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de Koning R, Gonzalez Utrilla M, Spanaus E, Moore M, Lomazzi M. Strategies used to improve vaccine uptake among healthcare providers: A systematic review. Vaccine X 2024; 19:100519. [PMID: 39105135 PMCID: PMC11299578 DOI: 10.1016/j.jvacx.2024.100519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2024] [Revised: 06/25/2024] [Accepted: 06/30/2024] [Indexed: 08/07/2024] Open
Abstract
Background Vaccination is one of the most effective available public health tools, preventing infectious diseases to safeguard public health and save millions of lives annually. However, in recent years vaccine hesitancy has increased among all populations, including healthcare workers. Healthcare providers are central to vaccination efforts due to their increased exposure to disease and vulnerable patients, and their role in patient confidence and decision-making. These decreasing uptake rates highlight a critical need to address specific barriers within this target group. This systematic review aims to explore the strategies used to improve vaccine uptake among healthcare providers. Methods A literature search was conducted in PubMed, EMBASE, and MEDLINE databases, alongside a grey literature search, to identify studies describing interventions to improve vaccine uptake among healthcare providers. This was followed by de-duplication and double-blinded screening processes using Rayyan. Data extraction and thematic analysis focused on categorising interventions and identifying frequencies of use, to develop recommendations for further interventions tailored to target regions. Results 60 studies were identified, predominantly concerning influenza vaccination. Interventions included educational initiatives, reminders, incentives, access solutions, feedback, and policy implementation. Key strategies included targeted educational lectures, posters, and pamphlets; mobile vaccination units; extended vaccination hours; and leadership engagement. The findings underscore the importance of a multifaceted approach combining educational efforts, enhanced accessibility, and motivational incentives to improve vaccination rates within the healthcare providers, especially where mandatory vaccination is controversial. Conclusions This review evaluates tailored strategies to enhance vaccine confidence and uptake among healthcare providers, advocating for a holistic approach that includes educational initiatives, reminder systems, incentives, improved access, feedback mechanisms, and policy enactment to effectively address hesitancy and promote public health.
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Affiliation(s)
- Rosaline de Koning
- World Federation of Public Health Associations, Ch des Mines 9, 1202 Geneva, Switzerland
- Department of Medical Anthropology, University College London, Gower St, London WC1E 6BT, United Kingdom
| | | | - Emma Spanaus
- World Federation of Public Health Associations, Ch des Mines 9, 1202 Geneva, Switzerland
- Fulda University of Applied Sciences, Fulda, Germany
| | - Michael Moore
- World Federation of Public Health Associations, Ch des Mines 9, 1202 Geneva, Switzerland
- University of Canberra, 11 Kirinari St, Bruce, ACT 2617, Australia
| | - Marta Lomazzi
- World Federation of Public Health Associations, Ch des Mines 9, 1202 Geneva, Switzerland
- Global Health Institute, University of Geneva, Ch des Mines 9, 1202 Geneva, Switzerland
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Okpani AI, Adu P, Paetkau T, Lockhart K, Yassi A. Are COVID-19 vaccination mandates for healthcare workers effective? A systematic review of the impact of mandates on increasing vaccination, alleviating staff shortages and decreasing staff illness. Vaccine 2024; 42:1022-1033. [PMID: 38281897 DOI: 10.1016/j.vaccine.2024.01.041] [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: 11/17/2023] [Revised: 01/06/2024] [Accepted: 01/14/2024] [Indexed: 01/30/2024]
Abstract
INTRODUCTION The rapid development of COVID-19 vaccines is a cornerstone in the global effort to combat the pandemic. Healthcare workers (HCWs), being at the forefront of the pandemic response, have been the focus of vaccine mandate policies. This review aims to evaluate the impacts of COVID-19 vaccine mandates among HCWs, a critical step in understanding the broader implications of such policies in healthcare settings. OBJECTIVE The review seeks to synthesize available literature to contribute to greater understanding of the outcomes associated with COVID-19 vaccine mandates for HCWs including vaccine uptake, infection rates, and staffing. METHODS A systematic search of relevant literature published from March 2020 to September 2023 was conducted. The Newcastle-Ottawa scale was employed for quality assessment of the included articles. A total of 4,779 publications were identified, with 15 studies meeting the inclusion criteria for the review. A narrative synthesis approach was used to analyze these studies. RESULTS COVID-19 vaccine mandates for HCWs were broadly successful in increasing vaccine uptake in most settings. Although the penalties imposed on unvaccinated HCWs did not lead to major disruption of health services, less well-resourced areas may have been more impacted. Furthermore, there is insufficient literature on the impact of the vaccine mandate on reducing SARS-CoV-2 infection among HCWs. CONCLUSION COVID-19 vaccine mandates for HCWs have significant implications for public health policy and healthcare management. The findings underscore the need for tailored approaches in mandate policies, considering the specific contexts of healthcare settings and the diverse populations of HCWs. While mandates have shown potential in increasing vaccine uptake with minimal impacts to staffing, more work is needed to investigate the impacts of mandates across various contexts. In addition to these impacts, future research should focus on long-term effects and implications on broader public health strategies.
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Affiliation(s)
- Arnold I Okpani
- School of Population and Public Health, The University of British Columbia, Vancouver, Canada.
| | - Prince Adu
- Department of Social Medicine, Heritage College of Osteopathic Medicine, Ohio University, Dublin, OH, USA
| | - Tyler Paetkau
- School of Population and Public Health, The University of British Columbia, Vancouver, Canada
| | - Karen Lockhart
- School of Population and Public Health, The University of British Columbia, Vancouver, Canada
| | - Annalee Yassi
- School of Population and Public Health, The University of British Columbia, Vancouver, Canada
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Wojczewski S, Leitner KM, Hoffmann K, Kutalek R, Jirovsky-Platter E. Vaccine hesitancy among physicians: a qualitative study with general practitioners and paediatricians in Austria and Germany. BMJ Open 2024; 14:e077411. [PMID: 38262649 PMCID: PMC10806645 DOI: 10.1136/bmjopen-2023-077411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 01/09/2024] [Indexed: 01/25/2024] Open
Abstract
OBJECTIVE This study aims to understand reasons for vaccine hesitancy (VH) among general practioners (GPs) and paediatricians. We aim to analyse how and when the healthcare workers (HCWs) developed vaccine-hesitant views and how they transfer these to patients. DESIGN AND SETTING Semistructured interviews with vaccine-hesitant GPs and paediatricians were conducted in Austria and Germany using an explorative qualitative research design. PARTICIPANTS We contacted 41 physicians through letters and emails and 10 agreed to participate, five were male and five female. DATA COLLECTION AND ANALYSIS Ten interviews were recorded, transcribed verbatim and anonymised. The material was analysed inductively following a grounded theory approach with open coding using the software atlas.ti. RESULTS Key themes that were identified were education and career path, understanding of medicine and medical profession, experiences with vaccines, doctor-patient interactions and continuous education activities and the link to VH. GPs and paediatricians' vaccine-hesitant attitudes developed during their medical training and, in particular, during extracurricular training in homeopathy, which most of the participants completed. Most participants work in private practices rather than with contracts with social insurance because they are not satisfied with the health system. Furthermore, they are critical of biomedicine. Most of the interview partners do not consider themselves antivaccination, but are sceptical towards vaccines and especially point out the side effects. Most do not vaccinate in their practices and some do only occasionally. Their vaccine-hesitant views are often fostered through respective online communities of vaccine-hesitant HCWs. CONCLUSIONS More studies on a connection between complementary medicine and vaccine-hesitant views of HCWs are needed. Education about vaccines and infectious diseases among healthworkers must increase especially tailored towards the use of internet and social media. Physicians should be made aware that through time and empathy towards their patients they could have a positive impact on undecided patients and parents regarding vaccine decisions.
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Affiliation(s)
- Silvia Wojczewski
- Department of Primary Care Medicine, Center for Public Health, Medical University of Vienna, Vienna, Austria
| | | | - Kathryn Hoffmann
- Department of Primary Care Medicine, Center for Public Health, Medical University of Vienna, Vienna, Austria
| | - Ruth Kutalek
- Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Vienna, Austria
| | - Elena Jirovsky-Platter
- Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Vienna, Austria
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Prieto-Campo Á, Batista AD, Magalhães Silva T, Herdeiro MT, Roque F, Figueiras A, Zapata-Cachafeiro M. Understanding vaccination hesitation among health professionals: a systematic review of qualitative studies. Public Health 2024; 226:17-26. [PMID: 37980837 DOI: 10.1016/j.puhe.2023.10.029] [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: 06/07/2023] [Revised: 10/04/2023] [Accepted: 10/12/2023] [Indexed: 11/21/2023]
Abstract
OBJECTIVES In terms of vaccination, people trust healthcare professionals (HCPs) more than any other source of information. They are the cornerstone of vaccination as they can move undecided populations not only towards vaccination but also towards non-vaccination. The aim of this systematic review was to explore the knowledge, beliefs, attitudes, and barriers associated with own vaccination and patient recommendation in HCPs. STUDY DESIGN This study incorporated a systematic review. METHODS A systematic review of studies published from January 1, 2000, to June 1, 2020, was conducted by searching PubMed and EMBASE electronic databases. Qualitative studies reporting outcomes related to knowledge, attitudes, or barriers related to vaccination/recommendation by healthcare personnel were included. The guidelines in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses were followed. RESULTS From a total of 2916 studies identified, 36 articles met the inclusion criteria. Some of the factors cited by the HCP that may contribute to vaccine hesitancy were (a) concerns regarding safety or efficacy of vaccines (23 articles); (b) time constraints (21 articles); (c) lack of knowledge about the vaccination/vaccine (19 articles); (d) costs (13 articles); (e) distrust of pharmaceutical industry (8 articles); and (f) considering oneself insusceptible (7 articles), stock shortage (7 articles), lack of personnel (5 articles), and feelings of unnecessary vaccination (5 articles). CONCLUSIONS Our review suggests that interventions to combat vaccine hesitancy should increase HCP education on vaccine efficacy and safety, as well as intervene on health system factors such as cost and time per visit. In this way, we could tackle the problem of vaccine hesitancy, which seriously threatens global public health.
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Affiliation(s)
- Á Prieto-Campo
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, 15786, Santiago de Compostela, Spain
| | - A D Batista
- Department of Medical Sciences, University of Aveiro, 3810-193, Aveiro, Portugal
| | - T Magalhães Silva
- Institute of Biomedicine (iBiMED), Department of Medical Sciences, University of Aveiro, Campus Universitário de Santiago, 3810-193, Aveiro, Portugal
| | - M T Herdeiro
- Institute of Biomedicine (iBiMED), Department of Medical Sciences, University of Aveiro, Campus Universitário de Santiago, 3810-193, Aveiro, Portugal
| | - F Roque
- Research Unit for Inland Development, Polytechnic of Guarda (UDI-IPG), Avenida Dr. Francisco Sá Carneiro, no. ° 50, 6300-559, Guarda, Portugal; Health Sciences Research Centre, University of Beira Interior (CICS-UBI), Av. Infante D. Henrique, 6200-506, Covilhã, Portugal; Escola Superior de Saúde, Instituto Politécnico da Guarda Rua da Cadeia, 6300-035, Guarda, Portugal.
| | - A Figueiras
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, 15786, Santiago de Compostela, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), Santiago de Compostela, Spain; Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - M Zapata-Cachafeiro
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, 15786, Santiago de Compostela, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), Santiago de Compostela, Spain; Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain.
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Alsaif F, Twigg M, Scott S, Blyth A, Wright D, Patel A. A systematic review of barriers and enablers associated with uptake of influenza vaccine among care home staff. Vaccine 2023; 41:6156-6173. [PMID: 37673716 DOI: 10.1016/j.vaccine.2023.08.082] [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: 06/12/2023] [Revised: 08/28/2023] [Accepted: 08/29/2023] [Indexed: 09/08/2023]
Abstract
Barriers and enablers to vaccination of care home (CH) staff should be identified in order to develop interventions to address them that increase uptake and protect residents. We aimed to synthesis the evidence describing the barriers and enablers that affect the influenza vaccination uptake of care home (CH) staff. METHOD We searched PubMed, MEDLINE, EMBASE, CINAHL, PsycINFO, AMED, IBSS, SCOPUS to identify quantitative, qualitative or mixed-method studies. Data related to health or social care workers in CHs reported barriers or enablers were extracted and mapped to the Theoretical Domains Framework (TDF); the data within each domain were grouped and categorized into key factors affecting influenza vaccine uptake among CH staff. RESULTS We screened 4025 studies; 42 studies met our inclusion criteria. Thirty-four (81 %) were surveys. Five theoretical domains were frequently reported as mediators of influenza vaccine uptake: Beliefs about consequences (32 studies), Environmental context and resources (30 studies), Emotions (26 studies), Social influences (25 studies), Knowledge (22 studies). The low acceptance rate of the influenza vaccine among CH staff can be attributed to multiple factors, including insufficient understanding of the vaccine, its efficacy, or misconceptions about the vaccine (knowledge), perceiving the vaccine as ineffective and unsafe (beliefs about consequences), fear of influenza vaccine and its side effects (emotions), and experiencing limited accessibility to the vaccine (environmental context and resources). CONCLUSION Interventions aimed at increasing influenza vaccine uptake among CH staff should focus on addressing the barriers identified in this review. These interventions should include components such as enhancing knowledge by providing accurate information about vaccine benefits and safety, addressing negative beliefs by challenging misconceptions, managing concerns and fears through open communication, and improving accessibility to the vaccine through convenient on-site options. This review provides a foundation for the development of tailored Interventions to improve influenza vaccine uptake among CH staff.
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Affiliation(s)
- Faisal Alsaif
- School of Pharmacy, University of East Anglia, Norwich Research Park, Norwich, NR4 7TJ, UK.
| | - Michael Twigg
- School of Pharmacy, University of East Anglia, Norwich Research Park, Norwich, NR4 7TJ, UK.
| | - Sion Scott
- School of Healthcare, University of Leicester, University Road, Leicester LE1 7RH, UK.
| | - Annie Blyth
- School of Economics, University of East Anglia, Norwich Research Park, Norwich NR4 7TJ, UK.
| | - David Wright
- School of Healthcare, University of Leicester, University Road, Leicester LE1 7RH, UK.
| | - Amrish Patel
- School of Economics, University of East Anglia, Norwich Research Park, Norwich NR4 7TJ, UK.
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Song I, Lee SH. COVID-19 vaccine refusal associated with health literacy: findings from a population-based survey in Korea. BMC Public Health 2023; 23:255. [PMID: 36747179 PMCID: PMC9900554 DOI: 10.1186/s12889-023-15182-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 01/27/2023] [Accepted: 02/01/2023] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Poor health literacy is associated with lower utilization of preventable services. However, the relationship between health literacy and COVID-19 vaccine hesitancy remains controvertible. METHODS This study used data from 229,242 individuals who completed the Community Health Survey in Korea from August 16 to October 31 in 2021. To operationalize COVID-19 vaccine hesitancy, we measured vaccine refusal, which is defined as not having been vaccinated and not intending to get vaccinated against COVID-19. Health literacy is operationalized in two dimensions; the ability to understand spoken directions from health professionals and the ability to understand written information regarding health. Covariates include sex, age, educational level, marital status, employment status, basic living security pension status, and subjective health status. Two multivariable logistic regression models were run to determine factors associated with COVID-19 vaccine refusal. Model 1 included sociodemographic characteristics and subjective health status. Model 2 added two health literacy variables. Odds ratio (OR) and 95% confidence intervals (CI) were calculated. RESULTS Only 3.9% of the Korean adult population were estimated to refuse COVID-19 vaccine. The most commonly cited reasons for COVID-19 vaccine refusal were concerns about vaccine adverse events (47.6%), followed by the assessment of one's own health status (29.5%). Individuals who found spoken directions very difficult to understand were more likely to refuse COVID-19 vaccine than those who found spoken directions very easy (OR = 1.55, 95% CI: 1.28-1.87, p < 0.001). People who did not pay attention to written information were more likely to refuse COVID-19 vaccine than those who reported it to be very easy to understand (OR = 1.28, 95% CI: 1.13-1.45, p < 0.001). People in all other categories of the literacy spectrum for either spoken or written information did not have an increased risk of COVID-19 vaccine refusal. CONCLUSION Health literacy was significantly associated with COVID-19 vaccine refusal. Health literacy programs could be beneficial to reduce vaccine refusal, particularly for the people who find spoken directions from health professionals very difficult to understand and those who do not pay attention to written information.
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Affiliation(s)
- Inmyung Song
- grid.411118.c0000 0004 0647 1065College of Nursing and Health, Kongju National University, 56 Gongjudaehak-Ro, 32588 Gongju-Si, Chungcheongnam-do Republic of Korea
| | - Soo Hyun Lee
- College of Nursing and Health, Kongju National University, 56 Gongjudaehak-Ro, 32588, Gongju-Si, Chungcheongnam-do, Republic of Korea.
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Prieto-Campo Á, García-Álvarez RM, López-Durán A, Roque F, Herdeiro MT, Figueiras A, Zapata-Cachafeiro M. Understanding Primary Care Physician Vaccination Behaviour: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13872. [PMID: 36360750 PMCID: PMC9654811 DOI: 10.3390/ijerph192113872] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 10/20/2022] [Accepted: 10/21/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Vaccine hesitancy decreases adult vaccination coverage and has been recognized by WHO as a major health threat. Primary care physicians (PCP) play a key role in vaccination by giving vaccine counselling to their patients. The aim of this systematic review is to identify the knowledge, beliefs, attitudes and barriers (KBAB) associated with own vaccination and patient recommendation in primary care physicians. METHODS MEDLINE/PubMed, EMBASE and Cochrane Library databases were used to search and identify relevant studies based on their title and abstract. In the next step, the full text of each previously selected article was read for eligibility. Articles were selected by two independent reviewers and data extraction was performed using tables. The following information was extracted: methodological characteristics, demographic factors, professional characteristics, and intrinsic or extrinsic factors influencing vaccination or recommendation. RESULTS Our search yielded 41 eligible papers, data-sources, previous practices, belief in the effectiveness or safety of the vaccine, perceived risk, and trust in health authorities were all shown to be related to own vaccination and patient recommendation. CONCLUSION Internet is the main source of information for PCP related to vaccine hesitancy. It is therefore essential to increase the presence and access to pro-vaccination content in this area. In addition, involving PCP in the establishment of vaccination recommendations could improve their credibility in the institutions. On the other hand, training in communication skills and establishing reminder systems could reflect higher vaccination coverage among their patients.
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Affiliation(s)
- Ángela Prieto-Campo
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, 15786 Santiago de Compostela, Spain
| | - Rosa María García-Álvarez
- Department of Preventive Medicine and Public Health, Hospital of Santiago de Compostela, 15706 Santiago de Compostela, Spain
| | - Ana López-Durán
- Department of Clinical Psychology and Psychobiology, University of Santiago de Compostela, 15786 Santiago de Compostela, Spain
| | - Fátima Roque
- Research Unit for Inland Development, Polytechnic of Guarda (UDI-IPG), Avenida Dr. Francisco Sá Carneiro, No. 50, 6300-559 Guarda, Portugal
- Health Sciences Research Centre, University of Beira Interior (CICS-UBI), Av. Infante D. Henrique, 6200-506 Covilhã, Portugal
- Escola Superior de Saúde, Instituto Politécnico da Guarda Rua da Cadeia, 6300-035 Guarda, Portugal
| | - Maria Teresa Herdeiro
- Institute of Biomedicine (iBiMED), Department of Medical Sciences, University of Aveiro, 3810-193 Aveiro, Portugal
| | - Adolfo Figueiras
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, 15786 Santiago de Compostela, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER of Epidemiology and Public Health, CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Health Research Institute of Santiago de Compostela (IDIS), 15786 Santiago de Compostela, Spain
| | - Maruxa Zapata-Cachafeiro
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, 15786 Santiago de Compostela, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER of Epidemiology and Public Health, CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Health Research Institute of Santiago de Compostela (IDIS), 15786 Santiago de Compostela, Spain
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Sobierajski T, Bulińska-Stangrecka H, Wanke-Rytt M, Stefanoff P, Augustynowicz E. Behavioural and Cognitive Attitudes of Paediatricians towards Influenza Self-Vaccination-Partial Mediation Model. Vaccines (Basel) 2022; 10:vaccines10081206. [PMID: 36016094 PMCID: PMC9416341 DOI: 10.3390/vaccines10081206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 07/24/2022] [Accepted: 07/25/2022] [Indexed: 11/18/2022] Open
Abstract
(1) Background: This study aims to analyse the attitudinal components influencing paediatricians’ self-vaccination. (2) Methods: The national-cross survey was conducted among paediatricians involved in childhood vaccination within the immunisation program. (3) Results: A hypothetical model indicating the influence of cognitive and behavioural factors on influenza vaccination among paediatricians was verified based on a survey of Polish paediatricians. A simple mediation model, based on Triandis’ Theory of Interpersonal Behaviour, reflects a relationship in which knowledge and beliefs about outcomes contribute to whether paediatricians vaccinate against influenza. (4) Conclusions: The presented research shows that the pro-vaccination behaviours of paediatricians are not only influenced by cognitive factors but also the behavioural components of attitudes, which are equally important. The conclusions point to the pivotal role of shaping both knowledge and understanding of the effectiveness of immunisation programmes in building the pro-vaccination attitudes of paediatricians. (5) Practical Implications: This is the first representative study of Polish paediatricians to demonstrate how their attitudes and behaviour are related to self-vaccination. Its conclusions allow policymakers to develop programmes to support effective measures against the spread of infectious diseases through the self-vaccination of medical professionals.
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Affiliation(s)
- Tomasz Sobierajski
- Faculty of Applied Social Sciences and Resocialization, University of Warsaw, Krakowskie Przedmieście 26/28, 00-927 Warsaw, Poland
- Correspondence: ; Tel.: +48-503-456-234
| | - Helena Bulińska-Stangrecka
- Faculty of Administration and Social Sciences, Warsaw University of Technology, Plac Politechniki Street 1, 00-661 Warsaw, Poland;
| | - Monika Wanke-Rytt
- Department of Pediatrics with Clinical Assessment Unit, Medical University of Warsaw, Żwirki i Wigury 61, 02-091 Warsaw, Poland;
| | - Paweł Stefanoff
- Division of Infection Control and Environmental Health, Norwegian Institute of Public Health, Lovisenberggata 8, 0456 Oslo, Norway;
- Department of Epidemiology of Infectious Diseases and Surveillance, National Institute of Public Health-National Institute of Hygiene, Chocimska 24, 00-791 Warsaw, Poland;
| | - Ewa Augustynowicz
- Department of Epidemiology of Infectious Diseases and Surveillance, National Institute of Public Health-National Institute of Hygiene, Chocimska 24, 00-791 Warsaw, Poland;
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Knowledge, attitudes, and practices regarding vaccination among community pharmacists. Prim Health Care Res Dev 2022; 23:e38. [PMID: 35866296 PMCID: PMC9309755 DOI: 10.1017/s1463423622000330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Background: Healthcare professionals’ vaccine recommendation is the most effective method to increase vaccination rates of the community. The vaccine counseling and recommendation behavior of pharmacists, who are among the easily accessible healthcare professionals, are influenced by their knowledge and attitudes about vaccines. Aim: It was aimed to investigate community pharmacists’ knowledge, attitudes, and practices regarding commonly used vaccines. Methods: A cross-sectional study was conducted as an online survey with a sample of 1100 community pharmacists in Turkey. Pharmacists were invited to participate in the study by phone calls. A structured survey, which consists of 40 questions to assess the knowledge, attitudes, and practices regarding vaccines, was sent to the e-mail addresses of pharmacists who volunteered to participate in the study. Findings: A total of 430 pharmacists completed the survey. Thirty percent of pharmacists had lack of knowledge about vaccination during pregnancy, whereas 52.2% and 31.4% of pharmacists believed that tetanus and influenza vaccines should be provided during pregnancy, respectively. Nearly 89% of pharmacists recommended vaccines to patients, mainly for influenza vaccine (83.9%). Only 31.5% of pharmacists had been vaccinated against influenza in the last season, whereas 50.5% had never been vaccinated. Pharmacists who had been vaccinated with influenza vaccine had a high rate of recommending influenza vaccines to the patients. Conclusion: The present study found that vaccination among pharmacists in Turkey and their knowledge on vaccination during pregnancy were low. Further education of pharmacists to improve their knowledge and attitudes toward vaccines is needed.
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Blayac T, Dubois D, Duchêne S, Nguyen-Van P, Rafaï I, Ventelou B, Willinger M. Nudging for Lockdown. SOCIAL PSYCHOLOGY 2022. [DOI: 10.1027/1864-9335/a000483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Abstract. We test the effectiveness of a social comparison nudge (SCN) to enhance lockdown compliance during the COVID-19 pandemic using a French representative sample ( N = 1,154). Respondents were randomly assigned to a favorable/unfavorable informational feedback (daily road traffic mobility patterns, in Normandy – a region of France) on peer lockdown compliance. Our dependent variable was the intention to comply with a possible future lockdown. We controlled for risk, time, and social preferences and tested the effectiveness of the nudge. We found no evidence of the effectiveness of the SCN among the whole French population, but the nudge was effective when its recipient and the reference population shared the same geographical location (Normandy). Exploratory results on this subsample ( N = 52) suggest that this effectiveness could be driven by noncooperative individuals.
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Affiliation(s)
- Thierry Blayac
- Economic Department, CEE-M, Univ. Montpellier, CNRS, INRAE, Institut Agro, Montpellier, France
| | - Dimitri Dubois
- Economic Department, CEE-M, Univ. Montpellier, CNRS, INRAE, Institut Agro, Montpellier, France
| | - Sébastien Duchêne
- Economic Department, CEE-M, Univ. Montpellier, CNRS, INRAE, Institut Agro, Montpellier, France
| | - Phu Nguyen-Van
- EconomiX, CNRS, UPL, Université Paris Nanterre (France) & TIMAS, Thang Long University (Vietnam)
| | - Ismaël Rafaï
- Economic Department, CEE-M, Univ. Montpellier, CNRS, INRAE, Institut Agro, Montpellier, France
| | | | - Marc Willinger
- Economic Department, CEE-M, Univ. Montpellier, CNRS, INRAE, Institut Agro, Montpellier, France
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Okuyan B, Bektay MY, Demirci MY, Ay P, Sancar M. Factors associated with Turkish pharmacists' intention to receive COVID-19 vaccine: an observational study. Int J Clin Pharm 2022; 44:247-255. [PMID: 34761359 PMCID: PMC8579896 DOI: 10.1007/s11096-021-01344-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Accepted: 10/18/2021] [Indexed: 01/02/2023]
Abstract
Background Pharmacists have been taking part in vaccination services during the COVID-19 pandemic. However, research identifying pharmacists' intention to get COVID-19 vaccine is limited. Aim The objective of this study was to determine the intention to receive COVID-19 vaccine and to identify the factors related to it based on the Health Belief Model framework among Turkish pharmacists. Method This is an observational study conducted between December 2020 and January 2021. The online survey was sent to all hospital and community pharmacists working in Turkey. Transtheoretical Model of Behaviour Change and Health Belief Model were used for the development of the questionnaire. Univariate and multivariate logistic regression analyses were conducted to identify factors associated with the intention to receive COVID-19 vaccine. Results Among all participants (n = 961), 74.7% had an intention to receive the COVID-19 vaccine. In model 1, perceived susceptibility, perceived severity, perceived benefits, and perceived barriers were associated with their intention to receive the COVID-19 vaccine (p < 0.05). In model 2, the intention to receive COVID-19 vaccine was associated with being male, years of experience in the professional field, not having contracted COVID-19, having a pharmacy staff who had contracted COVID-19, and having had received seasonal flu shot within the previous year (p < 0.05). Conclusion This study highlights the factors related to the intention of the pharmacists to receive COVID-19 vaccines. Health Belief Model is the strongest predictor for vaccination intention and could be used to develop behavioural change techniques to promote vaccination.
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Affiliation(s)
- Betul Okuyan
- Department of Clinical Pharmacy, Faculty of Pharmacy, Marmara University, 34854, Maltepe, Istanbul, Turkey
| | - Muhammed Yunus Bektay
- Department of Clinical Pharmacy, Faculty of Pharmacy, Marmara University, 34854, Maltepe, Istanbul, Turkey
- Department of Clinical Pharmacy, Faculty of Pharmacy, Bezmialem Vakif University, 34093, Fatih, Istanbul, Turkey
| | - Muhammed Yasir Demirci
- Department of Clinical Pharmacy, Faculty of Pharmacy, Marmara University, 34854, Maltepe, Istanbul, Turkey
| | - Pınar Ay
- Department of Public Health, Faculty of Medicine, Marmara University, 34854, Maltepe, Istanbul, Turkey
| | - Mesut Sancar
- Department of Clinical Pharmacy, Faculty of Pharmacy, Marmara University, 34854, Maltepe, Istanbul, Turkey.
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12
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Durach F, Buturoiu R, Craiu D, Cazacu C, Bargaoanu A. Crisis of confidence in vaccination and the role of social media. Eur J Paediatr Neurol 2022; 36:84-92. [PMID: 34933130 DOI: 10.1016/j.ejpn.2021.12.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 12/08/2021] [Accepted: 12/08/2021] [Indexed: 12/18/2022]
Abstract
INTRODUCTION The aim of this paper is to review the current situation of vaccine hesitancy, with emphasis on children with neurological disorders, and to present the role social media plays in this situation. METHODS A literature review using the following search words was performed: vaccine∗ OR immune∗ AND hesitancy OR confidence AND social media. RESULTS The search retrieved 277 results; 17 duplicates and 234 irrelevant articles were excluded. 43 articles were fully analyzed. CONCLUSIONS An increasing number of parents are becoming vaccine hesitant. Their motives are complex and nuanced and involve factors related to vaccine safety and efficiency, perceived personal risks and benefits, socio-demographic and psychological characteristics. Attitudes toward vaccination differ in adolescents from their parents. In children with neurological disorders, factors involved in vaccination decision included physicians' knowledge of neurological diseases and parents' concerns that vaccination would exacerbate the chronic disorder. Unfortunately, the current pandemic is associated with an increase in vaccine hesitancy and brought forward unique determinants. The social media platforms can be a tool for the anti-vaccine movement to spread misinformation, but it can also be valued as a way for promoting health and pro-vaccine information.
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Affiliation(s)
- Flavia Durach
- National University of Political Studies and Public Administration, Bulevardul Expozitiei 30A, postal code 012244, Bucharest/S1, Romania.
| | - Raluca Buturoiu
- National University of Political Studies and Public Administration, Bulevardul Expozitiei 30A, postal code 012244, Bucharest/S1, Romania.
| | - Dana Craiu
- Carol Davila University of Medicine and Pharmacy, Faculty of Medicine, Department of Neurosciences, Pediatric Neurology Discipline II, Strada Dionisie Lupu No. 37, postal code: 020021, Bucharest/S2, Romania; Alexandru Obregia Clinical Hospital, Pediatric Neurology Clinic, Center of Expertise for Rare Disorders in Pediatric Neurology, EpiCARE member, Sos. Berceni 10, Bucharest/S4, Romania.
| | - Cristina Cazacu
- Alexandru Obregia Clinical Hospital, Pediatric Neurology Clinic, Center of Expertise for Rare Disorders in Pediatric Neurology, EpiCARE member, Sos. Berceni 10, Bucharest/S4, Romania.
| | - Alina Bargaoanu
- National University of Political Studies and Public Administration, Bulevardul Expozitiei 30A, postal code 012244, Bucharest/S1, Romania.
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Delpech R, Poncet L, Gautier A, Panjo H, Ourabah R, Mourey P, Baumhauer M, Pendola-Luchel I, Ringa V, Rigal L. The role of organization of care in GPs' prevention practice. Prim Health Care Res Dev 2021; 22:e74. [PMID: 34796821 PMCID: PMC8628563 DOI: 10.1017/s1463423621000694] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 07/25/2021] [Accepted: 10/17/2021] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND General practitioners (GPs) do not systematically include preventive recommendations in their practice, and some characteristics of health care organization are associated with more systematic prevention. But the characteristics of health care organization may act in a nonuniform manner depending on the type of preventive care. Thus, one characteristic can be positively associated with one type of preventive care and negatively associated with another. Our aim was to investigate the association between health care organization in general practice and different areas of preventive care (immunization and addiction prevention), in search of nonuniform associations. METHODS We used a representative survey of 1,813 French GPs conducted in 2009. Four preventive care practices were studied: immunization through flu and HPV vaccination, and prevention of addictive behaviors concerning tobacco and alcohol use.Characteristics of GPs' health care organization and the social context of their practice were collected (spatial accessibility to GPs and socioeconomic level of the area of practice). We constructed mixed models to study associations and interactions between the organization variables and preventive care. RESULTS Four out of five characteristics of GPs' organization have uneven impacts on different types of preventive care (p-interaction < 10-4). For example, number of daily consultations is associated with better immunization prevention but with poorer prevention counseling in addictive behaviors. In contrast, working with digital medical files is uniformly associated with both types of preventive care (OR = 1.29 [1.15-1.45]; P < 10-4). CONCLUSION An approach centered on specific types of preventive care should help deepen our understanding of prevention and possibly help to identify a new typology for preventive care.
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Affiliation(s)
- Raphaëlle Delpech
- Department of General Practice, University of Paris-Saclay, Paris, France
- CESP (Centre for Research in Epidemiology and Population Health), Inserm U1018, University of Paris-Saclay, UVSQ, Gender, Sexual and Reproductive Health Team, Paris, France
| | - Lorraine Poncet
- CESP (Centre for Research in Epidemiology and Population Health), Inserm U1018, University of Paris-Saclay, UVSQ, Gender, Sexual and Reproductive Health Team, Paris, France
| | | | - Henri Panjo
- CESP (Centre for Research in Epidemiology and Population Health), Inserm U1018, University of Paris-Saclay, UVSQ, Gender, Sexual and Reproductive Health Team, Paris, France
- Institut National d’Études Démographiques (INED), Paris, France
| | - Rissane Ourabah
- Department of General Practice, University of Paris-Saclay, Paris, France
| | - Pascaline Mourey
- Department of General Practice, University of Paris-Saclay, Paris, France
| | - Mathilde Baumhauer
- Department of General Practice, University of Paris-Saclay, Paris, France
| | | | - Virginie Ringa
- CESP (Centre for Research in Epidemiology and Population Health), Inserm U1018, University of Paris-Saclay, UVSQ, Gender, Sexual and Reproductive Health Team, Paris, France
- Institut National d’Études Démographiques (INED), Paris, France
| | - Laurent Rigal
- Department of General Practice, University of Paris-Saclay, Paris, France
- CESP (Centre for Research in Epidemiology and Population Health), Inserm U1018, University of Paris-Saclay, UVSQ, Gender, Sexual and Reproductive Health Team, Paris, France
- Institut National d’Études Démographiques (INED), Paris, France
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14
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Breslin G, Dempster M, Berry E, Cavanagh M, Armstrong NC. COVID-19 vaccine uptake and hesitancy survey in Northern Ireland and Republic of Ireland: Applying the theory of planned behaviour. PLoS One 2021; 16:e0259381. [PMID: 34788330 PMCID: PMC8598022 DOI: 10.1371/journal.pone.0259381] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 10/18/2021] [Indexed: 11/19/2022] Open
Abstract
The Coronavirus Disease (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) first appeared in Wuhan, China in late 2019 and since then has caused unprecedented economic and social disruption as well as presenting a major challenge to public health. Despite mass progress in COVID-19 vaccination uptake, vaccine hesitancy or anti-vax information has been reported that can delay public acceptance of a vaccine. An online cross-sectional survey (n = 439) assessed COVID-19 vaccine uptake and hesitancy in adults in Northern Ireland and the Republic of Ireland. Participants completed an adapted version of the Theory of Planned Behaviour Vaccine Questionnaire, the Vaccine Attitudes Scale (VAX), Vaccine Confidence Scale, and questions on previous experience of COVID-19. Results showed that 66.7% of the sample intended to get a vaccination as soon as possible, 27.15% reported they will get a vaccine when others get theirs and when it is clear there are no side effects. 6.15% had no intention of getting a vaccine. Overall, there is a high mean intention (M = 6.12) and confidence to get a COVID-19 vaccine. There was low vaccine hesitancy (M = 2.49) as measured by the VAX scale. A further analysis of the sub factors of the VAX showed there is uncertainty and mistrust of side effects for children. The finding demonstrate that the Theory of Planned Behaviour can be useful in making recommendations for public health considerations when encouraging vaccine uptake and reducing vaccine hesitancy.
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Affiliation(s)
- Gavin Breslin
- School of Psychology, Ulster University, Coleraine, Northern Ireland
| | - Martin Dempster
- School of Psychology, The Queen’s University, Belfast, Northern Ireland
| | - Emma Berry
- School of Psychology, The Queen’s University, Belfast, Northern Ireland
| | - Matthew Cavanagh
- School of Psychology, Ulster University, Coleraine, Northern Ireland
| | - Nicola C. Armstrong
- Health and Social Care Research & Development (HSC R&D) Division, Public Health Agency, Belfast, Northern Ireland
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15
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Lin C, Mullen J, Smith D, Kotarba M, Kaplan SJ, Tu P. Healthcare Providers' Vaccine Perceptions, Hesitancy, and Recommendation to Patients: A Systematic Review. Vaccines (Basel) 2021; 9:vaccines9070713. [PMID: 34358132 PMCID: PMC8310254 DOI: 10.3390/vaccines9070713] [Citation(s) in RCA: 60] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 06/09/2021] [Accepted: 06/16/2021] [Indexed: 12/13/2022] Open
Abstract
Despite vaccines' effectiveness in reducing the rate of preventable diseases, vaccine hesitancy has threatened public health and economies worldwide. Healthcare providers' (HCP) communications and behavior strongly influence patient receptivity and uptake. The goal of this review was to examine HCP vaccine perceptions, knowledge, and reservations and how these attitudes affect their recommendations and vaccination practices. Primary research studies published by 16 September 2020 were searched in PubMed, Web of Science, Embase, CINAHL, and PsycINFO. A 14-item scale was developed for survey study and risk of bias appraisal (SSRBA). In total, 96 papers from 34 countries were included, covering 17 vaccines (HPV and influenza vaccines the most studied). Recommendation was positively associated with provider knowledge and experience, beliefs about disease risk, and perceptions of vaccine safety, necessity, and efficacy. HCP vaccination attitudes and practices varied across specialties, vaccines, and countries; demographic impact was inconclusive. Barriers included anticipation of patient/parental concerns or refusal, lacking clear guidelines, time constraints, and cost. For HPV, vaccines were more often recommended to older, female adolescents and by physicians who discussed sexual health. HCPs are vital advocates for patients and the public, but studies indicated a prevalence of provider hesitancy pertaining to inadequate knowledge, low vaccine confidence, and suboptimal uptake themselves. Improving HCP knowledge and assuring their access to information they deem trustworthy are essential to supporting HCPs' role as "trusted messengers" to promote vaccine acceptance.
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Affiliation(s)
- Cheryl Lin
- Policy and Organizational Management Program, Duke University, Durham, NC 27705, USA; (C.L.); (D.S.); (M.K.)
| | - Jewel Mullen
- Dell Medical School, The University of Texas at Austin, Austin, TX 78712, USA;
| | - Danielle Smith
- Policy and Organizational Management Program, Duke University, Durham, NC 27705, USA; (C.L.); (D.S.); (M.K.)
| | - Michaela Kotarba
- Policy and Organizational Management Program, Duke University, Durham, NC 27705, USA; (C.L.); (D.S.); (M.K.)
| | - Samantha J. Kaplan
- Medical Center Library and Archives, Duke University, Durham, NC 27710, USA;
| | - Pikuei Tu
- Policy and Organizational Management Program, Duke University, Durham, NC 27705, USA; (C.L.); (D.S.); (M.K.)
- Correspondence:
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16
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Vaccine hesitancy among hospital staff physicians: A cross-sectional survey in France in 2019. Vaccine 2021; 39:4481-4488. [PMID: 34210575 DOI: 10.1016/j.vaccine.2021.06.053] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 05/24/2021] [Accepted: 06/19/2021] [Indexed: 12/24/2022]
Abstract
BACKGROUND Healthcare professionals, because they recommend vaccines to their patients, answer their questions, and vaccinate them, are the cornerstone of vaccination in France. They can nonetheless be affected by vaccine hesitancy (VH). AIMS We sought to study the opinions, practices, and perceptions of French hospital staff physicians (HSPs) toward vaccination and the prevalence and correlates of VH among them. METHODS We conducted a cross-sectional survey in 14 public hospitals in France from September 2018 to October 2019. HSPs completed a standardized questionnaire -most of the time face-to-face - about their vaccine-related attitudes and practices. Data were weighted for age and sex. An agglomerative hierarchical cluster analysis of the HSPs' perceptions and opinions toward vaccination allowed us to identify vaccine-hesitant HSPs, and multiple Poisson regression with robust standard errors let us study the factors associated with VH. RESULTS The study included 1,795 HSPs (participation rate: 86%). Almost all (93.7%) were strongly favorable to vaccination, even though 42.2% (95CI = 39.8-44.6) showed moderate VH. VH prevalence was lowest among infectious disease specialists (12.3%; 95CI = 6.7-21.3) and pediatricians (27.7%; 95CI = 21.4-35.2). Hesitant HSPs were less trustful of vaccination information sources and doubted the safety of vaccines more often than HSPs with almost no VH. Compared with non-hesitant HSPs, those with higher VH had less often taken a medical course about vaccination and were less likely to be vaccinated against seasonal influenza, to recommend vaccines to their patients and to try to convince vaccine-hesitant patients to be vaccinated. CONCLUSIONS Strong favorability to vaccination does not prevent VH, which was observed in most specialties. Interventions are required to help hesitant HSPs to adopt more proactive vaccination practices.
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MacDonald NE, Comeau J, Dubé È, Graham J, Greenwood M, Harmon S, McElhaney J, Meghan McMurtry C, Middleton A, Steenbeek A, Taddio A. Royal society of Canada COVID-19 report: Enhancing COVID-19 vaccine acceptance in Canada. Facets (Ott) 2021. [DOI: 10.1139/facets-2021-0037] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
COVID-19 vaccine acceptance exists on a continuum from a minority who strongly oppose vaccination, to the “moveable middle” heterogeneous group with varying uncertainty levels about acceptance or hesitancy, to the majority who state willingness to be vaccinated. Intention for vaccine acceptance varies over time. COVID-19 vaccination decisions are influenced by many factors including knowledge, attitudes, and beliefs; social networks; communication environment; COVID-19 community rate; cultural and religious influences; ease of access; and the organization of health and community services and policies. Reflecting vaccine acceptance complexity, the Royal Society of Canada Working Group on COVID-19 Vaccine Acceptance developed a framework with four major factor domains that influence vaccine acceptance (people, communities, health care workers; immunization knowledge; health care and public health systems including federal/provincial/territorial/indigenous factors)—each influencing the others and all influenced by education, infection control, extent of collaborations, and communications about COVID-19 immunization. The Working Group then developed 37 interrelated recommendations to support COVID vaccine acceptance nested under four categories of responsibility: 1. People and Communities, 2. Health Care Workers, 3. Health Care System and Local Public Health Units, and 4. Federal/Provincial/Territorial/Indigenous. To optimize outcomes, all must be engaged to ensure co-development and broad ownership.
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Affiliation(s)
- Noni E. MacDonald
- Department of Pediatrics (Infectious Diseases), Faculty of Medicine, Dalhousie University and IWK Health Centre, Halifax, Canada
| | - Jeannette Comeau
- Division of Infectious Diseases, Dalhousie University and IWK Health Centre, Halifax, Canada
| | - Ève Dubé
- Scientific Group on Immunization at the Quebec National Institute of Public Health, Québec, Canada
- Department of Anthropology, Université Laval, Québec, QC G1V 0A6, Canada
| | - Janice Graham
- Department of Pediatrics, Division of Infectious Diseases, Dalhousie University, Halifax, NS B3H 2Y9, Canada
| | - Margo Greenwood
- School of Education, University of Northern British Columbia, Prince George, BC V2N 4Z9, Canada
- Department of First Nations Studies, University of Northern British Columbia, Prince George, BC V2N 4Z9, Canada
- National Collaborating Centre for Indigenous Health, Prince George, BC V2N 4Z9, Canada
| | - Shawn Harmon
- Department of Pediatrics, Technoscience and Regulation Research Unit, Dalhousie University, Halifax, NS B3H 4R2, Canada
| | - Janet McElhaney
- Medical Sciences Division, Northern Ontario School of Medicine, Sudbury, ON P3E 2C6, Canada
- Health Sciences North Research Institute, Sudbury, ON P3E 2H2, Canada
| | - C. Meghan McMurtry
- Pediatric Pain, Health and Communication Lab (PPHC), University of Guelph, Guelph, ON N1G 2W1, Canada
- Department of Psychology, University of Guelph, Guelph, ON N1G 2W1, Canada
- Clinical and Health Psychologist with the Pediatric Chronic Pain Program, McMaster Children’s Hospital, Hamilton, ON L8N 3Z5, Canada
| | - Alan Middleton
- Schulich Executive Education Centre, York University, North York, ON M3J 1P3, Canada
| | - Audrey Steenbeek
- School of Nursing, Faculty of Health, Dalhousie University, Halifax, NS B3H 4R2, Canada
| | - Anna Taddio
- Clinical Social and Administrative Pharmacy, Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON M5S 3M2, Canada
- The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada
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18
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Tomljenovic M, Petrovic G, Antoljak N, Hansen L. Vaccination attitudes, beliefs and behaviours among primary health care workers in northern Croatia. Vaccine 2020; 39:738-745. [PMID: 33386176 DOI: 10.1016/j.vaccine.2020.11.049] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2019] [Revised: 11/14/2020] [Accepted: 11/17/2020] [Indexed: 01/22/2023]
Abstract
Primary health care workers (HCWs) provide almost all vaccine services in Croatia, so they play an essential role in vaccine recommendations and uptake. The aim of this study was to determine the level of vaccine hesitancy among primary HCWs, to identify differences between nurses and physicians in attitudes, beliefs and behaviours towards vaccination, and to determine predictors of vaccine hesitancy among HCWs. We conducted a cross-sectional study from July to December in 2018 among physicians and nurses employed in the services of epidemiology, public health, school medicine, pediatrics and general practice/family medicine in Primorje-Gorski Kotar County, a primarily urban region with a population around 300 000 in the northern part of Croatia. The list of primary HCWs offices was obtained from the Croatian Health Insurance Fond website. We used a self-administered questionnaire on their attitudes, beliefs and behaviours relative to vaccination. Obtained response rate was 65.5% (324/495) of eligible primary HCWs; 64.1% (143/223) of physicians and 66.5% (181/272) of nurses. Seventeen percent of HCWs were identified as vaccine hesitant, and in univariate analysis, we observed an association between HCWs occupation and their own vaccination against flu (p = 0.001), measles (p = 0.016) and HPV (p = 0.025). Nurses and physicians differed (p < 0.001) in their general attitude, beliefs and behaviours towards vaccination, with a higher level of hesitancy among nurses. In multiple logistic regression, those more likely to be vaccine-hesitant were nurses (AOR = 5.73, 95%CI = 2.48-13.24), those who were uncertain or would never receive a vaccine against measles (AOR=11.13; 95%CI=5.37-23.10) and HPV (AOR=5.02; 95%CI=2.60-9.74), as well as those who had encountered a serious adverse event following immunization (AOR=7.55; 95%CI=3.13-19.18). As personal hesitancy may have a negative impact on vaccination education and recommendations, and therefore vaccine coverage, it is necessary to implement interventions to increase vaccination knowledge and confidence among primary health care workers, especially nurses.
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Affiliation(s)
- Morana Tomljenovic
- School of Medicine, University of Rijeka, Brace Branchetta 20/1, 51 000 Rijeka, Croatia; European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control, (ECDC), Gustav III:s Boulevard 40, Solna, Sweden.
| | - Goranka Petrovic
- Croatian Institute of Public Health, Rockefeller Street 7, 10 000 Zagreb, Croatia
| | - Nataša Antoljak
- Croatian Institute of Public Health, Rockefeller Street 7, 10 000 Zagreb, Croatia; School of Medicine, University of Zagreb, Salata 3, 10 000 Zagreb, Croatia
| | - Lisa Hansen
- National Institute for Public Health and the Environment, Antonie van Leeuwenhoeklaan 9, 3721 MA Bilthoven, Netherlands
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Grech V, Bonnici J, Zammit D. WITHDRAWN: Vaccine hesitancy in Maltese family physicians and their trainees vis-à-vis influenza and novel COVID-19 vaccination. Early Hum Dev 2020:105259. [PMID: 33213968 PMCID: PMC7660968 DOI: 10.1016/j.earlhumdev.2020.105259] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
This article has been withdrawn at the request of the author(s) and/or editor. The Publisher apologizes for any inconvenience this may cause. The full Elsevier Policy on Article Withdrawal can be found at https://www.elsevier.com/about/our-business/policies/article-withdrawal.
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Head KJ, Kasting ML, Sturm LA, Hartsock JA, Zimet GD. A National Survey Assessing SARS-CoV-2 Vaccination Intentions: Implications for Future Public Health Communication Efforts. SCIENCE COMMUNICATION 2020; 42:698-723. [PMID: 38602991 PMCID: PMC7520657 DOI: 10.1177/1075547020960463] [Citation(s) in RCA: 128] [Impact Index Per Article: 32.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
With SARS-CoV-2 vaccines under development, research is needed to assess intention to vaccinate. We conducted a survey (N = 3,159) with U.S. adults in May 2020 assessing SARS-CoV-2 vaccine intentions, intentions with a provider recommendation, and sociodemographic and psychosocial variables. Participants had high SARS-CoV-2 vaccine intentions (M = 5.23/7-point scale), which increased significantly with a provider recommendation (M = 5.47). Hierarchical linear regression showed that less education and working in health care were associated with lower intent, and liberal political views, altruism, and COVID-19-related health beliefs were associated with higher intent. This work can inform interventions to increase vaccine uptake, ultimately reducing COVID-19-related morbidity and mortality.
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Affiliation(s)
- Katharine J Head
- Indiana University-Purdue University Indianapolis, Indianapolis, IN, USA
| | | | - Lynne A Sturm
- Indiana University School of Medicine, Indianapolis, IN, USA
| | - Jane A Hartsock
- Indiana University-Purdue University Indianapolis, Indianapolis, IN, USA
| | - Gregory D Zimet
- Indiana University School of Medicine, Indianapolis, IN, USA
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21
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Verhees RAF, Snellings R, Dinant GJ, Knottnerus JA. Influenza vaccination among Dutch general practitioners and their attitude toward influenza vaccination in the elderly. Hum Vaccin Immunother 2020; 16:2709-2718. [PMID: 32412833 PMCID: PMC7733997 DOI: 10.1080/21645515.2020.1732728] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Knowledge, attitudes and beliefs (KABs) toward influenza vaccination (IV) play a key role in HCWs’ decisions to receive vaccination and can strongly influence patients’ IV uptake. We examined the knowledge, attitudes and beliefs of GPs toward IV, exploring their opinion on IV in the elderly, mandatory HCW vaccination and the desirability of an IV trial in the elderly with hospitalization/mortality as effect measure. From November 2018 to March 2019, surveys were emailed to GPs and GP-practices (n = 1676) in three regions of the Netherlands. We assessed the self-reported IV in GPs, reasons for (not) advising IV to personnel, (not) supporting mandatory IV for personnel and (not) desiring a trial on IV in the elderly on hospitalization/mortality. Multivariable logistic regression models were used to determine predictors for GP IV. A total of 552 surveys were completed and 71.9% of the GPs reported receiving IV. Determinants for IV in GPs were male sex (aOR 1.62, 95%CI 1.06–2.49, p = .03) and age ≥60 y (aOR 5.25, 95%CI 1.51–18.32, p = .01). Seventy-nine percent of the GPs recommend IV for their practice personnel. Mandatory IV for personnel was supported by 41.2% of the GPs with GP self-reporting IV being the only determinant (aOR 10.03 (95%CI 5.69–17.70 p = .00)). An IV trial on hospitalization and/or mortality was desired by 60.5% of the GPs. We concluded that the majority of Dutch GPs receives IV and recommends IV to their personnel. These high rates along with the hesitancy of GPs toward mandatory HCW IV should be considered when policymakers decide on a mandate for IV in HCW in general.
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Affiliation(s)
- Ruud Andreas Fritz Verhees
- Department of Family Medicine, School for Public Health and Primary Care (CAPHRI), Maastricht University , Maastricht, The Netherlands
| | | | - Geert Jan Dinant
- Department of Family Medicine, School for Public Health and Primary Care (CAPHRI), Maastricht University , Maastricht, The Netherlands
| | - Johannes Andreas Knottnerus
- Department of Family Medicine, School for Public Health and Primary Care (CAPHRI), Maastricht University , Maastricht, The Netherlands
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Rosso A, Massimi A, Pitini E, Nardi A, Baccolini V, Marzuillo C, De Vito C, Villari P. Factors affecting the vaccination choices of pregnant women for their children: a systematic review of the literature. Hum Vaccin Immunother 2020; 16:1969-1980. [PMID: 31916903 PMCID: PMC7482832 DOI: 10.1080/21645515.2019.1698901] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
In recent years, an increase in vaccine hesitancy has led to a decrease in vaccination coverage in several countries. We conducted a systematic review of studies that assessed knowledge of and attitudes toward pediatric vaccinations, and the vaccination choices and their determinants among pregnant women. A total of 6,277 records were retrieved, and 16 full texts were included in the narrative synthesis. The published literature on the topic shows that, overall, pregnant women believe that vaccines are important for the protection of their children and the community, but various concerns and misunderstandings persist around vaccine safety and efficacy, which reduce the trust of expectant mothers in immunization. Nevertheless, such attitudes and choices vary depending on the vaccine being considered and the corresponding determinants should therefore be studied in the context of each specific vaccination. Further research on this topic is needed, particularly in non-western countries.
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Affiliation(s)
- Annalisa Rosso
- Deparment of Public Health and Infectious Diseases, Sapienza University of Rome , Rome, Italy.,Local Health Unit-Azienda Sanitaria Locale Roma 2 , Rome, Italy
| | - Azzurra Massimi
- Deparment of Public Health and Infectious Diseases, Sapienza University of Rome , Rome, Italy
| | - Erica Pitini
- Deparment of Public Health and Infectious Diseases, Sapienza University of Rome , Rome, Italy
| | - Angelo Nardi
- Deparment of Public Health and Infectious Diseases, Sapienza University of Rome , Rome, Italy
| | - Valentina Baccolini
- Deparment of Public Health and Infectious Diseases, Sapienza University of Rome , Rome, Italy
| | - Carolina Marzuillo
- Deparment of Public Health and Infectious Diseases, Sapienza University of Rome , Rome, Italy
| | - Corrado De Vito
- Deparment of Public Health and Infectious Diseases, Sapienza University of Rome , Rome, Italy
| | - Paolo Villari
- Deparment of Public Health and Infectious Diseases, Sapienza University of Rome , Rome, Italy
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Liu Y, Mo X, Yu X, Wang J, Tian J, Kuang J, Peng J. Insufficient knowledge and inappropriate practices of emergency doctors towards tetanus prevention in trauma patients: a pilot survey. Hum Vaccin Immunother 2019; 16:349-357. [PMID: 31625792 PMCID: PMC7062443 DOI: 10.1080/21645515.2019.1653745] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 07/22/2019] [Accepted: 08/03/2019] [Indexed: 11/04/2022] Open
Abstract
China has a shocking number of tetanus cases in the world, but little research has investigated doctors' knowledge of and practices in tetanus prophylaxis, especially tetanus vaccination. To this end, we conducted a pilot study on 197 emergency doctors using a mixed method of web-based (163; 82.8%) and paper-based (34; 17.2%) surveys. There was no difference between the two groups except for the percentage of doctors receiving a tetanus booster in the past 10 years and the responses to question 11. Surprisingly, only 28.9% of doctors had received formal training on tetanus immunization and only 21.3% had themselves received a tetanus vaccine booster in the past 10 years. Furthermore, only 14.2% of the respondents confirmed the availability of the tetanus vaccine in their respective institutions. Finally, the correct rates and Tetanus-immune-globulin (TIG)-only option rates for questions 11-15 were unsatisfactory. Our results showed that most emergency doctors' knowledge and practices strayed from the recommendations of Advisory Committee on Immunization Practices (ACIP): 1) TIG alone for most trauma patients instead of vaccine was an overused treatment approach. 2) Most of the emergency doctors lacked formal training on and knowledge of tetanus vaccination. 3) Even the emergency doctors themselves were not properly vaccinated. 4) The tetanus vaccine was only available in a small number of the respondents' institutions. The findings of this study suggest an urgent need to improve this dire situation.
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Affiliation(s)
- Yong Liu
- Intensive Care Unit, Shenzhen Hospital, Southern Medical University, Shenzhen, PR China
| | - Xichao Mo
- Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, PR China
| | - Xiaxia Yu
- Department of Biomedical Engineering, Health Science Center, Shenzhen University, Shenzhen, PR China
| | - Jinxin Wang
- Intensive Care Unit, Shenzhen Hospital, Southern Medical University, Shenzhen, PR China
| | - Jinfei Tian
- Intensive Care Unit, Shenzhen Hospital, Southern Medical University, Shenzhen, PR China
| | - Jun Kuang
- Department of Thoracic Surgery, Shenzhen Hospital, Southern Medical University, Shenzhen, PR China
| | - Jie Peng
- Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, PR China
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24
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Attinsounon CA, Cordonnier C, Pulcini C, Di-Patrizio P, Thilly N, May T. Factors associated with influenza vaccination of general medicine interns in Nancy, France, in 2017. Eur J Clin Microbiol Infect Dis 2019; 38:2267-2273. [PMID: 31410622 DOI: 10.1007/s10096-019-03669-x] [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: 05/29/2019] [Accepted: 08/05/2019] [Indexed: 10/26/2022]
Abstract
Winter flu is an epidemic infectious disease which sometimes causes serious complications in vulnerable people treated in general practice. Currently, the most effective means of prevention is influenza vaccination, which is recommended for healthcare professionals, including general medicine interns. The target of 75% coverage set by WHO for healthcare professional is rarely reached. Our survey provides an assessment of reported influenza vaccination of general medicine interns (GMI) and evaluates factors influencing their vaccination status. A cross-sectional survey was conducted from 27 September to 2 November 2017 in the Faculty of Medicine at the University of Lorraine in France. An anonymous self-administered questionnaire was distributed electronically (SurveyMonkey software) to all GMI. It collected data on their vaccination status and on levers and barriers to influenza vaccination. The data were analysed using SAS 9.4 software. Multivariate analysis helped identify factors associated with their influenza vaccination status. Of the 595 GMI invited, 269 participated in the survey, with a response rate of 45.2%. During the 2015, 2016, and 2017 winters, overall self-declared vaccine coverage was 37.9, 49.4, and 56.5%, respectively. Being at the end of training (p = 0.008, OR = 3.2), the presence of a mobile vaccination team (p = 0.019, OR = 3.1), and recommending vaccination to one's relatives and friends (p < 0.0001, OR = 5.4) were the three factors independently associated with influenza vaccination. The two main reasons which had a strong influence on non-vaccination were forgetting to do so (30.5%) and lack of time (24.8%). Influenza vaccination coverage of GMI in Nancy falls well short of WHO targets. Vaccination campaigns and facilitated access to vaccination at study and work placement locations should be considered.
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Affiliation(s)
- Cossi Angelo Attinsounon
- Faculté de Médecine, CHUD-Borgou, Unité d'Enseignement et de Recherche en Maladies Infectieuses et Tropicales, Université de Parakou, 03 BP 112, Parakou, Benin. .,CHRU-Nancy, Service des Maladies Infectieuses et Tropicales, Université de Lorraine, 54000, Nancy, France.
| | - Clémence Cordonnier
- Département de Médecine Générale, Université de Lorraine, 54000, Nancy, France
| | - Céline Pulcini
- CHRU-Nancy, Service des Maladies Infectieuses et Tropicales, Université de Lorraine, 54000, Nancy, France.,APEMAC, Université de Lorraine, F-54000, Nancy, France
| | - Paolo Di-Patrizio
- Département de Médecine Générale, Université de Lorraine, 54000, Nancy, France
| | - Nathalie Thilly
- APEMAC, Université de Lorraine, F-54000, Nancy, France.,CHRU-Nancy, Plateforme d'Aide à la Recherche Clinique, Université de Lorraine, F-54000, Nancy, France
| | - Thierry May
- CHRU-Nancy, Service des Maladies Infectieuses et Tropicales, Université de Lorraine, 54000, Nancy, France.,APEMAC, Université de Lorraine, F-54000, Nancy, France
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25
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Diesner SC, Peutlberger S, Voitl P. Vaccination status of resident pediatricians and the potential risk for their patients - a cross-sectional questionnaire study in pediatric practices in Vienna. BMC Pediatr 2019; 19:153. [PMID: 31096960 PMCID: PMC6521505 DOI: 10.1186/s12887-019-1529-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2018] [Accepted: 05/08/2019] [Indexed: 11/10/2022] Open
Abstract
Background Pediatricians are advised by the Austrian ministry of health to be vaccinated against diphtheria, tetanus, pertussis, poliomyelitis, measles, mumps, rubella, varicella, hepatitis A, hepatitis B, meningococcus ACWY and meningococcus B, pneumococcus and seasonal influenza. As they take care of a vulnerable patient group including newborns and infants, who have not been vaccinated yet, it is important that they have a positive immunization status in order to protect their patients. This cross-sectional study aims to investigate the vaccination status of pediatricians and their assistants in practices in Vienna. Methods All 196 resident pediatricians in Vienna were invited to participate in this cross-sectional, questionnaire-based study. They had to specify their sex, medical profession, self-reported vaccination status for the respective vaccine preventable diseases and the type of practice they are working in (private versus government funded practice). Results High vaccination rates above 90% were found for measles, poliomyelitis, pertussis and hepatitis B, whereas seasonal influenza, meningococcus and pneumococcus were the least accepted vaccinations in this cohort. No significant differences were observed for male and female vaccination habits. Influenza and pneumococcus vaccines were more frequently received by pediatricians than their assistants. Health care workers (HCW) of private practices had significantly lower hepatitis B vaccination rates compared to those working in practices covered by the Vienna health insurance fund. Conclusion Resident pediatricians in Vienna reveal rather high vaccination rates for some but not all of the recommended immunizations, which puts their pediatric patients at risk. Measures for higher vaccination rates are needed especially for this medical professional group. Electronic supplementary material The online version of this article (10.1186/s12887-019-1529-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Susanne C Diesner
- First Vienna Pediatric Medical Center, Donaucitystrasse 1, 1220, Wien, Austria
| | - Sarah Peutlberger
- First Vienna Pediatric Medical Center, Donaucitystrasse 1, 1220, Wien, Austria
| | - Peter Voitl
- First Vienna Pediatric Medical Center, Donaucitystrasse 1, 1220, Wien, Austria. .,Sigmund Freud University Vienna, Freudplatz 1, 1020, Vienna, Austria.
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Maltezou HC, Theodoridou K, Ledda C, Rapisarda V, Theodoridou M. Vaccination of healthcare workers: is mandatory vaccination needed? Expert Rev Vaccines 2018; 18:5-13. [PMID: 30501454 DOI: 10.1080/14760584.2019.1552141] [Citation(s) in RCA: 76] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
INTRODUCTION Vaccinations of healthcare workers (HCWs) aim to directly protect them from occupational acquisition of vaccine-preventable diseases (VPDs) and to indirectly protect their patients and the essential healthcare infrastructure. However, outbreaks due to VPDs continue to challenge healthcare facilities and HCWs are frequently traced as sources of VPDs to vulnerable patients. In addition, HCWs were disproportionately affected during the current measles outbreak in Europe. Areas covered: We reviewed the recent published information about HCWs vaccinations with a focus on mandatory vaccination policies. Expert commentary: Although many countries have vaccination programs specifically for HCWs, their vaccination coverage remains suboptimal and a significant proportion of them remains susceptible to VPDs. The increasing vaccination hesitancy among HCWs is of concern, given their role as trusted sources of information about vaccines. Mandatory vaccinations for HCWs are implemented for specific VPDs in few countries. Mandatory influenza vaccination of HCWs was introduced in the United States a decade ago with excellent results. Mandatory vaccinations for VPDs that may cause significant morbidity and mortality should be considered. Issues of mistrust and misconceptions about vaccinations should also be addressed.
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Affiliation(s)
- Helena C Maltezou
- a Department for Interventions in Health-Care Facilities , Hellenic Center for Disease Control and Prevention , Athens , Greece
| | - Kalliopi Theodoridou
- b Department of Microbiology , Medical School of National and Kapodistrian University of Athens , Athens , Greece
| | - Caterina Ledda
- c Occupational Medicine, Department of Clinical and Experimental Medicine , University of Catania , Catania , Italy
| | - Venerando Rapisarda
- c Occupational Medicine, Department of Clinical and Experimental Medicine , University of Catania , Catania , Italy
| | - Maria Theodoridou
- d First Department of Pediatrics , National and Kapodistrian University of Athens , Athens , Greece
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27
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Petek D, Kamnik-Jug K. Motivators and barriers to vaccination of health professionals against seasonal influenza in primary healthcare. BMC Health Serv Res 2018; 18:853. [PMID: 30428886 PMCID: PMC6234642 DOI: 10.1186/s12913-018-3659-8] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2018] [Accepted: 10/29/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Over the last decade, the vaccination rates amongst the general population in Slovenia were declining. According to the World Health Organisation, the vaccination rates amongst healthcare workers are also low throughout Europe. The aim of this study was to evaluate vaccination rates for seasonal flu amongst healthcare workers on the primary care level in the Koroška region and to find motivators and barriers for vaccination. METHODS In a cross-sectional study, an anonymous questionnaire was distributed to all health centres, nursing homes and private contractors, who agreed to participate. Out of 334 distributed questionnaires, 250 (74.8%) were analysed. Bivariate and multivariable statistical analyses were conducted. RESULTS Only 12% of included health professionals were vaccinated in the 2014/15 season. The main motivators for vaccination coverage were: awareness of high risk of infection at the workplace, self-protection and protection of family members and co-workers. The main barriers for vaccination were doubt in the effectiveness of the vaccine, fear of side effects and the belief that health professionals are not at high risk of influenza infection. In the multivariable model, a positive association was found between the vaccination, older age and belief in the effectiveness against influenza, while a negative association was found between the nurses' profession and vaccination. CONCLUSION The trend of declining rates for seasonal influenza vaccination is continuing. Protection of the patients was not among the most important reasons for vaccination. This especially endangers clients of nursing homes. The recognized motivators, barriers and other factors that were important for vaccination coverage/hesitancy could be used for designing strategies and educational programmes for health professionals to improve the vaccination coverage rates. The strategy should include the specifics of health profession groups.
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Affiliation(s)
- Davorina Petek
- Department of Family Medicine, Faculty of Medicine, University of Ljubljana, Poljanski nasip 58, 1000, Ljubljana, Slovenia.
| | - Kristina Kamnik-Jug
- Primary Health Care Centre Slovenj Gradec, Partizanska pot 16, 2380, Slovenj Gradec, Slovenia
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28
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Fokoun C. Strategies implemented to address vaccine hesitancy in France: A review article. Hum Vaccin Immunother 2018; 14:1580-1590. [PMID: 29608390 DOI: 10.1080/21645515.2018.1458807] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
Abstract
Vaccination has been identified many decades ago as an effective means to prevent several diseases. However, in France, there is an emergence of vaccine hesitancy, that has caused a reduction of vaccination coverage rates. This issue reduces the effectiveness of the immunization process, and represents a real threat to public health that should be urgently addressed. The purpose of this review is to present actions that have been taken to fight against vaccine hesitancy and thus enhance vaccine uptake. The results indicate that different strategies have been proposed to reach this goal, mainly by vaccination campaigns. These findings highlight the strong implication of national health authorities and the medical staff of hospitals and health-care centers. However, actions implemented should be part of a long-term approach, and further studies are required to identify the most effective strategies to address vaccine hesitancy.
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Affiliation(s)
- Cécile Fokoun
- a Hospices Civils de Lyon, Lyon Public Health Institute , Lyon , France
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29
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MacDonald NE, Butler R, Dubé E. Addressing barriers to vaccine acceptance: an overview. Hum Vaccin Immunother 2018; 14:218-224. [PMID: 29048975 PMCID: PMC5791591 DOI: 10.1080/21645515.2017.1394533] [Citation(s) in RCA: 93] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Accepted: 10/14/2017] [Indexed: 12/25/2022] Open
Abstract
Addressing the drivers of vaccine hesitancy and the barriers to vaccine acceptance is a complex but important task. While the percentage of hesitant does vary from country to country and in time few, if any, countries are ever free from this problem. Overcoming hesitancy requires detection, diagnosis and tailored intervention as there is no simple strategy that can address all of the barriers to vaccine acceptance. Immunization program managers and health care workers need to become adept at recognizing and tackling hesitancy in all of its incarnations if high levels of vaccine acceptance are to be achieved but must also actively support immunization acceptors in order to build and support vaccine acceptance resiliency. This paper presents evidence-informed strategies to achieve these goals.
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Affiliation(s)
- Noni E. MacDonald
- Department of Paediatrics, Dalhousie University, Canadian Centre for Vaccinology, IWK Health Centre, Halifax, Nova Scotia, Canada
| | - Robb Butler
- Division of Communicable Diseases, Health Security and Environment, WHO Regional Office for Europe, Copenhagen Ø, Denmark
| | - Eve Dubé
- Institut National de Santé Publique du Québec, Québec, QC, Canada
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30
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Dini G, Toletone A, Sticchi L, Orsi A, Bragazzi NL, Durando P. Influenza vaccination in healthcare workers: A comprehensive critical appraisal of the literature. Hum Vaccin Immunother 2017; 14:772-789. [PMID: 28787234 PMCID: PMC5861785 DOI: 10.1080/21645515.2017.1348442] [Citation(s) in RCA: 173] [Impact Index Per Article: 24.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Influenza imposes a significant burden worldwide from the healthcare and socio-economic standpoints. This is also due to suboptimal vaccination coverage among the target population, even though immunization is recommended since many years and still remains the fundamental tool for its prevention. Healthcare workers (HCWs) are at increased risk of exposure to respiratory pathogens compared with the general population, including flu, with potential threat for their health and for patients' safety. Nevertheless, despite recommendation for immunization of this work-category in most of Western Countries, inadequate flu vaccine uptake is reported during the last decade in the European area. According to recent systematic reviews on this topic, the main determinants of vaccine acceptance among HCWs have been largely investigated and include desire for self-protection and to protect family rather than absolute disease risk or desire to protect patients, among the main drivers. On the other hand, concerns regarding safety of the vaccines resulted in decreased vaccine uptake. Moreover, influenza vaccine hesitancy among HCWs was also associated with several issues such as low risk perception, denial of the social benefit of influenza vaccination, low social pressure, lack of perceived behavioral control, negative attitude toward vaccines, not having been previously vaccinated against influenza, not having previously had influenza, lack of adequate influenza-specific knowledge, lack of access to vaccination facilities, and socio-demographic variables. The topic of influenza vaccination among HCWs is challenging, full of ethical issues. Systematic reviews of randomized controlled trials (RCTs) investigating the effectiveness of interventions for improving vaccine uptake among HCWs found that combined strategies were more effective than isolate approaches. Mandatory policies are currently under debate in several countries. High quality studies would help policy-makers and stake-holders to shape evidence-based initiatives and programs to improve the control of influenza.
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Affiliation(s)
- Guglielmo Dini
- a Department of Health Sciences (DISSAL), Postgraduate School of Occupational Medicine , University of Genoa , Genoa , Italy.,b Occupational Medicine Unit, Ospedale Policlinico San Martino , Genoa , Italy
| | - Alessandra Toletone
- a Department of Health Sciences (DISSAL), Postgraduate School of Occupational Medicine , University of Genoa , Genoa , Italy
| | - Laura Sticchi
- c Department of Health Sciences (DISSAL), Postgraduate School of Public Health , University of Genoa , Genoa , Italy.,d Hygiene Unit , Ospedale Policlinico San Martino , Genoa , Italy
| | - Andrea Orsi
- c Department of Health Sciences (DISSAL), Postgraduate School of Public Health , University of Genoa , Genoa , Italy.,d Hygiene Unit , Ospedale Policlinico San Martino , Genoa , Italy
| | - Nicola Luigi Bragazzi
- c Department of Health Sciences (DISSAL), Postgraduate School of Public Health , University of Genoa , Genoa , Italy
| | - Paolo Durando
- a Department of Health Sciences (DISSAL), Postgraduate School of Occupational Medicine , University of Genoa , Genoa , Italy.,b Occupational Medicine Unit, Ospedale Policlinico San Martino , Genoa , Italy
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31
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Alqahtani AS, Althobaity HM, Al Aboud D, Abdel-Moneim AS. Knowledge and attitudes of Saudi populations regarding seasonal influenza vaccination. J Infect Public Health 2017; 10:897-900. [PMID: 28473261 DOI: 10.1016/j.jiph.2017.03.011] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Revised: 02/15/2017] [Accepted: 03/26/2017] [Indexed: 10/19/2022] Open
Abstract
The World Health Organization Global Vaccine Action Plan aims to accelerate the control of preventable diseases, including seasonal influenza; however, seasonal influenza vaccination reluctance persists. The current study aimed to assess the knowledge and attitudes of Saudi nationals regarding seasonal influenza vaccinations. An anonymous questionnaire was targeted to Saudi nationals for self-enrolment in this study. Data were analyzed using descriptive and chi-squared analyses. This study included 1298 Saudi nationals (745 males and 553 females) who were ≥19 years old. A total of 44.53% of the participants had been vaccinated with the seasonal influenza vaccine. In total, 26.96% of the participants were certain that there were no contradictions between the influenza vaccine and other childhood vaccines and 36.67% knew that individuals with chronic diseases should be given the seasonal influenza vaccine. By contrast, only 123 of the participants (9.48%) understood that pregnant women could be vaccinated with the influenza vaccine. Vaccinated participants in our study showed a higher level of knowledge compared to non-vaccinated participants. Most of the participants reported that the most reliable source of information was healthcare worker advice. The current study provides important information regarding misperceptions in public attitudes towards seasonal influenza vaccinations; these data can be used to plan strategies to address existing gaps in healthcare.
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Affiliation(s)
| | | | | | - Ahmed S Abdel-Moneim
- College of Medicine, Taif University, Al-Taif 21944, Saudi Arabia; Beni-Suef University, Beni-Suef 62511, Egypt.
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