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Vicario CM, Mucciardi M, Faraone G, Lucifora C, Schade HM, Falzone A, Salehinejad MA, Craparo G, Nitsche MA. Individual predictors of vaccine hesitancy in the Italian post COVID-19 pandemic era. Hum Vaccin Immunother 2024; 20:2306677. [PMID: 38289323 PMCID: PMC10829816 DOI: 10.1080/21645515.2024.2306677] [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: 11/01/2023] [Accepted: 01/13/2024] [Indexed: 02/01/2024] Open
Abstract
A wide range of survey studies have explored vaccination hesitancy/resistance during the COVID-19 pandemic and provided evidence that this can be explained by several individual variables from the ideological, clinical, and socio-affective domain. However, evidence about which individual variables predict vaccine hesitancy in the post-pandemic state of COVID-19 is meager. We administered a battery of questionnaires to a group of 120 Italian participants with high and low scores on the adult vaccine hesitancy scale (aVHS) to investigate the predictive role of ideological (i.e. political orientation), clinical (i.e. anxiety, interoceptive accuracy), and socio-affective (i.e. alexithymia, disgust sensitivity/propensity, empathy) variables on vaccine hesitancy/resistance. This study provides evidence that lower interoceptive awareness and cognitive empathy are predictors of a greater hesitancy to get vaccinated in the post-pandemic COVID-19 state.
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Affiliation(s)
- Carmelo M Vicario
- Dipartimento di Scienze Cognitive, Psicologiche, Pedagogiche e Degli Studi Culturali, Università di Messina, Messina, Italy
| | - Massimo Mucciardi
- Dipartimento di Scienze Cognitive, Psicologiche, Pedagogiche e Degli Studi Culturali, Università di Messina, Messina, Italy
| | - Giulia Faraone
- Dipartimento di Scienze Cognitive, Psicologiche, Pedagogiche e Degli Studi Culturali, Università di Messina, Messina, Italy
| | - Chiara Lucifora
- Dipartimento di Filosofia e Comunicazione, Università di Bologna, Bologna, Italy
| | - Hannah M Schade
- Department of Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany
| | - Alessandra Falzone
- Dipartimento di Scienze Cognitive, Psicologiche, Pedagogiche e Degli Studi Culturali, Università di Messina, Messina, Italy
| | - Mohammad A Salehinejad
- Department of Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany
- School of Cognitive Sciences, Institute for Research in Fundamental Sciences, Tehran, Iran
| | - Giuseppe Craparo
- Faculty of Human and Social Sciences, Kore University of Enna, Cittadella Universitaria, Enna, Italy
| | - Michael A Nitsche
- Department of Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany
- University Clinic of Psychiatry and Psychotherapy and University Clinic of Child and Adolescent Psychiatry and Psychotherapy, Protestant Hospital of Bethel Foundation, University Hospital OWL, Bielefeld University, Bielefeld, Germany
- German Center for Mental Health (DZPG), Bochum, Germany
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2
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Filipe J, Lauzi S, Marinoni V, Servida F, Dall'Ara P. Zoonoses and pet owners: A survey on risk perception in Northern Italy. Comp Immunol Microbiol Infect Dis 2024; 112:102224. [PMID: 39053041 DOI: 10.1016/j.cimid.2024.102224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Revised: 07/05/2024] [Accepted: 07/22/2024] [Indexed: 07/27/2024]
Abstract
Veterinary and human medicine are focused on the issue of emerging and re-emerging diseases, which are especially represented by zoonosis that could be a threat for public health. Zoonotic risk may come from pets: some canine and/or feline viral, bacterial, parasitic, protozoal or mycotic diseases can be transmitted directly to humans. There are several strategies to prevent the transmission of such zoonosis, and among them vaccination plays an important role. Through a survey carried out in Northern Italy aimed to collect information regarding owners' knowledge and perception of the zoonotic risks associated with three zoonoses (rabies, leptospirosis, and dermatophytosis), it was demonstrated that dog owners tend to adhere more consistently to their pets' vaccination schedules and are more receptive to changes in vaccination scheduling compared to cat owners. This study also suggests that cat owners predominantly visit veterinarians for vaccination purposes, whereas dog owners seek veterinary services for a variety of reasons. The survey highlighted the ongoing need to enhance owners' understanding of zoonoses affecting their pets and also the protective role of vaccines. Veterinarians should undertake the responsibility of educating, reassuring, and informing pet owners about the significance of vaccines for their pets and for public health.
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Affiliation(s)
- Joel Filipe
- Department of Veterinary Medicine and Animal Sciences (DIVAS), University of Milan, Via dell'Università 6, Lodi, LO 26900, Italy.
| | - Stefania Lauzi
- Department of Veterinary Medicine and Animal Sciences (DIVAS), University of Milan, Via dell'Università 6, Lodi, LO 26900, Italy
| | - Veronica Marinoni
- Department of Veterinary Medicine and Animal Sciences (DIVAS), University of Milan, Via dell'Università 6, Lodi, LO 26900, Italy
| | | | - Paola Dall'Ara
- Department of Veterinary Medicine and Animal Sciences (DIVAS), University of Milan, Via dell'Università 6, Lodi, LO 26900, Italy
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3
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Beleites F, Adam M, Favaretti C, Hachaturyan V, Kühn T, Bärnighausen T, Barteit S. Evaluating the impact of short animated videos on COVID-19 vaccine hesitancy: An online randomized controlled trial. Internet Interv 2024; 35:100694. [PMID: 38149090 PMCID: PMC10750063 DOI: 10.1016/j.invent.2023.100694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 11/15/2023] [Accepted: 11/25/2023] [Indexed: 12/28/2023] Open
Abstract
Addressing the global challenge of vaccine hesitancy, amplified during the COVID-19 pandemic due to misinformation propagated via social media, necessitates innovative health communication strategies. This investigation scrutinizes the efficacy of Short, Animated, Story-based (SAS) videos in fostering knowledge, behavioral intent, and engagement around COVID-19 vaccination. We conducted an online three-arm parallel randomized controlled trial (RCT) involving 792 adult participants (≥18 years, English-speaking) from the United States. The intervention group viewed a SAS video on COVID-19 vaccination, the attention placebo control group watched a SAS video on hope, and the control group received no intervention. Our primary objectives were to assess the influence of SAS videos on knowledge, behavioral intent, and engagement regarding COVID-19 vaccination. Participants in the intervention group displayed significantly higher mean knowledge scores (20.6, 95 % CI: 20.3-20.9) compared to both the attention placebo control (18.8, 95 % CI: 18.5-19.1, P < .001) and control groups (18.7, 95 % CI: 18.4-19.0, P < .001). However, SAS videos did not notably affect behavioral intent. Perception of COVID-19 as a significant health threat emerged as a strong predictor for engaging with the post-trial video without further incentives (OR: 0.44; 95 % CI: 0.2-0.96). The 35-44 age group exhibited the highest post-trial engagement (P = .006), whereas right-wing political inclination negatively associated with engagement (OR: 1.98; 95 % CI: 3.9-1.01). Vaccination status correlated significantly with self-efficacy (P < .001), perceived social norms (P < .001), and perceived response efficacy of the COVID-19 vaccine (P < .001), all heightened in the intervention group. These findings suggest that while SAS videos effectively amplify COVID-19 vaccination knowledge, their impact on behavioral intent is not direct. They do, however, affect determinants of vaccination status, thereby indirectly influencing vaccination behavior. The study highlights the appeal of SAS videos among younger audiences, but underscores the need for further examination of factors impeding vaccination engagement. As SAS videos closely mirror conventional social media content, they hold significant potential as a public health communication tool on these platforms. Trial Registration: Trial was registered at drks.de with the identifier DRKS00027938, on 5 January 2022.
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Affiliation(s)
- Ferdinand Beleites
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany
| | - Maya Adam
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany
- Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, United States
| | - Caterina Favaretti
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany
- Behavioral Science for Disease Prevention and Health Care, Technical University of Munich, Munich, Germany
| | - Violetta Hachaturyan
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany
| | - Tilman Kühn
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany
- University of Vienna, Department of Nutritional Sciences, Vienna, Austria
- Medical University of Vienna, Center for Public Health, Vienna, Austria
| | - Till Bärnighausen
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany
- Africa Health Research Institute (AHRI), Somkhele, KwaZulu-Natal, South Africa
- Harvard Center for Population and Development Studies, T.H. Chan School of Public Health, Cambridge, MA, United States
| | - Sandra Barteit
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany
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Payette C, Hanby C, Cerezo M, Moran S, Blanchard J. Let Us Just Ask People What They Think: Community Perceptions and Recommendations about Coronavirus Vaccination. Ethn Dis 2024; 34:33-40. [PMID: 38854786 PMCID: PMC11156165 DOI: 10.18865/ed.34.1.33] [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] [Indexed: 06/11/2024] Open
Abstract
Introduction Despite widespread efforts to promote coronavirus disease 2019 vaccination in the United States, a significant segment of the population is still unvaccinated or incompletely vaccinated. Objective The objective of this study was to understand attitudes toward the vaccine in patients presenting to an urban emergency department. Methods We used a qualitative analysis and semistructured interviews with a convenience sample of patients presenting to an urban emergency department from January 18, 2021, to March 14, 2021. Our final sample consisted of 32 people. Results We found that people trusted their own medical providers rather than popular or political figures. Critiques of the vaccination program highlighted difficulties in navigation and perceptions of inequity. Conclusions Equitable distribution strategies and honest messaging may facilitate acceptance of the coronavirus disease 2019 vaccine. Trustworthy sources for vaccine knowledge should be used to target populations in which vaccine hesitancy is a persistent concern.
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Affiliation(s)
- Christopher Payette
- Department of Emergency Medicine, George Washington University School of Medicine and Health Sciences, Washington, DC
| | - Charlotte Hanby
- Department of Emergency Medicine, George Washington University School of Medicine and Health Sciences, Washington, DC
| | - Maria Cerezo
- School of Medicine, George Washington University School of Medicine and Health Sciences, Washington, DC
| | - Seamus Moran
- Department of Emergency Medicine, George Washington University School of Medicine and Health Sciences, Washington, DC
| | - Janice Blanchard
- Department of Emergency Medicine, George Washington University School of Medicine and Health Sciences, Washington, DC
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Montuori P, Gentile I, Fiorilla C, Sorrentino M, Schiavone B, Fattore V, Coscetta F, Riccardi A, Villani A, Trama U, Pennino F, Triassi M, Nardone A. Understanding Factors Contributing to Vaccine Hesitancy in a Large Metropolitan Area. Vaccines (Basel) 2023; 11:1558. [PMID: 37896961 PMCID: PMC10610669 DOI: 10.3390/vaccines11101558] [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: 08/18/2023] [Revised: 09/13/2023] [Accepted: 09/28/2023] [Indexed: 10/29/2023] Open
Abstract
Vaccine hesitancy has become a major global concern, leading to a significant decrease in the vaccination rate, with the World Health Organization recognizing it as one of the top ten threats to public health. Moreover, the health cost generated is evaluated to be 27 billion dollars per year in the US alone. To investigate the association between demographic variables and knowledge, attitudes, and behaviours related to vaccination, a survey-based cross-sectional study was conducted with 1163 individuals. Three models were used to perform a multiple linear regression analysis. In Model I, knowledge about vaccinations was found to be associated with smoking habits, education, and marital status. In Model II, attitudes towards vaccinations were significantly associated with sex, smoking habits, education, marital status, and knowledge. In Model III, behaviours related to vaccination were associated with sex, smoking habits, having children, knowledge, and attitudes. One potential solution to improve behaviours related to vaccinations in the general population is to implement specific public health programs, which can be a cost-effective intervention. This study provides valuable insights into the determinants of knowledge, attitudes, and behaviours related to vaccinations in the general population.
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Affiliation(s)
- Paolo Montuori
- Department of Public Health, "Federico II" University, Via Sergio Pansini nº 5, 80131 Naples, Italy
| | - Immanuela Gentile
- Department of Public Health, "Federico II" University, Via Sergio Pansini nº 5, 80131 Naples, Italy
| | - Claudio Fiorilla
- Department of Public Health, "Federico II" University, Via Sergio Pansini nº 5, 80131 Naples, Italy
| | - Michele Sorrentino
- Department of Public Health, "Federico II" University, Via Sergio Pansini nº 5, 80131 Naples, Italy
| | - Benedetto Schiavone
- Department of Public Health, "Federico II" University, Via Sergio Pansini nº 5, 80131 Naples, Italy
| | - Valerio Fattore
- Department of Public Health, "Federico II" University, Via Sergio Pansini nº 5, 80131 Naples, Italy
| | - Fabio Coscetta
- Department of Public Health, "Federico II" University, Via Sergio Pansini nº 5, 80131 Naples, Italy
| | - Alessandra Riccardi
- Department of Public Health, "Federico II" University, Via Sergio Pansini nº 5, 80131 Naples, Italy
| | - Antonio Villani
- Department of Public Health, "Federico II" University, Via Sergio Pansini nº 5, 80131 Naples, Italy
| | - Ugo Trama
- General Directorate of Health, Campania Region, Centro Direzionale C3, 80143 Naples, Italy
| | - Francesca Pennino
- Department of Public Health, "Federico II" University, Via Sergio Pansini nº 5, 80131 Naples, Italy
| | - Maria Triassi
- Department of Public Health, "Federico II" University, Via Sergio Pansini nº 5, 80131 Naples, Italy
| | - Antonio Nardone
- Department of Public Health, "Federico II" University, Via Sergio Pansini nº 5, 80131 Naples, Italy
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6
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Bianchi FP, Tafuri S. Spreading of misinformation on mass media and digital platforms regarding vaccines. A systematic scoping review on stakeholders, policymakers, and sentiments/behavior of Italian consumers. Hum Vaccin Immunother 2023; 19:2259398. [PMID: 37782549 PMCID: PMC10547076 DOI: 10.1080/21645515.2023.2259398] [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: 06/08/2023] [Accepted: 09/12/2023] [Indexed: 10/04/2023] Open
Abstract
Studies on traditional and social media have found that misinformation about vaccines has been widely spread over the last decade, negatively impacting public opinion and people's willingness to get vaccinated. We reviewed the sentiments of Italian users to define the characteristic of anti-vax and pro-vax contents and defined the strategies to deal with the misinformation. Scopus, MEDLINE/PubMed, Google Scholar (up to page 10), and ISI Web of Knowledge databases were systematically searched. Research articles, brief reports, commentaries, and letters published between January 1, 2010 and March 30, 2022 were included in the search. No-vax or ambiguous contents in Italian mass media are not prevalent compared to neutral and pro-vax content; the communication of no-vax groups is significantly simplified, favoring the understanding of the topics by users. Events related to vaccinations are associated with news coverage by media, search engine consultations, and user reactions on social networks. In this context, the activity of no-vax groups is triggered, and misinformation and fake news spread even further. A multifactorial approach is necessary to manage online user sentiment and use mass and social media as health promotion tools.
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Affiliation(s)
| | - Silvio Tafuri
- Interdisciplinary Department of Medicine, Aldo Moro University of Bari, Bari, Italy
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7
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Lee CYS, Suzuki JB. COVID-19: Variants, Immunity, and Therapeutics for Non-Hospitalized Patients. Biomedicines 2023; 11:2055. [PMID: 37509694 PMCID: PMC10377623 DOI: 10.3390/biomedicines11072055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 07/13/2023] [Accepted: 07/14/2023] [Indexed: 07/30/2023] Open
Abstract
The continuing transmission of coronavirus disease 2019 (COVID-19) remains a world-wide 21st-century public health emergency of concern. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused greater than 600 million cases of COVID-19 and over 6 million deaths globally. COVID-19 continues to be a highly transmissible disease despite efforts by public health officials and healthcare providers to manage and control the disease. Variants identified in selected worldwide epicenters add to the complexity of vaccine efficacy, overage, and antibody titer maintenance and bioactivity. The identification of the SARS-CoV-2 variants is described with respect to evading protective efficacy of COVID-19 vaccines and breakthrough infections. Vaccines and other therapeutics have prevented millions of SARS-CoV-2 infections and thousands of deaths in the United States. We explore aspects of the immune response in a condensed discussion to understand B and T cell lymphocyte regulatory mechanisms and antibody effectiveness and senescence. Finally, COVID-19 therapies including Paxlovid, Remdisivir, Molnupiravir and convalescent plasma in non-hospitalized patients are presented with limitations for identification, collection, and distribution to infected patients.
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Affiliation(s)
- Cameron Y S Lee
- Private Practice in Oral, Maxillofacial and Reconstructive Surgery, Aiea, HI 96701, USA
- Department of Periodontology and Oral Implantology, Kornberg School of Dentistry, Temple University, Philadelphia, PA 19140, USA
| | - Jon B Suzuki
- Department of Periodontology and Oral Implantology, Kornberg School of Dentistry, Temple University, Philadelphia, PA 19140, USA
- Department of Graduate Periodontics, University of Maryland, Baltimore, MD 20742, USA
- Department of Graduate Prosthodontics, University of Washington, Seattle, WA 98195, USA
- Department of Graduate Periodontics, Nova Southeastern University, Fort Lauderdale, FL 33314, USA
- Department of Microbiology and Immunology, School of Medicine, Temple University, Philadelphia, PA 19140, USA
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8
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Howard MC. Integrating the person-centered approach with the study of vaccine hesitancy: Applying latent profile analysis to identify vaccine hesitancy subpopulations and assess their relations with correlates and vaccination outcomes. Vaccine 2023:S0264-410X(23)00742-9. [PMID: 37357075 DOI: 10.1016/j.vaccine.2023.06.057] [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: 10/12/2022] [Revised: 05/26/2023] [Accepted: 06/15/2023] [Indexed: 06/27/2023]
Abstract
In scholarly and popular discussions of vaccine hesitancy, authors have repeatedly referred to different "types" of vaccine hesitant individuals; however, almost all modern research on vaccine hesitancy utilizes variable-centered approaches to identify the relation of variables rather than a person-centered approach to identify subpopulations, which suggests that a discrepancy exists between conceptual discussions and empirical research on vaccine hesitancy. For this reason, the current article conducts a latent profile analysis (LPA) on the dimensions of a well-supported vaccine hesitancy measure, which assess hesitancy towards vaccines in general. We also assess the relations of the resultant profiles (e.g., subpopulations) with relevant self-reported outcomes and correlates, wherein most of our outcomes are associated with COVID-19 and flu vaccines. Our LPA results support the existence of eight vaccine hesitancy profiles. The profile with the most unfavorable vaccination outcomes (e.g., willingness, receipt, and word-of-mouth) was associated with greater perceptions that vaccines cause health risks and unneeded when healthy; the profile with the most favorable vaccination outcomes was associated with low levels of all vaccine hesitancy dimensions. The other profiles produced a clear gradient between these two extremes. The profiles also differed regarding their standing on correlates, but the clearest difference was their relation with political orientation. Profiles with more unfavorable vaccination outcomes were associated with conservatism, whereas profiles with more favorable vaccinations outcomes were associated with liberalism. These results provide a new perspective for current understandings of vaccine hesitancy and open several avenues for future research.
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Affiliation(s)
- Matt C Howard
- The University of South Alabama, Mitchell College of Business, United States.
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9
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Regazzi L, Lontano A, Cadeddu C, Di Padova P, Rosano A. Conspiracy beliefs, COVID-19 vaccine uptake and adherence to public health interventions during the pandemic in Europe. Eur J Public Health 2023:7192366. [PMID: 37290405 PMCID: PMC10393495 DOI: 10.1093/eurpub/ckad089] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023] Open
Abstract
BACKGROUND Conspiracy beliefs can be a major hindrance causing a lack of compliance with public health measures, including vaccination. We examined the relationship between individual attitudes, socio-demographic factors, conspiracy beliefs, COVID-19 vaccine hesitancy and preferences about pandemic policies in Europe. METHODS We used data from the 10th round of the European Social Survey, conducted in 2021-22 in 17 European countries. Both a conspiracy index and a personal attitude index for each participant were built by using a Latent Class Analysis model. Then, we used a multilevel regression model to investigate the relationship between a personal attitudes index, socio-demographic factors and country of residence, and a conspiracy index. We descriptively analyse the relationship between the conspiracy index and four main items related to COVID-19. RESULTS We found that a higher probability of believing in conspiracy theories was associated with male gender, middle age, lower levels of education, unemployment, lower levels of trust and satisfaction and right-wing political orientation. The country of residence was a contextual factor, with eastern European countries having higher levels of conspiracy beliefs. Individuals who expressed conspiracy beliefs had lower COVID-19 vaccine uptake, were less satisfied with the way health services coped with the pandemic and less supportive of governmental restrictions. CONCLUSIONS This study provides valuable insights into the factors associated with conspiracy beliefs and their potential impact on public health. The findings highlight the need for effective strategies to address the underlying factors driving conspiracy beliefs, reduce vaccine hesitancy and promote acceptance of public health interventions.
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Affiliation(s)
- Luca Regazzi
- Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, Rome 00168, Italy
| | - Alberto Lontano
- Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, Rome 00168, Italy
| | - Chiara Cadeddu
- Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, Rome 00168, Italy
| | - Pasquale Di Padova
- National Institute for the Analysis of Public Policies (INAPP), Rome, Italy
| | - Aldo Rosano
- National Institute for the Analysis of Public Policies (INAPP), Rome, Italy
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10
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Profeti S, Toth F. Climbing the 'ladder of intrusiveness': the Italian government's strategy to push the Covid-19 vaccination coverage further. POLICY SCIENCES 2023:1-23. [PMID: 37361645 PMCID: PMC10183224 DOI: 10.1007/s11077-023-09509-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 04/25/2023] [Indexed: 06/28/2023]
Abstract
In all Western countries, the vaccination campaign against COVID-19 encountered some resistance. To overcome vaccine inertia and hesitancy, governments have used a variety of strategies and policy instruments. These instruments can be placed on a 'ladder of intrusiveness', starting from voluntary tools based on simple information and persuasion, through material incentives and disincentives of varying nature and magnitude, to highly coercive tools, such as lockdown for the unvaccinated and the introduction of the vaccination mandate. Italy's experience during the vaccination campaign against Covid provides an ideal observational point for starting to investigate this issue: not only was Italy among the top countries with the highest percentage of people vaccinated at the beginning of 2022, but-at least compared to other European countries-it was also one of the countries that had gradually introduced the most intrusive measures to increase vaccination compliance. In the article the different steps of the 'intrusiveness ladder' are presented, providing examples from various countries, and then tested on the Italian Covid-19 vaccination campaign between 2021 and the first months of 2022. For each phase of the campaign, the instrument mixes adopted by the Italian government are described, as well as the contextual conditions that led to their adoption. In the final section, an assessment of the composition and evolution of the Italian vaccination strategy is provided, based on the following criteria: legitimacy, feasibility, effectiveness, internal consistency and strategic coherence. Conclusions highlight the pragmatic approach adopted by the Italian government and underline the effects-both positive and negative-of scaling up the intrusiveness ladder.
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Affiliation(s)
- Stefania Profeti
- Dipartimento di Scienze Politiche e Sociali, University of Bologna, Strada Maggiore 45, 40125 Bologna, Italy
| | - Federico Toth
- Dipartimento di Scienze Politiche e Sociali, University of Bologna, Strada Maggiore 45, 40125 Bologna, Italy
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11
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Parisi L, Mulargia S, Comunello F, Bernardini V, Bussoletti A, Nisi CR, Russo L, Campagna I, Lanfranchi B, Croci I, Grassucci E, Gesualdo F. Exploring the vaccine conversation on TikTok in Italy: beyond classic vaccine stances. BMC Public Health 2023; 23:880. [PMID: 37173677 PMCID: PMC10176305 DOI: 10.1186/s12889-023-15748-y] [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: 11/16/2022] [Accepted: 04/25/2023] [Indexed: 05/15/2023] Open
Abstract
TikTok, a social media platform for creating and sharing short videos, has seen a surge in popularity during the COVID-19 pandemic. To analyse the Italian vaccine conversation on TikTok, we downloaded a sample of videos with a high play count (Top Videos), identified through an unofficial Application Programming Interface (consistent with TikTok's Terms of Service), and collected public videos from vaccine sceptic users through snowball sampling (Vaccine Sceptics' videos). The videos were analysed using qualitative and quantitative methods, in terms of vaccine stance, tone of voice, topic, conformity with TikTok style, and other characteristics. The final datasets consisted of 754 Top Videos (by 510 single users) plus 180 Vaccine Sceptics' videos (by 29 single users), posted between January 2020 and March 2021. In 40.5% of the Top Videos the stance was promotional, 33.9% were indefinite-ironic, 11.3% were neutral, 9.7% were discouraging, and 3.1% were ambiguous (i.e. expressing an ambivalent stance towards vaccines); 43% of promotional videos were from healthcare professionals. More than 95% of the Vaccine Sceptic videos were discouraging. Multiple correspondence analysis showed that, compared to other stances, promotional videos were more frequently created by healthcare professionals and by females, and their most frequent topic was herd immunity. Discouraging videos were associated with a polemical tone of voice and their topics were conspiracy and freedom of choice. Our analysis shows that Italian vaccine-sceptic users on TikTok are limited in number and vocality, and the large proportion of videos with an indefinite-ironic stance might imply that the incidence of affective polarisation could be lower on TikTok, compared to other social media, in the Italian context. Safety is the most frequent concern of users, and we recorded an interesting presence of healthcare professionals among the creators. TikTok should be considered as a medium for vaccine communication and for vaccine promotion campaigns.
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Affiliation(s)
- Lorenza Parisi
- Human Sciences Department, Link Campus University, Rome, Italy
| | - Simone Mulargia
- Department of Human Studies - Communication, Education, and Psychology, LUMSA University, Borgo S. Angelo, 13, Rome, 00193, Italy
| | - Francesca Comunello
- Department of Communication and Social Research, Sapienza University of Rome, Piazzale Aldo Moro 5, Rome, 00185, Italy
| | - Vittoria Bernardini
- Department of Communication and Social Research, Sapienza University of Rome, Piazzale Aldo Moro 5, Rome, 00185, Italy
| | - Arianna Bussoletti
- Department of Communication and Social Research, Sapienza University of Rome, Piazzale Aldo Moro 5, Rome, 00185, Italy
| | - Carla Rita Nisi
- Department of Communication and Social Research, Sapienza University of Rome, Piazzale Aldo Moro 5, Rome, 00185, Italy
| | - Luisa Russo
- Predictive and Preventive Medicine Research Unit, Bambino Gesù Children's Hospital IRCCS, Piazza S. Onofrio 4, Rome, 00165, Italy
| | - Ilaria Campagna
- Predictive and Preventive Medicine Research Unit, Bambino Gesù Children's Hospital IRCCS, Piazza S. Onofrio 4, Rome, 00165, Italy
| | - Barbara Lanfranchi
- Predictive and Preventive Medicine Research Unit, Bambino Gesù Children's Hospital IRCCS, Piazza S. Onofrio 4, Rome, 00165, Italy
| | - Ileana Croci
- Predictive and Preventive Medicine Research Unit, Bambino Gesù Children's Hospital IRCCS, Piazza S. Onofrio 4, Rome, 00165, Italy
| | - Eleonora Grassucci
- Predictive and Preventive Medicine Research Unit, Bambino Gesù Children's Hospital IRCCS, Piazza S. Onofrio 4, Rome, 00165, Italy
- Department of Information Engineering, Electronics, and Telecommunication, Sapienza University of Rome, Piazzale Aldo Moro 5, Rome, 00185, Italy
| | - Francesco Gesualdo
- Predictive and Preventive Medicine Research Unit, Bambino Gesù Children's Hospital IRCCS, Piazza S. Onofrio 4, Rome, 00165, Italy.
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12
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Ferrara M, Bertozzi G, Volonnino G, Di Fazio A, Di Fazio N, Arcangeli M, La Russa R, Frati P. Learning from the Past to Improve the Future—Vaccine Hesitancy Determinants in the Italian Population: A Systematic Review. Vaccines (Basel) 2023; 11:vaccines11030630. [PMID: 36992216 DOI: 10.3390/vaccines11030630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 02/27/2023] [Accepted: 03/10/2023] [Indexed: 03/14/2023] Open
Abstract
WHO identifies vaccine hesitancy (VH) as one of the ten threats to global health. The authors bring to the international scientific community an Italian episode that offers the opportunity to renew the discussion on the extent of the VH matter. The purpose of this systematic review is to analyze the factors determining vaccine hesitancy in the Italian population, to understand its roots, and suggest potential strategies to mitigate it. A systematic review of the literature according to the PRISMA guidelines was carried out using the SCOPUS and Medline (via PubMed) databases, using the following strategy: (COVID-19 vaccines) AND (vaccination hesitancy) AND (Italy). After the selection process, 36 articles were included in this systematic review. The most frequently detected factors associated with VH in the Italian population can be grouped as vaccine-related factors, socio-cultural factors, and demographic factors. Currently, we are facing a gap between the population and science, governments, and institutions. To heal this breach, it is necessary to strengthen the trust of the population through the implementation of health communication and public education strategies, while scientific literacy must continue to support families and individuals in discerning evidence from opinions to recognize the real risks and balance them with the benefits.
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Affiliation(s)
- Michela Ferrara
- Department of Anatomical, Histological, Forensic Medicine and Orthopedic Sciences, Sapienza University of Rome, 00185 Rome, Italy
| | - Giuseppe Bertozzi
- Department of Clinical and Experimental Medicine, Section of Forensic Pathology, University of Foggia, 71122 Foggia, Italy
| | - Gianpietro Volonnino
- Department of Anatomical, Histological, Forensic Medicine and Orthopedic Sciences, Sapienza University of Rome, 00185 Rome, Italy
| | - Aldo Di Fazio
- Regional Complex Intercompany Institute of Legal Medicine, 85100 Potenza, Italy
| | - Nicola Di Fazio
- Department of Anatomical, Histological, Forensic Medicine and Orthopedic Sciences, Sapienza University of Rome, 00185 Rome, Italy
| | - Mauro Arcangeli
- Department of Clinical Medicine, Public Health, Life and Environment Science, University of L'Aquila, 67100 L'Aquila, Italy
| | - Raffaele La Russa
- Department of Clinical and Experimental Medicine, Section of Forensic Pathology, University of Foggia, 71122 Foggia, Italy
| | - Paola Frati
- Department of Anatomical, Histological, Forensic Medicine and Orthopedic Sciences, Sapienza University of Rome, 00185 Rome, Italy
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Atanga Adongo C, Anamaale Tuoyire D, Azuug M, Baffour Appiah A, Taale F, Amadu I. DECOLONISING VACCINE PRODUCTION: UNPACKING GHANAIANS’ SUPPORT FOR MADE-IN-AFRICA VACCINES. Vaccine X 2023; 14:100283. [PMID: 37008957 PMCID: PMC10064421 DOI: 10.1016/j.jvacx.2023.100283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 02/24/2023] [Accepted: 03/14/2023] [Indexed: 03/19/2023] Open
Abstract
Localisation of vaccine production is essential worldwide, but it is particularly crucial for Africa. This continent is more vulnerable to disease burdens and also lags behind other continents regarding access to vaccines. Moreover, many people in Africa have a long-standing apathy towards locally made products and services. This mindset raises the question of whether Africans will support African-made vaccines and what the associated reasons are. Guided by the theories of nationalism and import substitution industrialisation, we formulated and tested eight hypotheses. To answer these, we analysed survey data from 6,731 residents backed by key informant interviews in Ghana. Our findings identified three types of local vaccine consumers: Afrocentric-ethnocentrics, Apathetic-Afrocentrics and Afrocentric-Fence Sitters. Four out of the eight hypothesised factors explain why some individuals have a positive attitude towards locally made vaccines, compared to those who are unsure of their stance. The proposed typology of local vaccine consumers and their defining characteristics can help design public health campaigns to mobilize support for locally produced vaccines.
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14
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Ann S, Baumann O. Psychological mechanisms and interventions directed at vaccination attitudes. FRONTIERS IN SOCIOLOGY 2023; 8:1076015. [PMID: 36844879 PMCID: PMC9945221 DOI: 10.3389/fsoc.2023.1076015] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 01/16/2023] [Indexed: 06/18/2023]
Abstract
Attitudes about vaccination impact not only the individual but also society. Therefore, understanding the underlying psychological processes of those who disagree with vaccination is critical for creating compassion through understanding and change through promoting autonomy. The current review aimed to fill a gap in the literature, outlining the state of the recent research on vaccination attitudes, specifically on the underlying mechanisms driving anti-vaccination movements and individuals' thoughts and behaviors. In addition, we aimed to evaluate current research on the effectiveness of interventions targeting these mechanisms. Overall, results indicated that those declining vaccines had beliefs related to distrust in the scientific community and pharmaceutical companies and moral preferences for purity and liberty. In addition, our review identified the potential for utilizing motivational interviewing techniques as an intervention. This literature review provides a platform for further research and enhances the current understanding of vaccination attitudes.
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15
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Palella M, Copat C, Grasso A, Cristaldi A, Oliveri Conti G, Ferrante M, Fiore M. Healthcare University Courses Fail to Improve Opinions, Knowledge, and Attitudes toward Vaccines among Healthcare Students: A Southern Italy Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:533. [PMID: 36612854 PMCID: PMC9819233 DOI: 10.3390/ijerph20010533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 12/22/2022] [Accepted: 12/22/2022] [Indexed: 06/17/2023]
Abstract
(1) Background: Healthcare providers have a crucial role in contrasting vaccine hesitancy (VH). We aimed to investigate opinions, knowledge, and attitudes toward vaccines in healthcare students (HS) at the University of Catania (Italy). (2) Methods: A survey was conducted from 1 October 2019 to 31 January 2020. Data on the opinions, knowledge, and attitudes of HS toward vaccinations were collected using an anonymous self-administered questionnaire. The opinion answers were added to calculate the VH index (<18 = low, 19−22 = medium, >23 = high). Data were summarized by the VH index, degree, year of study, and sex differences, using descriptive statistics. (3) Results: A total of 1275 students (53.7% females) participated in the study, with a median (IQR) age of 21 (19−22) years. The median level of VH was 20 (17−23), with slightly higher values in males. We found an inverse trend between VH and opinions, knowledge, and attitudes toward vaccines. The same trend was confirmed in all study courses. Furthermore, the comparison between sexes revealed a higher level of knowledge in women. (4) Conclusions: The results highlight a lack of knowledge about vaccines, as well as contrasting opinions and attitudes among future health professionals. Therefore, future interventions on these topics in the preparation of future healthcare providers are needed.
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Affiliation(s)
- Marco Palella
- Medical Specialization School in Hygiene and Preventive Medicine, Department of Medical, Surgical Sciences and Advanced Technologies “G.F. Ingrassia”, University of Catania, Via Santa Sofia 87, 95123 Catania, Italy
| | - Chiara Copat
- Department of Medical, Surgical and Advanced Technologies “G.F. Ingrassia”, University of Catania, Via Santa Sofia 87, 95123 Catania, Italy
| | - Alfina Grasso
- Department of Medical, Surgical and Advanced Technologies “G.F. Ingrassia”, University of Catania, Via Santa Sofia 87, 95123 Catania, Italy
| | - Antonio Cristaldi
- Department of Medical, Surgical and Advanced Technologies “G.F. Ingrassia”, University of Catania, Via Santa Sofia 87, 95123 Catania, Italy
| | - Gea Oliveri Conti
- Department of Medical, Surgical and Advanced Technologies “G.F. Ingrassia”, University of Catania, Via Santa Sofia 87, 95123 Catania, Italy
| | - Margherita Ferrante
- Department of Medical, Surgical and Advanced Technologies “G.F. Ingrassia”, University of Catania, Via Santa Sofia 87, 95123 Catania, Italy
| | - Maria Fiore
- Department of Medical, Surgical and Advanced Technologies “G.F. Ingrassia”, University of Catania, Via Santa Sofia 87, 95123 Catania, Italy
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16
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Marziali E, Lontano A, Regazzi L, Paladini A, Villani L, Calabrò GE, Damiani G, Laurenti P, Ricciardi W, Cadeddu C. Factors Influencing the Choice to Advise for or against COVID-19 Vaccination in the Physicians and Dentists of an Italian Region. Vaccines (Basel) 2022; 10:1793. [PMID: 36366302 PMCID: PMC9696475 DOI: 10.3390/vaccines10111793] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Revised: 10/21/2022] [Accepted: 10/23/2022] [Indexed: 09/19/2023] Open
Abstract
Healthcare workers (HCWs), particularly physicians, are a relevant and trusted source of information for patients, especially when health-related choices such as vaccination are concerned. Between July and November 2022, we administered a web-based survey to physicians and dentists living in the Latio region of Italy to explore whether their background might affect their willingness to recommend the COVID-19 vaccination to their patients (RCVtoPat) and their relatives (RCVtoRel). We performed a multivariable logistic regression to study the association between the two outcomes (RCVtoPat and RCVtoRel) and their potential determinants in our sample (n = 1464). We found that being a dentist, an increasing fear of COVID-19, and having been previously vaccinated against flu are positively associated with both RCVtoPat and RCVtoRel, while a better self-rated knowledge of COVID-19 vaccines is associated only with RCVtoRel. No role was found for age, sex, civil status, education level, information sources, previous SARS-CoV-2 infection, and chronic diseases. A sub-group analysis of physicians alone (n = 1305) demonstrated a positive association with RCVtoRel of being specialized in diagnostic/therapeutic services and a negative effect on RCVtoPat of being trained in general practice. We provide useful insights about the factors that should be addressed to ensure HCWs exert a positive influence on their patients and communities.
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Affiliation(s)
- Eleonora Marziali
- Section of Hygiene, University Department of Life Sciences and Public Health—Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Alberto Lontano
- Section of Hygiene, University Department of Life Sciences and Public Health—Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Luca Regazzi
- Section of Hygiene, University Department of Life Sciences and Public Health—Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Andrea Paladini
- Section of Hygiene, University Department of Life Sciences and Public Health—Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Leonardo Villani
- Section of Hygiene, University Department of Life Sciences and Public Health—Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Giovanna Elisa Calabrò
- Section of Hygiene, University Department of Life Sciences and Public Health—Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Gianfranco Damiani
- Section of Hygiene, University Department of Life Sciences and Public Health—Università Cattolica del Sacro Cuore, 00168 Rome, Italy
- Department of Women, Children and Public Health—Fondazione Policlinico Universitario “A. Gemelli” IRCCS, 00168 Rome, Italy
| | - Patrizia Laurenti
- Section of Hygiene, University Department of Life Sciences and Public Health—Università Cattolica del Sacro Cuore, 00168 Rome, Italy
- Department of Women, Children and Public Health—Fondazione Policlinico Universitario “A. Gemelli” IRCCS, 00168 Rome, Italy
| | - Walter Ricciardi
- Section of Hygiene, University Department of Life Sciences and Public Health—Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Chiara Cadeddu
- Section of Hygiene, University Department of Life Sciences and Public Health—Università Cattolica del Sacro Cuore, 00168 Rome, Italy
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17
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Bruno S, Nachira L, Villani L, Beccia V, Di Pilla A, Pascucci D, Quaranta G, Carducci B, Spadea A, Damiani G, Lanzone A, Federico B, Laurenti P. Knowledge and beliefs about vaccination in pregnant women before and during the COVID-19 pandemic. Front Public Health 2022; 10:903557. [PMID: 35991061 PMCID: PMC9386522 DOI: 10.3389/fpubh.2022.903557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 07/11/2022] [Indexed: 11/18/2022] Open
Abstract
Introduction Vaccine hesitancy threatens the health of populations and challenges Public Health professionals. Strategies to reduce it aim to improve people's risk perception about vaccine-preventable diseases, fill knowledge gaps about vaccines and increase trust in healthcare providers. During pregnancy, educational interventions can provide a proper knowledge about safety and efficacy of maternal and childhood vaccinations. Fighting hesitancy and clarifying doubts is fundamental during the COVID-19 pandemic, which may have affected people's knowledge and beliefs toward vaccination. This study aimed at assessing if the advent of the pandemic was associated with changes in pregnant women's knowledge and beliefs toward vaccination, and trust in healthcare services. Methods A repeated cross-sectional study was conducted through self-reported questionnaires in a Roman teaching hospital, where educational classes about vaccinations are routinely held as part of a birthing preparation course. Data were collected on a sample of pregnant women before and during the pandemic. Free-of-charge flu vaccinations were offered to all course participants and adherence to flu vaccination was assessed. Results The proportion of pregnant women reporting that vaccines have mild side effects and that are sufficiently tested increased from 78.6 to 92.0% (p = 0.001) and from 79.4 to 93.2% (p = 0.001), respectively. There was a reduction from 33.0 to 23.3% (p = 0.065) in the proportion of those declaring that healthcare workers (HCWs) give information only on the benefits and not on the risks of vaccines, and a reduction from 27.3 to 12.1% (p = 0.001) in those reporting that vaccines are an imposition and not a free choice of mothers. Trust in National Health Service (NHS) operators slightly decreased. Among participants, the monthly flu vaccination adherence ranged from 50.0% in November to 29.2% January for 2019–20 flu season, and from 56.3% in September to 14.5% in January for 2020–21 flu season, showing a higher vaccination acceptance in the earlier months of 2020-21 flu season. Conclusions The pandemic may have positively affected pregnant women's knowledge and opinions about vaccinations and trust in HCWs, despite a possible negative impact on their perceptions about NHS operators. This should inspire Public Health professionals to rethink their role as health communicators.
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Affiliation(s)
- Stefania Bruno
- Women, Children and Public Health Sciences Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Lorenza Nachira
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
- *Correspondence: Lorenza Nachira
| | - Leonardo Villani
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Viria Beccia
- Medical Oncology, Comprehensive Cancer Center, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Andrea Di Pilla
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
- Clinical Governance, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Domenico Pascucci
- Women, Children and Public Health Sciences Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Gianluigi Quaranta
- Women, Children and Public Health Sciences Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Brigida Carducci
- Women, Children and Public Health Sciences Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | | | - Gianfranco Damiani
- Women, Children and Public Health Sciences Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Antonio Lanzone
- Women, Children and Public Health Sciences Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Bruno Federico
- Department of Human Sciences, Society and Health, University of Cassino and Southern Lazio, Cassino, Frosinone, Italy
| | - Patrizia Laurenti
- Women, Children and Public Health Sciences Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
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18
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Franchina V, Bonfanti RC, Lo Coco G, Salerno L. The Role of Existential Concerns in the Individual's Decisions regarding COVID-19 Vaccine Uptake: A Survey among Non-Vaccinated Italian Adults during the Third Wave of the Pandemic. Vaccines (Basel) 2022; 10:1079. [PMID: 35891243 PMCID: PMC9319079 DOI: 10.3390/vaccines10071079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 06/28/2022] [Accepted: 06/30/2022] [Indexed: 11/17/2022] Open
Abstract
Recent studies have suggested that health constructs embraced by the Terror Management Theory (TMT) and the Basic Psychological Needs Theory (BPNT) may drive individuals' COVID-19 health-related decisions. This study examines the relationships between existential concerns (ECs; within the TMT), basic psychological needs (BPNs; within the BPNT) and COVID-19 vaccine hesitancy (VH), as well as the mediating role of negative attitudes toward COVID-19 vaccines. A cross-sectional survey was carried out from April to May 2021 on a sample of two hundred and eighty-seven adults (Mage = 36.04 ± 12.07; 59.9% females). Participants provided information regarding existential concerns, basic psychological needs, attitudes toward COVID-19 vaccines and vaccine hesitancy for Pfizer-BioNTech and AstraZeneca vaccines separately. Higher vaccine hesitancy (32.1%) and vaccine resistance (32.8%) rates were found for AstraZeneca than for Pfizer-BioNTech COVID-19 vaccine (22.3% and 10.1%, respectively). Structural equation modeling showed that existential concerns were related to Pfizer-BioNTech and AstraZeneca vaccine hesitancy both directly and indirectly through negative attitudes toward potential side effects of COVID-19 vaccines. The findings of the study confirm that the TMT is efficient in explaining COVID-19 vaccine hesitancy. Targeted efforts are needed to increase the acceptance of COVID-19 vaccines.
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Affiliation(s)
- Vittoria Franchina
- Department of Psychology, University of Salzburg, 5020 Salzburg, Austria;
| | - Rubinia Celeste Bonfanti
- Department of Psychology, Educational Science and Human Movement, University of Palermo, Viale delle Scienze, Edificio 15, 90128 Palermo, Italy; (R.C.B.); (G.L.C.)
| | - Gianluca Lo Coco
- Department of Psychology, Educational Science and Human Movement, University of Palermo, Viale delle Scienze, Edificio 15, 90128 Palermo, Italy; (R.C.B.); (G.L.C.)
| | - Laura Salerno
- Department of Psychology, Educational Science and Human Movement, University of Palermo, Viale delle Scienze, Edificio 15, 90128 Palermo, Italy; (R.C.B.); (G.L.C.)
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19
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Revisiting COVID-19 vaccine hesitancy around the world using data from 23 countries in 2021. Nat Commun 2022; 13:3801. [PMID: 35778396 PMCID: PMC9247969 DOI: 10.1038/s41467-022-31441-x] [Citation(s) in RCA: 163] [Impact Index Per Article: 81.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 06/14/2022] [Indexed: 12/04/2022] Open
Abstract
The COVID-19 pandemic continues to impact daily life, including health system operations, despite the availability of vaccines that are effective in greatly reducing the risks of death and severe disease. Misperceptions of COVID-19 vaccine safety, efficacy, risks, and mistrust in institutions responsible for vaccination campaigns have been reported as factors contributing to vaccine hesitancy. This study investigated COVID-19 vaccine hesitancy globally in June 2021. Nationally representative samples of 1,000 individuals from 23 countries were surveyed. Data were analyzed descriptively, and weighted multivariable logistic regressions were used to explore associations with vaccine hesitancy. Here, we show that more than three-fourths (75.2%) of the 23,000 respondents report vaccine acceptance, up from 71.5% one year earlier. Across all countries, vaccine hesitancy is associated with a lack of trust in COVID-19 vaccine safety and science, and skepticism about its efficacy. Vaccine hesitant respondents are also highly resistant to required proof of vaccination; 31.7%, 20%, 15%, and 14.8% approve requiring it for access to international travel, indoor activities, employment, and public schools, respectively. For ongoing COVID-19 vaccination campaigns to succeed in improving coverage going forward, substantial challenges remain to be overcome. These include increasing vaccination among those reporting lower vaccine confidence in addition to expanding vaccine access in low- and middle-income countries. Vaccine hesitancy is a public health challenge. Here the authors examine COVID-19 vaccine hesitancy in June 2021 using a survey including individuals from 23 countries, and report differences compared to a year earlier.
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20
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Rania N, Coppola I, Brucci M, Lagomarsino F. Attitudes and Beliefs of the Italian Population towards COVID-19 Vaccinations. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19106139. [PMID: 35627676 PMCID: PMC9141803 DOI: 10.3390/ijerph19106139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 05/09/2022] [Accepted: 05/14/2022] [Indexed: 11/16/2022]
Abstract
Background: Despite the numerous campaigns to encourage vaccination against COVID-19, the public debate and often conflicting information have left many individuals uncertain about the decision to make on whether or not to vaccinate. Methods: This research aims to analyze the attitudes and beliefs of the Italian population towards COVID-19 and other vaccinations through a quantitative methodology. In all, 500 adults (Age M = 39.52) participated in this exploratory study with an online questionnaire conducted in April 2021. Results: most participants believe vaccination is necessary to defeat COVID-19; there is an age-related difference in getting vaccinations, and women were more afraid of unexpected future effects than men; older participants have expressed a greater willingness to pay to be vaccinated against COVID-19 (4). Conclusion: In light of these results, it is necessary to pay greater attention to the perplexity and fears expressed by the population, especially women and youth, in relation to vaccinations; in fact, it would help to achieve a wider adherence to the tools designed to contain the spread of viruses at the base of severe health crises.
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21
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Cadeddu C, Regazzi L, Bonaccorsi G, Rosano A, Unim B, Griebler R, Link T, De Castro P, D’Elia R, Mastrilli V, Palmieri L. The Determinants of Vaccine Literacy in the Italian Population: Results from the Health Literacy Survey 2019. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19084429. [PMID: 35457297 PMCID: PMC9029177 DOI: 10.3390/ijerph19084429] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 03/29/2022] [Accepted: 03/31/2022] [Indexed: 01/06/2023]
Abstract
Vaccines are among the most important public health achievements of the last century; however, vaccine awareness and uptake still face significant challenges and the COVID-19 pandemic has only exacerbated this phenomenon. Vaccine Literacy (VL) is the ability to find, understand and judge immunisation-related information to make appropriate immunisation decisions. A cross-sectional study on a sample of 3500 participants, representative of the Italian adult population aged 18+ years, was conducted in Italy in 2021. A validated questionnaire, including sections on health literacy (HL), sociodemographic characteristics, risk factors, and lifestyles of respondents, was used. VL was measured by four items (item 19, 22, 26 and 29) of the HL section. While 67.6% of the respondents had a “good” (47.5%) or “sufficient” (20.1%) level of VL, 32.4% had “limited” VL levels. Although the overall VL level was quite high, many participants reported difficulties in dealing with vaccination information, particularly those with a lower educational level, those living in southern and insular regions of Italy, those with greater financial deprivation and those with a migration background. Improving VL in Italy should be a top priority in the political agenda, with special regard to socially and geographically disadvantaged communities.
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Affiliation(s)
- Chiara Cadeddu
- Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (C.C.); (L.R.)
| | - Luca Regazzi
- Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (C.C.); (L.R.)
| | | | - Aldo Rosano
- National Institute for the Analysis of Public Policy, 00198 Rome, Italy;
| | - Brigid Unim
- Department of Cardiovascular, Endocrine-Metabolic Diseases and Aging, Italian National Institute of Health, 00162 Rome, Italy;
| | - Robert Griebler
- Competence Centre Health Promotion and Health System, Austrian National Public Health Institute, A-1010 Vienna, Austria; (R.G.); (T.L.)
| | - Thomas Link
- Competence Centre Health Promotion and Health System, Austrian National Public Health Institute, A-1010 Vienna, Austria; (R.G.); (T.L.)
| | - Paola De Castro
- Scientific Communication Unit, Italian National Institute of Health, 00161 Rome, Italy;
| | - Roberto D’Elia
- Ministry of Health, Viale Giorgio Ribotta, 5, 00144 Rome, Italy; (R.D.); (V.M.)
| | - Valeria Mastrilli
- Ministry of Health, Viale Giorgio Ribotta, 5, 00144 Rome, Italy; (R.D.); (V.M.)
| | - Luigi Palmieri
- Department of Cardiovascular, Endocrine-Metabolic Diseases and Aging, Italian National Institute of Health, 00162 Rome, Italy;
- Correspondence:
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22
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Ophir Y, Walter N, Walter D, Velho RM, Lokmanoglu AD, Pruden ML, Andrews EA. Vaccine Hesitancy Under the Magnifying Glass: A Systematic Review of the Uses and Misuses of an Increasingly Popular Construct. HEALTH COMMUNICATION 2022:1-15. [PMID: 35361020 DOI: 10.1080/10410236.2022.2054102] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Resistance to vaccines has hindered attempts to contain and prevent outbreaks of infectious diseases for centuries. More recently, however, the term "vaccine hesitancy" has been used to describe not necessarily outright resistance but also a delay in acceptance or uncertainty regarding vaccines. Given concerns about hesitancy and its impact on vaccine uptake rates, researchers increasingly shifted the focus from resistance to vaccines toward vaccine hesitancy. Acknowledging the urgency to accurately assess the phenomenon, it is critical to understand the state of the literature, focusing on issues of conceptualization and operationalization. To carry out this systematic review, we collected and analyzed all published empirical articles from 2000 to 2021 that explicitly included quantitative self-report measures of vaccine hesitancy (k = 86). Using a mixed-method approach, the review demonstrates and quantifies crucial inconsistencies in the measurement of the construct, lack of clarity in regard to the determination of who should or should not be defined as hesitant, and overreliance on unrepresentative samples. Crucially, our analysis points to a potential systematic bias toward exaggerating the level of hesitancy in the population. Modeling a vaccine hesitancy co-citation network, the analysis also points to the existence of insular academic silos that make it harder to achieve a unified measurement tool. Theoretical and practical implications for academics, practitioners, and policymakers are discussed.
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Affiliation(s)
- Yotam Ophir
- Department of Communication, University at Buffalo, State University of New York
| | - Nathan Walter
- Department of Communication Studies, Northwestern University
| | - Dror Walter
- Department of Communication, Georgia State University
| | - Raphaela M Velho
- Department of Communication, University at Buffalo, State University of New York
| | | | - Meredith L Pruden
- Center for Information, Technology and Public Life, University of North Carolina at Chapel Hill
| | - Emily A Andrews
- Department of Communication Studies, Northwestern University
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VACCINE OPPOSAL IN PEOPLE OVER 60 YEARS OF AGE IN MARDIN/TURKEY – A TERRITORY WITH LOW RATE OF VACCINATION. JOURNAL OF CONTEMPORARY MEDICINE 2022. [DOI: 10.16899/jcm.1024259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Cadeddu C, Sapienza M, Castagna C, Regazzi L, Paladini A, Ricciardi W, Rosano A. Vaccine Hesitancy and Trust in the Scientific Community in Italy: Comparative Analysis from Two Recent Surveys. Vaccines (Basel) 2021; 9:1206. [PMID: 34696314 PMCID: PMC8540200 DOI: 10.3390/vaccines9101206] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 10/12/2021] [Accepted: 10/15/2021] [Indexed: 11/18/2022] Open
Abstract
Vaccination rates in Italy fell until 2015 because of unfounded safety concerns. Public education and a 2017 law on mandatory vaccination have boosted rates since then. The aim of our study is to explore how trust in the scientific community and attitudes towards vaccines have changed in the period of 2017-2019 in Italy. Data were extracted from the Italian section of the 2017 and 2019 editions of the European Social Survey (ESS). We compared the two surveys highlighting changes in public opinion on vaccines. A descriptive analysis of the socio-cultural variables according to the answers provided to key questions on the harmfulness of vaccines was conducted. Differences between percentages were tested by using the χ2 test. The association between the opinion about the harmfulness of vaccines and trust in the scientific community was analyzed through a logistic regression model. Compared to ESS8, ESS9 showed an increase in the percentage of respondents disagreeing with the harmfulness of vaccines. Trust in the scientific community raised in the period from 2017 to 2019 (59% vs. 69.6%). Higher education was significantly associated with disagreement regarding the harmfulness of vaccines (odds ratio (OR) = 2.41; 95% confidence interval (95%CI) 1.75-3.31), the strongest predictor was trust in the scientific community (OR = 10.47; 95% CI 7.55-14.52). In Italy, trust in the scientific community and in vaccinations has grown significantly in recent years, indicating a paradigm shift in public opinion compared to the past. Central actions and effective public communication strategies might reduce vaccine hesitancy and could be essential to garner public trust.
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Affiliation(s)
- Chiara Cadeddu
- Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy; (C.C.); (C.C.); (L.R.); (A.P.); (W.R.)
| | - Martina Sapienza
- Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy; (C.C.); (C.C.); (L.R.); (A.P.); (W.R.)
| | - Carolina Castagna
- Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy; (C.C.); (C.C.); (L.R.); (A.P.); (W.R.)
| | - Luca Regazzi
- Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy; (C.C.); (C.C.); (L.R.); (A.P.); (W.R.)
| | - Andrea Paladini
- Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy; (C.C.); (C.C.); (L.R.); (A.P.); (W.R.)
| | - Walter Ricciardi
- Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy; (C.C.); (C.C.); (L.R.); (A.P.); (W.R.)
| | - Aldo Rosano
- Unit of Statistics, National Institute for Public Policies Analysis (INAPP), Corso d‘Italia 33, 00198 Rome, Italy;
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Knowledge, Attitude, and Practice of Physicians Regarding Vaccinations in Yerevan, Armenia: A Case Study of HPV. Vaccines (Basel) 2021; 9:vaccines9101188. [PMID: 34696296 PMCID: PMC8540740 DOI: 10.3390/vaccines9101188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 10/03/2021] [Accepted: 10/12/2021] [Indexed: 11/17/2022] Open
Abstract
This paper highlights the low levels of vaccine coverage and high levels of reported vaccination hesitancy in Yerevan, Armenia, that present profound challenges to the control of disease through routine vaccination programmes. We draw on investigations of hesitancy towards the introduction of new vaccines, using the Human Papillomavirus (HPV) vaccine Gardasil as a case study, to interrogate underlying challenges to vaccine acceptance. We analyse primary data from the introduction of Gardasil, first used in Armenia in 2017, to investigate how levels of medical knowledge amongst physicians in 20 health facilities in Yerevan, Armenia, regarding vaccine science influence attitudes towards the introduction of a newly developed vaccine. A questionnaire-based cross-sectional study was completed by 348 physicians between December 2017 and September 2018. The responding physicians displayed a respectable level of knowledge and awareness regarding vaccination with respect to some characteristics (e.g., more than 81% knew that HPV infection was commonly asymptomatic, 73% knew that HPV infection was implicated in most cervical cancers, and 87% knew that cervical cancer is the most prevalent cancer amongst women) but low knowledge and poor understanding of other key issues such as the age at which women were most likely to develop cervical cancer (only 15% answered correctly), whether or not the vaccine should be administered to people who had already been infected (27% answered correctly) and whether sexually active young people should be treated for infection before vaccination (26% answered correctly). The study suggests that the drivers of vaccine hesitancy are complex and may not be consistent from vaccine to vaccine. The Armenian healthcare sector may need to provide additional training, awareness-raising and educational activities alongside the introduction of new vaccines to improve understanding of and trust in vaccination programmes.
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Political Ideologies, Government Trust, and COVID-19 Vaccine Hesitancy in South Korea: A Cross-Sectional Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182010655. [PMID: 34682401 PMCID: PMC8536119 DOI: 10.3390/ijerph182010655] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 10/05/2021] [Accepted: 10/07/2021] [Indexed: 11/17/2022]
Abstract
This study aimed to assess the correlation between political ideologies, government trust, and COVID-19 vaccine hesitancy in South Korea during the COVID-19 pandemic. A cross-sectional survey was conducted among South Korea’s general population and 1000 respondents (aged 18 years and older) were included. We used multivariate logistic regression models to identify the factors associated with vaccine hesitancy. Respondents who self-identified as liberal or held “no political opinion” had higher rates of vaccine hesitancy than conservative respondents. People’s trust in the government’s countermeasures was associated with vaccination. Respondents who had risk perceptions (affective and cognitive) of COVID-19 had lower rates of vaccine hesitancy. Perceptions that the vaccine was not safe and being aged 18–29, 30–39, or 40–49 were associated with a higher probability of vaccine hesitancy. This study found that even if vaccine safety and risk perceptions toward COVID-19 were adjusted, self-rated political ideologies and government trust was associated with COVID-19 vaccine hesitancy. More effort to communicate with those who are *liberal or “no political opinion”, younger, and have lower level of trust in the government are required to dissolve vaccine hesitancy. Further studies should analyze the mechanism of COVID-19 vaccine uptake for effective herd immunity.
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Tal O, Ne'eman Y, Sadia R, Shmuel R, Schejter E, Bitan M. Parents' attitudes toward children's vaccination as a marker of trust in health systems. Hum Vaccin Immunother 2021; 17:4518-4528. [PMID: 34613882 DOI: 10.1080/21645515.2021.1971472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
Children's vaccination is a major goal in health-care systems worldwide; nevertheless, disparities in vaccination coverage expose socio-demographic accessibility gaps, unawareness, physicians' disapproval and parents' incomplete adherence reflecting insufficient public-provider trust. Our goal was to analyze parents' attitude toward children's vaccination in correlation with trust among stakeholders. A total of 1031 parents replied to a "snowball" questionnaire; 72% reported high trust in their physician, 42% trusted the authorities, 11% trusted internet groups. Among minorities, parents who fully vaccinate their children were younger, live in urban areas, eat all kinds of foods and trust the authorities, similar to the general population. Low adherence to children's vaccination was correlated with trusting internet groups. Females complied significantly more to child vaccination, although in our study mothers were more highly educated and trusted authorities more than males. The results enable to draw a profile of the "vaccination compliant parent" (with an academic degree, young, urban, eats all kinds of foods, uses conservative medicine). Trust is a major factor influencing vaccination, yet external forces such as community voices, social trends and opinions of religious leaders may play a role in vaccination adherence, beyond personal beliefs, individual habits and self-care. In Israel, education and "healthy behavior" perception alongside generous coverage encourage most parents to comply with the routine vaccination program. In the shade of pandemic outbreaks, we suggest a social-determinant transparent approach to encourage parents to vaccinate their children. Social and religious leaders can pose as agents of change, especially in the case of less educated parents.
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Affiliation(s)
- Orna Tal
- Medical Management Program, Israel Academic College, Ramat Gan, Israel.,Israeli Center for Emerging Technologies, ICET, Zrifin, Israel
| | - Yifat Ne'eman
- Medical Management Program, Israel Academic College, Ramat Gan, Israel
| | - Rotem Sadia
- Medical Management Program, Israel Academic College, Ramat Gan, Israel
| | - Rouchama Shmuel
- Medical Management Program, Israel Academic College, Ramat Gan, Israel
| | - Eitan Schejter
- Medical Management Program, Israel Academic College, Ramat Gan, Israel
| | - Michal Bitan
- Medical Management Program, Israel Academic College, Ramat Gan, Israel
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Cadeddu C, Castagna C, Sapienza M, Lanza TE, Messina R, Chiavarini M, Ricciardi W, de Waure C. Understanding the determinants of vaccine hesitancy and vaccine confidence among adolescents: a systematic review. Hum Vaccin Immunother 2021; 17:4470-4486. [PMID: 34473589 DOI: 10.1080/21645515.2021.1961466] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
Vaccine hesitancy (VH) in the age of adolescence is a major public health issue, though it has not been widely examined in the scientific literature. This systematic review aims to address the determinants of VH among adolescents aged 10-19. PubMed, Scopus, and Web of Science were searched from the inception until 11 December 2020. Articles in English, assessing adolescents' attitudes toward vaccination in terms of hesitancy and/or confidence were considered eligible. Out of 14,704 articles, 20 studies were included in the qualitative analysis. Quality assessment was performed through the Appraisal tool for Cross-Sectional Studies (AXIS). A better knowledge of vaccine-preventable diseases, a higher confidence in vaccines, as well as an active involvement in the decision-making process showed a positive relationship with adolescents' vaccine uptake. These aspects should be considered to plan tailored interventions for the promotion of vaccination among adolescents and to reduce VH. Major limitations of this review are represented by the high heterogeneity of the tools used in the primary studies and the lack of standardization in outcomes definitions. Future research is needed to disentangle the interrelationship among the different determinants of VH in this age group.
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Affiliation(s)
- Chiara Cadeddu
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica Del Sacro Cuore, Rome, Italy
| | - Carolina Castagna
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica Del Sacro Cuore, Rome, Italy
| | - Martina Sapienza
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica Del Sacro Cuore, Rome, Italy
| | - Teresa Eleonora Lanza
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica Del Sacro Cuore, Rome, Italy
| | - Rosaria Messina
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica Del Sacro Cuore, Rome, Italy
| | - Manuela Chiavarini
- Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Walter Ricciardi
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica Del Sacro Cuore, Rome, Italy
| | - Chiara de Waure
- Department of Medicine and Surgery, University of Perugia, Perugia, Italy
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Vrachatis DA, Deftereos SG, Lansky A. Heroes, politics and media: the unshakable medical practice in the pandemic. Eur Heart J 2021; 42:2622-2625. [PMID: 33647950 DOI: 10.1093/eurheartj/ehab101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Dimitrios A Vrachatis
- 2nd Department of Cardiology, National and Kapodistrian University of Athens, 1 Rimini, Chaidari, 124 62 Athens, Greece
| | - Spyridon G Deftereos
- 2nd Department of Cardiology, National and Kapodistrian University of Athens, 1 Rimini, Chaidari, 124 62 Athens, Greece
| | - Alexandra Lansky
- Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA
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Caso D, Capasso M, Fabbricatore R, Conner M. Understanding the psychosocial determinants of Italian parents' intentions not to vaccinate their children: an extended theory of planned behaviour model. Psychol Health 2021; 37:1111-1131. [PMID: 34180333 DOI: 10.1080/08870446.2021.1936522] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE This study aimed to identify the psychosocial factors involved in Italian parents' intentions not to vaccinate their children. For this purpose, we used an extended version of the Theory of Planned Behaviour, which included both proximal and distal factors influencing intention not to vaccinate children. DESIGN Participants included 447 Italian parents, each completed an online questionnaire, which measured intention not to vaccinate children, attitude toward not vaccinating, subjective norms, perceived behavioural control, anticipated regret, negative attitude toward vaccines, risk perception, trust in healthcare institutions, trust in science and religious morality. RESULTS Results showed that attitude toward not vaccinating was strongly associated with intention not to vaccinate children. Furthermore, attitude toward not vaccinating was associated with negative attitude toward vaccines, which in turn was affected by all the distal factors considered (risk perception, trust in healthcare institutions, trust in science, religious morality). Finally, negative attitude toward vaccines fully mediated the effect of the distal factors on attitude toward not vaccinating children. CONCLUSION These findings provide support for the validity of the proposed extended TPB model in explaining parents' intention not to vaccinate children. Theoretical and practical implications, in terms of understanding and promoting vaccination behaviour, are discussed.
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Affiliation(s)
- Daniela Caso
- Department of Humanities, University of Naples Federico II, Naples, Italy
| | - Miriam Capasso
- Department of Humanities, University of Naples Federico II, Naples, Italy
| | - Rosa Fabbricatore
- Department of Social Sciences, University of Naples Federico II, Naples, Italy
| | - Mark Conner
- School of Psychology, University of Leeds, Leeds, UK
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Thaker J. The Persistence of Vaccine Hesitancy: COVID-19 Vaccination Intention in New Zealand. JOURNAL OF HEALTH COMMUNICATION 2021; 26:104-111. [PMID: 33719898 DOI: 10.1080/10810730.2021.1899346] [Citation(s) in RCA: 55] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Building public trust and willingness to vaccinate against COVID-19 is as important as developing an effective vaccine. However, a significant minority of the public are unwilling or hesitant to take a COVID-19 vaccine, when available. A nationally representative sample survey (N = 1040) was conducted in July 2020 in New Zealand to identify factors associated with COVID-19 vaccine intention. A 14-item general vaccine hesitancy scale was tested and found to be significantly associated with COVID-19 vaccine intention. A communication campaign from trusted scientific experts, with information that addresses prevailing concerns about vaccines, is likely to help increase COVID-19 vaccine uptake.
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Affiliation(s)
- Jagadish Thaker
- School of Communication, Journalism & Marketing, Massey University, Wellington, New Zealand
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32
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Debus M, Tosun J. Political ideology and vaccination willingness: implications for policy design. POLICY SCIENCES 2021; 54:477-491. [PMID: 34149102 PMCID: PMC8206899 DOI: 10.1007/s11077-021-09428-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/29/2021] [Indexed: 05/14/2023]
Abstract
UNLABELLED The COVID-19 pandemic has forced governments to impose major restrictions on individual freedom in order to stop the spread of the virus. With the successful development of a vaccine, these restrictions are likely to become obsolete-on the condition that people get vaccinated. However, parts of the population have reservations against vaccination. While this is not a recent phenomenon, it might prove a critical one in the context of current attempts to manage the COVID-19 pandemic. Consequently, the task of designing policies suitable for attaining high levels of vaccination deserves enhanced attention. In this study, we use data from the Eurobarometer survey fielded in March 2019. They show that 39% of Europeans consider vaccines to cause the diseases which they should protect against, that 50% believe vaccines have serious side effects, that 32% think that vaccines weaken the immune system, and that 10% do not believe vaccines are tested rigorously before authorization. We find that-even when controlling for important individual-level factors-ideological extremism on both ends of the spectrum explains skepticism of vaccination. We conclude that policymakers must either politicize the issue or form broad alliances among parties and societal groups in order to increase trust in and public support for the vaccines in general and for vaccines against COVID-19 in particular, since the latter were developed in a very short time period and resulted-in particular in case of the AstraZeneca vaccine-in reservations because of the effectiveness and side effects of the new vaccines. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1007/s11077-021-09428-0.
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Affiliation(s)
- Marc Debus
- School of Social Sciences, University of Mannheim, A5, 6, 68131 Mannheim, Germany
| | - Jale Tosun
- Institute of Political Science, Heidelberg University, Bergheimer Straße 58, 69115 Heidelberg, Germany
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