed: 02/17/2023] Open
Abstract
Rotavirus vaccination is the most effective means to prevent rotavirus gastroenteritis, but its coverage in China is not ideal. We aimed to explore parental preferences for rotavirus vaccination for their children under 5years old to improve vaccination coverage. A Discrete Choice Experiment was conducted online on 415 parents with at least one child under 5years old in 3 cities. Five attributes including vaccine effectiveness, protection duration, risk of mild side-effects, out-of-pocket costs, and time required for vaccination were identified. Each attribute was set at three levels. Mixed-logit models were used to measure parental preferences and the relative importance of vaccine attributes. The optimal vaccination strategy was also explored. 359 samples were included in the analysis. The impacts of the vaccine attribute levels on vaccine choice were all statistically significant (p < .01), except for 1-hour vaccination time. The risk of mild side-effects was the most important factor influencing vaccination. The time required for vaccination was the least important attribute. The largest increase in vaccination uptake (74.45%) occurred with decreased the vaccine risk of mild side-effects from 1/10 to 1/50. The predicted vaccination uptake of the optimal vaccination scenario was 91.79%. When deciding about vaccination, parents preferred the rotavirus vaccination with lower risk of mild side-effects, higher effectiveness, longer protection duration, 2-hour vaccination time and lower cost. The authorities should support enterprises to develop vaccines with lower side-effects, higher effectiveness and longer protection duration in the future. We call for appropriate government subsidies for the rotavirus vaccine.
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Affiliation(s)
- Wenwen Ma
- Centre for Health Management and Policy Research, School of Public Health,Cheeloo College of Medicine, Shandong University, Jinan, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China
| | - Liujin Zhang
- Centre for Health Management and Policy Research, School of Public Health,Cheeloo College of Medicine, Shandong University, Jinan, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China
| | - Deyu Ren
- Centre for Health Management and Policy Research, School of Public Health,Cheeloo College of Medicine, Shandong University, Jinan, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China
| | - Xiaoqing Meng
- Centre for Health Management and Policy Research, School of Public Health,Cheeloo College of Medicine, Shandong University, Jinan, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China
| | - Jia Yin
- Centre for Health Management and Policy Research, School of Public Health,Cheeloo College of Medicine, Shandong University, Jinan, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China
| | - Qiang Sun
- Centre for Health Management and Policy Research, School of Public Health,Cheeloo College of Medicine, Shandong University, Jinan, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China
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Qu S, Yang M, He W, Xie H, Zhou M, Campy KS, Tao X. Determinants of parental self-reported uptake of influenza vaccination in preschool children during the COVID-19 pandemic. Hum Vaccin Immunother 2023; 19:2268392. [PMID: 37964617 PMCID: PMC10653755 DOI: 10.1080/21645515.2023.2268392] [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: 06/13/2023] [Accepted: 10/05/2023] [Indexed: 11/16/2023] Open
Abstract
In China, the coverage rate of influenza vaccination among the general population is significantly lower than that of high-income countries, with only 2.46% of the population vaccinated. Preschool-aged children are particularly susceptible to influenza viruses, yet the factors that influence parents' willingness to vaccinate their children are not well understood. To address this research gap, we developed a theoretical model grounded in the Unified Theory of Acceptance and Use of Technology (UTAUT), which explores six key factors influencing parental self-reported uptake of influenza vaccination in preschool children: performance expectancy, effort expectancy, social influence, facilitating conditions, knowledge, and behavioral intention. We collected data from 872 parents of children in five major cities in China and employed structural equation modeling to examine the significance of the theoretical model and explore the potential moderating effects of demographic variables on path relationships. Our analysis revealed that several positive factors influenced parents' intention of influenza vaccination for preschool children, including effort expectancy (β = 0.38), social influence (β = 0.17), and knowledge (β = 0.52). Facilitating conditions (β = 0.34), knowledge (β = 0.40), and behavioral intention (β = 0.34) were found to be associated with self-reported uptake. Furthermore, we observed significant moderating effects of the child's gender and age, as well as the guardian's category and income, on the theoretical models. Parents' willingness to vaccinate preschool children against influenza is influenced by both psychological and demographic variables. Further studies are needed to determine if these relationships persist over time and across different regions.
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Affiliation(s)
- Shujuan Qu
- Department of Pediatrics, The Third Xiangya Hospital of Central South University, Changsha, China
| | - Minghua Yang
- Department of Pediatrics, The Third Xiangya Hospital of Central South University, Changsha, China
| | - Wei He
- Department of Pediatrics, The Third Xiangya Hospital of Central South University, Changsha, China
| | - Hao Xie
- Department of Pediatrics, The Third Xiangya Hospital of Central South University, Changsha, China
| | - Min Zhou
- School of Business Administration, Hunan University of Technology and Business, Changsha, China
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, USA
| | - Kathryn S. Campy
- Center for Public Health Initiatives, University of Pennsylvania, Philadelphia, PA, USA
| | - Xinyu Tao
- Graduate School of Science and Engineering, Chuo University, Tokyo, Japan
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Du H, Mao A, Fan J, Du S, Wang X, Qiu W. Risk Communication Principles for COVID-19 Vaccination: Application in China. Disaster Med Public Health Prep 2023; 17:e544. [PMID: 38050383 DOI: 10.1017/dmp.2023.185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/06/2023]
Affiliation(s)
- Haiping Du
- Institute of Medical Information, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Ayan Mao
- Institute of Medical Information, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jiangbo Fan
- Institute of Medical Information, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Shuai Du
- Institute of Medical Information, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xi Wang
- Institute of Medical Information, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Wuqi Qiu
- Institute of Medical Information, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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8
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Fu Y, Liu B, Luan Y, Zhao H, Chen D, Wang D, Cai W, Zhang L, Sun S, Zheng J, Yuan Y, Wang Y, Zhou H. Photonic Crystal Sensor Evaluating the Effectiveness of Medical Products under Different Storage Conditions. ACS APPLIED MATERIALS & INTERFACES 2023; 15:44147-44153. [PMID: 37691251 DOI: 10.1021/acsami.3c10771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/12/2023]
Abstract
The effectiveness of time- and temperature-sensitive medical products (TTSMPs) (vaccines, medicines, and biological agents) is generally evaluated by sporadically checking the storage conditions recorded in electronic thermometers. However, electronic thermometers do not achieve all-time and all-regional record, resulting in the wrong evaluation of a single TTSMP and seriously endangering public health. Herein, we report a photonic crystal sensor for evaluating the effectiveness of a single TTSMP processing storage environment. The photonic crystal sensor assembled by colloidal microspheres (WO3-x nanospheres were added into the microsphere gap) generates a fascinating composite color of angle-dependent structural color (maximum reflectivity = 45%) and durative color (WO3-x coloration). Effectiveness evaluation principle reveals that the pattern on the sensor, which was printed by the composite color, fades sensitively to time and temperature, thus having different visible periods (0-21 days affected by temperature). The visible periods of the patterns can be used to evaluate a single TTSMP's effectiveness stored under different temperatures. Furthermore, the photonic crystal sensor shows outstanding flexibility and slight adhesion, offering a promising application toward the effectiveness evaluation of TTSMPs throughout storage, transportation, and sales processes.
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Affiliation(s)
- Yue Fu
- School of Materials Science and Engineering, State Key Laboratory of Materials Processing and Die & Mould Technology, Huazhong University of Science and Technology, Wuhan 430074, China
| | - Bin Liu
- Beijing Aerospace Systems Engineering Research Institute, Beijing 100076, China
| | - Yihao Luan
- Aerospace Research Institute of Materials & Processing Technology, Beijing 100076, China
| | - Hu Zhao
- School of Materials Science and Engineering, State Key Laboratory of Materials Processing and Die & Mould Technology, Huazhong University of Science and Technology, Wuhan 430074, China
| | - Dan Chen
- School of Materials Science and Engineering, State Key Laboratory of Materials Processing and Die & Mould Technology, Huazhong University of Science and Technology, Wuhan 430074, China
| | - Dong Wang
- School of Materials Science and Engineering, State Key Laboratory of Materials Processing and Die & Mould Technology, Huazhong University of Science and Technology, Wuhan 430074, China
| | - Weihao Cai
- School of Materials Science and Engineering, State Key Laboratory of Materials Processing and Die & Mould Technology, Huazhong University of Science and Technology, Wuhan 430074, China
| | - Lu Zhang
- School of Materials Science and Engineering, State Key Laboratory of Materials Processing and Die & Mould Technology, Huazhong University of Science and Technology, Wuhan 430074, China
| | - Shuang Sun
- School of Materials Science and Engineering, State Key Laboratory of Materials Processing and Die & Mould Technology, Huazhong University of Science and Technology, Wuhan 430074, China
| | - Jiaqi Zheng
- School of Materials Science and Engineering, State Key Laboratory of Materials Processing and Die & Mould Technology, Huazhong University of Science and Technology, Wuhan 430074, China
| | - Yi Yuan
- School of Materials Science and Engineering, State Key Laboratory of Materials Processing and Die & Mould Technology, Huazhong University of Science and Technology, Wuhan 430074, China
| | - Yunming Wang
- School of Materials Science and Engineering, State Key Laboratory of Materials Processing and Die & Mould Technology, Huazhong University of Science and Technology, Wuhan 430074, China
| | - Huamin Zhou
- School of Materials Science and Engineering, State Key Laboratory of Materials Processing and Die & Mould Technology, Huazhong University of Science and Technology, Wuhan 430074, China
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Hou Z, Lai X, Liu Y, Jit M, Larson HJ, Fang H. Assessing the impact of the 2018 Changchun Changsheng vaccine incident on childhood vaccination in China. COMMUNICATIONS MEDICINE 2023; 3:114. [PMID: 37608146 PMCID: PMC10444794 DOI: 10.1038/s43856-023-00339-0] [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: 11/21/2022] [Accepted: 07/25/2023] [Indexed: 08/24/2023] Open
Abstract
BACKGROUND The 2018 Changchun Changsheng vaccine incident is an emergent public health event in China with reports of DTaP vaccines with compromised efficacy. This study aimed to estimate the impact of the vaccine incident on real-world vaccination behaviors in China. METHODS A cross-sectional survey was conducted in ten provinces in 2019. Vaccination records were collected from 5294 children aged 6-59 months, with information on 75,579 vaccine doses for seven National Immunization Program (NIP) vaccines and two non-NIP vaccines received from 2014 to 2019. Chi-square test, interrupted time series, and logistic regression were used to evaluate the impacts of vaccine incident on vaccination delay, measured as the proportion of delayed doses out of total doses in schedule. RESULTS Here we show significant increases in doses delayed ≤ 3 months (19.12% to 22.51%, p = 0.000) and > 3 months (7.17% to 11.82%, p = 0.000) for DTaP vaccine after the incident. By scaling nationally, there will be extra 2.1 million doses delayed ≤ 3 months and 2.8 million doses delayed > 3 months in the year following this incident. More guardians choose expensive private-market substitutes containing DTaP elements over government-funded DTaP vaccines. Controlling for socio-demographic factors, doses scheduled after the incident have higher odds of delays for DTaP vaccine (OR: 3.49, 95% CI: 3.08-3.96) and other NIP vaccines (OR: 2.76, 95% CI: 2.55-2.99), but not for non-NIP vaccines. CONCLUSIONS The observed delays in the incident-involved DTaP vaccine immunization reflect the negative effects of the vaccine incident on vaccination behaviors under the NIP. However, its effects seem minimal for non-NIP vaccines.
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Affiliation(s)
- Zhiyuan Hou
- School of Public Health, NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China
| | - Xiaozhen Lai
- Department of Health Policy and Management, School of Public Health, Peking University, Beijing, China
- Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Yang Liu
- Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
- Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene and Tropical Medicine, London, UK
| | - Mark Jit
- Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
- Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene and Tropical Medicine, London, UK
- School of Public Health, University of Hong Kong, Hong Kong SAR, China
| | - Heidi J Larson
- Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Hai Fang
- China Center for Health Development Studies, Peking University, Beijing, China.
- Peking University Health Science Center-Chinese Center for Disease Control and Prevention Joint Research Center for Vaccine Economics, Peking University, Beijing, China.
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10
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Han K, Hou Z, Tu S, Wang Q, Hu S, Xing Y, Du J, Zang S, Chantler T, Larson H. Caregivers' understanding of childhood influenza vaccination during the epidemic in China. A mixed-methods study. Front Public Health 2023; 11:1196019. [PMID: 37637809 PMCID: PMC10447896 DOI: 10.3389/fpubh.2023.1196019] [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: 03/29/2023] [Accepted: 07/28/2023] [Indexed: 08/29/2023] Open
Abstract
Introduction Influenza vaccination uptake among young children has been poor in China, but it is unclear how it changed during the COVID-19. This study aimed to investigate the uptake status and reasons of childhood influenza vaccination during the pandemic in China. Methods A mixed-methods study combining a questionnaire survey and semi-structured interviews was conducted in Anhui, Shaanxi, and Guangdong provinces between September and November 2021. 2081 caregivers completed the valid questionnaire. 38 caregivers participated in interviews, and data were analyzed thematically, using deductive and inductive coding. Results A total of 2081 caregivers completed the valid questionnaire, and 38 caregivers participated in interviews. Among the caregivers, a total of 1796 were in the age group for high-risk groups in the 2019-2020 flu season, and 46.10% reported that their children received influenza vaccination in the 2019-2020 flu season; 43.63% said that they vaccinated their children against influenza in the 2020-2021 flu season. Many caregivers indicated that the adoption of nonpharmacologic interventions (NPIs) during COVID-19 reduced the risk of influenza infection for children. Most caregivers consider the severity of influenza to be low, and some confused the common cold with influenza. Meanwhile, some caregivers lack confidence in the vaccine's effectiveness and importance. They thought that vaccines are not effective in preventing the constantly mutating virus. Despite clear perceptions about the severity of influenza and the effectiveness of the vaccine, we found that most caregivers did not receive any relevant medical information, and the communication about vaccines between caregivers and professional information sources, such as healthcare workers, is inadequate. Hence, caregivers have no scientific evidence to back up their perceptions. In terms of access to vaccination service, caregivers reported conflicts between time of vaccination service and their schedule, and the need for vaccine prices to be reduced. Discussion Targeted interventions are needed to address caregivers' lack of risk perception on influenza during COVID-19 and promote communication between caregivers and professional information sources. Extending vaccination service hours and increasing the number of vaccine clinics close to residential areas and expansion of financing sources for self-paid vaccination could facilitate the access to influenza vaccination service.
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Affiliation(s)
- Kaiyi Han
- School of Public and Health, Fudan University, Shanghai, China
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Zhiyuan Hou
- School of Public and Health, Fudan University, Shanghai, China
- NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China
| | - Shiyi Tu
- School of Public and Health, Fudan University, Shanghai, China
- NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China
| | - Qian Wang
- School of Public and Health, Fudan University, Shanghai, China
| | - Simeng Hu
- School of Public and Health, Fudan University, Shanghai, China
| | - Yuting Xing
- School of Public and Health, Fudan University, Shanghai, China
| | - Jing Du
- School of Public and Health, Fudan University, Shanghai, China
| | - Shujie Zang
- School of Public and Health, Fudan University, Shanghai, China
| | - Tracey Chantler
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Heidi Larson
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, United Kingdom
- Department of Health Metrics Sciences, University of Washington, Seattle, WA, United States
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11
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Equils O, Bakaj A, Wilson-Mifsud B, Chatterjee A. Restoring Trust: The Need for Precision Medicine in Infectious Diseases, Public Health and Vaccines. Hum Vaccin Immunother 2023; 19:2234787. [PMID: 37465958 PMCID: PMC10361134 DOI: 10.1080/21645515.2023.2234787] [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: 04/04/2023] [Revised: 06/26/2023] [Accepted: 07/05/2023] [Indexed: 07/20/2023] Open
Abstract
There are limited data on precision medicine in infectious diseases and vaccines; however, precise management of infectious diseases plays a critical role in trust for government, health-care organizations, science, and pharma. The improvement in biomedical technologies, availability of large clinical and -omic data and appropriate application of artificial intelligence may allow precision in vaccines and public health and restore trust. This is an invited editorial on the role of precision medicine in infectious diseases and vaccines.
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Affiliation(s)
- Ozlem Equils
- Public Health Non-Profit, MiOra, Los Angeles, CA, USA
- Clinical Development, Cidara Therapeutics, San Diego, CA, USA
| | - Angela Bakaj
- Public Health Non-Profit, MiOra, Los Angeles, CA, USA
| | - Brittany Wilson-Mifsud
- Chicago Medical School, Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA
| | - Archana Chatterjee
- Chicago Medical School, Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA
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12
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Luan M, Qi Q, Shi W, Tao Z, Bao Y, Zhou J. Differential impacts of vaccine scandal by ethnic and socioeconomic factors: Evidence from China. PLoS One 2023; 18:e0288841. [PMID: 37467255 DOI: 10.1371/journal.pone.0288841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 06/22/2023] [Indexed: 07/21/2023] Open
Abstract
Widespread vaccination against important diseases plays a key role for global health security, particularly in the context of the COVID-19 pandemic. However, building and maintaining trust in immunization services remains challenging because of doubts about quality and safety of vaccines. China has periodically faced mounting pressure and even public outrage triggered by incidents of poor-quality vaccines. We aimed to evaluate the impact of the diphtheria, pertussis, and tetanus (DPT) vaccine scandal of 2018 in China and the ensuing misinformation on vaccination, and investigate differential responses to the scandal by ethnic and socioeconomic factors. With data from January 2017 to December 2018 in Sichuan province, China, we used a difference-in-differences (DID) method to compare the changes in the county-level monthly DPT vaccinations against the hepatitis B vaccinations, both before and after the DPT vaccine scandal. We found that the number of DPT vaccinations decreased by 14.0 percent in response to the vaccine scandal and ensuing misinformation. The number of vaccinations in minority regions, under-developed regions, and regions with poor medical resources decreased more than in non-minority regions, developed regions, and regions with good medical resources (24.5 versus 10.1 percent, 17.3 versus 8.3 percent, and 17.0 versus 8.7 percent, respectively). People did more online searching for "Substandard vaccine" and "DPT vaccine" after the scandal, with the socioeconomically advantaged group searching more compared with the socioeconomically disadvantaged group. The results suggest the urgent need to make true information about the vaccine easily accessible over the internet, especially for the socioeconomically disadvantaged groups. Our findings for China can also have implications for immunization service planning for better safeguarding public health in other countries, particularly developing ones.
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Affiliation(s)
- Mengna Luan
- Research Institute of Economics and Management, Southwestern University of Finance and Economics, Chengdu, China
| | - Qi Qi
- Sichuan Center for Disease Control and Prevention, Chengdu, China
| | - Wenjing Shi
- Faculty of Business and Economics, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Zhigang Tao
- Cheung Kong Graduate School of Business, Beijing, China
| | - Ying Bao
- Sichuan Center for Disease Control and Prevention, Chengdu, China
| | - Jiushun Zhou
- Sichuan Center for Disease Control and Prevention, Chengdu, China
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13
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Akintunde TY, Chen JK, Ibrahim E, Isangha SO, Sayibu M, Musa TH. Factors associated with COVID-19 vaccine uptake among foreign migrants in China. Heliyon 2023; 9:e17567. [PMID: 37533745 PMCID: PMC10292914 DOI: 10.1016/j.heliyon.2023.e17567] [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: 11/01/2022] [Revised: 06/14/2023] [Accepted: 06/21/2023] [Indexed: 08/04/2023] Open
Abstract
Background/Purpose The COVID-19 outbreak created unique policy challenges for vaccinating special groups like migrants. As part of sustainable development goals, the equitable distribution of the COVID-19 vaccine can contribute to ensuring health for all. This study examined COVID-19 vaccine uptake among foreign migrants in China based on sociodemographics, cultural beliefs, past vaccine behaviors, and psychosocial factors. Design An online cross-sectional survey was conducted among foreign migrants in mainland China via social media platforms from 21 November through 20 December 2021. Bivariate (unadjusted odd-ratio) and multivariate logistic regression analyses were performed to establish the correlates of COVID-19 vaccine uptake. Result Surveyed foreign migrants that are culture neutral (AOR: 2.5, CI: 95%, 1.02-5.90, p = 0.044), willing to pay for vaccination (AOR: 2.27, CI: 95%, 1.18-3.98, p = 0.012), believe in vaccine efficacy (AOR: 3.00, CI: 95%, 1.75-5.16, p < 0.000), have poor psychological health (AOR: 1.96, CI: 95%, 1.14-3.38, p = 0 0.014), and have higher perceived seriousness of COVID-19 (AOR: 2.12, CI: 95%, 1.26-3.57, p = 0.005) are more likely to receive COVID-19 vaccine. Those migrants with a history of declining vaccination (AOR: 0.34, CI: 95%, 0.18-0.65, p = 0.000) and middle-income earners $1701-3500 (AOR: 0.43, CI: 95%, 0.23-0.82, p = 0.010) are less likely to receive the COVID-19 vaccine. Conclusion This study brings a unique perspective to understanding vaccine behavior among international migrants in China. There is an urgent call from the World Health Organization and countries for complete vaccination and efforts to improve vaccine coverage. However, fewer studies have been conducted globally on the vaccination of migrant populations. The current study provides empirical information to increase the knowledge of the correlates of vaccine behavior among immigrants in countries around the globe. Future studies should conduct cross-country comparisons to understand the factors associated with increasing vaccination rates among immigrant populations to formulate a strong policy to increase vaccine coverage among immigrant populations across countries.
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Affiliation(s)
- Tosin Yinka Akintunde
- Department of Sociology, School of Public Administration, Hohai University, China
- Department of Social Work, Chinese University of Hong Kong, Hong Kong
| | - Ji-Kang Chen
- Department of Social Work, Chinese University of Hong Kong, Hong Kong
| | - Elhakim Ibrahim
- Department of Demography, College for Health, Community and Policy, The University of Texas, San Antonio, TX, United States
| | - Stanley Oloji Isangha
- Department of Social and Behavioral Sciences, College of Liberal Art and Social Sciences, City University of Hong Kong, Hong Kong
| | - Muhideen Sayibu
- Department of Sci-Tech Communication and Policy, University of Science and Technology of China, Anhui, Hefei, China
| | - Taha Hussein Musa
- Department of Epidemiology and Health Statistics, Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, China
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14
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Yuan S, Rui J, Peng X. Trust in scientists on COVID-19 vaccine hesitancy and vaccine intention in China and the US. INTERNATIONAL JOURNAL OF DISASTER RISK REDUCTION : IJDRR 2023; 86:103539. [PMID: 36687293 PMCID: PMC9840227 DOI: 10.1016/j.ijdrr.2023.103539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Revised: 01/11/2023] [Accepted: 01/11/2023] [Indexed: 06/17/2023]
Abstract
When we recognize various factors which influence vaccine willingness, it is unclear whether these factors work the same in different countries. This study explored how trust in scientists was related to COVID-19 vaccine hesitancies and vaccine willingness in China and the U.S. We attempted to understand the extent to which the perceived trustworthiness of scientists would predict vaccine hesitancies and intention to get vaccinated differently in these two countries. An online survey with participants in China (N = 391) and in the U.S. (N = 363) was conducted. Participants were asked about their view of scientists' competence, benevolence, and integrity as dimensions of trustworthiness, three types of vaccine hesitancies, as well as their willingness to get vaccinated. The results showed that trust in scientists was negatively related to individual vaccine hesitancy in both China and the U.S., and trust was negatively associated with the level of contextual hesitancy and vaccine-specific hesitancy in the U.S. Higher trust in scientists was also associated with the willingness to get vaccines in the U.S., rather than in China. Results yielded differences in China and the U.S. in how trust in scientists and vaccine hesitancies predicted individuals' willingness to get vaccinated.
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Affiliation(s)
- Shupei Yuan
- Department of Communication, Northern Illinois University, DeKalb, Illinois, 60008, USA
| | - Jian Rui
- Department of New Media and Communication, South China University of Technology, Guangzhou, 510006, China
| | - Xu Peng
- Department of New Media and Communication, South China University of Technology, Guangzhou, 510006, China
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15
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Wang Y, Chen Y, Bao S. The impact of exposure to HPV related information and injunctive norms on young women's intentions to receive the HPV vaccine in China: A structural equation model based on KAP theory. Front Public Health 2023; 10:1102590. [PMID: 36726620 PMCID: PMC9884697 DOI: 10.3389/fpubh.2022.1102590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Accepted: 12/29/2022] [Indexed: 01/18/2023] Open
Abstract
Background The HPV vaccination is a crucial line of defensing against cervical cancer. As a result of government support and positive publicity from the majority of media, a craze for HPV vaccination has occurred in China. Besides, the intentions to get the HPV vaccine among women of appropriate age is also influenced by families' and friends' attitudes and perceptions toward HPV vaccine. Therefore, the purpose of this study was to investigate how HPV related information exposure and injunctive norms affect young Chinese women's intentions to receive the HPV vaccine. Methods A structural equation model was developed based on KAP theory, and 567 effective questionnaires were collected through an online survey. We used SPSS 26.0 for the reliability and validity analysis and the differential testing of demographic characteristics, and Amos 26.0 for the goodness-of-fit analysis and paths testing of the model. Results Our findings showed that (1) intention to receive HPV vaccine differed significantly in age (P = 0.046), educational background (P = 0.001), and occupation (P = 0.004). (2) Exposure to HPV related information positively affected knowledge about HPV (β = 0.316, P < 0.001) and intention to receive HPV vaccine (β = 0.141, P < 0.001). (3) Knowledge about HPV positively affected attitude toward HPV vaccine (β=0.341, P < 0.001), but negatively affected intention to receive HPV vaccine (β = -0.148, P < 0.05), and attitude toward HPV vaccine positively affected intention to receive HPV vaccine (β = 0.594, P < 0.001). (4) Injunctive norms positively affected attitude toward HPV vaccine (β = 0.362, P < 0.001) and intention to receive HPV vaccine (β = 0.420, P < 0.001). Conclusions Exposure to HPV related information influenced young Chinese women's intentions to receive the HPV vaccine and related knowledge, that is, the more frequently they were exposed to HPV related information, the stronger their intentions to receive the vaccine and the higher their HPV knowledge. Also, the perception and support of HPV vaccination by people around them will further influence their attitudes and intentions to receive the HPV vaccine.
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16
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Sheen GCH, Tung HH, Wu CH, Wu WC. WHO approves? Relative trust, the WHO, and China's COVID-19 vaccines. THE REVIEW OF INTERNATIONAL ORGANIZATIONS 2022; 18:1-23. [PMID: 36467252 PMCID: PMC9684827 DOI: 10.1007/s11558-022-09481-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 10/31/2022] [Indexed: 06/17/2023]
Abstract
This paper aims to answer a general question: whether an international organization (IO) is able to shape public opinion in the context of the COVID-19 pandemic. Since the pandemic took hold in early 2020, countries across the globe have switched gear from prevention to vaccination. Most had to not only secure a sufficient supply of vaccines, but also to curb vaccine hesitancy among their populations. Can endorsement by an international organization like the World Health Organization (WHO) enhance a vaccine's acceptability? Based on a survey experiment conducted in Taiwan, our study leverages the special relationship between China and Taiwan to show that WHO endorsement can induce acceptance of Chinese vaccines among Taiwanese people. However, the effect is found to be contextual in the sense that it only works when people's trust in the WHO is higher than their trust in the vaccine's country of origin. Our study not only contributes to the literature of IO legitimacy by empirically showing IOs' causal effects on public opinion, but also sheds light on how a vaccine's credibility can be enhanced to promote vaccination uptake. Supplementary Information The online version contains supplementary material available at 10.1007/s11558-022-09481-1.
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Affiliation(s)
| | - Hans H. Tung
- Department of Political Science and and Center for Research in Econometric Theory and Applications, National Taiwan University, Taipei, Taiwan
| | - Chien-Huei Wu
- Institute of European and American Studies, Academia Sinica, Taipei, Taiwan
| | - Wen-Chin Wu
- Institute of Political Science, Academia Sinica, Taipei, Taiwan
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17
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Ha NT, Chi NTY, Van Nuil J, Thwaites L, Chambers M. Media portrayal of vaccine: a content analysis of Vietnam online news about a pentavalent vaccine in the Expanded Program of Immunization. Wellcome Open Res 2022; 7:271. [PMID: 39220241 PMCID: PMC11362720 DOI: 10.12688/wellcomeopenres.18457.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/19/2022] [Indexed: 09/04/2024] Open
Abstract
Background: Vaccine hesitancy has become a prominent public health concern, particularly within the coronavirus disease 2019 (COVID-19) pandemic context. Worries about vaccine side effects are often cited as a reason for hesitancy, while media reporting about this topic plays an important role in influencing the public's perspectives about vaccines and vaccination. In Vietnam, during 2012-2013, there were several adverse events following immunization (AEFIs) of Quinvaxem- a pentavalent vaccine in the Expanded Immunization Program, which made big headlines in the media. Such incidences have contributed to changes in vaccination policies and influenced parents' concerns to date. This study explores the portrayal of Quinvaxem in Vietnam digital news during four periods marked by important events. Methods: We performed quantitative and qualitative analysis with a coding framework to identify main content focus, sentiments towards Quinvaxem, and emotional tones in these articles. Results: In total, we included 360 articles into analysis. The amount of news coverage about Quinvaxem increased after AEFIs happened, from 7 articles before AEFIs to 98 and 159 articles in the following periods when AEFIs and investigation into vaccine safety occurred. Most articles are neutral in titles (n=255/360) and content (n=215/360) towards Quinvaxem and do not convey emotional expressions (n=271/360). However, articles focusing on side effects contain negative sentiments and emotional expressions more frequently than articles of other contents while AEFIs details were conflicting across articles. Vaccine sentiments are provoked in the information about vaccine quality and safety, health authority, local delivery, and quoted vaccine opinions. Emotion-conveying elements in 89/360 articles included emotional wording and imagery and expressive punctuation. Conclusions: The heterogeneity of information in online news may reinforce uncertainty about vaccine safety and decrease vaccine intention. Our results have important implications for vaccine communication, given the current plan of the Vietnamese government to roll out COVID-19 vaccination to younger children.
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Affiliation(s)
- Nguyen Thanh Ha
- Oxford University Clinical Research Unit, Hochiminh, Vietnam
- Global Health Bioethics Network, Oxford, UK
| | - Nguyen Thi Yen Chi
- Department of International Health, Maastricht University, Maastricht, The Netherlands
| | - Jennifer Van Nuil
- Oxford University Clinical Research Unit, Hochiminh, Vietnam
- Global Health Bioethics Network, Oxford, UK
- Centre for Tropical Medicine and Global Health, Oxford, UK
| | - Louise Thwaites
- Oxford University Clinical Research Unit, Hochiminh, Vietnam
- Centre for Tropical Medicine and Global Health, Oxford, UK
| | - Mary Chambers
- Oxford University Clinical Research Unit, Hochiminh, Vietnam
- Global Health Bioethics Network, Oxford, UK
- Centre for Tropical Medicine and Global Health, Oxford, UK
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18
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Fan J, Wang X, Du S, Mao A, Du H, Qiu W. Discussion of the Trust in Vaccination against COVID-19. Vaccines (Basel) 2022; 10:vaccines10081214. [PMID: 36016102 PMCID: PMC9416738 DOI: 10.3390/vaccines10081214] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 07/27/2022] [Accepted: 07/28/2022] [Indexed: 12/03/2022] Open
Abstract
The COVID-19 pandemic has introduced serious challenges to global public health security, and the benefits of vaccination via public health interventions have been recognized as significant. Vaccination is an effective means of preventing and controlling the spread of COVID-19. However, trust is a major factor that influences vaccine hesitancy; thus, the distrust of vaccination has hindered the popularization of COVID-19 vaccines. This paper aims to discuss the main problems and the role of trust in the vaccination against COVID-19 to effectively promote and implement policy to promote the acceptance of COVID-19 vaccines.
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19
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Hou Z, Guo J, Lai X, Zhang H, Wang J, Hu S, Du F, Francis MR, Fang H. Influenza vaccination hesitancy and its determinants among elderly in China: A national cross-sectional study. Vaccine 2022; 40:4806-4815. [PMID: 35788295 DOI: 10.1016/j.vaccine.2022.06.063] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 06/10/2022] [Accepted: 06/15/2022] [Indexed: 10/17/2022]
Abstract
BACKGROUND The Chinese elderly face a significant threat from seasonal influenza, owing to the consistently low vaccination coverage. This study investigated the prevalence and determinants of influenza vaccination hesitancy among the Chinese elderly. METHODS In 2019, 3849 elderly individuals from 10 provinces in China were recruited in a cross-sectional survey. Multinomial logistic regression was applied to investigate the determinants of influenza vaccination hesitancy. RESULTS Among the elderly respondents, 37.18% expressed some degree of hesitancy towards influenza vaccination: 19.28% were hesitant, and 17.90% refused influenza vaccination, including 19.28% acceptors with doubts and 17.90% refusers. Only 39.10% of the respondents considered themselves as the priority group for influenza vaccination, and 13.93% reported receiving a recommendation for vaccination from healthcare workers. Respondents with higher education levels and from urban areas had significantly higher odds of vaccine hesitancy than their counterparts. Confidence in the safety of vaccines was negatively associated with vaccine hesitancy, but confidence in vaccine efficacy had no such association. Respondents who perceived themselves as highly susceptible to influenza (AOR = 0.85; 95 %CI = 0.77-0.93) and those aware of the elderly as a priority group for influenza vaccination (AOR = 0.51; 95 %CI = 0.41-0.64) had a significantly lower odds of being refusers. CONCLUSION This study found a high prevalence of hesitancy towards influenza vaccination among the Chinese elderly, especially well-educated and urban-dwelling respondents. The government should address vaccine hesitancy through culturally appropriate communication, subsidies for vaccination, and actively promoting vaccines through primary care professionals.
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Affiliation(s)
- Zhiyuan Hou
- School of Public Health, NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China.
| | - Jia Guo
- School of Public Health, Peking University, Beijing 100083, China; China Center for Health Development Studies, Peking University, Beijing 100083, China.
| | - Xiaozhen Lai
- School of Public Health, Peking University, Beijing 100083, China; China Center for Health Development Studies, Peking University, Beijing 100083, China.
| | - Haijun Zhang
- School of Public Health, Peking University, Beijing 100083, China; China Center for Health Development Studies, Peking University, Beijing 100083, China.
| | - Jiahao Wang
- School of Public Health, Peking University, Beijing 100083, China; China Center for Health Development Studies, Peking University, Beijing 100083, China.
| | - Simeng Hu
- School of Public Health, NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China.
| | - Fanxing Du
- School of Public Health, NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China.
| | - Mark R Francis
- Health Sciences Unit, Faculty of Social Sciences, Tampere University, Finland.
| | - Hai Fang
- China Center for Health Development Studies, Peking University, Beijing 100083, China; Peking University Health Science Center-Chinese Center for Disease Control and Prevention Joint Center for Vaccine Economics, Beijing 100083, China; Key Laboratory of Reproductive Health National Health Commission of the People's Republic of China, Beijing 100083, China.
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20
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Predictors of COVID-19 vaccine acceptability among health professions students in Vietnam. BMC Public Health 2022; 22:854. [PMID: 35484522 PMCID: PMC9047623 DOI: 10.1186/s12889-022-13236-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 04/15/2022] [Indexed: 11/12/2022] Open
Abstract
Background The COVID-19 vaccine hesitancy or refusal has actually been a threat to global health. In the current situation, health professions students are at risk for SARS-CoV-2 infection during their internship at healthcare facilities. Furthermore, those future healthcare workers will advise people to accept the COVID-19 vaccination. Therefore, the attitude of students towards vaccine acceptance and the predicting factors needs to be elucidated. This study applied the Health Belief Model to determine predictors of COVID-19 vaccine acceptability among health professions students. Methods Nine hundred eleven students participated in a cross-sectional online survey in Vietnam. Data were collected from 1st April to 30th June 2021. Data analysis was performed using SPSS software version 20.0 with Chi-square and Kruskal-Wallis tests before executing multinomial logistic regression to identify predictors of the COVID-19 vaccine acceptability Results The overall vaccine acceptance, hesitancy, and refusal rates were 58% (95% CI: 54.7% - 61.3%), 40.4% (95% CI: 37.2% - 43.7%) and 1.5% (95% CI: 0.8% - 2.6%), respectively. Regarding vaccination hesitancy, a predictor such as "Receiving recent flu shots” had a negative correlation, whereas "Vaccines have little efficacy & serious adverse effects” (Perceived barriers), nationality, and majors were positive correlates. For refusal, "Unvaccinated students feasibly infected COVID-19 during hospital internship” (Perceived susceptibility) was a negative correlate. For predicting both hesitancy and refusal, "Mass media appreciating effectiveness and safety of vaccines" (Cues to action), and " Health professions students get serious complications of COVID-19 if not vaccinated" (Perceived severity) were negative predictors. In contrast, "Manufacturers do not disclose adverse effects of vaccines" (Cues to action), and "Adverse effect causes death" (Perceived barrier) were recognized as positive predictors. Strong Health Belief Model predictors of vaccine refusal were "Manufacturers do not disclose adverse effects of vaccines" (Cues to action) with OR= 5.299(95% CI: 1.687-16.641, p= 0.004), and "Adverse effect causes death" (Perceived barrier) with OR= 10.255 (95% CI = 3.528-29.814, p= 0.0005). Conclusion Health professions students' acceptability of COVID-19 vaccination might be based on the perceived susceptibility to and severity of COVID-19, concerns about vaccine efficacy and safety, and the influence levels of information from various sources. Health education and measures to prevent the harmful effects of COVID-19 vaccine misinformation could potentially improve the acceptance rate of the COVID-19 vaccine
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21
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Sun Y, Li B, Li N, Li B, Chen P, Hao F, Sun C. Acceptance of COVID-19 Vaccine Among High-Risk Occupations in a Port City of China and Multifaceted Strategies for Increasing Vaccination Coverage: A Cross-Sectional Study. Risk Manag Healthc Policy 2022; 15:643-655. [PMID: 35444478 PMCID: PMC9015101 DOI: 10.2147/rmhp.s352947] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 04/04/2022] [Indexed: 01/03/2023] Open
Abstract
Purpose Considering high risk of imported epidemic in port cities, it is necessary to estimate COVID-19 vaccine acceptability and to promote vaccination coverage of high-risk occupations. Methods A cross-sectional survey was carried out among the occupations in Yantai city, China, using an online questionnaire service platform. Targeted strategies were developed based on the survey results. In addition, periodic monitoring of the vaccination rate was provided in order to evaluate the effectiveness of the strategies. Results A total of 2231 (73.22%) of 3047 participants were willing to accept the vaccine, while 2.53% refused and 24.25% were not sure. Frontline port workers (133/152, 87.50%) and healthcare workers (999/1155, 86.49%) had higher intentions to accept, while public places and commercial service staff (584/1011, 57.76%) had the lowest. The reasons for refusal and hesitation were mainly "doubt of safety or effectiveness" (661/816, 81.00%) and "hearing previous news about vaccines" (455/816, 55.76%). Multilevel strategies such as adequate organizations, health education and promotion, and easy access to vaccination were promoted by local authorities in collaboration with schools, hospitals, enterprises and institutions. The study showed a significant increase in vaccination rate among these occupations after the implementation of these strategies (p<0.001), reaching 87.96%. Conclusion COVID-19 vaccine acceptability among high-risk occupations was unsatisfactory before the stage of emergency vaccination. An advanced understanding of vaccine attitudes and acceptance can aid in the development of focused immunization promotion programs. It is worth emphasizing that wide strategies with the strong support and enthusiastic cooperation of the government and the industry executive can contribute to increasing occupations' acceptance of the ongoing COVID-19 immunization project.
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Affiliation(s)
- Yuan Sun
- Department of Immunization Planning, Yantai Center for Disease Control and Prevention, Yantai City, Shandong Province, People’s Republic of China
| | - Bo Li
- Department of Immunization Planning, Yantai Center for Disease Control and Prevention, Yantai City, Shandong Province, People’s Republic of China
| | - Na Li
- Department of Immunization Planning, Yantai Center for Disease Control and Prevention, Yantai City, Shandong Province, People’s Republic of China
| | - Bingyang Li
- Department of Immunization Planning, Yantai Center for Disease Control and Prevention, Yantai City, Shandong Province, People’s Republic of China
| | - Peng Chen
- Department of Immunization Planning, Yantai Center for Disease Control and Prevention, Yantai City, Shandong Province, People’s Republic of China
| | - Feng Hao
- Department of Immunization Planning, Yantai Center for Disease Control and Prevention, Yantai City, Shandong Province, People’s Republic of China
| | - Cuiqun Sun
- Department of Immunization Planning, Yantai Center for Disease Control and Prevention, Yantai City, Shandong Province, People’s Republic of China
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22
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Liu X, Yu W, Yin Z, Rodewald L, Song Y, Zhang Z, Ye J, Li L, Cao L, Cao L. Vaccine events raising public concern and associated immunization program policy and practice changes, China, 2005-2021. Vaccine 2022; 40:2561-2567. [PMID: 35339307 DOI: 10.1016/j.vaccine.2022.03.035] [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: 01/03/2022] [Revised: 03/12/2022] [Accepted: 03/14/2022] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Several vaccine events causing public concern have occurred in China that were investigated and responded to by the central government. We describe causes, influences, and policy or practice changes associated with vaccine events that occurred between 2005 and 2021. We make recommendations to foster resilience in China's Expanded Program of Immunization (EPI) system and vaccination enterprises and to sustain vaccine and program confidence. METHODS Our study included all vaccine events since 2005 that were investigated and responded to by the central government of China. We verified mainstream and social media visibility of the events through Internet search. We extracted event times, causes, investigation processes, results, actions, and policy or practice regulation changes from official reports of government meetings and from official websites with media briefings. RESULTS Seven vaccine events were identified, each of which caused more than 100,000 mainstream or social media reports nationally or nationally and internationally. The events ranged in magnitude from 145 children receiving out-of-date oral poliovirus vaccine to a measles supplementary immunization activity involving 103 million children. Few, if any, children were directly harmed by vaccines in the events. Government responded to each event with program or policy changes, and in one case, with legislation. Responses affected the conduct of campaigns and supplementary immunization activities, use of schools as vaccination venues, financial incentives for vaccinating with non-program vaccines, vaccine procurement and distribution, and program policy making. The most fundamental response was enacting the country's first vaccine law, the 2019 Vaccine Administration Law, which guides virtually all aspects of vaccination work, from vaccine development through regulation, program implementation, and safety and impact monitoring. CONCLUSIONS All seven events generated substantial national and international mainstream and social media criticism and discussion, most commonly expressed through concerns of vaccine safety or vaccine effectiveness. Most had temporally associated temporary declines in vaccine confidence and coverage, jeopardizing decades of vaccination effort. The central government responded to each event by attempting to address root causes. Faithful implementation of the Vaccine Administration Law is fundamental to program strengthening and sustaining confidence of families, stakeholders, and government in vaccines and immunization in China.
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Affiliation(s)
- Xiaoxue Liu
- Jinan Center for Disease Control and Prevention, No.2 Weiliu Road, Huaiyin District, Jinan, Shandong 250021, China
| | - Wenzhou Yu
- Chinese Center for Disease Control and Prevention, No.27 Nanwei Road, Xicheng District, Beijing 100050, China.
| | - Zundong Yin
- Chinese Center for Disease Control and Prevention, No.27 Nanwei Road, Xicheng District, Beijing 100050, China
| | - Lance Rodewald
- Chinese Center for Disease Control and Prevention, No.27 Nanwei Road, Xicheng District, Beijing 100050, China
| | - Yifan Song
- Chinese Center for Disease Control and Prevention, No.27 Nanwei Road, Xicheng District, Beijing 100050, China
| | - Zhaonan Zhang
- Chinese Center for Disease Control and Prevention, No.27 Nanwei Road, Xicheng District, Beijing 100050, China
| | - Jiakai Ye
- Chinese Center for Disease Control and Prevention, No.27 Nanwei Road, Xicheng District, Beijing 100050, China
| | - Li Li
- Chinese Center for Disease Control and Prevention, No.27 Nanwei Road, Xicheng District, Beijing 100050, China
| | - Lei Cao
- Chinese Center for Disease Control and Prevention, No.27 Nanwei Road, Xicheng District, Beijing 100050, China
| | - Lingsheng Cao
- Chinese Center for Disease Control and Prevention, No.27 Nanwei Road, Xicheng District, Beijing 100050, China
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23
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Liu M, Cui T, Wang Q, Han Y, Han Y, Yang L, Shi N, Yi Y, Jin H. Using an extended protection motivation theory to explain vaccine hesitancy: a cross-sectional study among Chinese adults. Hum Vaccin Immunother 2022; 18:2026136. [PMID: 35103578 PMCID: PMC8993063 DOI: 10.1080/21645515.2022.2026136] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Background Vaccine hesitancy was listed as one of the top 10 issues threatening global health in 2019. The objectives of this study were to (a) use an extended protection motivation theory (PMT) with an added trust component to identify predictors of vaccine hesitancy and (b) explore the predictive ability of vaccine hesitancy on vaccination behavior. Methods We conducted an online questionnaire from February 9 to April 9, 2021, in China. The target population was Chinese residents aged 18 and over. A total of 14,236 responses were received. Structural equation modeling was used to test the extended PMT model hypotheses. Results A total of 10,379 participants were finally included in this study, of whom 52.0% showed hesitancy toward vaccination. 2854 (27.5%) participants reported that they got flu shots in the past year, and 2561 (24.7%) participants were vaccinated against COVID-19. 2857 (27.5%) participants engaged in healthcare occupation. The model explained 85.7% variance of vaccine hesitancy. Self-efficacy was the strongest predictor, negatively associated with vaccine hesitancy (β = −0.584; p < .001). Response efficacy had a negative effect on vaccine hesitancy (β = −0.372; p < .001), while threat appraisal showed a positive effect (β = 0.104; p < .001). Compared with non-health workers, health workers showed more vaccine hesitancy, and response efficacy was the strongest predictor (β = −0.560; p < .001). Vaccine hesitancy had a negative effect on vaccination behavior (β = −0.483; p < .001), and the model explained 23.4% variance of vaccination behavior. Conclusions This study demonstrates that the extended PMT model is efficient in explaining vaccine hesitancy. However, the predictive ability of vaccine hesitancy on vaccination behavior is limited.
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Affiliation(s)
- Minqi Liu
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education School of Public Health Southeast University Nanjing, PR China.,Department of Epidemiology and Health Statistics, School of Public Health, Southeast University Nanjing, PR China
| | - Tingting Cui
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education School of Public Health Southeast University Nanjing, PR China.,Department of Epidemiology and Health Statistics, School of Public Health, Southeast University Nanjing, PR China
| | - Qiang Wang
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education School of Public Health Southeast University Nanjing, PR China.,Department of Epidemiology and Health Statistics, School of Public Health, Southeast University Nanjing, PR China
| | - Ying Han
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education School of Public Health Southeast University Nanjing, PR China.,Department of Epidemiology and Health Statistics, School of Public Health, Southeast University Nanjing, PR China
| | - Yue Han
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education School of Public Health Southeast University Nanjing, PR China.,Department of Epidemiology and Health Statistics, School of Public Health, Southeast University Nanjing, PR China
| | - Liuqing Yang
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education School of Public Health Southeast University Nanjing, PR China.,Department of Epidemiology and Health Statistics, School of Public Health, Southeast University Nanjing, PR China
| | - Naiyang Shi
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education School of Public Health Southeast University Nanjing, PR China.,Department of Epidemiology and Health Statistics, School of Public Health, Southeast University Nanjing, PR China
| | - Youqin Yi
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education School of Public Health Southeast University Nanjing, PR China.,Department of Epidemiology and Health Statistics, School of Public Health, Southeast University Nanjing, PR China
| | - Hui Jin
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education School of Public Health Southeast University Nanjing, PR China.,Department of Epidemiology and Health Statistics, School of Public Health, Southeast University Nanjing, PR China
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24
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Zhou F, Zhang W, Cai H, Cao Y. Portrayals of 2v, 4v and 9vHPV vaccines on Chinese social media: a content analysis of hot posts on Sina Weibo. Hum Vaccin Immunother 2021; 17:4433-4441. [PMID: 34543155 DOI: 10.1080/21645515.2021.1971016] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Rather than receive the effective 2vHPV vaccines that are readily available in China, Chinese women usually wait to receive 4v and 9vHPV vaccines, which are difficult to acquire. This means that Chinese women miss the opportunity for optimal protection from cervical cancer. As social media platforms are the main channel by which Chinese women learn about HPV vaccines, this study aimed to explore how HPV vaccines are described on social media, and in particular how they discuss or distinguish 2 v, 4 v and 9vHPV vaccines. The Octopus Web crawler tool was used to capture hot Weibo posts from 2013-2021, and 1,164 valid data were obtained. Results suggested that there are very few posts with great influence on Weibo about HPV vaccines among 9 years and much of them are created by "lay people." HPV-related topics lacked persistent popularity, comprised highly repetitive content and the spread of information was geographically diverse. There were significant differences in the media descriptions of different kinds of HPV vaccines. Price was mentioned more often in the descriptions of 2vHPV vaccines, whereas appointments were referred to most often in the descriptions of 9vHPV vaccines. There was little media attention paid to the safety and effectiveness of HPV vaccines. Chinese media should develop better collaborations with public health professionals, pay more attention to the originality of their news coverage of HPV vaccines and strive to promote HPV vaccination. Such collaboration will help news media to better understand the key points of HPV information that need to be disseminated.
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Affiliation(s)
- Fangzhou Zhou
- School of Journalism and Culture Communication, Zhongnan University of Economics and Law, Wuhan, PR China
| | - Wen Zhang
- School of Journalism and Culture Communication, Zhongnan University of Economics and Law, Wuhan, PR China
| | - Hongning Cai
- Department of Gynecological Oncology, Hubei Maternal and Child Health Care Hospital, Wuhan, PR China
| | - Yuan Cao
- Analytical and Testing Center, Wuhan University of Science and Technology, Wuhan, PR China
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25
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AlShurman BA, Khan AF, Mac C, Majeed M, Butt ZA. What Demographic, Social, and Contextual Factors Influence the Intention to Use COVID-19 Vaccines: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:9342. [PMID: 34501932 PMCID: PMC8431323 DOI: 10.3390/ijerph18179342] [Citation(s) in RCA: 73] [Impact Index Per Article: 24.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 08/21/2021] [Accepted: 08/31/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND During the COVID-19 crisis, an apparent growth in vaccine hesitancy has been noticed due to different factors and reasons. Therefore, this scoping review was performed to determine the prevalence of intention to use COVID-19 vaccines among adults aged 18-60, and to identify the demographic, social, and contextual factors that influence the intention to use COVID-19 vaccines. METHODS This scoping review was conducted by using the methodological framework for scoping review outlined by Arksey and O'Malley. A search strategy was carried out on four electronic databases: PubMed, Scopus, CINAHL, and PsycINFO. All peer-reviewed articles published between November 2019 and December 2020 were reviewed. Data were extracted to identify the prevalence of, and factors that influence, the intention to use COVID-19 vaccines. RESULTS A total of 48 relevant articles were identified for inclusion in the review. Outcomes presented fell into seven themes: demographics, social factors, vaccination beliefs and attitudes, vaccine-related perceptions, health-related perceptions, perceived barriers, and vaccine recommendations. Age, gender, education level, race/ethnicity, vaccine safety and effectiveness, influenza vaccination history, and self-protection from COVID-19 were the most prominent factors associated with intention to use COVID-19 vaccines. Furthermore, the majority of studies (n = 34/48) reported a relatively high prevalence of intention to get vaccinated against COVID-19, with a range from 60% to 93%. CONCLUSION This scoping review enables the creation of demographic, social, and contextual constructs associated with intention to vaccinate among the adult population. These factors are likely to play a major role in any targeted vaccination programs, particularly COVID-19 vaccination. Thus, our review suggests focusing on the development of strategies to promote the intention to get vaccinated against COVID-19 and to overcome vaccine hesitancy and refusal. These strategies could include transparent communication, social media engagement, and the initiation of education programs.
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Affiliation(s)
- Bara’ Abdallah AlShurman
- School of Public Health Sciences, University of Waterloo, Waterloo, ON N2L 3G1, Canada; (B.A.A.); (A.F.K.); (C.M.)
| | - Amber Fozia Khan
- School of Public Health Sciences, University of Waterloo, Waterloo, ON N2L 3G1, Canada; (B.A.A.); (A.F.K.); (C.M.)
| | - Christina Mac
- School of Public Health Sciences, University of Waterloo, Waterloo, ON N2L 3G1, Canada; (B.A.A.); (A.F.K.); (C.M.)
| | - Meerab Majeed
- Faculty of Health Sciences, McMaster University, Hamilton, ON L8N 3Z5, Canada;
| | - Zahid Ahmad Butt
- School of Public Health Sciences, University of Waterloo, Waterloo, ON N2L 3G1, Canada; (B.A.A.); (A.F.K.); (C.M.)
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26
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McDonald T. Lethal ageism in the shadow of pandemic response tactics. Int Nurs Rev 2021; 69:249-254. [PMID: 34292599 PMCID: PMC8447079 DOI: 10.1111/inr.12700] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 06/23/2021] [Accepted: 06/25/2021] [Indexed: 01/02/2023]
Abstract
Aim This paper examines aspects of pandemic policy responses to the COVID‐19 and SARS‐CoV‐2 variants and presents an integrated view of the consequences of response tactics at national and health service levels for older adults. Background Nurses are positioned at the intersection of health service and policy implementation; therefore, their influence on clinical protocols and health policy directions post pandemic is crucial to preventing further premature deaths in the 65+ years age group and others. Sources of evidence Perspectives presented here are based on a critical evaluation of the many published reports, comments, research and insights concerning the pandemic. That evidence, combined with my experience in various fields of study and professional service, enables me to envisage what some decisions and policies may mean for older people, nurses and societies worldwide. Discussion Established information on world population patterns and the location and health of national groups has been made less reliable by population shifts caused by years of geo‐political conflicts and now the impact of the pandemic. Added to this already chaotic context, the pandemic has further disrupted societies, health services and economies. Ageist responses by these systems have further disadvantaged older people and generated trust deficits that need to be resolved. Conclusion When the pandemic recedes, policy and management decisions taken by governments and hospital administrators will be a telling indicator of whether the established systematic ageism exposed during the pandemic will continue to compromise the health and longevity of older adults. Implications for nursing, health and social policy The ascendency of nursing influence within the health and social policy environment must be further strengthened to enable nurses to champion equity and fairness in the pandemic recovery effort.
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Affiliation(s)
- Tracey McDonald
- Associate Editor, International Nursing Review, Official Journal of International Council of Nurses, Geneva, Switzerland
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27
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Sun R, Wang X, Lin L, Zhang N, Li L, Zhou X. The impact of negative emotional reactions on parental vaccine hesitancy after the 2018 vaccine event in China: A cross-sectional survey. Hum Vaccin Immunother 2021; 17:3042-3051. [PMID: 33950775 DOI: 10.1080/21645515.2021.1907149] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Vaccination programs are cost-effective for preventing communicable diseases, yet vaccine events caused vaccine crises among parents nationwide, which has created challenges for current and future vaccination programs. This study aimed to investigate parents' emotional reactions (i.e., anger and anxiety) toward the 2018 vaccine event in China and explore the associations between parental emotional reactions and vaccine decision-making. A cross-sectional survey was conducted among 1,135 parents in 2018. Five-point Likert scales were provided for respondents to rank their anger and anxiety toward the event, and their vaccine-related trust and intentions before and after the event. Multiple logistic regression analyses were employed to explore the associations. Regarding the vaccine event, 576 (50.8%) and 402 (35.4%) respondents felt very angry and angry, and 310 (27.4%) and 516 (45.5%) respondents felt very anxious and anxious, respectively. Altogether, 797 (70.3%) respondents reported a lower trust in domestically produced vaccines after the event, and 704 (62.3%) respondents reported declines in intention to choose domestically produced vaccines for their children. Multiple logistic regression analyses revealed that anxiety was a predictor of lower trust and intention after the event (p < .001), anger was a predictor of lower trust (p = .005), and both were risk factors for declines in trust and intention (p < .01). This study confirmed that negative emotional reactions toward a vaccine event were important contributors for parental vaccine decisions. Health authorities and facilities are encouraged to act in a timely manner to reduce the public's negative emotions by providing rapid crisis responses.
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Affiliation(s)
- Ruyu Sun
- Institute of Social Medicine, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, P.R. China
| | - Xiaomin Wang
- Institute of Social Medicine, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, P.R. China
| | - Leesa Lin
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | - Ning Zhang
- Institute of Social Medicine, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, P.R. China
| | - Lu Li
- Institute of Social Medicine, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, P.R. China
| | - Xudong Zhou
- Institute of Social Medicine, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, P.R. China
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28
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Zhou M, Zhan J, Kong N, Campy KS, Chen Y. Factors associated with intention to uptake pneumococcal vaccines among Chinese elderly aged 60 years and older during the early stage of COVID-19 pandemic. PSYCHOL HEALTH MED 2021; 27:91-105. [PMID: 33769153 DOI: 10.1080/13548506.2021.1905862] [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: 10/21/2022]
Abstract
Innoculation of pneumococcal vaccines among the elderly is an effective public health policy to prevent pneumococcal diseases and it is widely promoted by many developed countries. The pneumococcal vaccination rate among the elderly in China was only 3.7% in 2019, it grew rapidly during the early stage of the COVID-19 pandemic. The purpose of this cross-sectional study was to investigate the psychological and demographic-economic factors related to the uptake behavior of pneumococcal vaccination among the Chinese elderly by using an integrated model based on the unified theory of acceptance and use of technology (UTAUT), and knowledge, attitudes and practices (KAP). The theoretical model was tested via structural equation modeling (SEM) with data collected from 516 Chinese older adults aged 60 years and older. Our results suggested that knowledge, performance expectancy, effort expectancy, attitude, and trust had a significant correlation with behavioral intention; behavioral intention and trust had a positive correlation with the uptake behavior, gender, and and education level and chronic obstructive pulmonary disease exerted significant moderating effects. To increase the coverage of pneumococcal vaccination among the elderly, it is necessary to provide effective health education by authoritative experts, thereby enhancing their knowledge and positive attitude towardthe vaccination.
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Affiliation(s)
- Min Zhou
- International Business School, Hunan University of Technology and Business, Changsha, China.,Weldon School of Biomedical Engineering, Purdue University, West Lafayette, Indiana, USA
| | - Jiaying Zhan
- School of Accounting, Hunan University of Technology and Business, Changsha, China
| | - Nan Kong
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, Indiana, USA
| | - Kathryn S Campy
- Center for Public Health Initiatives, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Yan Chen
- International Business School, Hunan University of Technology and Business, Changsha, China
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29
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Gao J, Tang F, Wang Z, Yu J, Hu R, Liu L, Kang G. Post-marketing safety surveillance for inactivated Enterovirus 71 vaccines in Jiangsu, China from 2017 to 2019. Vaccine 2021; 39:1415-1419. [PMID: 33541795 DOI: 10.1016/j.vaccine.2021.01.048] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 01/05/2021] [Accepted: 01/16/2021] [Indexed: 02/03/2023]
Abstract
INTRODUCTION Two types of enterovirus 71 (EV71) vaccines, manufactured using human diploid (H2) and Vero cells, have been administered in Jiangsu Province, China since 2017. In this study, we evaluated their safety profiles using records collected from the Chinese National Adverse Events Following Immunization (AEFIs) Information System (CNAEFIS) and Electronic Immunization Registries System (EIRS) between 2017 and 2019. METHODS Demographic characteristics of the patients, AEFI incidence rates(IRs), symptoms, and time intervals were summarized from the reported AEFI data in the CNAEFIS. Also, the administered doses of the two vaccines were exported from the EIRS to calculate the IRs of AEFIs and thus compare the AEFIs between the two types of EV71 vaccines. RESULTS In total, 209, 407, and 344 AEFIs cases following EV71 vaccine administration were reported during 2017, 2018, and 2019, respectively, yielding IRs of 59.2, 48.2, and 54.2 per 100,000 doses, respectively. Fever, irritability, allergic eruptions, fatigue, loss of appetite, redness and induration at the injection site were the most commonly reported AEFIs. No significant differences in rare reactions were found between the two types of EV71 vaccinations. The majority of AEFIs were developed within 30 min to 3 days after administration. CONCLUSION EV71 vaccines showed satisfactory safety profiles since their first use 3 years ago in the Jiangsu Province. The AEFI profiles were identical to those in pre-marketing studies; most AEFIs after vaccination were mild and common. More active surveillance studies should be performed to provide more comprehensive post-marketing safety data.
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Affiliation(s)
- Jun Gao
- Jiangsu Provincial Centre of Disease Control and Prevention, Jiangsu Province, China
| | - Fenyang Tang
- Jiangsu Provincial Centre of Disease Control and Prevention, Jiangsu Province, China
| | - Zhiguo Wang
- Jiangsu Provincial Centre of Disease Control and Prevention, Jiangsu Province, China
| | - Jing Yu
- Jiangsu Provincial Centre of Disease Control and Prevention, Jiangsu Province, China
| | - Ran Hu
- Jiangsu Provincial Centre of Disease Control and Prevention, Jiangsu Province, China
| | - Li Liu
- Jiangsu Provincial Centre of Disease Control and Prevention, Jiangsu Province, China
| | - Guodong Kang
- Jiangsu Provincial Centre of Disease Control and Prevention, Jiangsu Province, China.
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30
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Dong D, Xu RH, Wong EL, Hung C, Feng D, Feng Z, Yeoh E, Wong SY. Public preference for COVID-19 vaccines in China: A discrete choice experiment. Health Expect 2020; 23:1543-1578. [PMID: 33022806 PMCID: PMC7752198 DOI: 10.1111/hex.13140] [Citation(s) in RCA: 95] [Impact Index Per Article: 23.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 09/02/2020] [Accepted: 09/06/2020] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND As the coronavirus disease 2019 (COVID-19) pandemic is sweeping across the globe, there is an urgent need to develop effective vaccines as the most powerful strategy to end the pandemic. This study aimed to examine how factors related to vaccine characteristics, their social normative influence and convenience of vaccination can affect the public's preference for the uptake of the COVID-19 vaccine in China. METHODS An online discrete choice experiment (DCE) survey was administered to a sample of China's general population. Participants were asked to make a series of hypothetical choices and estimate their preference for different attributes of the vaccine. A mixed logit regression model was used to analyse the DCE data. Willingness to pay for each attribute was also calculated. RESULTS Data of 1236 participants who provided valid responses were included in the analysis. There was strong public preference for high effectiveness of the vaccine, followed by long protective duration, very few adverse events and being manufactured overseas. Price was the least important attribute affecting the public preference in selecting the COVID-19 vaccine. CONCLUSIONS The strong public preferences detected in this study should be considered when developing COVID-19 vaccination programme in China. The results provide useful information for policymakers to identify the individual and social values for a good vaccination strategy. PATIENT OR PUBLIC CONTRIBUTION The design of the experimental choices was fully based on interviews and focus group discussions participated by 26 Chinese people with diverse socio-economic backgrounds. Without their participation, the study would not be possible.
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Affiliation(s)
- Dong Dong
- The Jockey Club School of Public Health & Primary CareFaculty of MedicineThe Chinese University of Hong KongHong Kong SARChina
- Centre for Health Systems and Policy ResearchThe Chinese University of Hong KongHong Kong SARChina
| | - Richard Huan Xu
- The Jockey Club School of Public Health & Primary CareFaculty of MedicineThe Chinese University of Hong KongHong Kong SARChina
- Centre for Health Systems and Policy ResearchThe Chinese University of Hong KongHong Kong SARChina
| | - Eliza Lai‐yi Wong
- The Jockey Club School of Public Health & Primary CareFaculty of MedicineThe Chinese University of Hong KongHong Kong SARChina
- Centre for Health Systems and Policy ResearchThe Chinese University of Hong KongHong Kong SARChina
| | - Chi‐Tim Hung
- The Jockey Club School of Public Health & Primary CareFaculty of MedicineThe Chinese University of Hong KongHong Kong SARChina
- Centre for Health Systems and Policy ResearchThe Chinese University of Hong KongHong Kong SARChina
| | - Da Feng
- School of PharmacyTongji Medical CollegeHuazhong University of Science & TechnologyWuhanChina
| | - Zhanchun Feng
- School of Medicine and Health ManagementTongji Medical CollegeHuazhong University of Science & TechnologyWuhanChina
| | - Eng‐kiong Yeoh
- The Jockey Club School of Public Health & Primary CareFaculty of MedicineThe Chinese University of Hong KongHong Kong SARChina
- Centre for Health Systems and Policy ResearchThe Chinese University of Hong KongHong Kong SARChina
| | - Samuel Yeung‐shan Wong
- The Jockey Club School of Public Health & Primary CareFaculty of MedicineThe Chinese University of Hong KongHong Kong SARChina
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31
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Characterizing News Report of the Substandard Vaccine Case of Changchun Changsheng in China: A Text Mining Approach. Vaccines (Basel) 2020; 8:vaccines8040691. [PMID: 33212869 PMCID: PMC7711875 DOI: 10.3390/vaccines8040691] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Revised: 11/14/2020] [Accepted: 11/15/2020] [Indexed: 01/19/2023] Open
Abstract
Background: The substandard vaccine case of that broke out in July 2018 in China triggered an outburst of news reports both domestically and aboard. Distilling the abundant textual information is helpful for a better understanding of the character during this public event. Methods: We collected the texts of 2211 news reports from 83 mainstream media outlets in China between 15 July and 25 August 2018, and used a structural topic model (STM) to identify the major topics and features that emerged. We also used dictionary-based sentiment analysis to uncover the sentiments expressed by the topics as well as their temporal variations. Results: The main topics of the news report fell into six major categories, including: (1) Media Investigation, (2) Response from the Top Authority, (3) Government Action, (4) Knowledge Dissemination, (5) Finance Related and (6) Commentary. The topic prevalence shifted during different stages of the events, illustrating the actions by the government. Sentiments generally spanned from negative to positive, but varied according to different topics. Conclusion: The characteristics of news reports on vaccines are shaped by various topics at different stages. The inner dynamics of the topic and its alterations are driven by the interaction between social sentiment and governmental intervention.
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Wang Q, Zhang W, Cai H, Cao Y. Understanding the perceptions of Chinese women of the commercially available domestic and imported HPV vaccine: A semantic network analysis. Vaccine 2020; 38:8334-8342. [PMID: 33190947 DOI: 10.1016/j.vaccine.2020.11.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 10/08/2020] [Accepted: 11/03/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND A domestic human papillomavirus (HPV) vaccine, Cecolin, that protects against HPV strains 16 and 18 was introduced to the Chinese market at a relatively low price in May 2020.This study has explored Chinese women's perceptions of both domestic and imported HPV vaccines, which differ in price and valency. METHODS Sentiment analysis and semantic network analyses were performed based on a sample of 45,729 domestic HPV vaccine-related posts from females on the Sina Weibo between April 17 and May 2, 2020. The geographic distribution was also analyzed based on the users' locations, which were retrieved from the database. RESULTS Most of the posts were positive and neutral (85%), although 15% were negative (e.g., expressions of anger, sadness, fear and disgust). Semantic analyses of the negative posts revealed that Chinese women generally had positive attitudes towards the HPV vaccine and were willing to be vaccinated. However, obvious geographical variations were identified. Women who lived in economically developed areas expressed a stronger desire to obtain imported quadrivalent or nonavalent vaccines due to concerns regarding effectiveness and quality. The women expressed disgust and anger mainly regarding difficulties in making an appointment, age restrictions for the nonavalent vaccine and gender restrictions. However, the population targeted by the domestic vaccine, namely women who lived in economically undeveloped areas and had relatively low incomes, had a low awareness of the HPV vaccine. CONCLUSION Government should provide programs, which educate females that bivalent HPV vaccine can offer protection against the majority of high-risk HPV types. Increasing awareness of the domestic vaccine among the population in economically undeveloped areas and provision of free domestic bivalent HPV vaccination/screening for low-income high-risk women would help to prevent cervical carcinoma. This issue also depends on rebuilding trust and repairing damage to the relationship between government/domestic vaccine manufacturers and the public.
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Affiliation(s)
- Qi Wang
- School of Industrial Design, Hubei University of Technology, 28 Nanli Road, Wuhan 430068, PR China
| | - Wen Zhang
- School of Journalism and Culture Communication, Zhongnan University of Economics and Law, 182 Nanhu Avenue, Wuhan 430073, PR China.
| | - Hongning Cai
- Department of Gynecological Oncology, Hubei Maternal and Child Health Care Hospital, Wuhan 430070, Hubei, PR China
| | - Yuan Cao
- Cloud-clone Diagnostic Reagents Institute, Wuhan 430056, Hubei, PR China
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Yang R, Penders B, Horstman K. Vaccine Hesitancy in China: A Qualitative Study of Stakeholders' Perspectives. Vaccines (Basel) 2020; 8:vaccines8040650. [PMID: 33153098 PMCID: PMC7711886 DOI: 10.3390/vaccines8040650] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 09/25/2020] [Accepted: 10/27/2020] [Indexed: 12/03/2022] Open
Abstract
A series of vaccine incidents have stimulated vaccine hesitance in China over the last decade. Many scholars have studied the institutional management of these incidents, but a qualitative study of stakeholders’ perspectives on vaccine hesitancy in China is missing. To address this lacuna, we conducted in-depth interviews and collected online data to explore diverse stakeholders’ narratives on vaccine hesitance. Our analysis shows the different perspectives of medical experts, journalists, parents, and self-defined vaccination victims on vaccination and vaccination hesitance. Medical experts generally consider vaccines, despite some flaws, as safe, and they consider most vaccine safety incidents to be related to coupling symptoms, not to vaccinations. Some parents agree with medical experts, but most do not trust vaccine safety and do not want to put their children at risk. Media professionals, online medical experts, and doctors who do not need to align with the political goal of maintaining a high vaccination rate are less positive about vaccination and consider vaccine hesitance a failure of expert–lay communication in China. Our analysis exhibits the tensions of medical expert and lay perspectives on vaccine hesitance, and suggests that vaccination experts ‘see like a state’, which is a finding consistent with other studies that have identified the over-politicization of expert–lay communication in Chinese public discourse. Chinese parents need space to express their concerns so that vaccination programs can attune to them.
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Du F, Chantler T, Francis MR, Sun FY, Zhang X, Han K, Rodewald L, Yu H, Tu S, Larson H, Hou Z. The determinants of vaccine hesitancy in China: A cross-sectional study following the Changchun Changsheng vaccine incident. Vaccine 2020; 38:7464-7471. [DOI: 10.1016/j.vaccine.2020.09.075] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 09/16/2020] [Accepted: 09/25/2020] [Indexed: 01/01/2023]
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Pogue K, Jensen JL, Stancil CK, Ferguson DG, Hughes SJ, Mello EJ, Burgess R, Berges BK, Quaye A, Poole BD. Influences on Attitudes Regarding Potential COVID-19 Vaccination in the United States. Vaccines (Basel) 2020; 8:E582. [PMID: 33022917 PMCID: PMC7711655 DOI: 10.3390/vaccines8040582] [Citation(s) in RCA: 292] [Impact Index Per Article: 73.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Revised: 09/28/2020] [Accepted: 09/28/2020] [Indexed: 01/01/2023] Open
Abstract
The COVID-19 pandemic continues to ravage the world, with the United States being highly affected. A vaccine provides the best hope for a permanent solution to controlling the pandemic. However, to be effective, a vaccine must be accepted and used by a large majority of the population. The aim of this study was to understand the attitudes towards and obstacles facing vaccination with a potential COVID-19 vaccine. To measure these attitudes a survey was administered to 316 respondents across the United States by a survey corporation. Structural equation modeling was used to analyze the relationships of several factors with attitudes toward potential COVID-19 vaccination. Prior vaccine usage and attitudes predicted attitudes towards COVID-19 vaccination. Assessment of the severity of COVID-19 for the United States was also predictive. Approximately 68% of all respondents were supportive of being vaccinated for COVID-19, but side effects, efficacy and length of testing remained concerns. Longer testing, increased efficacy and development in the United States were significantly associated with increased vaccine acceptance. Messages promoting COVID-19 vaccination should seek to alleviate the concerns of those who are already vaccine-hesitant. Messaging directed at the benefits of vaccination for the United States as a country would address the second predictive factor. Enough time should be taken to allay concerns about both short- and long-term side effects before a vaccine is released.
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Affiliation(s)
- Kendall Pogue
- Department of Microbiology and Molecular Biology, Brigham Young University, Provo, UT 84602, USA; (K.P.); (C.K.S.); (S.J.H.); (E.J.M.); (R.B.); (B.K.B.); (A.Q.)
| | - Jamie L. Jensen
- Department of Biology, Brigham Young University, Provo, UT 84602, USA; (J.L.J.); (D.G.F.)
| | - Carter K. Stancil
- Department of Microbiology and Molecular Biology, Brigham Young University, Provo, UT 84602, USA; (K.P.); (C.K.S.); (S.J.H.); (E.J.M.); (R.B.); (B.K.B.); (A.Q.)
| | - Daniel G. Ferguson
- Department of Biology, Brigham Young University, Provo, UT 84602, USA; (J.L.J.); (D.G.F.)
| | - Savannah J. Hughes
- Department of Microbiology and Molecular Biology, Brigham Young University, Provo, UT 84602, USA; (K.P.); (C.K.S.); (S.J.H.); (E.J.M.); (R.B.); (B.K.B.); (A.Q.)
| | - Emily J. Mello
- Department of Microbiology and Molecular Biology, Brigham Young University, Provo, UT 84602, USA; (K.P.); (C.K.S.); (S.J.H.); (E.J.M.); (R.B.); (B.K.B.); (A.Q.)
| | - Ryan Burgess
- Department of Microbiology and Molecular Biology, Brigham Young University, Provo, UT 84602, USA; (K.P.); (C.K.S.); (S.J.H.); (E.J.M.); (R.B.); (B.K.B.); (A.Q.)
| | - Bradford K. Berges
- Department of Microbiology and Molecular Biology, Brigham Young University, Provo, UT 84602, USA; (K.P.); (C.K.S.); (S.J.H.); (E.J.M.); (R.B.); (B.K.B.); (A.Q.)
| | - Abraham Quaye
- Department of Microbiology and Molecular Biology, Brigham Young University, Provo, UT 84602, USA; (K.P.); (C.K.S.); (S.J.H.); (E.J.M.); (R.B.); (B.K.B.); (A.Q.)
| | - Brian D. Poole
- Department of Microbiology and Molecular Biology, Brigham Young University, Provo, UT 84602, USA; (K.P.); (C.K.S.); (S.J.H.); (E.J.M.); (R.B.); (B.K.B.); (A.Q.)
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Changes in parents’ decisions pertaining to vaccination of their children after the Changchun Changsheng vaccine scandal in Guangzhou, China. Vaccine 2020; 38:6751-6756. [DOI: 10.1016/j.vaccine.2020.08.039] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 07/24/2020] [Accepted: 08/16/2020] [Indexed: 11/19/2022]
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Yang F, Jiang Y. Heterogeneous Influences of Social Support on Physical and Mental Health: Evidence from China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E6838. [PMID: 32962140 PMCID: PMC7558190 DOI: 10.3390/ijerph17186838] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 09/15/2020] [Accepted: 09/16/2020] [Indexed: 01/19/2023]
Abstract
Employing a national representative survey (the China Labor-force Dynamics Survey 2016, CLDS2016) data (N = 14246), this paper examines the heterogeneous influences of social support on individual physical and mental health in China. Social support is characterized by four dimensions: emotional support, tangible or instrumental support, interaction or exchange support, and community support. Physical health is measured by self-rated health and body mass index (BMI), while mental health is measured by depression, hopelessness, failure, fear, loneliness, and meaninglessness. The results indicate that different dimensions of social support have heterogeneous effects on individual physical and mental health. Specifically, the correlation between emotional support and individual physical health is not significant, but emotional support is significantly related to some mental health variables. Tangible or instrumental support is significantly related to individual self-rated physical health but not to BMI or mental health. Interaction or exchange support is significantly correlated with individual self-rated health and some mental health variables. In general, there are significant correlations between community support, and individual physical and mental health. The results also suggest that the influences of social support on physical and mental health of individuals at different ages (<60 years and ≥60 years) are heterogeneous. The results of this study provide direction for the dimension selection of social support to promote individual health.
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Affiliation(s)
- Fan Yang
- Department of Labor and Social Security, School of Public Administration, Sichuan University, Chengdu 610065, China
| | - Yao Jiang
- Department of Accounting, School of Management, Sichuan Agricultural University, Chengdu 611130, China;
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Tu S, Sun FY, Chantler T, Zhang X, Jit M, Han K, Rodewald L, Du F, Yu H, Hou Z, Larson H. Caregiver and service provider vaccine confidence following the Changchun Changsheng vaccine incident in China: A cross-sectional mixed methods study. Vaccine 2020; 38:6882-6888. [PMID: 32912643 PMCID: PMC7476908 DOI: 10.1016/j.vaccine.2020.08.063] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 08/23/2020] [Accepted: 08/25/2020] [Indexed: 01/04/2023]
Abstract
INTRODUCTION The Changchun Changsheng Vaccine Incident (CCVI) occurred mid-2018 and involved irregularities in the manufacture and quality control of diphtheria-tetanus-acellular-pertussis and rabies vaccines. This study investigates vaccine confidence amongst Chinese caregivers and vaccination-service providers (VSPs) six months after the CCVI. METHODS Quantitative surveys were conducted in January 2019 with 2124 caregivers of children and 555 VSPs in three areas in China. The proportions of respondents who agreed to the four statements from the Vaccine Confidence Index™ were used to measure vaccine confidence. Descriptive and univariate analyses were performed to study the level of vaccine confidence. Semi-structured interviews were conducted with 48 caregivers, 43 VSPs and 9 immunization program managers. Interviews were analyzed thematically using a combination of deductive and inductive coding. Media surveillance was conducted to monitor public responses to the CCVI. RESULTS Media surveillance indicated that public attention to vaccine-related issues increased sharply immediately post-CCVI but declined rapidly thereafter. Six months post-CCVI, 96.0% of caregivers and the same proportion of VSPs reported that vaccination was important and compatible with their religious beliefs. 82.7% and 88.2% of caregivers agreed that vaccines were safe and effective. 92.8% and 94.6% of VSPs agreed that vaccines were safe and effective. Both caregivers and VSPs reported an immediate decline in vaccine confidence post-CCVI. In most cases this trust was regained over time following government and public health responses, however some people remained hesitant about vaccinating their children. Many VSPs were overwhelmed by consultations, workload and psychological pressure after the CCVI. CONCLUSION After an initial decline, vaccine confidence recovered to pre-incident levels six months after the CCVI. However, some caregivers moved from the higher to the lower end of the vaccine confidence spectrum, pointing to the need to promote the acceptance of vaccination especially given the need for new vaccines to control the coronavirus epidemic.
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Affiliation(s)
- Shiyi Tu
- School of Public Health, NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China
| | - Fiona Yueqian Sun
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Tracey Chantler
- Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Xuan Zhang
- Chinese Center for Disease Control and Prevention, Beijing, China
| | - Mark Jit
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Kaiyi Han
- School of Public Health, NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China; Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Lance Rodewald
- Chinese Center for Disease Control and Prevention, Beijing, China
| | - Fanxing Du
- School of Public Health, NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China
| | - Hongjie Yu
- School of Public Health, NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China; Key Laboratory of Public Health Safety (Ministry of Education), Fudan University, Shanghai, China
| | - Zhiyuan Hou
- School of Public Health, NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China.
| | - Heidi Larson
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, United Kingdom
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Zhao M, Liu H, Qu S, He L, Campy KS. Factors associated with parental acceptance of influenza vaccination for their children: the evidence from four cities of China. Hum Vaccin Immunother 2020; 17:457-464. [PMID: 32614707 DOI: 10.1080/21645515.2020.1771988] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND It is necessary and urgent to vaccinate 245 million Chinese children against influenza pandemics. The main purpose of this study was to evaluate different psychological and demographic factors that influence parental willingness to vaccinate their children against influenza. METHODS A hybrid theoretical framework was expanded and verified with 462 sample data collected from four cities in China. Structural equation models were used to test nine theoretical hypotheses, and the non-standardized coefficient method was used to discuss the moderating effects among demographic variables. RESULTS Knowledge is considered to be the significant factor of performance expectancy (β = 0.228), effort expectancy (β = 0.227) and perceived risk (β = -0.138), and social influence also has the significant impacts on the above three variables, with β values of 0.437, 0.386, and -0.172. Performance expectancy (β = 0.402), effort expectancy (β = 0.343), and perceived risk (β = -0.244) thus significantly affect parental behavioral intention regarding children's influenza vaccination. Gender, education, and kids' gender are demographic variables with significant moderating effects, while age, income, number of kids are not significant. CONCLUSION To improve the acceptability of influenza vaccination among Chinese children, the promoting policies should emphasize on public knowledge and social influence, as well as effectiveness, affordability, and safety of vaccination.
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Affiliation(s)
- Mingyi Zhao
- Department of Pediatrics, Third Xiangya Hospital, Central South University , Changsha, China
| | - Haiyan Liu
- Department of Pediatrics, Third Xiangya Hospital, Central South University , Changsha, China
| | - Shujuan Qu
- Department of Pediatrics, Third Xiangya Hospital, Central South University , Changsha, China
| | - Li He
- Department of Pediatrics, Third Xiangya Hospital, Central South University , Changsha, China
| | - Kathryn S Campy
- Center for Public Health Initiatives, University of Pennsylvania , Philadelphia, PA, USA
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Game Analysis on the Evolution of Decision-Making of Vaccine Manufacturing Enterprises under the Government Regulation Model. Vaccines (Basel) 2020; 8:vaccines8020267. [PMID: 32486520 PMCID: PMC7378765 DOI: 10.3390/vaccines8020267] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 05/15/2020] [Accepted: 05/27/2020] [Indexed: 01/14/2023] Open
Abstract
The harm caused by defective vaccines to human health and social stability is immeasurable. Aiming at the government’s supervision of the vaccine market, an evolutionary game model is constructed to analyze the quality of supervision and the key factors in the dynamic interaction between government departments and vaccine manufacturers under different supervision modes in the vaccine manufacturing process. The results show that: (1) Severe punishment by government regulatory authorities, and increased costs of rectification after investigation and handling of involuntary behaviors of vaccine enterprises can effectively prevent involuntary behaviors of vaccine enterprises. (2) In the early stage of the game, the success rate of the government’s efficient supervision will make the vaccine enterprises continuously self-disciplined; when the vaccine market is relatively stable, the government’s supervision departments tend to be more conducive to passive supervision. (3) The success rate of government regulatory departments and the probability of a third-party reporting to play a great role in promoting the self-discipline of enterprises. (4) The power of government and regulation are conducive to promoting the active supervision of the government regulatory authorities but corruption of government and awareness of people are different. Once the phenomenon of vaccine enterprises’ non-discipline increases, the government regulation must change from passive regulation to active regulation. Therefore, the government should implement different measures according to the characteristics of each period in the manufacturing process to effectively prevent problematic vaccines. The conclusions and policy recommendations are significant for addressing the issue of insufficient self-discipline of vaccine manufacturers.
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Raghupathi V, Ren J, Raghupathi W. Studying Public Perception about Vaccination: A Sentiment Analysis of Tweets. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E3464. [PMID: 32429223 PMCID: PMC7277574 DOI: 10.3390/ijerph17103464] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 05/04/2020] [Accepted: 05/11/2020] [Indexed: 01/04/2023]
Abstract
Text analysis has been used by scholars to research attitudes toward vaccination and is particularly timely due to the rise of medical misinformation via social media. This study uses a sample of 9581 vaccine-related tweets in the period January 1, 2019 to April 5, 2019. The time period is of the essence because during this time, a measles outbreak was prevalent throughout the United States and a public debate was raging. Sentiment analysis is applied to the sample, clustering the data into topics using the term frequency-inverse document frequency (TF-IDF) technique. The analyses suggest that most (about 77%) of the tweets focused on the search for new/better vaccines for diseases such as the Ebola virus, human papillomavirus (HPV), and the flu. Of the remainder, about half concerned the recent measles outbreak in the United States, and about half were part of ongoing debates between supporters and opponents of vaccination against measles in particular. While these numbers currently suggest a relatively small role for vaccine misinformation, the concept of herd immunity puts that role in context. Nevertheless, going forward, health experts should consider the potential for the increasing spread of falsehoods that may get firmly entrenched in the public mind.
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Affiliation(s)
- Viju Raghupathi
- Koppelman School of Business, Brooklyn College of the City University of New York, Brooklyn, NY 11210, USA;
| | - Jie Ren
- Gabelli School of Business, Fordham University, New York, NY 10023, USA;
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Yang J, Atkins KE, Feng L, Baguelin M, Wu P, Yan H, Lau EHY, Wu JT, Liu Y, Cowling BJ, Jit M, Yu H. Cost-effectiveness of introducing national seasonal influenza vaccination for adults aged 60 years and above in mainland China: a modelling analysis. BMC Med 2020; 18:90. [PMID: 32284056 PMCID: PMC7155276 DOI: 10.1186/s12916-020-01545-6] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Accepted: 03/03/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND China has an aging population with an increasing number of adults aged ≥ 60 years. Influenza causes a heavy disease burden in older adults, but can be alleviated by vaccination. We assessed the cost-effectiveness of a potential government-funded seasonal influenza vaccination program in older adults in China. METHODS We characterized the health and economic impact of a fully funded influenza vaccination program for older adults using China-specific influenza disease burden, and related cost data, etc. Using a decision tree model, we calculated the incremental costs per quality-adjusted life year (QALY) gained of vaccination from the societal perspective, at a willingness-to-pay threshold equivalent to GDP per capita (US$8840). Moreover, we estimated the threshold vaccination costs, under which the fully funded vaccination program is cost-effective using GDP per capita as the willingness-to-pay threshold. RESULTS Compared to current self-paid vaccination, a fully funded vaccination program is expected to prevent 19,812 (95% uncertainty interval, 7150-35,783) influenza-like-illness outpatient consultations per year, 9418 (3386-17,068) severe acute respiratory infection hospitalizations per year, and 8800 (5300-11,667) respiratory excess deaths due to influenza per year, and gain 70,212 (42,106-93,635) QALYs per year. Nationally, the incremental costs per QALY gained of the vaccination program is US$4832 (3460-8307), with a 98% probability of being cost-effective. The threshold vaccination cost is US$10.19 (6.08-13.65). However, variations exist between geographical regions, with Northeast and Central China having lower probabilities of cost-effectiveness. CONCLUSIONS Our results support the implementation of a government fully funded older adult vaccination program in China. The regional analysis provides results across settings that may be relevant to other countries with similar disease burden and economic status, especially for low- and middle-income countries where such analysis is limited.
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Affiliation(s)
- Juan Yang
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Katherine E Atkins
- Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene and Tropical Medicine, London, UK
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
- Centre for Global Health Research, Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Edinburgh, UK
| | - Luzhao Feng
- Key Laboratory of Surveillance and Early-warning on Infectious Disease, Division of Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Marc Baguelin
- Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene and Tropical Medicine, London, UK
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
- MRC Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, London, UK
| | - Peng Wu
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Han Yan
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Eric H Y Lau
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Joseph T Wu
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Yang Liu
- Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene and Tropical Medicine, London, UK
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | - Benjamin J Cowling
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Mark Jit
- Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene and Tropical Medicine, London, UK
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
- Modelling and Economics Unit, Public Health England, London, UK
| | - Hongjie Yu
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China.
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Yang R, Penders B, Horstman K. Addressing Vaccine Hesitancy in China: A Scoping Review of Chinese Scholarship. Vaccines (Basel) 2019; 8:E2. [PMID: 31861816 PMCID: PMC7157208 DOI: 10.3390/vaccines8010002] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 12/12/2019] [Accepted: 12/18/2019] [Indexed: 02/03/2023] Open
Abstract
Despite the well-developed Chinese National Immunization Program, vaccine hesitancy in China is rising. As part of the response, Chinese scholars have studied determinants and proposed solutions to vaccination hesitancy. We performed a scoping review of Chinese literature (2007-2019), drawn from four Chinese databases. We mapped relevant information and presented a systemic account of the proposed determinants and responses to vaccine hesitancy in China. We identified 77 relevant studies that reveal four approaches to vaccine hesitancy. Most Chinese studies define vaccine hesitancy as a problem of vaccine safety and vaccine incident response and place accountability on the level of governance, such as regulation deficits and inappropriate crisis management. A first minority of studies tied vaccination hesitancy to unprofessional medical conduct and called for additional resources and enhanced physician qualifications. A second minority of studies positioned vaccination hesitancy as a problem of parental belief and pointed to the role of media, proposing enhanced communication and education. Chinese literature ties vaccine hesitancy primarily to vaccine safety and medical conduct. Compared to international research, parental concerns are underrepresented. The Chinese context of vaccination scandals notably frames the discussion of vaccination hesitancy and potential solutions, which stresses the importance of considering vaccination hesitancy in specific social and political contexts.
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Affiliation(s)
- Ronghui Yang
- Department of Health, Ethics and Society, Care and Public Health Research Institute (CAPHRI), Maastricht University, PO Box 616, 6200 MD Maastricht, The Netherlands; (B.P.); (K.H.)
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Zhuang J, Lu Y, Wagner AL, Jiang Q. Profit considerations in vaccine safety-related events in China. Expert Rev Vaccines 2019; 18:1187-1199. [PMID: 31674844 DOI: 10.1080/14760584.2019.1688150] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Objectives: China has made remarkable achievements in the field of immunization. However, several widespread vaccine safety-related events have recently received worldwide attention and reflect flaws in vaccine management. This study aimed to summarize vaccine safety-related events between 1985 and 2018 in China and analyze the profit motives of these events.Methods. Literature and media reviews were conducted to discover vaccine safety-related events. We developed a conceptual model with profit-related variables, and using information available from each event, we identified which profit-related variable was implicated, and how it related to the pursuit of higher profits.Results: A total of 39 vaccine safety-related events were found in vaccine production, procurement, transportation, and daily management, along with adverse events following immunization (AEFIs). Overall, 90% (35/39) of the events could be classified as profit-driven. The motives of most events could be tied to one or more reasons, including decreasing costs among vaccine producers (67%, 26/39), reducing actual procurement price (67%, 26/39), and reducing costs of transportation and/or cold chain (24/39, 62%).Conclusions: In order to deal with vaccine-related challenges, a more restrictive supervision system on vaccine production and more emergency preparedness, including health and risk communication strategies, for vaccine safety should be implemented.
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Affiliation(s)
- Jianlin Zhuang
- School of Public Health, Fudan University, Shanghai, China.,Department of General Affairs and Emergency Response, Changing District Centers for Disease Control and Prevention, Shanghai, China
| | - Yihan Lu
- School of Public Health, Fudan University, Shanghai, China
| | - Abram L Wagner
- Department of Epidemiology, University of Michigan, Ann Arbor, MI, USA
| | - Qingwu Jiang
- School of Public Health, Fudan University, Shanghai, China
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