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Blonde L, Umpierrez GE, Reddy SS, McGill JB, Berga SL, Bush M, Chandrasekaran S, DeFronzo RA, Einhorn D, Galindo RJ, Gardner TW, Garg R, Garvey WT, Hirsch IB, Hurley DL, Izuora K, Kosiborod M, Olson D, Patel SB, Pop-Busui R, Sadhu AR, Samson SL, Stec C, Tamborlane WV, Tuttle KR, Twining C, Vella A, Vellanki P, Weber SL. American Association of Clinical Endocrinology Clinical Practice Guideline: Developing a Diabetes Mellitus Comprehensive Care Plan-2022 Update. Endocr Pract 2022; 28:923-1049. [PMID: 35963508 PMCID: PMC10200071 DOI: 10.1016/j.eprac.2022.08.002] [Citation(s) in RCA: 139] [Impact Index Per Article: 69.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 08/01/2022] [Accepted: 08/02/2022] [Indexed: 02/06/2023]
Abstract
OBJECTIVE The objective of this clinical practice guideline is to provide updated and new evidence-based recommendations for the comprehensive care of persons with diabetes mellitus to clinicians, diabetes-care teams, other health care professionals and stakeholders, and individuals with diabetes and their caregivers. METHODS The American Association of Clinical Endocrinology selected a task force of medical experts and staff who updated and assessed clinical questions and recommendations from the prior 2015 version of this guideline and conducted literature searches for relevant scientific papers published from January 1, 2015, through May 15, 2022. Selected studies from results of literature searches composed the evidence base to update 2015 recommendations as well as to develop new recommendations based on review of clinical evidence, current practice, expertise, and consensus, according to established American Association of Clinical Endocrinology protocol for guideline development. RESULTS This guideline includes 170 updated and new evidence-based clinical practice recommendations for the comprehensive care of persons with diabetes. Recommendations are divided into four sections: (1) screening, diagnosis, glycemic targets, and glycemic monitoring; (2) comorbidities and complications, including obesity and management with lifestyle, nutrition, and bariatric surgery, hypertension, dyslipidemia, retinopathy, neuropathy, diabetic kidney disease, and cardiovascular disease; (3) management of prediabetes, type 2 diabetes with antihyperglycemic pharmacotherapy and glycemic targets, type 1 diabetes with insulin therapy, hypoglycemia, hospitalized persons, and women with diabetes in pregnancy; (4) education and new topics regarding diabetes and infertility, nutritional supplements, secondary diabetes, social determinants of health, and virtual care, as well as updated recommendations on cancer risk, nonpharmacologic components of pediatric care plans, depression, education and team approach, occupational risk, role of sleep medicine, and vaccinations in persons with diabetes. CONCLUSIONS This updated clinical practice guideline provides evidence-based recommendations to assist with person-centered, team-based clinical decision-making to improve the care of persons with diabetes mellitus.
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Affiliation(s)
| | | | - S Sethu Reddy
- Central Michigan University, Mount Pleasant, Michigan
| | | | | | | | | | | | - Daniel Einhorn
- Scripps Whittier Diabetes Institute, La Jolla, California
| | | | | | - Rajesh Garg
- Lundquist Institute/Harbor-UCLA Medical Center, Torrance, California
| | | | | | | | | | | | - Darin Olson
- Colorado Mountain Medical, LLC, Avon, Colorado
| | | | | | - Archana R Sadhu
- Houston Methodist; Weill Cornell Medicine; Texas A&M College of Medicine; Houston, Texas
| | | | - Carla Stec
- American Association of Clinical Endocrinology, Jacksonville, Florida
| | | | - Katherine R Tuttle
- University of Washington and Providence Health Care, Seattle and Spokane, Washington
| | | | | | | | - Sandra L Weber
- University of South Carolina School of Medicine-Greenville, Prisma Health System, Greenville, South Carolina
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Bitar AN, Zawiah M, Al-Ashwal FY, Kubas M, Saeed RM, Abduljabbar R, Jaber AAS, Sulaiman SAS, Khan AH. Misinformation, perceptions towards COVID-19 and willingness to be vaccinated: A population-based survey in Yemen. PLoS One 2021; 16:e0248325. [PMID: 34714827 PMCID: PMC8555792 DOI: 10.1371/journal.pone.0248325] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 10/19/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Since the beginning of the COVID-19 outbreak, many pharmaceutical companies have been racing to develop a safe and effective COVID-19 vaccine. Simultaneously, rumors and misinformation about COVID-19 are still widely spreading. Therefore, this study aimed to investigate the prevalence of COVID-19 misinformation among the Yemeni population and its association with vaccine acceptance and perceptions. METHODS A cross-sectional online survey was conducted in four major cities in Yemen. The constructed questionnaire consisted of four main sections (sociodemographic data, misinformation, perceptions (perceived susceptibility, severity, and worry), and vaccination acceptance evaluation). Subject recruitment and data collection were conducted online utilizing social websites and using the snowball sampling technique. Descriptive and inferential analyses were performed using SPSS version 27. RESULTS The total number of respondents was 484. Over 60% of them were males and had a university education. More than half had less than 100$ monthly income and were khat chewers, while only 18% were smokers. Misinformation prevalence ranged from 8.9% to 38.9%, depending on the statement being asked. Men, university education, higher income, employment, and living in urban areas were associated with a lower misinformation level (p <0.05). Statistically significant association (p <0.05) between university education, living in urban areas, and being employed with perceived susceptibility were observed. The acceptance rate was 61.2% for free vaccines, but it decreased to 43% if they had to purchase it. Females, respondents with lower monthly income, and those who believed that pharmaceutical companies made the virus for financial gains were more likely to reject the vaccination (p <0.05). CONCLUSION The study revealed that the acceptance rate to take a vaccine was suboptimal and significantly affected by gender, misinformation, cost, and income. Furthermore, being female, non-university educated, low-income, and living in rural areas were associated with higher susceptibility to misinformation about COVID-19. These findings show a clear link between misinformation susceptibility and willingness to vaccinate. Focused awareness campaigns to decrease misinformation and emphasize the vaccination's safety and efficacy might be fundamental before initiating any mass vaccination in Yemen.
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Affiliation(s)
- Ahmad Naoras Bitar
- Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia
| | - Mohammed Zawiah
- Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia
- Department of Pharmacy Practice, College of Clinical Pharmacy, University of Al Hodeida, Al Hodeida, Yemen
- * E-mail: (FYA); (MZ)
| | - Fahmi Y. Al-Ashwal
- Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia
- Clinical Pharmacy Department, University of Science and Technology Hospital, Sana’a, Yemen
- * E-mail: (FYA); (MZ)
| | - Mohammed Kubas
- Clinical Pharmacy Department, University of Science and Technology Hospital, Sana’a, Yemen
- Pharmacy Practice Department, Kulliyyah of Pharmacy, International Islamic University Malaysia, Kuantan, Pahang, Malaysia
| | - Ramzi Mukred Saeed
- Department of Clinical Pharmacy and Pharmacy Practice, University of Science and Technology, Sana’a, Yemen
- Department of Pharmaceutical sciences, School of Pharmacy, The University of Jordan, Amman, Jordan
| | - Rami Abduljabbar
- Department of Biopharmaceutics and Clinical Pharmacy, School of Pharmacy, The University of Jordan, Amman, Jordan
| | - Ammar Ali Saleh Jaber
- Department of Clinical Pharmacy & Pharmacotherapeutics, Dubai Pharmacy College for Girls, Dubai, United Arab Emirates
| | - Syed Azhar Syed Sulaiman
- Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia
| | - Amer Hayat Khan
- Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia
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Enria L, Bangura JS, Kanu HM, Kalokoh JA, Timbo AD, Kamara M, Fofanah M, Kamara AN, Kamara AI, Kamara MM, Suma IS, Kamara OM, Kamara AM, Kamara AO, Kamara AB, Kamara E, Lees S, Marchant M, Murray M. Bringing the social into vaccination research: Community-led ethnography and trust-building in immunization programs in Sierra Leone. PLoS One 2021; 16:e0258252. [PMID: 34679104 PMCID: PMC8535180 DOI: 10.1371/journal.pone.0258252] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 09/20/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Vaccine hesitancy is a complex, contested social phenomenon and existing research highlights the multifaceted role of trust in strengthening vaccine confidence. However, understanding public engagement with vaccination through the lens of (mis)trust requires more contextual evidence on trust's qualitative determinants. This includes expanding the geographic focus beyond current studies' focus on High Income Countries. Furthermore, obstacles remain in effectively integrating social science findings in the design of vaccine deployment strategies, and in ensuring that those who implement interventions and are affected by them are directly involved in producing knowledge about vaccination challenges. METHODS We piloted a community-led ethnographic approach, training Community Health Workers (CHWs) in Kambia District, Sierra Leone, in qualitative social science methods. Methods included participant observation, participatory power mapping and rumour tracking, focus group discussions and key stakeholder interviews. CHWs, with the support of public health officials and professional social scientists, conducted research on vaccination challenges, analysed data, tested new community engagement strategies based on their findings and elicited local perspectives on these approaches. RESULTS Our findings on vaccine confidence in five border communities highlighted three key themes: the impact of prior experiences with the health system on (mis)trust; relevance of livelihood strategies and power dynamics for vaccine uptake and access; and the contextual nature of knowledge around vaccines. Across these themes, we show how expressions of trust centered on social proximity, reliability and respect and the role of structural issues affecting both vaccine access and confidence. The pilot also highlighted the value and practical challenges to meaningfully co-designed research. CONCLUSION There is scope for broader application of a community-led ethnographic approach will help redesign programming that is responsive to local knowledge and experience. Involving communities and low-cadre service providers in generating knowledge and solutions can strengthen relationships and sustain dialogue to bolster vaccine confidence.
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Affiliation(s)
- Luisa Enria
- Department of Global Health and Development, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Joseph S. Bangura
- Kambia District Health Management Team, Ministry of Health and Sanitation, Government of Sierra Leone, Kambia, Sierra Leone
| | - Hassan M. Kanu
- Kambia District Health Management Team, Ministry of Health and Sanitation, Government of Sierra Leone, Kambia, Sierra Leone
| | - Joseph A. Kalokoh
- Kambia District Health Management Team, Ministry of Health and Sanitation, Government of Sierra Leone, Kambia, Sierra Leone
| | - Alie D. Timbo
- Kambia District Health Management Team, Ministry of Health and Sanitation, Government of Sierra Leone, Kambia, Sierra Leone
| | - Mohamed Kamara
- Kambia District Health Management Team, Ministry of Health and Sanitation, Government of Sierra Leone, Kambia, Sierra Leone
| | - Maligie Fofanah
- Kambia District Community Health Workers Programme, Kambia, Sierra Leone
| | - Alhassan N. Kamara
- Kambia District Community Health Workers Programme, Kambia, Sierra Leone
| | - Adikalie I. Kamara
- Kambia District Community Health Workers Programme, Kambia, Sierra Leone
| | - Morlai M. Kamara
- Kambia District Community Health Workers Programme, Kambia, Sierra Leone
| | - Ibrahim Sorie Suma
- Kambia District Community Health Workers Programme, Kambia, Sierra Leone
| | - Osman M. Kamara
- Kambia District Community Health Workers Programme, Kambia, Sierra Leone
| | - Alusine M. Kamara
- Kambia District Community Health Workers Programme, Kambia, Sierra Leone
| | - Alhajie O. Kamara
- Kambia District Community Health Workers Programme, Kambia, Sierra Leone
| | - Abu B. Kamara
- Kambia District Community Health Workers Programme, Kambia, Sierra Leone
| | - Emmah Kamara
- Kambia District Community Health Workers Programme, Kambia, Sierra Leone
| | - Shelley Lees
- Department of Global Health and Development, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Mark Marchant
- Department of Global Health and Development, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Mariama Murray
- National AIDS Control Programme, Ministry of Health and Sanitation, Government of Sierra Leone, Kambia, Sierra Leone
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Alshahrani NZ, Alshahrani SM, Farag S, Rashid H. Domestic Saudi Arabian Travellers' Understanding about COVID-19 and Its Vaccination. Vaccines (Basel) 2021; 9:vaccines9080895. [PMID: 34452020 PMCID: PMC8402648 DOI: 10.3390/vaccines9080895] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Revised: 07/21/2021] [Accepted: 08/09/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND There is a lack of data on Saudi domestic air travellers' understanding regarding COVID-19 and their attitude towards the COVID-19 vaccination. OBJECTIVES This study aimed to assess Saudi domestic air travellers' understanding regarding COVID-19 and attitude towards mandating the COVID-19 vaccination for travellers. METHODS A survey using a self-administered, structured, and closed-ended questionnaire was conducted among domestic air travellers in Saudi Arabia. Participants' socio-demographic information, travel history, health status, and attitudes and willingness to accept the COVID-19 vaccination were collected and analysed. RESULTS Of the 2236 respondents who participated in the survey, 542 (24.25%) had a history of COVID-19, 803 (35.9%) were exposed to a COVID-19 case, 1425 (63.7%) were concerned about catching COVID-19 during air travel, 796 (35.6%) thought the COVID-19 vaccination should be obligatory for travellers, 1105 (49.4%) thought it should be optional, and 335 (15.0%) thought the vaccination was unnecessary. Being of the male gender (adjusted odds ratio [aOR] 1.41, 95% confidence interval [95% CI] 1.14-1.69), being concerned about contracting COVID-19 (aOR 1.34, 95% CI 1.12-2.10) and frequent travelling (aOR 1.40, 95% CI 1.10-3.40) were predictors of vaccination uptake. CONCLUSION This study demonstrates that although domestic Saudi travellers were concerned about COVID-19 infection, vaccine hesitancy was prevalent among them.
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Affiliation(s)
- Najim Z. Alshahrani
- Department of Family and Community Medicine, Faculty of Medicine, University of Jeddah, Jeddah 21589, Saudi Arabia
- Correspondence: ; Tel.: +966-544404833
| | | | - Shehata Farag
- Department of Family and Community Medicine, King Khalid University, Abha 62529, Saudi Arabia;
- Biostatistics Department, High Institute of Public Health, Alexandria University, Alexandria 21526, Egypt
| | - Harunor Rashid
- National Centre for Immunisation Research and Surveillance (NCIRS), Westmead, NSW 2145, Australia;
- Discipline of Child and Adolescent Health, The Children’s Hospital at Westmead Clinical School, Westmead, NSW 2145, Australia
- Marie Bashir Institute for Infectious Diseases and Biosecurity, School of Biological Sciences and Sydney Medical School, The University of Sydney, Westmead, NSW 2145, Australia
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Anderson E, Brigden A, Davies A, Shepherd E, Ingram J. Maternal vaccines during the Covid-19 pandemic:A qualitative interview study with UK pregnant women. Midwifery 2021; 100:103062. [PMID: 34198208 PMCID: PMC8192261 DOI: 10.1016/j.midw.2021.103062] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 05/21/2021] [Accepted: 06/02/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND There is suboptimal uptake of recommended maternal vaccines (pertussis and influenza) during pregnancy in the UK. The Covid-19 pandemic has impacted healthcare services, and potentially vaccine coverage, and brought the need for new vaccines to be tested and rolled out. OBJECTIVES To explore: i) the impact of the Covid-19 pandemic on pregnant women's access to, and attitudes towards, routine maternal vaccines and; ii) women's attitudes towards testing Covid-19 vaccines on pregnant women and their personal willingness to take part in such a trial. DESIGN Qualitative interview study with pregnant women in the Bristol and surrounding area (UK). METHODS Semi-structured telephone/videoconference interviews were conducted (following a topic guide), transcribed verbatim and subjected to thematic analysis. RESULTS Thirty-one pregnant women (selected for demographic range) were interviewed in April/May 2020. Participants felt the pandemic had elevated the importance of routine maternal vaccines, though women were concerned about safety management around appointment attendance. Women were wary of receiving a new Covid-19 vaccine, with most perceiving it as riskier than Covid-19 itself. CONCLUSIONS It is important to maximise the safety and efficiency of maternity appointments to encourage uptake of routine maternal vaccines, and to communicate this well. For pregnant women to gain a new vaccine or participate in a vaccine trial, they need to be convinced that the risk posed by the virus is greater than any risk of receiving a new vaccine.
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Affiliation(s)
- Emma Anderson
- Centre for Academic Child Health, Bristol Medical School: Population Health Sciences, University of Bristol, 1-5 Whiteladies Road, Bristol BS8 1NU.
| | - Amberly Brigden
- Centre for Academic Child Health, Bristol Medical School: Population Health Sciences, University of Bristol, 1-5 Whiteladies Road, Bristol BS8 1NU
| | - Anna Davies
- Centre for Academic Child Health, Bristol Medical School: Population Health Sciences, University of Bristol, 1-5 Whiteladies Road, Bristol BS8 1NU
| | - Emily Shepherd
- Centre for Academic Child Health, Bristol Medical School: Population Health Sciences, University of Bristol, 1-5 Whiteladies Road, Bristol BS8 1NU
| | - Jenny Ingram
- Centre for Academic Child Health, Bristol Medical School: Population Health Sciences, University of Bristol, 1-5 Whiteladies Road, Bristol BS8 1NU
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Basch CH, Meleo-Erwin Z, Fera J, Jaime C, Basch CE. A global pandemic in the time of viral memes: COVID-19 vaccine misinformation and disinformation on TikTok. Hum Vaccin Immunother 2021; 17:2373-2377. [PMID: 33764283 DOI: 10.1080/21645515.2021.1894896] [Citation(s) in RCA: 71] [Impact Index Per Article: 23.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
Misinformation and disinformation regarding COVID-19 and vaccination against it may be contributing to vaccine hesitancy. Social media outlets have reportedly made efforts to limit false information yet untruths related to COVID-19 persist online. The purpose of this study was to describe the content on COVID-19 vaccination on TikTok, an emerging social media platform. One-hundred trending videos were identified from the hashtag #covidvaccine and were coded for content. Collectively, these videos garnered over 35 million views. The coding category with the highest number of videos was "Discouraged a Vaccine" (n = 38), followed by "Encouraged a Vaccine" (n = 36). While only 36 videos encouraged a vaccine, these videos garnered over 50% of the total cumulative views and just under 50% of the total likes; the 38 videos that discouraged a vaccine garnered 39.6% of the total cumulative views, 44.3% of likes, and 47.4% of comments. Of the 38 videos discouraging the vaccine, 25 (65.79%) showed a parody of an adverse reaction and, collectively, received 71.07% of the total views among videos in this category. Twenty-two of these 38 videos (57.89%) falsely conveyed that a vaccine was available, as they were not at the time of the study. Anti-vaccination messaging may undermine efforts to ensure widespread uptake of the various COVID-19 vaccines, particularly for young people who are more likely than other age cohorts to use TikTok.
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Affiliation(s)
- Corey H Basch
- Department of Public Health, William Paterson University, Wayne, New Jersey, USA
| | - Zoe Meleo-Erwin
- Department of Public Health, William Paterson University, Wayne, New Jersey, USA
| | - Joseph Fera
- Department of Mathematics, Lehman College, The City University of New York, New York, New York, USA
| | - Christie Jaime
- Department of Public Health, William Paterson University, Wayne, New Jersey, USA
| | - Charles E Basch
- Department of Health and Behavior Studies, Teachers College, Columbia University, New York, New York, USA
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Vaccine hesitancy in the era of COVID-19. Public Health 2021; 194:245-251. [PMID: 33965796 PMCID: PMC7931735 DOI: 10.1016/j.puhe.2021.02.025] [Citation(s) in RCA: 578] [Impact Index Per Article: 192.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 02/19/2021] [Accepted: 02/22/2021] [Indexed: 12/14/2022]
Abstract
Objectives In 2019, a new coronavirus has been identified and many efforts have been directed toward the development of effective vaccines. However, the willingness for vaccination is deeply influenced by several factors. So the aim of our review was to analyze the theme of vaccine hesitancy during COVID-19 pandemic, with a particular focus on vaccine hesitancy toward COVID-19 vaccine. Study design Narrative review. Methods In November 2020, we performed a search for original peer-reviewed articles in the electronic database PubMed (MEDLINE). The key search terms were “Vaccine hesitancy AND COVID-19”. We searched for studies published during COVID-19 pandemic and reporting information about the phenomenon of vaccine hesitancy. Results Fifteen studies were included in the review. The percentage of COVID-19 vaccine acceptance was not so high (up to 86.1% students or 77.6% general population); for influenza vaccine, the maximum percentage was 69%. Several factors influenced the acceptance or refusal (ethnicity, working status, religiosity, politics, gender, age, education, income, etc.). The most given reasons to refuse vaccine were as follows: being against vaccines in general, concerns about safety/thinking that a vaccine produced in a rush is too dangerous, considering the vaccine useless because of the harmless nature of COVID-19, general lack of trust, doubts about the efficiency of the vaccine, belief to be already immunized, doubt about the provenience of vaccine. Conclusions The high vaccine hesitancy, also during COVID-19 pandemic, represents an important problem, and further efforts should be done to support people and give them correct information about vaccines.
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