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Parsons Leigh J, FitzGerald EA, Moss SJ, Cherak MS, Brundin-Mather R, Dodds A, Stelfox HT, Dubé È, Fiest KM, Halperin DM, Ahmed SB, MacDonald SE, Straus SE, Manca T, Ng Kamstra J, Soo A, Longmore S, Kupsch S, Sept B, Halperin SA. The evolution of vaccine hesitancy through the COVID-19 pandemic: A semi-structured interview study on booster and bivalent doses. Hum Vaccin Immunother 2024; 20:2316417. [PMID: 38390696 PMCID: PMC10896168 DOI: 10.1080/21645515.2024.2316417] [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: 11/27/2023] [Accepted: 02/06/2024] [Indexed: 02/24/2024] Open
Abstract
We sought in-depth understanding on the evolution of factors influencing COVID-19 booster dose and bivalent vaccine hesitancy in a longitudinal semi-structured interview-based qualitative study. Serial interviews were conducted between July 25th and September 1st, 2022 (Phase I: univalent booster dose availability), and between November 21st, 2022 and January 11th, 2023 (Phase II: bivalent vaccine availability). Adults (≥18 years) in Canada who had received an initial primary series and had not received a COVID-19 booster dose were eligible for Phase I, and subsequently invited to participate in Phase II. Twenty-two of twenty-three (96%) participants completed interviews for both phases (45 interviews). Nearly half of participants identified as a woman (n = 11), the median age was 37 years (interquartile range: 32-48), and most participants were employed full-time (n = 12); no participant reported needing to vaccinate (with a primary series) for their workplace. No participant reported having received a COVID-19 booster dose at the time of their interview in Phase II. Three themes relating to the development of hesitancy toward continued vaccination against COVID-19 were identified: 1) effectiveness (frequency concerns; infection despite vaccination); 2) necessity (less threatening, low urgency, alternate protective measures); and 3) information (need for data, contradiction and confusion, lack of trust, decreased motivation). The data from interviews with individuals who had not received a COVID-19 booster dose or bivalent vaccine despite having received a primary series of COVID-19 vaccines highlights actionable targets to address vaccine hesitancy and improve public health literacy.
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Affiliation(s)
- Jeanna Parsons Leigh
- Faculty of Health, School of Health Administration, Dalhousie University, Halifax, Nova Scotia, Canada
- Department of Critical Care Medicine, University of Calgary, Calgary, Alberta, Canada
- Canadian Center for Vaccinology & IWK Health Center, Halifax, Nova Scotia, Canada
| | - Emily A. FitzGerald
- Faculty of Health, School of Health Administration, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Stephana Julia Moss
- Faculty of Health, School of Health Administration, Dalhousie University, Halifax, Nova Scotia, Canada
- CRISMA Center, Department of Critical Care, University of Pittsburgh, Pittsburgh, USA
| | - Michal S. Cherak
- Faculty of Health, School of Health Administration, Dalhousie University, Halifax, Nova Scotia, Canada
- Canadian Center for Vaccinology & IWK Health Center, Halifax, Nova Scotia, Canada
| | | | - Alexandra Dodds
- Faculty of Health, School of Health Administration, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Henry T. Stelfox
- Department of Critical Care Medicine, University of Calgary, Calgary, Alberta, Canada
- Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Ève Dubé
- Centre de Recherche du CHU de Québec, Université Laval, Québec, Canada
- Département d’anthropologie, Université Laval, Québec, Canada
| | - Kirsten M. Fiest
- Department of Critical Care Medicine, University of Calgary, Calgary, Alberta, Canada
- O’Brien Institute for Public Health, University of Calgary, Calgary, Alberta, Canada
- Department of Psychiatry & Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Donna M. Halperin
- Canadian Center for Vaccinology & IWK Health Center, Halifax, Nova Scotia, Canada
- Rankin School of Nursing, St. Francis Xavier University, Antigonish, Nova Scotia, Canada
| | - Sofia B. Ahmed
- Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
- Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Shannon E. MacDonald
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Sharon E. Straus
- Li Ka Shing Knowledge Institute of St. Michael’s Hospital, Unity Health Toronto, Toronto, Ontario, Canada
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Terra Manca
- Faculty of Health Disciplines, Athabasca University, Athabasca, Alberta, Canada
- Sociology and Social Anthropology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Josh Ng Kamstra
- Department of Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Andrea Soo
- Department of Critical Care Medicine, University of Calgary, Calgary, Alberta, Canada
- Alberta Health Services, Calgary, Alberta, Canada
| | - Shelly Longmore
- Department of Critical Care Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Shelly Kupsch
- Department of Critical Care Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Bonnie Sept
- Department of Critical Care Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Scott A. Halperin
- Canadian Center for Vaccinology & IWK Health Center, Halifax, Nova Scotia, Canada
- Department of Pediatrics, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
- Department of Microbiology and Immunology, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
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Akinsola KO, Bakare AA, Gobbo E, King C, Hanson C, Falade A, Herzig van Wees S. A systematic review of measures of healthcare workers' vaccine confidence. Hum Vaccin Immunother 2024; 20:2322796. [PMID: 38506574 PMCID: PMC10956625 DOI: 10.1080/21645515.2024.2322796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 02/21/2024] [Indexed: 03/21/2024] Open
Abstract
Healthcare workers (HCW) perceptions toward vaccines influence patient and community vaccine decision making. In an era of rising vaccine hesitancy, understanding HCW vaccine confidence is critical. This systematic review aims to review instruments that have been validated to measure HCW vaccine confidence. We conducted a search in five databases in June 2023. Data was descriptively synthesized. Twelve articles describing 10 different tools were included. Most tools included dimensions or items on vaccine knowledge (n = 9), safety (n = 8), vaccine usefulness (n = 8), recommendation behavior (n = 8), and self-vaccination practice (n = 7). All, except one study, were conducted in high-income countries. There was variability in the quality of the validation process. There is limited existing literature on development and validation of tools for HCW vaccine confidence. Based on the tools currently available, the Pro-VC-Be tool is the most well validated. Further research needs to include low- and middle-income contexts.
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Affiliation(s)
| | - Ayobami A. Bakare
- Department of Community Medicine, University College Hospital, Ibadan, Nigeria
- Global Public Health Department, Karolinska Institutet, Stockholm, Sweden
| | - Elisa Gobbo
- Global Public Health Department, Karolinska Institutet, Stockholm, Sweden
| | - Carina King
- Global Public Health Department, Karolinska Institute, Stockholm, Sweden
| | - Claudia Hanson
- Global Public Health Department, Karolinska Institute, Stockholm, Sweden
- Department of Disease Control, London School of Hygiene & Tropical Medicine, London, UK
- Centre of Excellence for Women and Child Health, Aga Khan University, Nairobi, Kenya
| | - Adegoke Falade
- Department of Pediatrics, University College Hospital, Ibadan, Nigeria
- Pediatrics Department, University of Ibadan, Ibadan, Nigeria
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3
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Bakare D, Gobbo E, Akinsola KO, Bakare AA, Salako J, Hanson C, Herzig van Wees S, Falade A, King C. Healthcare worker practices for HPV vaccine recommendation: A systematic review and meta-analysis. Hum Vaccin Immunother 2024; 20:2402122. [PMID: 39400296 PMCID: PMC11486212 DOI: 10.1080/21645515.2024.2402122] [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: 06/20/2024] [Revised: 08/23/2024] [Accepted: 09/05/2024] [Indexed: 10/15/2024] Open
Abstract
Healthcare workers (HCWs) are trusted sources of information for vaccination and their attitude toward vaccination is thus critical. We aimed to synthesize existing literature on healthcare workers' HPV vaccine confidence and their practices of recommending this vaccine. We conducted a systematic literature review and meta-analysis, with the search conducted last in March 2024. For the inclusion criteria, the studies needed to include healthcare worker practices or behaviors on recommending the HPV vaccination. Seventy-three articles were included. The proportions of HCWs recommending varied considerably by region and gender of the recipient, but there was no statistically significant difference in income level or pre- or post-HPV vaccine introduction into the national vaccination program. The main barriers to recommending HPV vaccination were concerns around safety and efficacy, cost, parental concerns, and systemic barriers. The results illustrate the importance of contextually adapted approaches to improving vaccine acceptance and recommendation.
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Affiliation(s)
- Damola Bakare
- Department of Paediatrics, University of Ibadan, Ibadan, Nigeria
| | - Elisa Gobbo
- Department of Global Public Health, Karolinska Institute, Stockholm, Sweden
| | | | - Ayobami A. Bakare
- Department of Global Public Health, Karolinska Institute, Stockholm, Sweden
- Department of Community Medicine, University College Hospital, Ibadan, Nigeria
| | - Julius Salako
- Department of Paediatrics, University of Ibadan, Ibadan, Nigeria
| | - Claudia Hanson
- Department of Global Public Health, Karolinska Institute, Stockholm, Sweden
- Department of Disease Control, London School of Hygiene and Tropical Medicine, London, UK
- Centre of Excellence for Women and Child Health, Aga Khan University, Nairobi, Kenya
| | | | - Adegoke Falade
- Department of Paediatrics, University of Ibadan, Ibadan, Nigeria
- Department of Paediatrics, University College Hospital, Ibadan, Nigeria
| | - Carina King
- Department of Global Public Health, Karolinska Institute, Stockholm, Sweden
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Chen C, Chen T, Huang M, Huang Y, Zhang L, Li P. Factors associated with HPV vaccine hesitancy among college students: A cross-sectional survey based on 3Cs and structural equation model in China. Hum Vaccin Immunother 2024; 20:2309731. [PMID: 38314749 PMCID: PMC10854271 DOI: 10.1080/21645515.2024.2309731] [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: 09/19/2023] [Accepted: 01/22/2024] [Indexed: 02/07/2024] Open
Abstract
Despite the high effectiveness of HPV vaccines in preventing infection, vaccine hesitancy remains a concern, particularly in China. This study aimed to explore college students' attitudes toward HPV vaccination and identify associated factors. Data was collected through a cross-sectional survey using self-administered questionnaires in four cities from May to June 2022. Chi-square tests and logistic regression analyses were conducted to identify factors. Additionally, an integrated structural equation model (SEM) based on the 3Cs (confidence, convenience, complacency) was developed to understand underlying factors contributing to hesitancy. The results from 2261 valid questionnaires were enlightening. A significant 89.47% (59.4% for females) considered HPV vaccination necessary, with 9.82% remaining neutral and only 0.71% deeming it unnecessary. Factors like higher education, being a medical student, residing in urban areas, having medical insurance, more extraordinary living expenses, a family history of tumors, and a solid understanding of HPV played a role in perceiving the vaccine as necessary. Among the 1438 female respondents, 84.36% had no hesitancy toward HPV vaccination, 13.53% expressed hesitancy, and 2.11% refused vaccination. Factors like age, understanding of HPV, medical staff recommendations, living expenses, and family history influenced hesitancy levels. SEM revealed that the 3Cs significantly affected vaccine hesitancy. Factors like price, booking process, vaccination times, trust in vaccines, medical staff recommendations, efficiency, and risk perception collectively influenced hesitancy. In conclusion, this study found high acceptance of HPV vaccination but acknowledged the complexity of hesitancy factors. It recommends medical staff disseminate scientific knowledge, offer recommendations, simplify booking procedures, and expand vaccination sites to address vaccine hesitancy effectively.
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Affiliation(s)
- Cheng Chen
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ting Chen
- School of Public Health, Wuhan University of Science and Technology, Wuhan, China
| | - Mingzhao Huang
- School of Public Health, Wuhan University of Science and Technology, Wuhan, China
- Hubei Key Laboratory of Occupational Disease Hazard Identification and Control, Wuhan, China
| | - Yan Huang
- Center for Chinese Public Administration Research, School of Government, Sun Yat-sen University, Guangzhou, China
| | - Luying Zhang
- School of Public Health, Fudan University, Shanghai, China
| | - Pindong Li
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Institute of Radiation Oncology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Key Laboratory of Precision Radiation, Wuhan, China
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de Souza Amorim Matos CC, Couto MT, Oduwole EO, Shey Wiysonge C. Caregivers' perceptions on routine childhood vaccination: A qualitative study on vaccine hesitancy in a South Brazil state capital. Hum Vaccin Immunother 2024; 20:2298562. [PMID: 38196242 PMCID: PMC10793707 DOI: 10.1080/21645515.2023.2298562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 12/20/2023] [Indexed: 01/11/2024] Open
Abstract
Immunization programs worldwide have been facing challenges in keeping vaccination coverage high. Even though universally known for its robust National Immunization Program, Brazil has also faced significant challenges regarding vaccination coverage. One of the reasons for this is vaccine hesitancy, a complex, multi-causal, and context-specific phenomenon. This qualitative study aims to understand the factors associated with decision-making and the drivers of vaccine hesitancy in Florianopolis, Santa Catarina state capital, regarding caregivers' perceptions of routine childhood vaccination. In-depth interviews were conducted in the Capital city of Santa Catarina State. Families with children up to 6 years old were included. Data were analyzed based on thematic content analysis. Twenty-nine caregivers in 18 families were interviewed. These caregivers were mainly mothers and fathers. Three themes emerged: 1. Access to information and the decision-making process, where we discuss the role of social circles, healthcare workers, and the internet; 2. Individual-institutions power relationships: Perceptions about the State's role and the Health institutions: 3. Reasons and motivations: The senses and meanings behind non-vaccination, where we discuss the drivers of vaccine hesitancy related to risk perception, caregivers' opinions on the medical-pharmaceutical industry, vaccines' composition and their side effects, families' lifestyles and worldviews, and the childhood routine vaccination schedule. The results of this study reaffirm the complexity of the decision-making process in childhood vaccination and further enable a better contextual understanding of the complex and challenging phenomenon of vaccine hesitancy.
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Affiliation(s)
- Camila Carvalho de Souza Amorim Matos
- Departamento de Medicina Preventiva, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil
- Departamento de Ciências da Saúde, Universidade Federal de Santa Catarina, Araranguá, Brazil
| | - Marcia Thereza Couto
- Departamento de Medicina Preventiva, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Elizabeth O. Oduwole
- Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa
| | - Charles Shey Wiysonge
- Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa
- Division of Epidemiology and Biostatistics, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
- Vaccine-Preventable Diseases Programme, Universal Health Coverage/Communicable and Non-Communicable Diseases Cluster, World Health Organization Regional Office for Africa, Brazzaville, Congo
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Cogordan C, Fressard L, Brosset E, Bocquier A, Velter A, Annequin M, Bourrelly M, Constance J, Michels D, Mora M, Morel S, Oliveri C, Maradan G, Berenger C, Spire B, Verger P. Sexual and preventive behaviors associated with HAV, HBV, and HPV vaccine hesitancy among men who have sex with men in France. Hum Vaccin Immunother 2024; 20:2348845. [PMID: 38783608 PMCID: PMC11135958 DOI: 10.1080/21645515.2024.2348845] [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: 02/22/2024] [Accepted: 04/24/2024] [Indexed: 05/25/2024] Open
Abstract
Vaccination coverage against hepatitis A virus (HAV), hepatitis B virus (HBV), and human papillomaviruses (HPV) is insufficient among men who have sex with men (MSM), partly because of their high prevalence of vaccine hesitancy (VH) specific to these vaccines. This study aimed to investigate determinants of specific VH in MSM, focusing on characteristics of their sexual activity, propensity to use prevention tools and medical care, disclosure of sexual orientation to health care professionals (HCPs), and perceived stigmatization. A cross-sectional electronic survey (February - August 2022) collected perceptions of HBV, HAV, and HPV, and of their respective vaccines among 3,730 French MSM and enabled the construction of a specific VH variable. Using agglomerative hierarchical cluster analysis, we constructed a typology of MSM sexual and prevention practices. We identified three MSM clusters (low- (C1, 24%), moderate- (C2, 41%), and high- (C3, 35%) "sexual activity/medical engagement") that showed an increasing gradient in the use of medical prevention with regular medical care and exposure to high-risk sexual practices. A multiple ordinal logistic regression showed that overall specific VH was higher in the C1 cluster and in men who had not informed their physician of their sexual orientation. This typology could usefully help to adapt vaccination communication strategies for MSM prevention program according to patients' profiles. HCPs should be encouraged and trained to ask men about their sexual practices and to provide appropriate vaccination recommendations nonjudgmentally.
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Affiliation(s)
- Chloé Cogordan
- ORS PACA, Southeastern Health Regional Observatory, Marseille, France
| | - Lisa Fressard
- ORS PACA, Southeastern Health Regional Observatory, Marseille, France
| | - Emeline Brosset
- ORS PACA, Southeastern Health Regional Observatory, Marseille, France
| | - Aurélie Bocquier
- ORS PACA, Southeastern Health Regional Observatory, Marseille, France
- Inserm, INSPIIRE, Université de Lorraine, Nancy, France
| | - Annie Velter
- Santé publique France (The French Public Health Agency), Saint-Maurice, France
- Aix Marseille Univ, Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l’Information Médicale, ISSPAM, Marseille, France
| | - Margot Annequin
- ORS PACA, Southeastern Health Regional Observatory, Marseille, France
- Aix Marseille Univ, Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l’Information Médicale, ISSPAM, Marseille, France
| | - Michel Bourrelly
- Aix Marseille Univ, Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l’Information Médicale, ISSPAM, Marseille, France
| | - Jean Constance
- ORS PACA, Southeastern Health Regional Observatory, Marseille, France
| | - David Michels
- AIDES, Pantin, France
- Laboratoire de recherche communautaire, Coalition PLUS, Pantin, France
| | - Marion Mora
- Aix Marseille Univ, Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l’Information Médicale, ISSPAM, Marseille, France
| | | | - Camilla Oliveri
- ORS PACA, Southeastern Health Regional Observatory, Marseille, France
- Aix Marseille Univ, Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l’Information Médicale, ISSPAM, Marseille, France
| | - Gwenaëlle Maradan
- ORS PACA, Southeastern Health Regional Observatory, Marseille, France
| | - Cyril Berenger
- ORS PACA, Southeastern Health Regional Observatory, Marseille, France
| | - Bruno Spire
- Aix Marseille Univ, Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l’Information Médicale, ISSPAM, Marseille, France
| | - Pierre Verger
- ORS PACA, Southeastern Health Regional Observatory, Marseille, France
- Unité des Virus Émergents, UVE: Aix-Marseille Univ Università di Corsica, Marseille, France
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White P, Alberti H, Rowlands G, Tang E, Gagnon D, Dubé È. Vaccine hesitancy educational interventions for medical students: A systematic narrative review in western countries. Hum Vaccin Immunother 2024; 20:2397875. [PMID: 39323010 PMCID: PMC11441049 DOI: 10.1080/21645515.2024.2397875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2024] [Revised: 08/15/2024] [Accepted: 08/24/2024] [Indexed: 09/27/2024] Open
Abstract
Physician recommendations can reduce vaccine hesitancy (VH) and improve uptake yet are often done poorly and can be improved by early-career training. We examined educational interventions for medical students in Western countries to explore what is being taught, identify effective elements, and review the quality of evidence. A mixed methods systematic narrative review, guided by the JBI framework, assessed the study quality using MERSQI and Cote & Turgeon frameworks. Data were extracted to analyze content and framing, with effectiveness graded using value-based judgment. Among the 33 studies with 30 unique interventions, effective studies used multiple methods grounded in educational theory to teach knowledge, skills, and attitudes. Most interventions reinforced a deficit-based approach (assuming VH stems from misinformation) which can be counterproductive. Effective interventions used hands-on, interactive methods emulating real practice, with short- and long-term follow-ups. Evidence-based approaches like motivational interviewing should frame interventions instead of the deficit model.
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Affiliation(s)
- Philip White
- Population Health Sciences Institute, Newcastle University Medical School, Newcastle upon Tyne, UK
| | - Hugh Alberti
- School of Medical Education, Newcastle University Medical School, Newcastle upon Tyne, UK
| | - Gill Rowlands
- Population Health Sciences Institute, Newcastle University Medical School, Newcastle upon Tyne, UK
| | - Eugene Tang
- Population Health Sciences Institute, Newcastle University Medical School, Newcastle upon Tyne, UK
| | - Dominique Gagnon
- Direction des risques biologiques, Institut national de santé publique du Québec, Quebec, Canada
| | - Ève Dubé
- Department of Anthropology, Laval University, Quebec, Canada
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Li X, Bai Y, Weng L, Bai Y, Gong W. COVID-19 vaccine hesitancy among the Chinese elderly: A multi-stakeholder qualitative study. Hum Vaccin Immunother 2024; 20:2315663. [PMID: 38439589 PMCID: PMC10936594 DOI: 10.1080/21645515.2024.2315663] [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: 11/27/2023] [Accepted: 02/04/2024] [Indexed: 03/06/2024] Open
Abstract
The United Nations reported that the mortality risk of Corona Virus Disease 2019 (COVID-19) is five times higher in the elderly than the global average. Although the COVID-19 vaccine effectively prevents infections and reduce mortality among the elderly, vaccine hesitancy among the Chinese elderly poses a significant threat. This study, utilizing the "Confidence, Convenience and Complacency (3 Cs)" vaccine hesitancy model, aimed to explore factors contributing to vaccine hesitancy among the Chinese elderly and assess national countermeasures and potential improvement approaches. Thirteen elderly with vaccine hesitancy and eleven vaccine-related staff participated in semi-structured interviews. Thematic analysis revealed three key determinants of vaccine hesitancy among the elderly: perceived low threat of COVID-19, lack of confidence in COVID-19 vaccine, and poor accessibility to vaccination. China has implemented strategies, including advocacy through diverse channels, joint multi-sectoral promotion vaccination, and enhancing ongoing vaccination services. Recommendations from the vaccine-related staff emphasize improving vaccine awareness among the elderly, and prioritizing the vaccination environment and process. The study underscores the importance of targeted vaccination promotion programs addressing hesitation reasons to improve vaccination rates. Furthermore, existing countermeasures can serve as a foundation for enhancing vaccination strategies, including improved publicity, administration, and management approaches.
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Affiliation(s)
- Xiaoyu Li
- HER Team and Department of Maternal and Child Health, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Yanping Bai
- HER Team and Department of Maternal and Child Health, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Lijun Weng
- HER Team and Department of Maternal and Child Health, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Yunshan Bai
- Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Wenjie Gong
- HER Team and Department of Maternal and Child Health, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- Department of Psychiatry, University of Rochester, Rochester, NY, USA
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Araujo-Chaveron L, Olivier C, Pellissier G, Bouvet E, Mueller JE. Analyzing the 7C psychological antecedents of vaccine acceptance throughout the COVID-19 pandemic among healthcare sector workers in France: A repeated cross-sectional study (CappVac-Cov). Vaccine 2024; 42:126103. [PMID: 38972764 DOI: 10.1016/j.vaccine.2024.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2024] [Revised: 07/01/2024] [Accepted: 07/02/2024] [Indexed: 07/09/2024]
Abstract
BACKGROUND Across various stages of the COVID-19 pandemic and related vaccine recommendations in France, we assessed the association of the 7C-psychological antecedents with vaccine uptake/intention for booster vaccination among healthcare-sector workers (HCSWs). We also assessed whether 7C-antecedent profiles changed over time. METHODOLOGY The Research Group for the Prevention of Occupational Infections in Healthcare Workers (GERES) conducted three repeated web-surveys which were disseminated by email chain-referral among HCSWs throughout France. The questionnaires waves took place: July-November 2021, February-March 2022 and January-March 2023 (P2, P3 and P4). We also reanalysed data from a prior similar study conducted late 2020-early 2021 (Moirangthem et al. (2022)) (P1). To evaluate the association of 7C-items with vaccine uptake-intention for future vaccination, we estimated adjusted prevalence ratios (aPR) using robust variance Poisson regression. We report the 7C-item population attributable loss in vaccine intention. RESULTS The four surveys (P1-P4) encompassed 5234, 339, 351 and 437 participants. At earlier stages of the vaccine campaign, the principal antecedents of vaccine intention were favorable perception of vaccination benefit-risk-balance (BRB) (vs. unfavorable, aPR: 2.32), reactance to employer encouragement for vaccination (motivates vs. dissuades-me, aPR:2.23), vaccine confidence (vs. not-being-confident, aPR: 1.71) and social conformism towards vaccination (favorable vs. skeptical opinion in private environment, aPR: 1.33). Under a vaccine mandate for HCSWs, only perceiving vaccination as a collective action was associated with current vaccine status (agree vs. disagree, aPR: 2.19). At later stages of the epidemic, hypothetical booster vaccine intentions were strongly associated with BRB perception (favorable vs. unfavorable, aPR: 2.07) and perceiving vaccination as a collective action (agree vs. disagree, aPR: 1.69). Fearing a severe side effect from vaccination decreased population vaccine intention by 26.2 %. CONCLUSION Our results suggest that both 7C-antecedents and their association with vaccine behaviour can change over time, and underscore the importance of assuring confidence in vaccine safety.
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Affiliation(s)
- Lucia Araujo-Chaveron
- EHESP French School of Public Health, Paris, France; Institut Pasteur, Paris, France
| | - Cyril Olivier
- Research Group for the Prevention of Occupational Infections in Healthcare Workers (GERES), Paris, France
| | - Gérard Pellissier
- Research Group for the Prevention of Occupational Infections in Healthcare Workers (GERES), Paris, France
| | - Elisabeth Bouvet
- Research Group for the Prevention of Occupational Infections in Healthcare Workers (GERES), Paris, France
| | - Judith E Mueller
- EHESP French School of Public Health, Paris, France; Institut Pasteur, Paris, France; Univ. Rennes, EHESP, CNRS, Inserm, Arènes - UMR 6051, RSMS (Recherche sur les Services et Management en Santé) - U 1309, F-35000 Rennes, France.
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Le Breton A, Touzet H, Fressard L, Chamboredon P, Peretti-Watel P, Ward J, Verger P. Dissatisfaction with working conditions associated with lower vaccine confidence, commitment and behaviors among nurses: A large scale cross-sectional survey in France. Int J Nurs Stud 2024; 161:104935. [PMID: 39489079 DOI: 10.1016/j.ijnurstu.2024.104935] [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: 04/19/2024] [Revised: 09/10/2024] [Accepted: 10/18/2024] [Indexed: 11/05/2024]
Abstract
BACKGROUND Before, during, and after the COVID-19 pandemic, doctor shortages led many countries to expand nurses' role in their mass vaccination programs. Nonetheless, nurses often express marked vaccine hesitancy. Simultaneously, their working conditions have been deteriorating. OBJECTIVES To study 1) the association between nurses' perceptions of their working conditions and their vaccination-related behaviors (vaccination recommendations to their patients), and 2) the mediating role in this associations of their trust in health authorities, vaccine confidence, and vaccine proactive efficacy. DESIGN A cross-sectional survey. SETTINGS Salaried, community (self-employed) and mixed nurses in France. PARTICIPANTS 18,888 nurses registered with the French national order of nurses (ONI, registration is mandatory) (N = 439,323). METHODS In February 2023, this cross-sectional study used an online questionnaire to survey the nurses mandatorily registered with the French national order of nurses. Seven items adapted from models of psychosocial risk factors at work assessed their satisfaction with their working conditions. The international short version of the Pro-VC-Be (health professionals, vaccine confidence and behaviors), a validated instrument measuring psychosocial determinants of health-care professionals' vaccine behaviors) evaluated their vaccine-related attitudes and behaviors. Multiple group mediation analysis with structural equation modeling measured the associations between satisfaction at work, trust in health authorities, vaccine confidence, proactive efficacy (commitment and self-efficacy) in vaccination, and vaccination recommendations (against seasonal influenza for those with a chronic disease and against COVID-19 among adults). RESULTS Among the 18,888 participants, satisfaction at work had generally deteriorated, and only 47 % considered vaccines safe. Among salaried nurses (61 %), satisfaction at work was statistically significantly associated (p < 10-3) with trust in health authorities (β = 0.26 [0.24; 0.28]), vaccine confidence (total effect: β = 0.35 [0.31; 0.38]), proactive efficacy (total effect: β = 0.18 [0.16; 0.21]), and, to a smaller extent, with seasonal influenza and Covid-19 vaccine recommendations (total effect: β = 0.13 [0.09; 0.16]). Trust in health authorities played a statistically significant role (p < 10-3) mediating the associations of satisfaction at work with vaccine confidence and proactive efficacy. These three dimensions in turn mediated the relation between satisfaction at work and frequency of vaccination recommendations. These relations were similar among community nurses. CONCLUSIONS Satisfaction at work appears to enhance nurses' vaccination attitudes and behaviors, which are likely to reinforce their capacity to promote their patients' vaccination. Significant improvement in their working conditions is needed to enable them to accomplish this role serenely.
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Affiliation(s)
- Anaïs Le Breton
- Cermes3 (INSERM, CNRS, EHESS, Université de Paris), Villejuif, France
| | - Hugo Touzet
- Cermes3 (INSERM, CNRS, EHESS, Université de Paris), Villejuif, France
| | - Lisa Fressard
- Observatoire régional de la santé PACA (Southeastern Health Regional Observatory), Marseille, France
| | | | - Patrick Peretti-Watel
- Observatoire régional de la santé PACA (Southeastern Health Regional Observatory), Marseille, France; Unité des Virus Émergents (UVE: Aix-Marseille Univ, Università di Corsica, IRD 190, Inserm 1207, IRBA), France
| | - Jeremy Ward
- Cermes3 (INSERM, CNRS, EHESS, Université de Paris), Villejuif, France
| | - Pierre Verger
- Observatoire régional de la santé PACA (Southeastern Health Regional Observatory), Marseille, France; Unité des Virus Émergents (UVE: Aix-Marseille Univ, Università di Corsica, IRD 190, Inserm 1207, IRBA), France.
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Eiden AL, Drakeley S, Modi K, Mackie D, Bhatti A, DiFranzo A. Attitudes and beliefs of healthcare providers toward vaccination in the United States: A cross-sectional online survey. Vaccine 2024; 42:126437. [PMID: 39418687 DOI: 10.1016/j.vaccine.2024.126437] [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: 06/11/2024] [Revised: 08/26/2024] [Accepted: 10/07/2024] [Indexed: 10/19/2024]
Abstract
BACKGROUND Healthcare providers' (HCPs') beliefs and practices regarding vaccination influence vaccine acceptance in patients. OBJECTIVE To describe HCPs' beliefs and practices regarding vaccines and perceptions of patient perspectives related to vaccine hesitancy. METHODS This was a non-interventional, cross-sectional, online survey administered to 1213 HCPs based in the United States from December 2021 through January 2022. HCPs provided responses regarding their demographic and professional characteristics, beliefs about vaccine safety and effectiveness, vaccination practices, and their views regarding patients' willingness to receive vaccination. RESULTS Study participants included doctors (55.4 %); physician assistants (11.2 %); pharmacists (11.7 %); nurse practitioners (11.1 %); and registered nurses (10.6 %) from across the United States (West, 35.6 %; Midwest, 27.0 %; South, 25.6 %; Northeast, 11.9 %). HCPs belonged to group practices or clinics (34.5 %), private practices (31.9 %), hospital-based practices (21.9 %), or pharmacies (11.7 %). Most HCPs strongly believed it was their duty to promote vaccination (78.1 %) and used in-person conversations to educate patients about vaccines (85.0 %); 95.1 % had been vaccinated against COVID-19. HCPs reported that 54.9 % of patients accept all vaccines without hesitation, 21.0 % accept all vaccines but hesitate, 16.8 % accept only select vaccines, and 7.2 % reject all vaccines. Reasons commonly cited by patients for being hesitant to accept vaccines or refusal included negative media (hesitancy: 64.6 %; refusal: 73.2 %), the influence of friends or family (hesitancy: 60.5 %; refusal: 68.7 %), distrust of the government (hesitancy: 45.8 %; refusal: 68.4 %), concerns over long-term side effects (hesitancy: 56.1 %; refusal: 68.3 %), and worries about vaccine-related autism or infertility (hesitancy: 49.7 %; refusal: 71.9 %). HCPs reported that the largest contributors to vaccine misinformation among patients were social media (91.0 %), celebrities/TV personalities (63.5 %), and mass media (61.1 %). CONCLUSIONS Despite most HCPs being active proponents of vaccination, misconceptions about vaccination and vaccine hesitancy persists. Consideration should be given to HCP training to support their efforts to promote vaccine acceptance.
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Affiliation(s)
| | | | - Kushal Modi
- Oracle Life Science, Oracle, Austin, TX, USA
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12
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Taubert F, Schmid P, Holford D, Verger P, Fasce A, Karlsson LC, Soveri A, Lewandowsky S, Betsch C. Association of the belief in conspiracy narratives with vaccination status and recommendation behaviours of German physicians. Vaccine X 2024; 20:100560. [PMID: 39444597 PMCID: PMC11497475 DOI: 10.1016/j.jvacx.2024.100560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 09/18/2024] [Accepted: 09/18/2024] [Indexed: 10/25/2024] Open
Abstract
Vaccine hesitancy has been identified as one of the top ten threats to global health by the World Health Organization (WHO). The belief in conspiracy narratives is repeatedly discussed as a major driver of vaccine hesitancy among the general population. However, there is a lack of research investigating the role of the belief in conspiracy narratives in vaccination decisions and recommendation behaviours of physicians. This is particularly relevant as physicians are one of the major and trusted sources of information for patients' vaccination decisions. This study therefore investigated the association between believing in COVID-19-related conspiracy narratives and physicians' own COVID-19 vaccination status and their recommendation behavior for COVID-19 and other vaccines (e.g., HPV or flu). In a cross-sectional survey among German physicians (N = 602, April 2022) two conspiracy narratives were assessed, stating that the coronavirus is a hoax or that it is human-made. Additional control variables included trust in health institutions, the rejection of complementary and alternative medicine (CAM), the 5C psychological antecedents of vaccination (confidence, complacency, constraints, calculation, and collective responsibility) and demographic variables. Hierarchical regressions indicated that greater belief in the conspiracy narrative claiming that the coronavirus is a hoax was associated with lower COVID-19 vaccination uptake and fewer COVID-19 vaccination recommendations among physicians. The results for recommendation behavior remain robust even when controlling for other variables. Contrary to our assumption, believing that the coronavirus is human-made was not related to vaccination status nor vaccine recommendation behavior. In conclusion, believing in conspiracy narratives that question the existence and thus also the danger of the virus is an important independent predictor of vaccine hesitancy among physicians that should be addressed in future public health interventions.
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Affiliation(s)
- Frederike Taubert
- Institute for Planetary Health Behavior, Health Communication, University of Erfurt, Nordhäuser Straße 63, 99089 Erfurt, Germany
- Implementation Research, Health Communication Working Group, Bernhard Nocht Institute for Tropical Medicine, University of Hamburg, Bernhard-Nocht-Straße 74, 20359 Hamburg, Germany
| | - Philipp Schmid
- Institute for Planetary Health Behavior, Health Communication, University of Erfurt, Nordhäuser Straße 63, 99089 Erfurt, Germany
- Implementation Research, Health Communication Working Group, Bernhard Nocht Institute for Tropical Medicine, University of Hamburg, Bernhard-Nocht-Straße 74, 20359 Hamburg, Germany
- Centre for Language Studies, Radboud University Nijmegen, Erasmusplein 1, 6500 HD Nijmegen, The Netherlands
| | - Dawn Holford
- School of Psychological Science, University of Bristol, 12A Priory Road, Bristol BS8 1TU, United Kingdom
| | - Pierre Verger
- Southeastern France Health Regional Observatory (ORS PACA), Faculty of Medicine, 2 Place Le Verrier, 13004 Marseille, France
| | - Angelo Fasce
- Southeastern Health Regional Observatory (ORS PACA), 13004 Marseille, France
| | - Linda C. Karlsson
- Department of Psychology and Speech-Language Pathology, University of Turku, 20014 Turku, Finland
- Department of Psychology, Åbo Akademi University, Tehtaankatu 2, 20500 Turku, Finland
| | - Anna Soveri
- Department of Psychology, Åbo Akademi University, Tehtaankatu 2, 20500 Turku, Finland
- Department of Clinical Medicine, University of Turku, 20014 Turku, Finland
| | - Stephan Lewandowsky
- School of Psychological Science, University of Bristol, 12A Priory Road, Bristol BS8 1TU, United Kingdom
- School of Psychological Science, University of Western Australia, 35 Stirling Hwy, Crawley, WA 6009, Australia
- Department of Psychology, University of Potsdam, Am Neuen Palais 10, 14469 Potsdam, Germany
| | - Cornelia Betsch
- Institute for Planetary Health Behavior, Health Communication, University of Erfurt, Nordhäuser Straße 63, 99089 Erfurt, Germany
- Implementation Research, Health Communication Working Group, Bernhard Nocht Institute for Tropical Medicine, University of Hamburg, Bernhard-Nocht-Straße 74, 20359 Hamburg, Germany
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13
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Wilpstra CD, Morrell S, Mirza NA, Ralph JL. Consequences of COVID-19 Vaccine Hesitancy Among Healthcare Providers During the First 10 Months of Vaccine Availability: Scoping Review. Can J Nurs Res 2024; 56:204-224. [PMID: 38693882 PMCID: PMC11308270 DOI: 10.1177/08445621241251711] [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: 05/03/2024] Open
Abstract
BACKGROUND Throughout the COVID-19 pandemic, healthcare providers (HCPs)-including nurses-have played important roles in the vaccination effort. It is expected that COVID-19 vaccine hesitancy among HCPs has numerous consequences; however, the scope of these consequences and their impacts on providers, patients, and the broader healthcare system remained unclear. PURPOSE To identify existing and emerging evidence to understand the state of knowledge of the consequences of COVID-19 vaccine hesitancy among HCPs. METHODS A scoping review was completed based upon the JBI scoping review methodology. The databases searched included OVID Medline, EBSCOhost CINAHL, ProQuest Nursing and Allied Health Source, ProQuest APA PsycInfo, and ProQuest Dissertations and Theses. The final literature search was completed on June 2, 2022. Studies were screened and retrieved based on predefined inclusion and exclusion criteria using Covidence reference management software. Data extraction followed criteria recommended in the JBI scoping review framework with additional relevant variables identified by the authors. RESULTS A total of 33 sources were included in the review. Consequences of HCP COVID-19 vaccine hesitancy were grouped under three themes and seven subthemes. Consequences affecting HCPs included health-related, psychosocial, and employment-related consequences. Consequences affecting patients pertained to COVID-19 vaccination communication and COVID-19 vaccination practices of HCPs. Consequences to the healthcare system involved consequences to coworkers and employment/attendance/staffing-related consequences. CONCLUSIONS Healthcare provider COVID-19 vaccine hesitancy was found to have numerous consequences. By understanding the scope and extent of these consequences, healthcare leaders, researchers, and HCPs can work together to protect providers, patients, and healthcare systems.
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Affiliation(s)
| | - Sherry Morrell
- Faculty of Nursing, University of Windsor, Windsor, Canada
| | | | - Jody L. Ralph
- Faculty of Nursing, University of Windsor, Windsor, Canada
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14
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Holford D, Anderson EC, Biswas A, Garrison A, Fisher H, Brosset E, Gould VC, Verger P, Lewandowsky S. Healthcare professionals' perceptions of challenges in vaccine communication and training needs: a qualitative study. BMC PRIMARY CARE 2024; 25:264. [PMID: 39033114 PMCID: PMC11265004 DOI: 10.1186/s12875-024-02509-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Accepted: 07/01/2024] [Indexed: 07/23/2024]
Abstract
BACKGROUND Healthcare professionals (HCPs) can play an important role in encouraging patients and their caregivers to be vaccinated. The objective of this qualitative study was to investigate HCPs' perspectives on challenges in vaccine communication and unmet training needs in this domain. METHODS Semi-structured interviews were conducted with 41 HCPs (mainly nurses and physicians) with vaccination roles (23 in England; 18 in France), gathering information on: (1) HCPs' approach to vaccine conversations with patients; (2) Challenges of communicating about vaccines; (3) Vaccine-related training and learning resources available to HCPs, and; (4) HCPs' training needs around vaccine communication. RESULTS HCPs described a range of communication experiences that indicated insufficient time, information, and skills to confidently navigate difficult conversations with vaccine-hesitant patients. Communication skills were especially important to avoid conflict that could potentially damage the patient-provider relationship. Some HCPs interviewed had received communication training, but for most, this training was not specific to vaccination. Although general communication skills were transferable to vaccine conversations, most HCPs welcomed specific training and informational resources to support countering patients' misconceptions or misinformation about vaccines. CONCLUSIONS HCPs would benefit from training tailored to address vaccine communication with patients, and this should be part of a systemic approach that also provides time and space to have effective vaccine conversations.
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Affiliation(s)
- Dawn Holford
- School of Psychological Science, University of Bristol, 12A Priory Road, Bristol, BS8 1TU, United Kingdom.
| | - Emma C Anderson
- Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Aishmita Biswas
- School of Psychological Science, University of Bristol, 12A Priory Road, Bristol, BS8 1TU, United Kingdom
| | - Amanda Garrison
- Faculté Des Sciences Médicales Et Paramédicales, Southeastern Health Regional Observatory (Observatoire Régional de La Santé, ORS) PACA, Marseille, France
| | - Harriet Fisher
- Bristol Medical School, National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Behavioural Science and Evaluation (BSE) University of Bristol, Bristol, United Kingdom
| | - Emeline Brosset
- Faculté Des Sciences Médicales Et Paramédicales, Southeastern Health Regional Observatory (Observatoire Régional de La Santé, ORS) PACA, Marseille, France
| | - Virginia C Gould
- School of Psychological Science, University of Bristol, 12A Priory Road, Bristol, BS8 1TU, United Kingdom
| | - Pierre Verger
- Faculté Des Sciences Médicales Et Paramédicales, Southeastern Health Regional Observatory (Observatoire Régional de La Santé, ORS) PACA, Marseille, France
- Unité des Virus Émergents (UVE: Aix-Marseille Univ, Università di Corsica, IRD 190, Inserm 1207, IRBA), Marseille, France
| | - Stephan Lewandowsky
- School of Psychological Science, University of Bristol, 12A Priory Road, Bristol, BS8 1TU, United Kingdom
- Department of Psychology, University of Potsdam, Potsdam, Germany
- School of Psychological Science, University of Western Australia, Perth, Australia
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15
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Hijazi R, Gesser-Edelsburg A, Mesch GS. Vaccine communication strategies among healthcare workers as a reflection of the Israeli Ministry of Health's communication strategies before and after the COVID-19 pandemic. Front Public Health 2024; 12:1377393. [PMID: 38846621 PMCID: PMC11153784 DOI: 10.3389/fpubh.2024.1377393] [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: 01/27/2024] [Accepted: 05/07/2024] [Indexed: 06/09/2024] Open
Abstract
Background Healthcare workers play a central role in communicating information to the public regarding vaccines. Most of the literature has focused on healthcare workers' hesitancy and doubts about getting the flu vaccine themselves. However, few studies have dealt with how they perceive their role in communicating information regarding vaccines, especially following the COVID-19 pandemic. Objectives (1) To identify the communication strategies used by the Israeli Ministry of Health regarding vaccines during epidemic crises (before and after the COVID-19 pandemic); (2) To identify the communication strategies used by healthcare workers regarding vaccines before and after the COVID-19 pandemic. Methods A qualitative study based on in-depth interviews was conducted among healthcare workers and used a semi-structured protocol as a research tool. A total of 18 healthcare workers were sampled using purposeful and snowball sampling. Results Despite healthcare workers' perception that there has been a decrease in trust in the Israeli Ministry of Health among the public following the COVID-19 outbreak, they still rely on the Israeli Ministry of Health as their primary source of information and use the same communication strategies (such as fear appeals and correcting information) as of the Israeli Ministry of Health to communicate with the public, healthcare providers, and other relevant stakeholders. Conclusion Healthcare workers have been shaped by the professional socialization processes within the health system, leading to a predominant reliance on established communication strategies and informational channels. This reliance underscores the importance of evolving these methods to better engage with the public. To address this, there is a compelling need to innovate and adopt new communication techniques that emphasize effective dialogue and transparent interactions. By doing so, healthcare professionals can ensure that their outreach is not only informative but also responsive to the diverse needs and preferences of the community.
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Affiliation(s)
- Rana Hijazi
- The Health and Risk Communication Lab, School of Public Health, University of Haifa, Haifa, Israel
| | - Anat Gesser-Edelsburg
- The Health and Risk Communication Lab, School of Public Health, University of Haifa, Haifa, Israel
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16
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Beusterien KM, Law AW, Maculaitis MC, Will O, Kopenhafer L, Olsen P, Hauber B, Vietri JT, Cappelleri JC, Coulter JR, Shea KM. Healthcare Providers' and Pregnant People's Preferences for a Preventive to Protect Infants from Serious Illness Due to Respiratory Syncytial Virus. Vaccines (Basel) 2024; 12:560. [PMID: 38793811 PMCID: PMC11125959 DOI: 10.3390/vaccines12050560] [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: 04/01/2024] [Revised: 05/07/2024] [Accepted: 05/14/2024] [Indexed: 05/26/2024] Open
Abstract
We assessed the impact of respiratory syncytial virus (RSV) preventive characteristics on the intentions of pregnant people and healthcare providers (HCPs) to protect infants with a maternal vaccine or monoclonal antibodies (mAbs). Pregnant people and HCPs who treated pregnant people and/or infants were recruited via convenience sample from a general research panel to complete a cross-sectional, web-based survey, including a discrete choice experiment (DCE) wherein respondents chose between hypothetical RSV preventive profiles varying on five attributes (effectiveness, preventive type [maternal vaccine vs. mAb], injection recipient/timing, type of medical visit required to receive the injection, and duration of protection during RSV season) and a no-preventive option. A best-worst scaling (BWS) exercise was included to explore the impact of additional attributes on preventive preferences. Data were collected between October and November 2022. Attribute-level preference weights and relative importance (RI) were estimated. Overall, 992 pregnant people and 310 HCPs participated. A preventive (vs. none) was chosen 89.2% (pregnant people) and 96.0% (HCPs) of the time (DCE). Effectiveness was most important to preventive choice for pregnant people (RI = 48.0%) and HCPs (RI = 41.7%); all else equal, pregnant people (RI = 5.5%) and HCPs (RI = 7.2%) preferred the maternal vaccine over mAbs, although preventive type had limited influence on choice. Longer protection, protection starting at birth or the beginning of RSV season, and use for both pre-term and full-term babies were ranked highest in importance (BWS). Pregnant people and HCPs strongly preferred a preventive to protect infants against RSV (vs. none), underscoring the need to incorporate RSV preventives into routine care.
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17
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Vuolanto P, Almeida AN, Anderson A, Auvinen P, Beja A, Bracke P, Cardano M, Ceuterick M, Correia T, De Vito E, Delaruelle K, Delicado A, Esposito M, Ferrara M, Gariglio L, Guerreiro C, Marhánková JH, Hilário AP, Hobson-West P, Iorio J, Järvinen KM, Koivu A, Kotherová Z, Kuusipalo A, Lermytte E, Mendonça J, Morais R, Numerato D, Polak P, Rudek T, Sbaragli S, Scavarda A, Silva K, da Silva PA, Sivelä J, Moura ES, Świątkiewicz-mośny M, Tipaldo G, Wagner A. Trust matters: The Addressing Vaccine Hesitancy in Europe Study. Scand J Public Health 2024; 52:379-390. [PMID: 38346923 PMCID: PMC11067405 DOI: 10.1177/14034948231223791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 12/07/2023] [Accepted: 12/13/2023] [Indexed: 05/04/2024]
Abstract
This article presents the design of a seven-country study focusing on childhood vaccines, Addressing Vaccine Hesitancy in Europe (VAX-TRUST), developed during the COVID-19 pandemic. The study consists of (a) situation analysis of vaccine hesitancy (examination of individual, socio-demographic and macro-level factors of vaccine hesitancy and analysis of media coverage on vaccines and vaccination and (b) participant observation and in-depth interviews of healthcare professionals and vaccine-hesitant parents. These analyses were used to design interventions aimed at increasing awareness on the complexity of vaccine hesitancy among healthcare professionals involved in discussing childhood vaccines with parents. We present the selection of countries and regions, the conceptual basis of the study, details of the data collection and the process of designing and evaluating the interventions, as well as the potential impact of the study. Laying out our research design serves as an example of how to translate complex public health issues into social scientific study and methods.
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Affiliation(s)
- Pia Vuolanto
- Tampere University, Faculty of Social Sciences, Research Center for Knowledge, Science, Technology and Innovation Studies, Finland
| | | | | | - Petra Auvinen
- Tampere University, Faculty of Social Sciences, Research Center for Knowledge, Science, Technology and Innovation Studies, Finland
| | - André Beja
- Global Health and Tropical Medicine, GHTM, Associate Laboratory in Translation and Innovation Towards Global Health, LA-REAL, Instituto de Higiene e Medicina Tropical, IHMT, Universidade Nova de Lisboa, UNL, Portugal
| | - Piet Bracke
- Ghent University, Department of Sociology, Health and Demographic Research, Belgium
| | - Mario Cardano
- University of Turin, Department of Cultures, Politics and Society, Italy
| | - Melissa Ceuterick
- Ghent University, Department of Sociology, Health and Demographic Research, Belgium
| | - Tiago Correia
- Global Health and Tropical Medicine, GHTM, Associate Laboratory in Translation and Innovation Towards Global Health, LA-REAL, Instituto de Higiene e Medicina Tropical, IHMT, Universidade Nova de Lisboa, UNL, Portugal
| | - Elisabetta De Vito
- University of Cassino and Southern Lazio, Department of Human, Social and Health Sciences, Italy
| | - Katrijn Delaruelle
- Ghent University, Department of Sociology, Health and Demographic Research, Belgium
| | - Ana Delicado
- Universidade de Lisboa, Instituto de Ciências Sociais, Portugal
| | - Maurizio Esposito
- University of Cassino and Southern Lazio, Department of Human, Social and Health Sciences, Italy
| | - Maria Ferrara
- University of Cassino and Southern Lazio, Department of Human, Social and Health Sciences, Italy
| | - Luigi Gariglio
- University of Turin, Department of Cultures, Politics and Society, Italy
| | - Cátia Guerreiro
- Global Health and Tropical Medicine, GHTM, Associate Laboratory in Translation and Innovation Towards Global Health, LA-REAL, Instituto de Higiene e Medicina Tropical, IHMT, Universidade Nova de Lisboa, UNL, Portugal
| | | | | | - Pru Hobson-West
- University of Nottingham, School of Sociology and Social Policy, UK
| | - Juliana Iorio
- Universidade de Lisboa, Instituto de Ciências Sociais, Portugal
| | - Katri-Maria Järvinen
- Tampere University, Faculty of Social Sciences, Research Center for Knowledge, Science, Technology and Innovation Studies, Finland
| | - Annariina Koivu
- Tampere University, Faculty of Social Sciences, Research Center for Knowledge, Science, Technology and Innovation Studies, Finland
| | - Zuzana Kotherová
- Charles University, Faculty of Social Sciences, the Czech Republic
| | - Aapo Kuusipalo
- Tampere University, Faculty of Social Sciences, Research Center for Knowledge, Science, Technology and Innovation Studies, Finland
| | - Esther Lermytte
- Ghent University, Department of Sociology, Health and Demographic Research, Belgium
| | - Joana Mendonça
- Universidade de Lisboa, Instituto de Ciências Sociais, Portugal
| | - Rita Morais
- Universidade de Lisboa, Instituto de Ciências Sociais, Portugal
| | - Dino Numerato
- Charles University, Faculty of Social Sciences, the Czech Republic
| | - Paulina Polak
- Jagiellonian University, Institute of Sociology, Poland
| | - Tadeusz Rudek
- Jagiellonian University, Institute of Sociology, Poland
| | - Sara Sbaragli
- University of Cassino and Southern Lazio, Department of Human, Social and Health Sciences, Italy
| | - Alice Scavarda
- University of Turin, Department of Cultures, Politics and Society, Italy
| | - Katielle Silva
- Universidade de Lisboa, Instituto de Ciências Sociais, Portugal
| | | | - Jonas Sivelä
- Finnish Institute for Health and Welfare, Cultural, Behavioural and Media Insights Center, Finland
| | - Eva Soares Moura
- Charles University, Faculty of Social Sciences, the Czech Republic
| | | | - Giuseppe Tipaldo
- University of Turin, Department of Cultures, Politics and Society, Italy
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18
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Barqawi HJ, Samara KA, Haddad ES, Bakkour LM, Amawi FB. Attitudes and practices to adult vaccination among physicians before and after COVID-19 pandemic in the United Arab Emirates. Vaccine X 2024; 17:100455. [PMID: 38356876 PMCID: PMC10865396 DOI: 10.1016/j.jvacx.2024.100455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Revised: 01/15/2024] [Accepted: 01/30/2024] [Indexed: 02/16/2024] Open
Abstract
Introduction Vaccination remains underutilised worldwide with low vaccine uptake rates across the board with many adults remaining unprotected. Across the Arab world, attitudes towards vaccines vary but high rates of vaccine hesitancy have been found. This study aims to explore the adult vaccination attitudes and practices by physicians in the UAE, both before and after the introduction of the COVID-19 vaccines. Methodology This cross-sectional, descriptive study used convenience and snowball sampling to collect comprehensive data from UAE physicians. A self-administered questionnaire was distributed in two stages: the first (pre-COVID-19 vaccines) between the months of June and October 2020 and the second between the months of November 2022 and March 2023. Results 1000 responses, 500 from each time period, were collected. Nearly a third were family physicians or internists with more than 70% of the physicians working in governmental hospitals. 95% agreed that vaccines are safe in both cohorts but 74.4% reported not having enough time to advise about vaccines. 80.8% of physicians in the 2022 cohort reported safety concerns as the most common reason for patients to refuse vaccines. The most recommended vaccines were influenza (68.6%), Hepatitis B (66.0%) and HPV (61.4%), with pneumococcal coming in close at 57.8%. Family medicine physicians showed the highest utilisation of preventive practices across both cohorts. Nearly half of all family medicine physicians did not regularly evaluate both the influenza and general immunisation status of their patients. 54.6% of physicians reported having patients with VPDs in the last five years (not including COVID-19) in 2022. Conclusion Physicians have overly positive attitudes, but their practices reflect a more superficial appreciation of vaccines and lack of initiative. Physicians need to adopt a pro-vaccine stance, armed with the proper tools and the right mentality and beliefs.
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Affiliation(s)
- Hiba J. Barqawi
- Department of Clinical Sciences, College of Medicine, University of Sharjah, United Arab Emirates
| | - Kamel A. Samara
- College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Enad S. Haddad
- College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Layane M. Bakkour
- College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Firas B. Amawi
- Dr. Sulaiman Al Habib Hospital, Dubai, United Arab Emirates
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19
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Clari M, Albanesi B, Comoretto RI, Conti A, Renzi E, Luciani M, Ausili D, Massimi A, Dimonte V. Effectiveness of interventions to increase healthcare workers' adherence to vaccination against vaccine-preventable diseases: a systematic review and meta-analysis, 1993 to 2022. Euro Surveill 2024; 29:2300276. [PMID: 38426238 PMCID: PMC10986662 DOI: 10.2807/1560-7917.es.2024.29.9.2300276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 12/13/2023] [Indexed: 03/02/2024] Open
Abstract
BackgroundVaccination adherence among healthcare workers (HCWs) is fundamental for the prevention of vaccine-preventable diseases (VPDs) in healthcare. This safeguards HCWs' well-being, prevents transmission of infections to vulnerable patients and contributes to public health.AimThis systematic review and meta-analysis aimed to describe interventions meant to increase HCWs' adherence to vaccination and estimate the effectiveness of these interventions.MethodsWe searched literature in eight databases and performed manual searches in relevant journals and the reference lists of retrieved articles. The study population included any HCW with potential occupational exposure to VPDs. We included experimental and quasi-experimental studies presenting interventions aimed at increasing HCWs' adherence to vaccination against VPDs. The post-intervention vaccination adherence rate was set as the main outcome. We included the effect of interventions in the random-effects and subgroup meta-analyses.ResultsThe systematic review considered 48 studies on influenza and Tdap vaccination from database and manual searches, and 43 were meta-analysed. A statistically significant, positive effect was seen in multi-component interventions in randomised controlled trials (relative risk (RR) = 1.37; 95% CI: 1.13-1.66) and in observational studies (RR = 1.43; 95% CI: 1.29-1.58). Vaccination adherence rate was higher in community care facilities (RR = 1.58; 95% CI: 1.49-1.68) than in hospitals (RR = 1.24; 95% CI: 0.76-2.05).ConclusionInterventions aimed at increasing HCWs' adherence to vaccination against VPDs are effective, especially multi-component ones. Future research should determine the most effective framework of interventions for each setting, using appropriate study design for their evaluation, and should compare intervention components to understand their contribution to the effectiveness.
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Affiliation(s)
- Marco Clari
- Department of Sciences of Public Health and Paediatrics, University of Turin, Turin, Italy
- These authors contributed equally to this work and shared first authorship
| | - Beatrice Albanesi
- Department of Sciences of Public Health and Paediatrics, University of Turin, Turin, Italy
- These authors contributed equally to this work and shared first authorship
| | | | - Alessio Conti
- Department of Sciences of Public Health and Paediatrics, University of Turin, Turin, Italy
| | - Erika Renzi
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Michela Luciani
- Department of Medicine and Surgery, University of Milano - Bicocca, Milan Italy
| | - Davide Ausili
- Department of Medicine and Surgery, University of Milano - Bicocca, Milan Italy
| | - Azzurra Massimi
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Valerio Dimonte
- Department of Sciences of Public Health and Paediatrics, University of Turin, Turin, Italy
- Azienda Ospedaliero-Universitaria Città della Salute e della Scienza, Turin, Italy
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20
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Garrison A, Fressard L, Mitilian E, Gosselin V, Berthiaume P, Casanova L, Gagneur A, Verger P. Motivational interview training improves self-efficacy of GP interns in vaccination consultations: A study using the Pro-VC-Be to measure vaccine confidence determinants. Hum Vaccin Immunother 2023; 19:2163809. [PMID: 36703495 PMCID: PMC10012912 DOI: 10.1080/21645515.2022.2163809] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Immunization-specific motivational interviewing (MI), a patient-centered communication style used to encourage internal motivation for attitudinal and behavioral change, can provide healthcare professionals (HCPs) with the skills and practice required to respond to patients' doubts and concerns related to vaccines. We sought to assess the impact of an MI-training of General Practitioner (GP) interns on the psychosocial determinants of their vaccine confidence and behaviors. French GP interns participated in a virtual three-day MI-workshop in southeastern France. We used the validated Pro-VC-Be questionnaire - before and after the MI-workshop spanning over three months - to measure the evolution of these determinants. Scores before and after workshop trainings were compared in pairs. Participants' scores for commitment to vaccination (+10.5 ± 20.5, P = .001), perceived self-efficacy (+36.0 ± 25.8, P < .0001), openness to patients (+18.7 ± 17.0, P < .0001), and trust in authorities (+9.5 ± 17.2, P = 0.01) significantly increased after the training sessions, but not the score for confidence in vaccines (+1.5 ± 11.9, P = .14). The effect sizes of the four score improvements were moderate to large, with self-efficacy and openness to patients having the largest effect sizes (P = .83 and 0.78, respectively). This study provides evidence that certain determinants of overall vaccine confidence in HCPs, reflected respectively in the openness to patients and self-efficacy scores of the Pro-VC-Be, improve after immunization MI-training workshops. Incorporating immunization-specific MI-training in the curriculum for HCPs could improve several necessary skills to improve HCP-patient relationships and be useful for vaccination and other healthcare services.
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Affiliation(s)
- Amanda Garrison
- Faculté des Sciences Médicales et Paramédicales, Observatoire Régional de la Santé (ORS) PACA, Marseille, France
| | - Lisa Fressard
- Faculté des Sciences Médicales et Paramédicales, Observatoire Régional de la Santé (ORS) PACA, Marseille, France
| | - Eva Mitilian
- Faculté des Sciences Médicales et Paramédicales, Observatoire Régional de la Santé (ORS) PACA, Marseille, France.,Faculté des Sciences Médicales et Paramédicales, Département Universitaire de Médecine Générale (DUMG), Aix Marseille Université, Marseille, France
| | - Virginie Gosselin
- Centre de Recherche du Centre Hospitalier, Universitaire de Sherbrooke, Sherbrooke, Québec, Canada
| | | | - Ludovic Casanova
- Faculté des Sciences Médicales et Paramédicales, Observatoire Régional de la Santé (ORS) PACA, Marseille, France.,Faculté des Sciences Médicales et Paramédicales, Département Universitaire de Médecine Générale (DUMG), Aix Marseille Université, Marseille, France
| | - Arnaud Gagneur
- Centre de Recherche du Centre Hospitalier, Universitaire de Sherbrooke, Sherbrooke, Québec, Canada.,Department of Pediatrics, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Québec, Canada
| | - Pierre Verger
- Faculté des Sciences Médicales et Paramédicales, Observatoire Régional de la Santé (ORS) PACA, Marseille, France
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21
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Serbanescu-Kele Apor de Zalán C, Bouwman M, van Osch F, Damoiseaux J, Funnekotter-van der Snoek MA, Verduyn Lunel F, Van Hunsel F, de Vries J. Changes in Local and Systemic Adverse Effects following Primary and Booster Immunisation against COVID-19 in an Observational Cohort of Dutch Healthcare Workers Vaccinated with BNT162b2 (Comirnaty ®). Vaccines (Basel) 2023; 12:39. [PMID: 38250852 PMCID: PMC10821042 DOI: 10.3390/vaccines12010039] [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: 12/15/2023] [Accepted: 12/25/2023] [Indexed: 01/23/2024] Open
Abstract
In healthcare workers (HCWs) and in the general population, fear of adverse effects is among the main reasons behind COVID-19 vaccine hesitancy. We present data on self-reported adverse effects from a large cohort of HCWs who underwent primary (N = 470) and booster (N = 990) mRNA vaccination against SARS-CoV-2. We described general patterns in, and predictors of self-reported adverse effect profiles. Adverse effects following immunisation (AEFI) were reported more often after the second dose of primary immunisation than after the first dose, but there was no further increase in adverse effects following the booster round. Self-reported severity of systemic adverse effects was less following booster immunisation. Prior infection with SARS-CoV-2 was found to be a significant predictor of AEFI following primary immunisation, but was no longer a predictor after booster vaccination. Compared to other studies reporting specifically on adverse effects of SARS-CoV-2 vaccination in healthcare workers, we have a relatively large cohort size, and are the first to compare adverse effects between different rounds of vaccination. Compared to studies in the general population, we have a considerably homogenous population. Insights in AEFI following primary and booster vaccinations may help in addressing vaccine hesitancy, both in HCWs and in the general population.
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Affiliation(s)
- Christiaan Serbanescu-Kele Apor de Zalán
- Department of Intensive Care, VieCuri Medical Centre, 5912 BL Venlo, The Netherlands
- Department of Internal Medicine, VieCuri Medical Centre, 5912 BL Venlo, The Netherlands
| | - Maud Bouwman
- Department of Medical Microbiology, VieCuri Medical Centre, 5912 BL Venlo, The Netherlands; (M.B.); (J.D.); (J.d.V.)
| | - Frits van Osch
- Department of Clinical Epidemiology, VieCuri Medical Centre, 5912 BL Venlo, The Netherlands;
- Department of Epidemiology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, 6229 HX Maastricht, The Netherlands
| | - Jan Damoiseaux
- Department of Medical Microbiology, VieCuri Medical Centre, 5912 BL Venlo, The Netherlands; (M.B.); (J.D.); (J.d.V.)
- Central Diagnostic Laboratory, Maastricht University Medical Centre, 6229 HX Maastricht, The Netherlands
| | | | - Frans Verduyn Lunel
- Department of Medical Microbiology, Utrecht University Medical Centre, 3584 CX Utrecht, The Netherlands;
| | - Florence Van Hunsel
- Department of Pharmacy, University of Groningen, 9713 AV Groningen, The Netherlands;
- Netherlands Pharmacovigilance Centre (Lareb), 5237 MH Hertogenbosch, The Netherlands
| | - Janneke de Vries
- Department of Medical Microbiology, VieCuri Medical Centre, 5912 BL Venlo, The Netherlands; (M.B.); (J.D.); (J.d.V.)
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22
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Pandher R, Bilszta JLC. Novel COVID-19 vaccine hesitancy and acceptance, and associated factors, amongst medical students: a scoping review. MEDICAL EDUCATION ONLINE 2023; 28:2175620. [PMID: 36788502 PMCID: PMC9930839 DOI: 10.1080/10872981.2023.2175620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 01/29/2023] [Accepted: 01/30/2023] [Indexed: 06/18/2023]
Abstract
Medical students are likely to be exposed to COVID-19 patients so achieving high vaccination coverage rates for this group of healthcare workers is important, as is their potential as vaccination role models. The aim of this scoping review was to evaluate the current literature to determine the rates of COVID-19 vaccine hesitancy and acceptance, and associated factors, amongst medical students. Systematic searches of the Medline Ovid, Embase, PubMed, and Education Resources Information Centre (ERIC) online databases was conducted for relevant articles with keywords: 'COVID-19', 'vaccine hesitancy & acceptance' and 'medical students'. Articles were included for review if they reported the rates of vaccine hesitancy and acceptance, and associated factors, amongst medical students. Of the 258 articles identified, 52 met the inclusion criteria and underwent full-text review. Rates of vaccine hesitancy ranged from 5.4-86.7%, with generally positive attitudes towards COVID-19 vaccination. The main factors associated with vaccine hesitancy were concerns about the safety and efficacy of vaccines due to their accelerated development, being a pre-clinical medical student, and low perceived personal risk of COVID-19 infection. Inconsistencies were found for the influence of gender on attitudes towards vaccinations. Previous vaccination behaviours were predictive of willingness to receive the COVID-19 vaccine. Knowledge about COVID-19 vaccinations and their importance was found to be deficient amongst vaccine hesitant medical students. Generally, medical students express low levels of vaccine hesitancy. However, due to the variability in the factors associated with vaccine hesitancy across different populations and the dynamic and contextual nature of hesitancy, it is recommended that vaccination intent and associated attitudes are monitored on a longitudinal basis. It is important to map vaccine hesitancy at a local level to allow medical schools to develop strategies to encourage vaccination specific to their school's needs.
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Affiliation(s)
- Robyn Pandher
- Department of Medical Education, Melbourne Medical School, University of Melbourne, Parkville, Australia
| | - Justin L C Bilszta
- Department of Medical Education, Melbourne Medical School, University of Melbourne, Parkville, Australia
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23
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Patterson L, Berry E, Parsons C, Clarke B, Little A, Beggs J, Chuter A, Jackson T, Hsia Y, McGrath H, Millman C, Murphy S, Bradley DT, Milligan S. Using the COM-B framework to elucidate facilitators and barriers to COVID-19 vaccine uptake in pregnant women: a qualitative study. BMC Pregnancy Childbirth 2023; 23:640. [PMID: 37674175 PMCID: PMC10481472 DOI: 10.1186/s12884-023-05958-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 08/27/2023] [Indexed: 09/08/2023] Open
Abstract
Since April 2021, COVID-19 vaccines have been recommended for pregnant women. Despite this, COVID-19 vaccine uptake in this group is low compared to the non-pregnant population of childbearing age. Our aim was to understand barriers and facilitators to COVID-19 vaccine uptake among pregnant women in Northern Ireland using the COM-B framework, and so to make recommendations for public health interventions. The COM-B proposes that human behaviour is influenced by the extent to which a person has the capability, opportunity, and motivation to enact that behaviour. Understanding the factors underpinning behaviour through this lens helps discern what needs to change to change behaviour, therefore supporting the development of targeted interventions.This study consisted of eight semi-structured interviews with new/expectant mothers who did not receive a COVID-19 vaccine dose while pregnant since April 2021, and a focus group with five participants who received at least one COVID-19 vaccine dose while pregnant. Interview and focus group data were analysed using semi-deductive reflexive thematic analysis framed by a subtle realist approach. The COM-B was used to categorise codes and subthemes were developed within each COM-B construct.Within Psychological Capability, subthemes captured the need for consistent and reliable COVID-19 vaccine information and access to balanced and jargon-free, risk-benefit information that is tailored to the pregnant individual. The behaviour/opinions of family, friends, and local healthcare providers had a powerful influence on COVID-19 vaccine decisions (Social Opportunity). Integrating the COVID-19 vaccine as part of routine antenatal pathways was believed to support access and sense of familiarity (Physical Opportunity). Participants valued health autonomy, however experienced internal conflict driven by concerns about long-term side effects for their baby (Reflective Motivation). Feelings of fear, lack of empathy from healthcare providers, and anticipated guilt commonly underpinned indecision as to whether to get the vaccine (Automatic Motivation).Our study highlighted that the choice to accept a vaccine during pregnancy generates internal conflict and worry. Several participants cited their concern was primarily around the safety for their baby. Healthcare professionals (HCPs) play a significant part when it comes to decision making about COVID-19 vaccines among pregnant women. HCPs and pregnant women should be involved in the development of interventions to improve the delivery and communication of information.
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Affiliation(s)
- Lynsey Patterson
- Public Health Agency, Belfast, UK.
- Centre for Public Health, Queen's University Belfast, Belfast, UK.
| | - Emma Berry
- School of Psychology, Queen's University Belfast, Belfast, UK
| | - Carole Parsons
- School of Pharmacy, Queen's University Belfast, Belfast, UK
| | | | | | - Jillian Beggs
- PPI, Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Antony Chuter
- PPI, Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Tracy Jackson
- PPI, Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Yingfen Hsia
- School of Pharmacy, Queen's University Belfast, Belfast, UK
- Centre for Neonatal and Paediatric Infection, St George's University of London, London, UK
| | | | | | - Siobhan Murphy
- Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - Declan T Bradley
- Public Health Agency, Belfast, UK
- Centre for Public Health, Queen's University Belfast, Belfast, UK
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24
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Viskupič F, Wiltse DL. Partisan self-identification predicts attitudes of South Dakota nurses toward COVID-19 vaccine mandate for healthcare workers. HEALTH POLICY AND TECHNOLOGY 2023; 12:100777. [PMID: 37389329 PMCID: PMC10290765 DOI: 10.1016/j.hlpt.2023.100777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/01/2023]
Abstract
Objectives Nurses are at greater risk of infection from COVID-19. However, mistrust of the vaccine exists even among this group. In the United States, the government implemented a vaccine mandate for health care workers to increase vaccination rates. This study investigated the drivers of nurses' attitudes toward the mandate. Methods We fielded a survey to study the attitudes of nurses toward COVID-19 vaccine mandate for HCWs. We contacted nurses in South Dakota, United States, based on the information from the South Dakota Board of Nursing. The survey was open in June and July 2022. We conducted a multivariate regression analysis to identify the factors that predict attitudes toward this regulation. Results We received 1,084 responses. Results of regression analysis showed statistically significant relationships between partisan self-identification, evangelical identity, gender, and COVID-19 vaccination status and support for COVID-19 vaccine mandate for healthcare workers. Age, time with patients, positive COIVD-19 test in the last year, education, and nurse classification variables were not statistically significant. Conclusions The same factors that drive people's attitudes toward COVID-19 mitigation policies also explain nurses' attitudes toward a vaccine mandate for healthcare workers. The politicization of the COVID-19 pandemic is present also among nurses. Health care officials should be mindful of the influence of these biases as they evaluate the vaccine mandate and develop new regulations.
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Affiliation(s)
- Filip Viskupič
- School of American and Global Studies, South Dakota State University, United States of America
| | - David L Wiltse
- School of American and Global Studies, South Dakota State University, United States of America
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25
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Fasce A, Karlsson L, Verger P, Mäki O, Taubert F, Garrison A, Schmid P, Holford DL, Lewandowsky S, Rodrigues F, Betsch C, Soveri A. Endorsement of alternative medicine and vaccine hesitancy among physicians: A cross-sectional study in four European countries. Hum Vaccin Immunother 2023; 19:2242748. [PMID: 37581343 PMCID: PMC10431744 DOI: 10.1080/21645515.2023.2242748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 07/13/2023] [Accepted: 07/27/2023] [Indexed: 08/16/2023] Open
Abstract
Vaccine hesitancy has become a threat to public health, especially as it is a phenomenon that has also been observed among healthcare professionals. In this study, we analyzed the relationship between endorsement of complementary and alternative medicine (CAM) and vaccination attitudes and behaviors among healthcare professionals, using a cross-sectional sample of physicians with vaccination responsibilities from four European countries: Germany, Finland, Portugal, and France (total N = 2,787). Our results suggest that, in all the participating countries, CAM endorsement is associated with lower frequency of vaccine recommendation, lower self-vaccination rates, and being more open to patients delaying vaccination, with these relationships being mediated by distrust in vaccines. A latent profile analysis revealed that a profile characterized by higher-than-average CAM endorsement and lower-than-average confidence and recommendation of vaccines occurs, to some degree, among 19% of the total sample, although these percentages varied from one country to another: 23.72% in Germany, 17.83% in France, 9.77% in Finland, and 5.86% in Portugal. These results constitute a call to consider health care professionals' attitudes toward CAM as a factor that could hinder the implementation of immunization campaigns.
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Affiliation(s)
- Angelo Fasce
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Linda Karlsson
- Institute of Clinical Medicine, University of Turku, Turku, Finland
| | - Pierre Verger
- Faculté des Sciences Médicales et Paramédicales, Southeastern Health Regional Observatory (Observatoire Régional de la Santé, ORS-PACA), Marseille, France
| | - Otto Mäki
- Department of Psychology and Speech-Language Pathology, University of Turku, Turku, Finland
| | - Frederike Taubert
- Institute for Planetary Health Behavior, University of Erfurt, Erfurt, Germany
- Health Communication Working Group, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
| | - Amanda Garrison
- Faculté des Sciences Médicales et Paramédicales, Southeastern Health Regional Observatory (Observatoire Régional de la Santé, ORS-PACA), Marseille, France
| | - Philipp Schmid
- Institute for Planetary Health Behavior, University of Erfurt, Erfurt, Germany
- Department of Implementation Research, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
| | - Dawn Liu Holford
- School of Psychological Science, University of Bristol, Bristol, UK
| | - Stephan Lewandowsky
- School of Psychological Science, University of Bristol, Bristol, UK
- School of Psychological Science, University of Western Australia, Perth, Australia
- Department of Psychology, University of Potsdam, Postdam, Germany
| | | | - Cornelia Betsch
- Health Communication Working Group, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
| | - Anna Soveri
- Institute of Clinical Medicine, University of Turku, Turku, Finland
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26
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Karlsson LC, Garrison A, Holford D, Fasce A, Lewandowsky S, Taubert F, Schmid P, Betsch C, Rodrigues F, Fressard L, Verger P, Soveri A. Healthcare professionals' attitudes to mandatory COVID-19 vaccination: Cross-sectional survey data from four European countries. Hum Vaccin Immunother 2023; 19:2256442. [PMID: 37724556 PMCID: PMC10512846 DOI: 10.1080/21645515.2023.2256442] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 09/04/2023] [Indexed: 09/21/2023] Open
Abstract
Mandatory vaccinations are widely debated since they restrict individuals' autonomy in their health decisions. As healthcare professionals (HCPs) are a common target group of vaccine mandates, and also form a link between vaccination policies and the public, understanding their attitudes toward vaccine mandates is important. The present study investigated physicians' attitudes to COVID-19 vaccine mandates in four European countries: Finland, France, Germany, and Portugal. An electronic survey assessing attitudes to COVID-19 vaccine mandates and general vaccination attitudes (e.g. perceived vaccine safety, trust in health authorities, and openness to patients) was sent to physicians in the spring of 2022. A total of 2796 physicians responded. Across all countries, 78% of the physicians were in favor of COVID-19 vaccine mandates for HCPs, 49% favored COVID-19 vaccine mandates for the public, and 67% endorsed COVID-19 health passes. Notable differences were observed between countries, with attitudes to mandates found to be more positive in countries where the mandate, or similar mandates, were in effect. The associations between attitudes to mandates and general vaccination attitudes were mostly small to neglectable and differed between countries. Nevertheless, physicians with more positive mandate attitudes perceived vaccines as more beneficial (in Finland and France) and had greater trust in medical authorities (in France and Germany). The present study contributes to the body of research within social and behavioral sciences that support evidence-based vaccination policymaking.
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Affiliation(s)
- Linda C. Karlsson
- Department of Clinical Medicine, University of Turku, Turku, Finland
| | - Amanda Garrison
- Faculté des Sciences Médicales et Paramédicales, Southeastern Health Regional Observatory (Observatoire Régional de la Santé, ORS-PACA), Marseille, France
| | - Dawn Holford
- School of Psychological Science, University of Bristol, Bristol, UK
| | - Angelo Fasce
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Stephan Lewandowsky
- School of Psychological Science, University of Bristol, Bristol, UK
- Department of Psychology, University of Potsdam, Potsdam, Germany
- School of Psychological Science, University of Western Australia, Perth, Australia
| | - Frederike Taubert
- Institute for Planetary Health Behavior, Health Communication, University of Erfurt, Erfurt, Germany
- Health Communication Working Group, Implementation Research, Bernhard Nocht Institute for Tropical Medicine, University of Hamburg, Hamburg, Germany
| | - Philipp Schmid
- Institute for Planetary Health Behavior, Health Communication, University of Erfurt, Erfurt, Germany
- Health Communication Working Group, Implementation Research, Bernhard Nocht Institute for Tropical Medicine, University of Hamburg, Hamburg, Germany
- Centre for Language Studies, Radboud University Nijmegen, Nijmegen, The Netherlands
| | - Cornelia Betsch
- Institute for Planetary Health Behavior, Health Communication, University of Erfurt, Erfurt, Germany
- Health Communication Working Group, Implementation Research, Bernhard Nocht Institute for Tropical Medicine, University of Hamburg, Hamburg, Germany
| | | | - Lisa Fressard
- Faculté des Sciences Médicales et Paramédicales, Southeastern Health Regional Observatory (Observatoire Régional de la Santé, ORS-PACA), Marseille, France
| | - Pierre Verger
- Faculté des Sciences Médicales et Paramédicales, Southeastern Health Regional Observatory (Observatoire Régional de la Santé, ORS-PACA), Marseille, France
| | - Anna Soveri
- Department of Clinical Medicine, University of Turku, Turku, Finland
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27
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Loi AST, Sridhar R, Lim SM. Measles and Varicella Vaccination Program in a Hospital: Implementation and Impact on Contact Tracing. Vaccines (Basel) 2023; 11:1131. [PMID: 37514947 PMCID: PMC10385976 DOI: 10.3390/vaccines11071131] [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: 05/31/2023] [Revised: 06/16/2023] [Accepted: 06/19/2023] [Indexed: 07/30/2023] Open
Abstract
Healthcare workers are recommended to get vaccinated against measles and varicella. This study aims to describe the implementation process of a measles and varicella vaccination program and report on the reduction in the number of susceptible healthcare workers exposed to measles, varicella, and disseminated herpes zoster at a tertiary hospital. The Consolidated Framework for Implementation Research (CFIR) model was used to describe the vaccination program implemented from October 2015 to September 2018. The number of exposed, reviewed, and susceptible healthcare workers during contact tracing for exposure to (a) measles and (b) varicella and disseminated herpes zoster in 2016, 2017, and 2018 is reported. A total of 6770 (95%) out of 7083 healthcare workers completed their immunization review by 2018. In 2016, 20 (10%) out of 198 healthcare workers exposed to measles were considered susceptible. In 2018, no one was found susceptible out of the 51 staff members exposed to measles (p < 0.01). For exposure to varicella and disseminated herpes zoster, seven (5%) out of 154 exposed healthcare workers were susceptible in 2016. In comparison, only two (1%) out of 377 exposed healthcare workers in 2018 were susceptible (p < 0.01). The vaccination program effectively reduced number of healthcare workers susceptible to measles, varicella, and disseminated zoster.
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Affiliation(s)
| | - Revathi Sridhar
- Epidemiology Unit, Division of Infectious Diseases, National University Hospital, Singapore 119074, Singapore
| | - See Ming Lim
- Occupational Health Clinic, National University Hospital, Singapore 119074, Singapore
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28
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Malo B, Labbé F, Meyer SB, Filice E, Graham JE, MacDonald NE, Bettinger JA, Greyson D, MacDonald SE, Driedger SM, Kawchuk G, Dubé E. "I Want People to Be Able to Make an Informed Choice": How Quebec naturopaths discuss vaccination in their practice. Vaccine 2023:S0264-410X(23)00553-4. [PMID: 37210310 DOI: 10.1016/j.vaccine.2023.05.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 03/22/2023] [Accepted: 05/09/2023] [Indexed: 05/22/2023]
Abstract
Health care providers' recommendations can play an important role in individuals' vaccination decisions. Despite being one of the most popular complementary and alternative medicine (CAM), naturopathy is understudied in relation to vaccination decisions. We sought to address this gap through this study of vaccination perspectives of naturopathy practitioners in the province of Quebec, Canada. We conducted in-depth interviews with 30 naturopaths. Thematic analysis was conducted. Main themes were developed deductively (i.e., based on prior literature) and expanded through inductive coding of the data. Participants noted that they discuss vaccination in their practice, but only when clients asked questions or wanted advice. Naturopaths described refraining from explicitly recommending for or against vaccination. Instead, they focus on empowering their clients to make their own informed decision regarding vaccination. Most participants noted that they direct clients towards sources of information so that clients could decide for themselves, but some mentioned they discussed with clients what they considered to be risks associated with vaccination, as well as its benefits. These discussions were framed through a personalized and individual approach with clients.
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Affiliation(s)
- Benjamin Malo
- Axe Maladies infectieuses et immunitaires, Centre de recherche du CHU de Québec-Université Laval, Québec, Canada; Département d'anthropologie, Université Laval, Québec, Canada
| | - Fabienne Labbé
- Axe Santé des populations et pratiques optimales en santé, Centre de recherche du CHU de Québec-Université Laval, Québec, Canada
| | - Samantha B Meyer
- School of Public Health Sciences, University of Waterloo, Waterloo, Canada
| | - Eric Filice
- School of Public Health Sciences, University of Waterloo, Waterloo, Canada
| | - Janice E Graham
- Department of Pediatrics, Dalhousie University, Halifax, Canada
| | | | - Julie A Bettinger
- Vaccine Evaluation Center, BC Children's Hospital Research Institute, University of British Columbia, Vancouver, Canada
| | - Devon Greyson
- Vaccine Evaluation Center, BC Children's Hospital Research Institute, University of British Columbia, Vancouver, Canada
| | | | - S Michelle Driedger
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Gregory Kawchuk
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada
| | - Eve Dubé
- Axe Maladies infectieuses et immunitaires, Centre de recherche du CHU de Québec-Université Laval, Québec, Canada; Département d'anthropologie, Université Laval, Québec, Canada; Direction des risques biologiques et de la santé au travail, Institut national de santé publique du Québec, Québec, Canada.
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Marcinowicz L, Fejfer-Wirbal E, Dudzik A, Genowska A, Terlikowski S. Barriers and Facilitators to COVID-19 Vaccine Uptake among Polish Patients: A Qualitative Interview Study. Vaccines (Basel) 2023; 11:vaccines11010177. [PMID: 36680021 PMCID: PMC9861893 DOI: 10.3390/vaccines11010177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 01/11/2023] [Accepted: 01/12/2023] [Indexed: 01/18/2023] Open
Abstract
The decision to receive a COVID-19 vaccine is influenced by a variety of individual and contextual factors. However, there are very few studies that analyse individual vaccination decisions using a qualitative methodology. To close this gap, we conducted a qualitative interview study to examine the opinions and experiences with the vaccine among patients previously hospitalized due to COVID-19, including barriers and facilitators to vaccine uptake. An exploratory qualitative study, using semi-structured telephone interviews, was conducted among 22 patients admitted for COVID-19 in Poland in 2022. Opinions of patients previously hospitalized with COVID-19 on vaccination were varied. Barriers to COVID-19 vaccine uptake stemmed from concerns about vaccine safety, patients' religious beliefs, and negative stories. High disease severity and anxiety over personal and family health were important arguments in favour of receiving the COVID-19 vaccine. The study findings indicated the need for ongoing health education by healthcare staff as well as coordination and integration of multi-sectoral institutional measures regarding COVID-19 prevention strategies as well as increased public health initiatives on social media and engagement of community leaders for awareness about vaccines and vaccination. It is crucial to build trust in COVID-19 vaccinations among the general public by disseminating reliable information through trustworthy and credible sources. However, it ought to be emphasised that, regardless of the measures taken, some individuals will remain unconvinced about receiving a COVID-19 vaccine.
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Affiliation(s)
- Ludmiła Marcinowicz
- Department of Obstetrics, Gynecology and Maternity Care, Medical University of Bialystok, 15-295 Bialystok, Poland
| | - Ewa Fejfer-Wirbal
- Department of Health Sciences, Prof. Edward F. Szczepanik State Vocational University in Suwalki, Noniewicza 10, 16-400 Suwalki, Poland
| | - Agnieszka Dudzik
- Department of Foreign Languages, Medical University of Bialystok, 15-222 Bialystok, Poland
| | - Agnieszka Genowska
- Department of Public Health, Medical University of Bialystok, 15-295 Bialystok, Poland
- Correspondence:
| | - Sławomir Terlikowski
- Department of Obstetrics, Gynecology and Maternity Care, Medical University of Bialystok, 15-295 Bialystok, Poland
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Garrison A, Karlsson L, Fressard L, Fasce A, Rodrigues F, Schmid P, Taubert F, Holford D, Lewandowsky S, Nynäs P, Anderson EC, Gagneur A, Dubé E, Soveri A, Verger P. International adaptation and validation of the Pro-VC-Be: measuring the psychosocial determinants of vaccine confidence in healthcare professionals in European countries. Expert Rev Vaccines 2023; 22:726-737. [PMID: 37507356 DOI: 10.1080/14760584.2023.2242479] [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: 02/18/2023] [Revised: 06/29/2023] [Accepted: 07/26/2023] [Indexed: 07/30/2023]
Abstract
BACKGROUND Healthcare professionals (HCPs) play an important role in vaccination; those with low confidence in vaccines are less likely to recommend them to their patients and to be vaccinated themselves. The study's purpose was to adapt and validate long- and short-form versions of the International Professionals' Vaccine Confidence and Behaviors (I-Pro-VC-Be) questionnaire to measure psychosocial determinants of HCPs' vaccine confidence and their associations with vaccination behaviors in European countries. RESEARCH DESIGN AND METHODS After the original French-language Pro-VC-Be was culturally adapted and translated, HCPs involved in vaccination (mainly GPs and pediatricians) across Germany, Finland, France, and Portugal completed a cross-sectional online survey in 2022. A 10-factor multigroup confirmatory factor analysis (MG-CFA) of the long-form (10 factors comprising 34 items) tested for measurement invariance across countries. Modified multiple Poisson regressions tested the criterion validity of both versions. RESULTS 2,748 HCPs participated. The 10-factor structure fit was acceptable to good everywhere. The final MG-CFA model confirmed strong factorial invariance and showed very good fit. The long- and short-form I-Pro-VC-Be had good criterion validity with vaccination behaviors. CONCLUSION This study validates the I-Pro-VC-Be among HCPs in four European countries; including long- and short-form tools for use in research and public health.
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Affiliation(s)
- Amanda Garrison
- Faculté des Sciences Médicales Et Paramédicales, Southeastern Health Regional Observatory (Observatoire Régional de la Santé, ORS) PACA, Marseille, France
| | - Linda Karlsson
- Institute of Clinical Medicine, University of Turku, Turku, Finland
| | - Lisa Fressard
- Faculté des Sciences Médicales Et Paramédicales, Southeastern Health Regional Observatory (Observatoire Régional de la Santé, ORS) PACA, Marseille, France
| | - Angelo Fasce
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | | | - Philipp Schmid
- Institute for Planetary Health Behaviour, University of Erfurt, Erfurt, Germany
- Health Communication, Department of Implementation Research, Bernhard-Nocht-Institute for Tropical Medicine, Hamburg, Germany
| | - Frederike Taubert
- Institute for Planetary Health Behaviour, University of Erfurt, Erfurt, Germany
- Health Communication, Department of Implementation Research, Bernhard-Nocht-Institute for Tropical Medicine, Hamburg, Germany
| | - Dawn Holford
- School of Psychological Science, University of Bristol, Bristol, UK
| | - Stephan Lewandowsky
- School of Psychological Science, University of Bristol, Bristol, UK
- Department of Psychology, University of Potsdam, Potsdam, Germany
- School of Psychological Science, University of Western Australia, Crawley, WA, Australia
| | - Peter Nynäs
- Faculty of Arts, Psychology and Theology, Abo Akademi University, Turku, Finland
| | | | - Arnaud Gagneur
- Department of Pediatrics, University of Sherbrooke, Sherbrooke, Québec, Canada
| | - Eve Dubé
- Département d'anthropologie, Faculté des Sciences Sociales, Université Laval, Laval, Canada
| | - Anna Soveri
- Institute of Clinical Medicine, University of Turku, Turku, Finland
| | - Pierre Verger
- Faculté des Sciences Médicales Et Paramédicales, Southeastern Health Regional Observatory (Observatoire Régional de la Santé, ORS) PACA, Marseille, France
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Betsch C, Schmid P, Verger P, Lewandowsky S, Soveri A, Hertwig R, Fasce A, Holford D, De Raeve P, Gagneur A, Vuolanto P, Correia T, Tavoschi L, Declich S, Marceca M, Linos A, Karnaki P, Karlsson L, Garrison A. A call for immediate action to increase COVID-19 vaccination uptake to prepare for the third pandemic winter. Nat Commun 2022; 13:7511. [PMID: 36473855 PMCID: PMC9726862 DOI: 10.1038/s41467-022-34995-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 11/15/2022] [Indexed: 12/12/2022] Open
Affiliation(s)
- Cornelia Betsch
- University of Erfurt, Erfurt, Germany.
- Bernhard-Nocht-Institute for Tropical Medicine, Hamburg, Germany.
| | - Philipp Schmid
- University of Erfurt, Erfurt, Germany
- Bernhard-Nocht-Institute for Tropical Medicine, Hamburg, Germany
| | - Pierre Verger
- Faculty of Medicine, Southeastern Regional Health Observatory, Marseille, France
| | | | | | - Ralph Hertwig
- Max Planck Institute for Human Development, Berlin, Germany
| | | | - Dawn Holford
- School of Psychological Science, University of Bristol, Bristol, UK
| | - Paul De Raeve
- European Federation of Nurses Associations, Brussels, Belgium
| | - Arnaud Gagneur
- Faculté de Médecine et des Sciences de la Santé, University of Sherbrooke, Sherbrooke, QC, Canada
| | | | - Tiago Correia
- Global Health and Tropical Medicine, GHTM, Instituto de Higiene e Medicina Tropical, IHMT, Universidade Nova de Lisboa, Lisbon, Portugal
| | - Lara Tavoschi
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Silvia Declich
- Istituto Superiore di Sanità, Italian National Institute of Health, Rome, Italy
| | - Maurizio Marceca
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | | | | | | | - Amanda Garrison
- Faculty of Medicine, Southeastern Regional Health Observatory, Marseille, France
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32
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Gagneux-Brunon A, Dauby N, Launay O, Botelho-Nevers E. Attitudes towards monkeypox vaccination among healthcare workers in France and Belgium: an element of complacency? J Hosp Infect 2022; 130:144-145. [PMID: 36174773 PMCID: PMC9534062 DOI: 10.1016/j.jhin.2022.09.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 09/15/2022] [Accepted: 09/19/2022] [Indexed: 12/04/2022]
Affiliation(s)
- A Gagneux-Brunon
- Centre International de Recherche en Infectiologie, Team GIMAP, Univ Lyon, Université Jean Monnet, Université Claude Bernard Lyon 1, Inserm, U1111, CNRS, UMR530, France; CIC INSERM 1408 Vaccinologie, CHU de Saint-Etienne, France; Chaire PREVACCI, Université Jean Monnet, Saint-Etienne, France.
| | - N Dauby
- Department of Infectious Diseases, CHU Saint-Pierre - Université Libre de Bruxelles, Brussels, Belgium; School of Public Health, Université Libre de Bruxelles, Brussels, Belgium
| | - O Launay
- Université Paris Cité, Inserm CIC 1417, F-CRIN I-REIVAC, Assistance Publique - Hôpitaux de Paris, Hôpital Cochin, Paris, France
| | - E Botelho-Nevers
- Centre International de Recherche en Infectiologie, Team GIMAP, Univ Lyon, Université Jean Monnet, Université Claude Bernard Lyon 1, Inserm, U1111, CNRS, UMR530, France; CIC INSERM 1408 Vaccinologie, CHU de Saint-Etienne, France; Chaire PREVACCI, Université Jean Monnet, Saint-Etienne, France
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Vasudevan L, Bruening R, Hung A, Woolson S, Brown A, Hastings SN, Linton T, Embree G, Hostler CJ, Mahanna E, Okeke NL, Bosworth H, Sperber NR. COVID-19 vaccination intention and activation among health care system employees: A mixed methods study. Vaccine 2022; 40:5141-5152. [PMID: 35902277 PMCID: PMC9276645 DOI: 10.1016/j.vaccine.2022.07.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 07/05/2022] [Accepted: 07/07/2022] [Indexed: 01/01/2023]
Abstract
BACKGROUND Achieving high COVID-19 vaccination rates among employees is necessary to prevent outbreaks in health care settings. The goal of the study was to produce actionable and timely evidence about factors underlying the intention and decisions to obtain the COVID-19 vaccine by employees. METHODS The study was conducted from December 2020 - May 2021 with employees from a VA health care system in Southeastern US. The study used a convergent mixed methods design comprising two main activities: a cross-sectional survey conducted prior to COVID-19 vaccine distribution, and semi-structured interviews conducted 4-6 months after vaccine distribution. Data were collected about participant characteristics, vaccination intention prior to distribution, vaccination decision post-distribution, determinants of vaccination intention and decision, activating factors, sources of information and intervention needs. Data from the survey and interviews were analyzed separately and integrated narratively in the discussion. RESULTS Prior to vaccine distribution, 77% of employees wanted to be vaccinated. Post vaccine distribution, we identified 5 distinct decision-making groups: 1) vaccine believers who actively sought vaccination and included those sometimes described as "immunization advocates", 2) go along to get along (GATGA) individuals who got vaccinated but did not actively seek it, 3) cautious acceptors who got the COVID-19 vaccine after some delay, 4) fence sitters who remained uncertain about getting vaccinated, and 5) vaccine refusers who actively rejected the COVID-19 vaccine. Participants identifying with Black or multiple races were more likely to express hesitancy in their vaccination intention. CONCLUSION The findings of our study highlight distinct decision-making profiles associated with COVID-19 vaccination among employees of a VA health care system, and provide tailored recommendations to reduce vaccine hesitancy in this population.
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Affiliation(s)
- Lavanya Vasudevan
- Department of Family Medicine and Community Health, Duke University, Durham, NC, USA; Duke Global Health Institute, Durham, NC, USA; Duke Human Vaccine Institute, Durham, NC, USA.
| | - Rebecca Bruening
- Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham VA Health Care System, Durham, NC, USA
| | - Anna Hung
- Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham VA Health Care System, Durham, NC, USA; Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Sandra Woolson
- Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham VA Health Care System, Durham, NC, USA
| | - Adrian Brown
- Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham VA Health Care System, Durham, NC, USA
| | - Susan N Hastings
- Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham VA Health Care System, Durham, NC, USA; Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA; Department of Medicine, Duke University School of Medicine, Durham, NC, USA; Center for the Study of Aging and Human Development, Duke University School of Medicine, Durham, NC, USA; Geriatrics Research, Education and Clinical Center, Durham VA Health Care System, Durham, NC, USA
| | - Tammy Linton
- Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham VA Health Care System, Durham, NC, USA; Office of Public Health and Epidemiology, Durham VA Health Care System, Durham, NC, USA
| | - Genevieve Embree
- Department of Medicine, Duke University School of Medicine, Durham, NC, USA; Office of Public Health and Epidemiology, Durham VA Health Care System, Durham, NC, USA
| | - Christopher J Hostler
- Department of Medicine, Duke University School of Medicine, Durham, NC, USA; Office of Public Health and Epidemiology, Durham VA Health Care System, Durham, NC, USA
| | - Elizabeth Mahanna
- Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham VA Health Care System, Durham, NC, USA
| | - Nwora Lance Okeke
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA; Department of Medicine, Duke University School of Medicine, Durham, NC, USA
| | - Hayden Bosworth
- Department of Family Medicine and Community Health, Duke University, Durham, NC, USA; Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham VA Health Care System, Durham, NC, USA; Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA; Department of Medicine, Duke University School of Medicine, Durham, NC, USA; Center for the Study of Aging and Human Development, Duke University School of Medicine, Durham, NC, USA
| | - Nina R Sperber
- Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham VA Health Care System, Durham, NC, USA; Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA; Duke-Margolis Center for Health Policy, Durham, NC, USA
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Dubov A, Distelberg BJ, Abdul-Mutakabbir JC, Peteet B, Roberts L, Montgomery SB, Rockwood N, Patel P, Shoptaw S, Chrissian AA. Racial/Ethnic Variances in COVID-19 Inoculation among Southern California Healthcare Workers. Vaccines (Basel) 2022; 10:1331. [PMID: 36016219 PMCID: PMC9414471 DOI: 10.3390/vaccines10081331] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 08/13/2022] [Accepted: 08/15/2022] [Indexed: 01/25/2023] Open
Abstract
Healthcare workers (HCWs) from minoritized communities are a critical partner in moving vaccine-hesitant populations toward vaccination, yet a significant number of these HCWs are delaying or deciding against their own COVID-19 vaccinations. Our study aims to provide a more nuanced understanding of vaccine hesitancy among racially and ethnically minoritized HCWs and to describe factors associated with vaccine non-acceptance. Analysis of a sub-sample of racially and ethnically minoritized HCWs (N = 1131), who participated in a cross-sectional study at two large Southern California medical centers, was conducted. Participants completed an online survey consisting of demographics, work setting and clinical role, influenza vaccination history, COVID-19 knowledge, beliefs, personal COVID-19 exposure, diagnosis, and impact on those closest to them. While overall most HCWs were vaccinated (84%), 28% of Black, 19% of Hispanic, and 8% of Asian American HCWs were vaccine-hesitant. Age, education level, occupation, history of COVID-19, and COVID-19 related knowledge were predictive of vaccine hesitancy. We found significant variations in COVID-19 related knowledge and reasons for vaccine hesitancy among Black (governmental mistrust), Hispanic (preference for physiological immunity), and Asian-American HCWs (concern about side effects) who were vaccine-hesitant or not. Our findings highlight racial and ethnic differences in vaccine-hesitancy and barriers to vaccination among HCWs of color. This study indicates the necessity of targeted interventions to reduce vaccine hesitancy that are mindful of the disparities in knowledge and access and differences between and among racial and ethnic groups.
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Affiliation(s)
- Alex Dubov
- School of Behavioral Health, Loma Linda University, Loma Linda, CA 92350, USA
| | - Brian J. Distelberg
- School of Behavioral Health, Loma Linda University, Loma Linda, CA 92350, USA
| | | | - Bridgette Peteet
- School of Behavioral Health, Loma Linda University, Loma Linda, CA 92350, USA
| | - Lisa Roberts
- School of Nursing, Loma Linda University, Loma Linda, CA 92350, USA
| | | | - Nicholas Rockwood
- School of Behavioral Health, Loma Linda University, Loma Linda, CA 92350, USA
| | - Pranjal Patel
- School of Medicine, Loma Linda University, Loma Linda, CA 92350, USA
| | - Steven Shoptaw
- Department of Family Medicine, University of California Los Angeles, Los Angeles, CA 90032, USA
| | - Ara A. Chrissian
- School of Medicine, Loma Linda University, Loma Linda, CA 92350, USA
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35
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Garcia L, Firek A, Freund D, Massai D, Khurana D, Lee JE, Zamarripa S, Sasaninia B, Michaels K, Nightingale J, Gatto NM. Decisions to Choose COVID-19 Vaccination by Health Care Workers in a Southern California Safety Net Medical Center Vary by Sociodemographic Factors. Vaccines (Basel) 2022; 10:1247. [PMID: 36016135 PMCID: PMC9412623 DOI: 10.3390/vaccines10081247] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 07/28/2022] [Accepted: 07/30/2022] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Limited information exists regarding COVID-19 vaccine hesitancy among healthcare workers (HCWs). Our previous survey analyzed the reasons for HCWs' decisions to accept vaccination, suggesting that a "one-size fits all" approach may not suffice to increase vaccine uptake. METHODS Based on the vaccination acceptance group (acceptor, hesitant, refuser), we examined differences by sociodemographic factors (race/ethnicity, household income, education) from Likert Scale responses to fourteen influences affecting a decision to be vaccinated using the Kruskal-Wallis test and multinomial logistic regression with mutual adjustment for these sociodemographic factors, age, and sex. RESULTS Non-Hispanic White vaccine acceptors ranked lower confidence in preventing, withstanding, or treating COVID-19, while Non-Hispanic Blacks more highly regarded the motivation of a religious leader, colleague, or family member. Social media was ranked more influential among Non-Hispanic Asians. Acceptors with lower incomes ranked a job requirement influential; conversely, higher income vaccine hesitant HCWs highly rated this reason. More highly educated acceptors ranked being motivated by colleagues, family, and other HCWs higher. Adjustment weakened some but not all the differences between groups. CONCLUSIONS Sociodemographic factors affect HCWs' decisions to be vaccinated against COVID-19. Our findings may help develop more focused and tailored strategies to improve vaccination acceptance.
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Affiliation(s)
- Lauren Garcia
- School of Community and Global Health, Claremont Graduate University, 150 E 10th St, Claremont, CA 91711, USA; (L.G.); (D.F.); (D.M.)
| | - Anthony Firek
- Comparative Effectiveness and Clinical Outcomes Research Center, Riverside University Health System, 26520 Cactus Avenue, Moreno Valley, CA 92555, USA; (A.F.); (D.K.); (S.Z.); (B.S.); (K.M.); (J.N.)
| | - Deborah Freund
- School of Community and Global Health, Claremont Graduate University, 150 E 10th St, Claremont, CA 91711, USA; (L.G.); (D.F.); (D.M.)
- Department of Economic Sciences, Claremont Graduate University, 150 E 10th St, Claremont, CA 91711, USA;
| | - Donatella Massai
- School of Community and Global Health, Claremont Graduate University, 150 E 10th St, Claremont, CA 91711, USA; (L.G.); (D.F.); (D.M.)
| | - Dhruv Khurana
- Comparative Effectiveness and Clinical Outcomes Research Center, Riverside University Health System, 26520 Cactus Avenue, Moreno Valley, CA 92555, USA; (A.F.); (D.K.); (S.Z.); (B.S.); (K.M.); (J.N.)
- Division of Addiction Psychiatry, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, 10833 Le Conte Ave, Los Angeles, CA 90095, USA
| | - Jerusha E. Lee
- Department of Economic Sciences, Claremont Graduate University, 150 E 10th St, Claremont, CA 91711, USA;
| | - Susanna Zamarripa
- Comparative Effectiveness and Clinical Outcomes Research Center, Riverside University Health System, 26520 Cactus Avenue, Moreno Valley, CA 92555, USA; (A.F.); (D.K.); (S.Z.); (B.S.); (K.M.); (J.N.)
| | - Bijan Sasaninia
- Comparative Effectiveness and Clinical Outcomes Research Center, Riverside University Health System, 26520 Cactus Avenue, Moreno Valley, CA 92555, USA; (A.F.); (D.K.); (S.Z.); (B.S.); (K.M.); (J.N.)
| | - Kelsey Michaels
- Comparative Effectiveness and Clinical Outcomes Research Center, Riverside University Health System, 26520 Cactus Avenue, Moreno Valley, CA 92555, USA; (A.F.); (D.K.); (S.Z.); (B.S.); (K.M.); (J.N.)
| | - Judi Nightingale
- Comparative Effectiveness and Clinical Outcomes Research Center, Riverside University Health System, 26520 Cactus Avenue, Moreno Valley, CA 92555, USA; (A.F.); (D.K.); (S.Z.); (B.S.); (K.M.); (J.N.)
| | - Nicole M. Gatto
- Comparative Effectiveness and Clinical Outcomes Research Center, Riverside University Health System, 26520 Cactus Avenue, Moreno Valley, CA 92555, USA; (A.F.); (D.K.); (S.Z.); (B.S.); (K.M.); (J.N.)
- School of Public Health, Loma Linda University, 24951 Circle Dr, Loma Linda, CA 92354, USA
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, 1975 Zonal Ave., Los Angeles, CA 90089, USA
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