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Abdelmasseh M, Cuaranta A, Iqbal A, Kadiyala V, Willis J, Gorka A, Thompson E, Finley R, Payne B, Sanabria J. COVID-19 vaccination hesitance and adverse effects among US adults: a longitudinal cohort study. FRONTIERS IN EPIDEMIOLOGY 2024; 4:1365090. [PMID: 39081839 PMCID: PMC11286423 DOI: 10.3389/fepid.2024.1365090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Accepted: 07/01/2024] [Indexed: 08/02/2024]
Abstract
Introduction Although Coronavirus disease 2019 (COVID-19) vaccination is critical to control its spread, vaccine hesitancy varies significantly among the United States population; moreover, some vaccine recipients experienced various adverse effects. We aim to assess the impact of COVID-19 vaccine hesitancy in a university-affiliated community, the factors affecting participants' decisions, and their adverse effects. Methods A pre-vaccination online Institutional Review Board IRB-approved survey was emailed in Nov/Dec 2020, 2 months before the implementation of state-policy protocols for COVID-19 vaccination. A post-vaccination survey was emailed in May/June 2021, two months after protocol execution. A third follow-up survey was sent in Nov/Dec 2021, and a fourth was sent in June/July 2022. The study population included three groups of adult participants: university students, faculty, and staff-(MS), university health system patients-(MP), and Cancer Center patients-(MCP). The study was designed as a longitudinal cohort study. Statistical analyses were performed using SPSS. Results With a combined response rate of 26% (40,578/157,292) among the four surveys, 15,361 participants completed the first survey (MS = 4,983, MP = 9,551, and MCP = 827). 2/3 of participants (63.5%) were willing to get vaccinated, with a significant difference in acceptance among groups, MS:56.6%, MP:66.2%, and MCP:71.6% (p < 0.05). Vaccine acceptance rates reached 89% in the second survey after the vaccine's approval, with a lower acceptance rate of MS:84.6% than with MP:90.74% and MCP:92.47% participants (p < 0.05). Safety and effectiveness concerns were the main factors affecting participants' decisions in all the first three surveys; however, participants reported these concerns decreased between pre-vaccination, post-vaccination, and follow-up surveys with 87%, 56%, and 46%, respectively(p < 0.05). More than two-thirds of the participants (70%) reported having either minor/moderate symptoms (61.6%) or major symptoms (8.6%) after getting some of the vaccine doses (p < 0.05). Conclusion The hesitance of COVID-19 vaccination was associated with concerns regarding its safety and efficacy. Vaccine acceptance rose higher than expected after protocol execution, likely due to continuous education, whereas safety and efficacy remain factors hindering vaccine acceptance. Continuous education focusing on safety and efficacy of the vaccine can reduce vaccine hesitancy and raise the rates of vaccination.
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Affiliation(s)
- M. Abdelmasseh
- Department of Surgery, Marshall University School of Medicine, Huntington, WV, United States
- Marshall Institute for Interdisciplinary Research (MIIR), Marshall University, Huntington, WV, United States
| | - A. Cuaranta
- Department of Surgery, Marshall University School of Medicine, Huntington, WV, United States
- Marshall Institute for Interdisciplinary Research (MIIR), Marshall University, Huntington, WV, United States
| | - A. Iqbal
- Department of Surgery, Marshall University School of Medicine, Huntington, WV, United States
- Marshall Institute for Interdisciplinary Research (MIIR), Marshall University, Huntington, WV, United States
| | - V. Kadiyala
- Department of Informatics and Biostatistics, Marshall University School of Medicine, Huntington, WV, United States
| | - J. Willis
- Department of Informatics and Biostatistics, Marshall University School of Medicine, Huntington, WV, United States
| | - A. Gorka
- Department of Informatics and Biostatistics, Marshall University School of Medicine, Huntington, WV, United States
| | - E. Thompson
- Department of Surgery, Marshall University School of Medicine, Huntington, WV, United States
- Marshall Institute for Interdisciplinary Research (MIIR), Marshall University, Huntington, WV, United States
| | - R. Finley
- Department of Surgery, Marshall University School of Medicine, Huntington, WV, United States
- Marshall Institute for Interdisciplinary Research (MIIR), Marshall University, Huntington, WV, United States
| | - B. Payne
- Department of Surgery, Marshall University School of Medicine, Huntington, WV, United States
- Marshall Institute for Interdisciplinary Research (MIIR), Marshall University, Huntington, WV, United States
| | - J. Sanabria
- Department of Surgery, Marshall University School of Medicine, Huntington, WV, United States
- Marshall Institute for Interdisciplinary Research (MIIR), Marshall University, Huntington, WV, United States
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Khoury G, Ward JK, Mancini J, Gagneux-Brunon A, Luong Nguyen LB. Health Literacy and Health Care System Confidence as Determinants of Attitudes to Vaccines in France: Representative Cross-Sectional Study. JMIR Public Health Surveill 2024; 10:e45837. [PMID: 38713494 PMCID: PMC11109853 DOI: 10.2196/45837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 10/05/2023] [Accepted: 01/25/2024] [Indexed: 05/08/2024] Open
Abstract
BACKGROUND Health literacy involves individuals' knowledge, personal skills, and confidence to take action to evaluate and appraise health-related information and improve their health or that of their community. OBJECTIVE This study aimed to analyze the association between health literacy and attitude toward vaccines, adjusted with other factors. METHODS We used the SLAVACO Wave 3, a survey conducted in December 2021 among a sample of 2022 individuals, representative of the French adult population. We investigated factors associated with the attitude toward vaccines using respondents' different sociodemographic data, health literacy levels, and the health care system confidence levels using a multinomial logistic regression analysis. RESULTS Among the participants, 440.4 (21.8%) were classified as "distrustful of vaccines in general," 729.2 (36.1%) were "selectively hesitant," and 852.4 (42.2%) were "nonhesitant." In our model, the level of health literacy was not statistically different between the "distrustful of vaccines in general" and the "selectively hesitant" (P=.48), but it was associated with being a "nonhesitant" (adjusted odds ratio [aOR] 1.86, 95% CI 1.25-2.76). The confidence in the health care system was a strong predictor for a "nonhesitant" attitude toward vaccines (aOR 12.4, 95% CI 7.97-19.2). We found a positive correlation of 0.34 (P<.001) between health literacy and confidence in the health care system, but the interaction term between health literacy and health care system confidence was not significant in our model. CONCLUSIONS Health literacy was associated with a "nonhesitant" attitude toward vaccines. The findings demonstrated that health literacy and confidence in the health care system are modestly correlated. Therefore, to tackle the subject of vaccine hesitancy, the main focus should be on increasing the population's confidence and on increasing their health literacy levels or providing vaccine information addressing the needs of less literate citizens.
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Affiliation(s)
- Georges Khoury
- CIC Cochin Pasteur, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Jeremy K Ward
- Cermes3, CNRS, INSERM, Université Paris Cité, Paris, France
| | - Julien Mancini
- Cancer, Biomedicine & Society Group, APHM, Hop Timone, Public Health Department (BIOSTIC), INSERM, IRD, ISSPAM, SESSTIM, Aix-Marseille University, Marseille, France
| | - Amandine Gagneux-Brunon
- Centre International de Recherche en Infectiologie, Team GIMAP, Inserm, U1111, CNRS, UMR530, CHU de Saint-Etienne, Saint-Etienne, France
| | - Liem Binh Luong Nguyen
- CIC Cochin Pasteur, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, Paris, France
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Curzio O, Cori L, Bianchi F, Prinelli F, Galli M, Giacomelli A, Imiotti MC, Jesuthasan N, Recchia V, Adorni F. COVID-19 Vaccine Hesitancy among Unvaccinated Adults: A Cross-Sectional Exploratory Analysis of Vaccination Intentions in Italy Related to Fear of Infection. Vaccines (Basel) 2023; 11:1790. [PMID: 38140194 PMCID: PMC10747686 DOI: 10.3390/vaccines11121790] [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: 09/05/2023] [Revised: 11/22/2023] [Accepted: 11/28/2023] [Indexed: 12/24/2023] Open
Abstract
From the initial COVID-19 outbreak, Italy was the first Western country to be seriously affected by the pandemic. Understanding vaccine hesitancy can help efforts to achieve broad vaccination coverage. The objectives of this research were to determine the extent of vaccine hesitancy in Italy and to understand the characteristics of those segments of the population with some hesitancy. Between January and February 2021, 41,473 subjects answered the second questionnaire delivered in phase II of the web-based EPICOVID19 survey. Among the included adult volunteers living in Italy, 4653 (11.2%) reported having previously received at least one dose of the COVID-19 vaccine. In the sample of 36,820 respondents, all not vaccinated (age 51.1 ± 13.5; 59.7% female; 63.6% high level of education), the comparison between hesitant and inclined participants was accompanied by percentages and odds ratios. A total of 2449 individuals were hesitant (6.7% of the unvaccinated ones). Hesitancy was higher among women (OR = 1.48; 95%CI: 1.36-1.62); it was highest in the 50-59 and 40-49 age groups and among those with a lower educational level. A higher level of education was associated with a lower proportion of hesitancy (5.54%) compared with 9.44% among respondents with a low level of education (OR = 0.56; 95%CI: 0.46-0.68). Hesitancy was most common in subjects who did not report fear of infection (12.4%, OR = 4.0; 95%CI: 3.46-4.61). The results can guide the design of tailored information and communication campaigns through considering objective and subjective characteristics.
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Affiliation(s)
- Olivia Curzio
- Institute of Clinical Physiology of the National Research Council (IFC-CNR), 56124 Pisa, Italy; (O.C.); (F.B.); (M.C.I.); (V.R.)
| | - Liliana Cori
- Institute of Clinical Physiology of the National Research Council (IFC-CNR), 56124 Pisa, Italy; (O.C.); (F.B.); (M.C.I.); (V.R.)
| | - Fabrizio Bianchi
- Institute of Clinical Physiology of the National Research Council (IFC-CNR), 56124 Pisa, Italy; (O.C.); (F.B.); (M.C.I.); (V.R.)
| | - Federica Prinelli
- Institute of Biomedical Technologies of the National Research Council (ITB-CNR), 20154 Segrate, Italy; (F.P.); (N.J.)
| | - Massimo Galli
- Third Division of Infectious Diseases, Fatebenefratelli Sacco Hospital, 20157 Milan, Italy; (M.G.); (A.G.); (F.A.)
| | - Andrea Giacomelli
- Third Division of Infectious Diseases, Fatebenefratelli Sacco Hospital, 20157 Milan, Italy; (M.G.); (A.G.); (F.A.)
| | - Maria Cristina Imiotti
- Institute of Clinical Physiology of the National Research Council (IFC-CNR), 56124 Pisa, Italy; (O.C.); (F.B.); (M.C.I.); (V.R.)
| | - Nithiya Jesuthasan
- Institute of Biomedical Technologies of the National Research Council (ITB-CNR), 20154 Segrate, Italy; (F.P.); (N.J.)
| | - Virginia Recchia
- Institute of Clinical Physiology of the National Research Council (IFC-CNR), 56124 Pisa, Italy; (O.C.); (F.B.); (M.C.I.); (V.R.)
| | - Fulvio Adorni
- Third Division of Infectious Diseases, Fatebenefratelli Sacco Hospital, 20157 Milan, Italy; (M.G.); (A.G.); (F.A.)
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BECHINI ANGELA, VANNACCI ALFREDO, SALVATI CRISTINA, CRESCIOLI GIADA, LOMBARDI NICCOLÒ, CHIESI FABRIZIO, SHTYLLA JONIDA, DEL RICCIO MARCO, BONANNI PAOLO, BOCCALINI SARA. Knowledge and training of Italian students in Healthcare Settings on COVID-19 vaccines and vaccination strategies, one year after the immunization campaign. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2023; 64:E152-E160. [PMID: 37654864 PMCID: PMC10468188 DOI: 10.15167/2421-4248/jpmh2023.64.2.2934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 06/21/2023] [Indexed: 09/02/2023]
Abstract
Introduction COVID-19 vaccines represent an important opportunity for defeating the disease, as long as high vaccination acceptance rates are achieved. Healthcare workers (HCWs) have a relevant role in the promotion of immunization among the population and since students in healthcare area will be HCWs it is crucial to provide more in-depth knowledge on vaccinations. Therefore, the aim of the study is to assess the knowledge of medical and pharmaceutical area students regarding COVID-19 vaccination and the impact of a specific Elective Teaching Activity (ETA) on the increase of students' knowledge. The ETA was held one year after the immunization campaign in Italy. Methods Students' knowledge was tested with a questionnaire before and after attending the course. Descriptive statistical methods were used to analyse the results obtained. Student's t-tests for paired data were used. Results Overall, 387 students at the University of Florence attended the course and took the same test before and after the ETA on COVID-19 vaccines. Despite achieving satisfactory average scores in the pre-course test (26/32 ± 4.0), all students were able to significantly enhance their final score (+17.1%; p < 0.001), indicating that the ETA was highly effective in improving their knowledge of COVID-19 vaccination. Medical students demonstrated a better comprehension of the role of the medical specialist in public health in the COVID-19 vaccination campaign, while some uncertainties were revealed regarding the role of pharmacists. Conclusions The results of this study confirm that specific training activities on vaccination are effective for implementing the knowledge of future health professionals.
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Affiliation(s)
- ANGELA BECHINI
- Department of Health Sciences, University of Florence, Florence, Italy
| | - ALFREDO VANNACCI
- Department of Neurosciences, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy
| | - CRISTINA SALVATI
- Department of Health Sciences, University of Florence, Florence, Italy
| | - GIADA CRESCIOLI
- Department of Neurosciences, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy
| | - NICCOLÒ LOMBARDI
- Department of Neurosciences, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy
| | | | - JONIDA SHTYLLA
- SIAF - Digital Learning and IT Training Process Unit, Area for the Innovation and Management of Information and Computer Systems, University of Florence, Florence, Italy
| | - MARCO DEL RICCIO
- Department of Health Sciences, University of Florence, Florence, Italy
| | - PAOLO BONANNI
- Department of Health Sciences, University of Florence, Florence, Italy
| | - SARA BOCCALINI
- Department of Health Sciences, University of Florence, Florence, Italy
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Yang L, Zhen S, Li L, Wang Q, Yang G, Cui T, Shi N, Xiu S, Zhu L, Xu X, Wang L, Jin H, Ji L. Assessing vaccine literacy and exploring its association with vaccine hesitancy: A validation of the vaccine literacy scale in China. J Affect Disord 2023; 330:275-282. [PMID: 36907456 DOI: 10.1016/j.jad.2023.03.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 02/27/2023] [Accepted: 03/07/2023] [Indexed: 03/14/2023]
Abstract
BACKGROUND Assessment of vaccine literacy is essential for understanding people's ability to access various vaccine information to meet health demands. Few studies have examined the role of vaccine literacy in vaccine hesitancy, which is a psychological state. This study aimed to validate the applicability of the HLVa-IT (Vaccine Health Literacy of Adults in Italian) scale in Chinese settings and to explore the association between vaccine literacy and vaccine hesitancy. METHODS From May to June 2022, we conducted an online cross-sectional survey in mainland China. Potential factor domains were obtained by the exploratory factor analysis. Cronbach's alpha coefficient, composite reliability values, and square root values of average variances extracted were calculated to determine the internal consistency and discriminant validity. The association between vaccine literacy, vaccine acceptance, with vaccine hesitancy was assessed using logistic regression analysis. RESULTS Totally, 12,586 participants completed the survey. Two potential dimensions, the functional and the interactive/critical, were identified. Cronbach's alpha coefficient and composite reliability values were >0.90. The square root values of average variances extracted exceeded the related correlations. The functional dimension (adjusted odds ratio (aOR): 0579; 95 % Confidence Interval (CI); 0.529, 0.635), interactive (aOR: 0.654; 95%CI: 0.531, 0.806)/critical (aOR: 0.709; 95%CI: 0.575, 0.873) dimension were significantly and negatively associated with vaccine hesitancy. Similar results were also found in different vaccines acceptance subgroups. LIMITATIONS This report is limited by the convenience sampling method. CONCLUSIONS The modified HLVa-IT is suitable for use in Chinese settings. Vaccine literacy was negatively associated with vaccine hesitancy.
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Affiliation(s)
- Liuqing Yang
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, PR China; Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, PR China
| | - Shiqi Zhen
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, PR China
| | - Lan Li
- Institute of Disaster Risk Reduction, University College London, London, United Kingdom
| | - Qiang Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, PR China; Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, PR China
| | - Guoping Yang
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, PR China
| | - Tingting Cui
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, PR China; Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, PR China
| | - Naiyang Shi
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, PR China; Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, PR China
| | - Shixin Xiu
- Department of Immunization Planning, Wuxi Center for Disease Control and Prevention, Wuxi, PR China
| | - Lin Zhu
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, PR China
| | - Xuepeng Xu
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, PR China
| | - Liping Wang
- Yancheng Center for Disease Control and Prevention, Yancheng, PR China
| | - Hui Jin
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, PR China; Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, PR China.
| | - Lili Ji
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, PR China
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Zhang E, Dai Z, Wang S, Wang X, Zhang X, Fang Q. Vaccine Literacy and Vaccination: A Systematic Review. Int J Public Health 2023; 68:1605606. [PMID: 36866001 PMCID: PMC9970990 DOI: 10.3389/ijph.2023.1605606] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Accepted: 02/06/2023] [Indexed: 02/16/2023] Open
Abstract
Objectives: Vaccine literacy (VL) is an essential component of health literacy and is regarded as the promising technique for eliminating vaccine hesitancy. This review summarizes the relationship between VL and vaccination, including vaccine hesitancy, vaccination attitude, vaccination intention, and vaccination uptake. Methods: A systematic search was conducted in the PubMed, Embase, Web of Science, CINAHL, PsycINFO, and Cochrane Library databases. Studies that explored the relationship between VL and vaccination were included, and the PRISMA recommendations were followed. Results: 1523 studies were found, and 21 articles were selected. The earliest article was published in 2015 and focused on the HPV vaccination and VL of female college students. Three studies surveyed parents' VL about childhood vaccinations, and the remaining 17 focused on COVID-19 VL in different groups. Conclusion: Although VL plays a role in determining the level of vaccine hesitancy across various populations, the association remains unclear. In the future, additional assessment methods could be developed and used to conduct prospective cohort and longitudinal studies to determine the causal relationship between VL and vaccination.
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Affiliation(s)
- Enming Zhang
- School of Nursing, Shanghai Jiao Tong University, Shanghai, China
| | - Zhengyue Dai
- School of Nursing, Shanghai Jiao Tong University, Shanghai, China
| | - Suxing Wang
- School of Nursing, Shanghai Jiao Tong University, Shanghai, China
| | - Xiaolong Wang
- School of Nursing, Shanghai Jiao Tong University, Shanghai, China
| | - Xian Zhang
- Nursing Department, Caohejing Community Health Service Center, Shanghai, China
| | - Qiong Fang
- School of Nursing, Shanghai Jiao Tong University, Shanghai, China
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Bianchi FP, Stefanizzi P, Cuscianna E, Di Lorenzo A, Martinelli A, Tafuri S. Effectiveness of on-site influenza vaccination strategy in Italian healthcare workers: a systematic review and statistical analysis. Expert Rev Vaccines 2023; 22:17-24. [PMID: 36409195 DOI: 10.1080/14760584.2023.2149500] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
INTRODUCTION One of the main determinants of non-adherence to influenza vaccination among healthcare workers (HCWs) is lack of time to attend vaccination services. Therefore, international Public Health Organizations have recommended on-site influenza vaccination in order to improve vaccination coverage among HCWs. AREAS COVERED We conducted a systematic narrative review of the relevant literature to evaluate the effectiveness of this strategy among HCWs in Italy. Fifteen studies, selected among scientific articles available in MEDLINE/PubMed, ISI Web of Knowledge and Scopus and published from January 1st, 2018, to May 31st, 2022, were included. A significant relationship was evidenced between influenza vaccine uptake and adoption of an on-site outpatient clinic (OR = 2.06; 95%CI = 1.43-2.95). The review highlighted a significant increase in VC when on-site vaccination was implemented (even exceeding +150% compared to the previous season), among other measures. Nevertheless, none of the reported experiences proved to meet the minimum target of 75% VC among HCWs. EXPERT OPINION Despite strategies to achieve greater willingness to immunize in this category, mandatory vaccination appears to be the only one that can guarantee protection for HCWs and the patients they care for.
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Affiliation(s)
| | - Pasquale Stefanizzi
- Interdisciplinary Department of Medicine, Aldo Moro University of Bari, Bari, Italy
| | - Eustachio Cuscianna
- Interdisciplinary Department of Medicine, Aldo Moro University of Bari, Bari, Italy
| | - Antonio Di Lorenzo
- Interdisciplinary Department of Medicine, Aldo Moro University of Bari, Bari, Italy
| | - Andrea Martinelli
- Interdisciplinary Department of Medicine, Aldo Moro University of Bari, Bari, Italy
| | - Silvio Tafuri
- Interdisciplinary Department of Medicine, Aldo Moro University of Bari, Bari, Italy
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Vaccine Literacy, COVID-19 Vaccine-Related Concerns, and Intention to Recommend COVID-19 Vaccines of Healthcare Workers in a Pediatric and Maternity Hospital: A Cross-Sectional Study. Vaccines (Basel) 2022; 10:vaccines10091482. [PMID: 36146559 PMCID: PMC9506120 DOI: 10.3390/vaccines10091482] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 08/31/2022] [Accepted: 09/02/2022] [Indexed: 11/17/2022] Open
Abstract
Vaccine literacy of healthcare workers (HCWs) may affect the COVID-19 vaccine uptake of the general population. This study aimed to clarify the vaccine literacy level of HCWs in Japan and its impacts on their concerns about vaccines and intention to recommend that others receive vaccines. This cross-sectional survey was conducted in July 2021 based on the recruitment of HCWs in a pediatric and maternity hospital and research center in Tokyo, Japan. All HCWs in this center had the chance to receive the COVID-19 vaccine before the survey, and their vaccine coverage was relatively high, at 95%. A total of 1519 workers answered the questionnaire. The results showed that HCWs with lower functional vaccine literacy had 1.5 times as many concerns about the efficacy of vaccines and 1.6 times as many concerns about the future side effects compared with those with higher literacy. Further, HCWs with higher vaccine literacy were more likely to recommend that older people, people with comorbidities, and pregnant women receive vaccines. Our findings suggest that high vaccine literacy alleviates concerns about COVID-19 vaccines and raised the intention to recommend vaccines to others. To achieve high vaccine coverage, countermeasures such as personalized education are essential.
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9
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Bianchi FP, Stefanizzi P, Brescia N, Lattanzio S, Martinelli A, Tafuri S. COVID-19 vaccination hesitancy in Italian healthcare workers: a systematic review and meta-analysis. Expert Rev Vaccines 2022; 21:1289-1300. [PMID: 35757890 DOI: 10.1080/14760584.2022.2093723] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
INTRODUCTION As for other vaccines, vaccination hesitancy may be a determining factor in the success (or otherwise) of the COVID-19 immunization campaign in healthcare workers (HCWs). AREAS COVERED To estimate the proportion of HCWs in Italy who expressed COVID-19 vaccine hesitancy, we conducted a systematic review of the relevant literature and a meta-analysis. Determinants of vaccine compliance and options suggested by these studies to address vaccine hesitancy among HCWs were also analyzed. Seventeen studies were included in the meta-analysis and systematic review, selected from scientific articles available in the MEDLINE/PubMed, Google Scholar and Scopus databases between January 1, 2020 and January 25, 2022. The vaccine hesitancy rate among HCWs was 13.1% (95%CI: 6.9-20.9%). The vaccine hesitancy rate among HCWs investigated before and during the vaccination campaign was 18.2% (95%CI=12.8-24.2%) and 8.9% (95%CI=3.4-16.6%), respectively. That main reasons for vaccine hesitation were lack of information about vaccination, opinion that the vaccine is unsafe, and fear of adverse events. EXPERT OPINION Despite strategies to achieve a greater willingness to immunize in this category, mandatory vaccination appears to be one of the most important measures that can guarantee the protection of HCWs and the patients they care for.
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Affiliation(s)
| | - Pasquale Stefanizzi
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari
| | - Nazario Brescia
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari
| | - Sabrina Lattanzio
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari
| | - Andrea Martinelli
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari
| | - Silvio Tafuri
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari
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10
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Kricorian K, Civen R, Equils O. COVID-19 vaccine hesitancy: misinformation and perceptions of vaccine safety. Hum Vaccin Immunother 2021; 18:1950504. [PMID: 34325612 PMCID: PMC8920251 DOI: 10.1080/21645515.2021.1950504] [Citation(s) in RCA: 204] [Impact Index Per Article: 68.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Despite COVID-19’s devastating toll, many Americans remain unwilling to receive the COVID-19 vaccine. The authors conducted a US national survey to understand the health literacy of adults regarding the vaccine, as well as their COVID-19 beliefs and experiences. People who believed the COVID-19 vaccine was unsafe were less willing to receive the vaccine, knew less about the virus and were more likely to believe COVID-19 vaccine myths. On average, they were less educated, lower income, and more rural than people who believed the vaccine is safe. The results highlight the importance of developing clear health communications accessible to individuals from varied socioeconomic and educational backgrounds.
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Affiliation(s)
| | - Rachel Civen
- Los Angeles County Department of Public Health, Los Angeles, CA, USA
| | - Ozlem Equils
- MiOra, Encino, CA, USA.,Los Angeles County Department of Public Health, Los Angeles, CA, USA
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11
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Biasio LR, Bonaccorsi G, Lorini C, Pecorelli S. Assessing COVID-19 vaccine literacy: a preliminary online survey. Hum Vaccin Immunother 2020; 17:1304-1312. [PMID: 33118868 PMCID: PMC8078752 DOI: 10.1080/21645515.2020.1829315] [Citation(s) in RCA: 132] [Impact Index Per Article: 33.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
The COVID-19 infodemic can be countered by scientific evidence, clear and consistent communication, and improved health literacy of both individuals in need of information and those providing it. A rapid online survey was carried out to evaluate vaccine literacy (VL) skills in the general population and perceptions about COVID-19 vaccine candidates, along with behavior and beliefs about current vaccinations. Observed VL levels were consistent with previous observations – where comparable self-reported tools were administered face-to-face and by paper-and-pencil – the mean functional score being = 2.92, while the interactive-critical score was = 3.27, out of a maximum of 4. Perceptions regarding future COVID-19 vaccines, along with beliefs about vaccination, were mostly positive and significantly associated with functional and interactive-critical VL scales. Despite limitations, the study confirms that surveys via the web are a suitable method to evaluate and track attitudes during infectious disease outbreaks and assess health literacy skills about vaccination, which can be useful to adapt medical communication strategies, for a better understanding of the value of immunization.
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Affiliation(s)
- Luigi Roberto Biasio
- Giovanni Lorenzini Foundation, Milan, Italy.,Contract Lecturer in Vaccinology, Rome, Italy
| | | | - Chiara Lorini
- Department of Health Sciences, University of Florence, Florence Italy
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Schiavone S, Attena F. Measuring Health Literacy in Southern Italy: A cross-sectional study. PLoS One 2020; 15:e0236963. [PMID: 32760150 PMCID: PMC7410250 DOI: 10.1371/journal.pone.0236963] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 07/16/2020] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Health Literacy (HL) is an important determinant of individual health. Limited HL is an increasing problem affecting the general population. This study aims to assess the level of HL in patients attending outpatient medical facilities in general medicine located in Naples and Caserta and investigate the association of HL with health behaviours and health status. MATERIALS AND METHODS The study involved patients attending outpatient medical facilities in general medicine. The questionnaire had four sections-the sociodemographic information, the 16-items version of the European Health Literacy Survey questionnaire, the general self-efficacy scale (GSE) and the health status scale (EQ-VAS). Univariate and multivariate analyses were performed to investigate the sociodemographic determinants of HL. The Pearson correlation coefficients were determined to compare HL with health behaviours (GSE) and health status (EQ-VAS). RESULTS The study showed that 61.6% of 503 patients had a low level of HL. After the multivariate analysis, HL was found to be higher among patients with higher education level and general self-efficacy score ≥30. There were no differences in HL between the age groups and people with or without chronic diseases. HL was stronger correlated with GSE than with EQ-VAS (0.53 vs 0.27). CONCLUSION This is the first study on HL for Southern Italy. It showed a low level of HL. As the sample was not representative of the reference population, we cannot derive a corresponding conclusion for the general population of Southern Italy. Therefore, more data in Italy are needed to plan actions for improving HL.
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Affiliation(s)
- Sara Schiavone
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Francesco Attena
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, Naples, Italy
- * E-mail:
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Madeddu G, Vroling H, Oordt-Speets A, Babudieri S, O'Moore É, Noordegraaf MV, Monarca R, Lopalco PL, Hedrich D, Tavoschi L. Vaccinations in prison settings: A systematic review to assess the situation in EU/EEA countries and in other high income countries. Vaccine 2019; 37:4906-4919. [PMID: 31327651 DOI: 10.1016/j.vaccine.2019.07.014] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Revised: 06/06/2019] [Accepted: 07/02/2019] [Indexed: 01/06/2023]
Abstract
INTRODUCTION In 2016, more than 600,000 persons were being held in EU/EEA correctional facilities on a given day. People in prison may be at risk of vaccine-preventable diseases. While vaccination recommendations for people in prison exist, little is known on coverage and implementation options. METHODS We performed a systematic review on existing evidence on vaccination in prison settings in the EU/EEA. We searched peer-reviewed and grey literature following international methodology and reporting standards, to gather records published between 1980 and 2016 in all languages. We analysed quantitative (acceptance, uptake, cost-effectiveness) and qualitative (barriers) outcomes. RESULTS Out of 7041 identified records, 19 full-text articles were included from peer-reviewed literature and two from grey literature. Of these, 18 reported on hepatitis A and/or B virus (HAV/HBV), two on influenza and one on MMR vaccination. Two studies on HAV vaccine reported varying acceptance (5-91%) and uptake rates (62.9-70.5%). Seven studies reported on HBV vaccination. A comparative study showed a significantly higher uptake of the third HBV vaccine dose with the very rapid (63%) compared to the standard schedule (20%). HBV vaccination was generally well accepted (54-100%), whereas uptake was variable (dose 1:23-100%, dose 2:48-92%, dose 3:19-80%). One study on the combined HAV/HBV vaccine reported an acceptance rate of 34%, and declining uptake following dose 1. One study on influenza vaccine showed an uptake of 42-46%, while another reported a MMR vaccine acceptance of 80% and an uptake of 74%. Overall, main reasons for non-vaccination included release from/or transfer between prisons, and refusal. CONCLUSIONS This systematic review highlighted important knowledge gaps and operational challenges for vaccination in prison settings. Vaccination is an effective measure that warrants comprehensive and tailored implementation to reduce the preventable disease burden, avoid risks of large outbreaks of vaccine-preventable diseases, and contribute to health equity for people in prison.
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Affiliation(s)
- Giordano Madeddu
- Department of Medical, Surgical and Experimental Sciences, Unit of Infectious Diseases, University of Sassari, Sassari, Italy.
| | - Hilde Vroling
- Pallas Health Research and Consultancy B.V., Rotterdam, the Netherlands
| | | | - Sergio Babudieri
- Department of Medical, Surgical and Experimental Sciences, Unit of Infectious Diseases, University of Sassari, Sassari, Italy
| | - Éamonn O'Moore
- Health and Justice Team, Public Health England and UK Collaborating Centre, WHO Health in Prisons Programme (Europe), Reading, United Kingdom
| | | | - Roberto Monarca
- Health Without Barriers - European Federation for Prison Health, Viterbo, Italy
| | - Pier Luigi Lopalco
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Dagmar Hedrich
- European Monitoring Centre for Drugs and Drug Addiction, Lisbon, Portugal
| | - Lara Tavoschi
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy; European Centre for Disease Prevention and Control, Stockholm, Sweden
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Abstract
Despite weak health literacy is considered a concause of vaccine hesitancy, it is rarely taken into account when discussing about this subject. The association between health literacy skills and vaccine acceptance has been shown to be uneven when using general measures, also depending on the population settings and type of vaccine considered. Vaccine literacy has been built on the same idea of health literacy, but very few specific measuring tools have been developed until now. It is desirable that more of these instruments are validated and extensively used with the objective of assessing peoples' vaccine literacy skills and defining interventions aimed at their improvement.
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Siani A. Measles outbreaks in Italy: A paradigm of the re-emergence of vaccine-preventable diseases in developed countries. Prev Med 2019; 121:99-104. [PMID: 30763627 DOI: 10.1016/j.ypmed.2019.02.011] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Revised: 01/10/2019] [Accepted: 02/08/2019] [Indexed: 10/27/2022]
Abstract
Over the last decade, outbreaks of vaccine-preventable diseases have been reported in developed countries around the world. In particular, measles outbreaks have been ongoing in the European Union since 2017, with the majority of cases concentrated in Romania and Italy. Measles has been identified as a powerful indicator of the status of vaccination programs in a region, as outbreaks have been reported to quickly emerge as a result of underlying problems in the immunisation routine. This paper aims to report and critically comment on the factors underpinning the recent measles outbreaks in Italy, considering the psychological, cultural, social and political causes of vaccine hesitancy and refusal amongst the population. Data from government agencies including the Italian National Institute of Statistics (ISTAT) and the Italian National Institute of Health (ISS) are analysed to describe incidence and mortality trends from 1887 to the present day, including regional variations and the impact of measles vaccination coverage. The topic of compulsory vaccination is currently the object of heated debate in the Italian social and political panorama; this paper discusses the current state of the vaccination controversy in the Italian political discourse and its potential impact on immunisation policies and measles vaccine coverage amongst the population. A burgeoning body of evidence indicates that every effort should be made to bolster the existing legislation on mandatory vaccination through widespread health education campaigns aimed at improving scientific literacy amongst the Italian population with regards to the topic of immunisation.
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Affiliation(s)
- Alessandro Siani
- School of Biological Sciences, University of Portsmouth, Portsmouth, UK.
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Kraśnicka J, Krajewska-Kułak E, Klimaszewska K, Cybulski M, Guzowski A, Kowalewska B, Jankowiak B, Rolka H, Doroszkiewicz H, Kułak W. Mandatory and recommended vaccinations in Poland in the views of parents. Hum Vaccin Immunother 2018; 14:2884-2893. [PMID: 30257128 DOI: 10.1080/21645515.2018.1496766] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Abstract
Background: Vaccinations are currently the key element in the prevention of the spread of infectious diseases. We studied parents' opinions about mandatory and recommended preventive vaccinations in Poland. Methods: A diagnostic survey using an original questionnaire was done in a group of 300 parents. Results: A total of 3.7% of parents did not vaccinate their children. 90% were aware of the threat potentially posed by infectious diseases, and 73.7% knew that breastfeeding alone does not ensure sufficient protection against them. 28% believed that it is necessary to vaccinate a child against all diseases, 51.7% that the number of vaccinations is insufficient, and 62.7% that vaccine use is safe. 40.7% thought that unvaccinated children should not be able to attend nurseries and kindergartens, as they pose a threat to other children. Postvaccinal adverse events occurred in 21.3% of children, mainly (71.9%) an increase in body temperature above 38°C. 88.3% were informed about possible vaccine-induced complications, most often by nurses (79.7%). 88% of the respondents were aware of the possibility to switch to an alternative immunization program, 92% were informed on the possible administration of recommended vaccines, and 53% took advantage of combined vaccines. Conclusions: Views on vaccinations were mostly varied, depending on the age, sex, education, and financial situation of the respondents. Most of the parents who did not vaccinate their children believed that immunity can be acquired by infection. They were in favor of a limited number of vaccinations, were more critical of the vaccination program in Poland, considered the vaccines used in Poland to be unsafe, and blamed vaccines for multiple developmental defects and autism in children. Parents whose children experienced vaccine-induced adverse reactions were more likely to have doubts before the next vaccination.
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Affiliation(s)
- Jolanta Kraśnicka
- a Family Doctors Clinic "Pro Medica Centrum" in Białystok , Białystok , Poland
| | | | - Krystyna Klimaszewska
- b Department of Integrated Medical Care , Medical University of Bialystok , Białystok , Poland
| | - Mateusz Cybulski
- b Department of Integrated Medical Care , Medical University of Bialystok , Białystok , Poland
| | - Andrzej Guzowski
- b Department of Integrated Medical Care , Medical University of Bialystok , Białystok , Poland
| | - Beata Kowalewska
- b Department of Integrated Medical Care , Medical University of Bialystok , Białystok , Poland
| | - Barbara Jankowiak
- b Department of Integrated Medical Care , Medical University of Bialystok , Białystok , Poland
| | - Hanna Rolka
- b Department of Integrated Medical Care , Medical University of Bialystok , Białystok , Poland
| | - Halina Doroszkiewicz
- c Department of Geriatrics , Medical University of Bialystok , Białystok , Poland
| | - Wojciech Kułak
- d Department of Pediatric Rehabilitation , Medical University of Bialystok , Białystok , Poland
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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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Boccalini S, Bechini A, Innocenti M, Sartor G, Manzi F, Bonanni P, Panatto D, Lai PL, Zangrillo F, Rizzitelli E, Iovine M, Amicizia D, Bini C, Marcellusi A, Mennini FS, Rinaldi A, Trippi F, Ferriero AM, Lisi GC. [The universal influenza vaccination in children with Vaxigrip Tetra ® in Italy: an evaluation of Health Technology Assessment]. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2018; 59:E1-E86. [PMID: 30465031 PMCID: PMC6219245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Affiliation(s)
- Sara Boccalini
- Dipartimento di Scienze della Salute, Università degli Studi di Firenze
| | - Angela Bechini
- Dipartimento di Scienze della Salute, Università degli Studi di Firenze
| | | | - Gino Sartor
- Dipartimento di Scienze della Salute, Università degli Studi di Firenze
| | - Federico Manzi
- Dipartimento di Scienze della Salute, Università degli Studi di Firenze
| | - Paolo Bonanni
- Dipartimento di Scienze della Salute, Università degli Studi di Firenze
| | - Donatella Panatto
- Dipartimento di Scienze della Salute, Università degli Studi di Genova
| | - Piero Luigi Lai
- Dipartimento di Scienze della Salute, Università degli Studi di Genova
| | | | | | | | - Daniela Amicizia
- Dipartimento di Scienze della Salute, Università degli Studi di Genova
| | - Chiara Bini
- Economic Evaluation and HTA (CEIS- EEHTA) - Facoltà di Economia, Università Tor Vergata
| | - Andrea Marcellusi
- Economic Evaluation and HTA (CEIS- EEHTA) - Facoltà di Economia, Università Tor Vergata
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