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Yang X, Shi N, Liu C, Zhang J, Miao R, Jin H. Relationship between vaccine hesitancy and vaccination behaviors: Systematic review and meta-analysis of observational studies. Vaccine 2024; 42:99-110. [PMID: 38081754 DOI: 10.1016/j.vaccine.2023.11.051] [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: 08/31/2023] [Revised: 11/07/2023] [Accepted: 11/25/2023] [Indexed: 01/01/2024]
Abstract
BACKGROUND Vaccination is crucial for prevention of infectious diseases, and identification of the impact of vaccine hesitancy on vaccination programs is crucial for early intervention and formulation of policies to alleviate vaccine hesitancy. The aim of this systematic review was to explore the relationship between vaccine hesitancy and negative vaccination behavior globally. METHODS We searched for observational studies in various databases. We conducted a meta-analysis using pooled odds ratios (OR) and 95 % confidence intervals (CI), performed meta regression and subgroup analysis to explore the role factors such as location and individual characteristics on the association between vaccine hesitancy and vaccination behavior. RESULTS A total of 46 articles were included in systematic analysis and 34 articles were included in the meta-analysis. The systematic analysis comprised 162,601 samples, whereas the meta-analysis included 147,554 samples. The meta-analysis showed that a higher rate of vaccine hesitancy was associated with an increased likelihood of adverse vaccination behaviors (all adverse behaviors: OR = 1.50, 95 % CI, 1.33-1.70, P < 0.001; unvaccinated: OR = 1.48, 95 % CI, 1.29-1.70, P < 0.001; vaccine delay: OR = 2.61, 95 % CI, 1.97-3.44, P < 0.001). The meta-regression results indicated that the heterogeneity observed was mainly from sample selection methods, age of vaccinees and the health status of participants. The results showed that parents of minor vaccinees or without high-risk health status had a higher association between vaccine hesitancy and vaccine uptake compared with populations exposed to higher health risks or adult vaccinees. CONCLUSION The findings provide evidence on the association between vaccine hesitancy and adverse vaccination behaviors. The results showed that these population-specific factors should be considered in future research, and during formulation of interventions and implementation of policies to improve vaccination uptake.
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Affiliation(s)
- Xuying Yang
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing 210009, China; Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing 210009, China
| | - Naiyang Shi
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing 210009, China; Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing 210009, China
| | - Chang Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing 210009, China; Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing 210009, China
| | - Jiarong Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing 210009, China; Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing 210009, China
| | - Ruishuai Miao
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing 210009, China; Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing 210009, China
| | - Hui Jin
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing 210009, China; Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing 210009, China.
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Bussink-Voorend D, Hautvast JLA, Vandeberg L, Visser O, Hulscher MEJL. A systematic literature review to clarify the concept of vaccine hesitancy. Nat Hum Behav 2022; 6:1634-1648. [PMID: 35995837 DOI: 10.1038/s41562-022-01431-6] [Citation(s) in RCA: 64] [Impact Index Per Article: 32.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 07/13/2022] [Indexed: 11/25/2022]
Abstract
Vaccine hesitancy (VH) is considered a top-10 global health threat. The concept of VH has been described and applied inconsistently. This systematic review aims to clarify VH by analysing how it is operationalized. We searched PubMed, Embase and PsycINFO databases on 14 January 2022. We selected 422 studies containing operationalizations of VH for inclusion. One limitation is that studies of lower quality were not excluded. Our qualitative analysis reveals that VH is conceptualized as involving (1) cognitions or affect, (2) behaviour and (3) decision making. A wide variety of methods have been used to measure VH. Our findings indicate the varied and confusing use of the term VH, leading to an impracticable concept. We propose that VH should be defined as a state of indecisiveness regarding a vaccination decision.
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Affiliation(s)
- Daphne Bussink-Voorend
- Radboud University Medical Center, Radboud Institute for Health Sciences, Primary and Community Care, Nijmegen, the Netherlands.
| | - Jeannine L A Hautvast
- Radboud University Medical Center, Radboud Institute for Health Sciences, Primary and Community Care, Nijmegen, the Netherlands
| | - Lisa Vandeberg
- Behavioural Science Institute, Radboud University, Nijmegen, the Netherlands
| | - Olga Visser
- Radboud University Medical Center, Radboud Institute for Health Sciences, Primary and Community Care, Nijmegen, the Netherlands
| | - Marlies E J L Hulscher
- Radboud University Medical Center, Radboud Institute for Health Sciences, IQ Healthcare, Nijmegen, the Netherlands
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Machida M, Kojima T, Popiel HA, Geiger M, Odagiri Y, Inoue S. Development, validity, and reliability of the Japanese version of the 7C of vaccination readiness scale. Am J Infect Control 2022; 51:426-433. [PMID: 35839960 DOI: 10.1016/j.ajic.2022.07.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 07/04/2022] [Accepted: 07/05/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND The 7C of vaccination readiness scale measures the seven psychological components that structure people's vaccination readiness. We aimed to develop the Japanese version of this scale (7C scale Japanese version) and to assess its validity and reliability. METHODS The full and short versions of 7C scale Japanese were developed based on translation guidelines provided by the ISPOR Task Force. An Internet survey, including 709 participants, was performed to assess the scale's validity and reliability within a confirmatory factor analysis (CFA) framework (men: 38.8%, age range: 20-92 years). Invariance analysis using multiple-group CFA was conducted to test cross-cultural validity between participants in this study and those in the 7C original version study. McDonald's omega and intraclass correlation coefficient were calculated to evaluate internal consistency and test-retest reliability, respectively. To clarify the criterion validity, regression analysis, with previous COVID-19 vaccination status as the dependent variable, was performed to calculate pseudo R2. RESULTS The 7C scale Japanese version exhibited good content validity, structural validity, configural invariance, and criterion validity. The results showed good internal consistency, and test-retest reliability, except for the "calculation" component. CONCLUSIONS 7C scale Japanese version exhibited acceptable reliability and validity; however, "calculation" may be a less reliable subscale.
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Affiliation(s)
- Masaki Machida
- Department of Preventive Medicine and Public Health, Tokyo Medical University, 6-1-1 Shinjuku, Shinjuku-ku, Tokyo, 160-8402, Japan; Department of Infection Prevention and Control, Tokyo Medical University Hospital, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo 160-0023, Japan.
| | - Takako Kojima
- Center for International Education and Research, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo 160-0023, Japan
| | - Helena Akiko Popiel
- Center for International Education and Research, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo 160-0023, Japan
| | - Mattis Geiger
- Department of Implementation Research, Health Communication Working Group, Bernhard Nocht Institute for Tropical Medicine, Bernhard-Nocht-Straße 74, Hamburg 20359, Germany
| | - Yuko Odagiri
- Department of Preventive Medicine and Public Health, Tokyo Medical University, 6-1-1 Shinjuku, Shinjuku-ku, Tokyo, 160-8402, Japan
| | - Shigeru Inoue
- Department of Preventive Medicine and Public Health, Tokyo Medical University, 6-1-1 Shinjuku, Shinjuku-ku, Tokyo, 160-8402, Japan
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Schwendener CL, Kiener LM, Jafflin K, Rouached S, Juillerat A, Meier V, Schärli Maurer S, Muggli F, Gültekin N, Baumann A, Debergh M, Gruillot C, Huber B, Merten S, Buhl A, Deml MJ, Tarr PE. HPV vaccine awareness, knowledge and information sources among youth in Switzerland: a mixed methods study. BMJ Open 2022; 12:e054419. [PMID: 35105636 PMCID: PMC8808397 DOI: 10.1136/bmjopen-2021-054419] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES We aimed to provide a detailed characterisation of human papillomavirus (HPV) vaccine awareness, knowledge and information sources in the HPV vaccine decision-making process of youth, both male and female, in Switzerland. DESIGN With a mixed-method study design, we conducted quantitative questionnaires and qualitative interviews, which lasted 20-45 min. SETTING AND PARTICIPANTS We recruited participants, 15-26 years of age, in physicians' offices, in a local sexual health clinic, and during military enlistment. We administered quantitative questionnaires to 997 youth participants (585 male, 412 female) and conducted qualitative interviews with 31 youth (17 male, 14 female). PRIMARY AND SECONDARY OUTCOME MEASURES We assessed HPV vaccine awareness, knowledge, information sources and vaccination status. RESULTS In the study's quantitative component, 108 (20%) male and 262 (65%) female participants had received ≥1 dose of HPV vaccine. 697 (70%) participants were knowledgeable about the HPV vaccine. Females were more likely to be knowledgeable than males (342/412 (83%) vs 355/585 (61%); p<0.01). Younger participants in the sample compared with older participants were more likely to be aware of HPV vaccine (135/148 (91%) vs 695/849 (82%); p<0.01). The three most mentioned information sources were school health programmes (442 (53%)), healthcare providers (190 (23%)) and participants' social networks (163 (20%)). Overall, 554/710 (78%) participants had a female-gendered perception of HPV vaccine, a finding which was further supported and explained by qualitative data. CONCLUSIONS Despite a male HPV vaccine recommendation being made >4 years prior to the data collection, HPV vaccine knowledge was higher among females than males, and a female-gendered perception of HPV vaccine remains prevalent. Internet and social media were minor HPV vaccine information sources. Study findings demonstrate that HPV knowledge matters for HPV vaccine uptake and suggest that we should improve HPV information quality and access for youth, particularly by tailoring knowledge campaigns to young men.
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Affiliation(s)
- Corina L Schwendener
- University Department of Medicine and Infectious Diseases Service, Kantonsspital Baselland, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Laura M Kiener
- University Department of Medicine and Infectious Diseases Service, Kantonsspital Baselland, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Kristen Jafflin
- University of Basel, Basel, Switzerland
- Swiss Tropical and Public Health Institute, Basel, Switzerland
| | - Sarah Rouached
- University Department of Medicine and Infectious Diseases Service, Kantonsspital Baselland, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Anna Juillerat
- University Department of Medicine and Infectious Diseases Service, Kantonsspital Baselland, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Vincent Meier
- University Department of Medicine and Infectious Diseases Service, Kantonsspital Baselland, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | | | - Franco Muggli
- Rekrutierungszentrum Monte Ceneri, Swiss Armed Forces, Bern, Switzerland
| | - Nejla Gültekin
- Eidgenössisches Departement für Verteidigung, Bevölkerungsschutz und Sport VBS Schweizer Armee, Swiss Armed Forces, Bern, Switzerland
| | - Aron Baumann
- Swiss Tropical and Public Health Institute, Basel, Switzerland
| | - Marlyse Debergh
- Institute of Sociological Research, University of Geneva, Geneva, Geneva, Switzerland
| | - Catherine Gruillot
- PROFA Consultation de santé sexuelle - planning familial, Renens, Switzerland
| | - Benedikt Huber
- Department of Pediatrics, HFR Fribourg Cantonal Hospital, Fribourg, Switzerland
| | - Sonja Merten
- University of Basel, Basel, Switzerland
- Swiss Tropical and Public Health Institute, Basel, Switzerland
| | - Andrea Buhl
- University of Basel, Basel, Switzerland
- Swiss Tropical and Public Health Institute, Basel, Switzerland
| | - Michael J Deml
- Institute of Sociological Research, University of Geneva, Geneva, Geneva, Switzerland
- Division of Social and Behavioural Sciences, School of Public Health & Family Medicine, University of Cape Town Faculty of Health Sciences, Cape Town, Western Cape, South Africa
| | - Philip E Tarr
- University Department of Medicine and Infectious Diseases Service, Kantonsspital Baselland, Basel, Switzerland
- University of Basel, Basel, Switzerland
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