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Yu F, Jiao L, Chen Q, Wang Q, De Allegri M, Cao Z, Chen W, Ma X, Wang C, Wachinger J, Jin Z, Bunker A, Geldsetzer P, Yang J, Xue L, Bärnighausen T, Chen S. Preferences regarding COVID-19 vaccination among 12,000 adults in China: A cross-sectional discrete choice experiment. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0003387. [PMID: 38990924 PMCID: PMC11239003 DOI: 10.1371/journal.pgph.0003387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 05/28/2024] [Indexed: 07/13/2024]
Abstract
Understanding public preferences concerning vaccination is critical to inform pandemic response strategies. To investigate Chinese adults' preferences regarding COVID-19 vaccine attributes, we conducted a cross-sectional online survey in 12,000 Chinese adults in June-July, 2021. Participants were requested to answer a series of discrete choice questions related to hypothetical COVID-19 vaccines. Using mixed logit models, our analysis revealed that participants had a higher preference for COVID-19 vaccines with longer duration of protection (coefficient: 1.272, 95% confidence interval [1.016 to 1.529]) and higher efficacy (coefficient: 1.063, [0.840, 1.287]). Conversely, participants demonstrated a lower preference associated with higher risk of rare but serious side-effects (coefficient: -1.158, [-1.359, -0.958]), oral administration (coefficient: -0.211, [-0.377, -0.046]), more doses (coefficient: -0.148, [-0.296, 0.000]) and imported origin (coefficient: -0.653, [-0.864, -0.443]). Moreover, preferences were heterogeneous by individual factors: highly educated participants were more sensitive to the negative vaccine attributes including price (coefficient -0.312, [-0.370, -0.253]) and imported vaccine (coefficient -0.941, [-1.186, -0.697]); there was also substantial heterogeneity in vaccine preferences with respect to age group, marital status, work status, income, chronic diagnosis history, COVID-19 vaccination history and geographic regions. As the first study of examining the public preferences for COVID-19 vaccine in China with a large nationwide sample of 12,000 adults, our results indicate that future vaccine should pose lower risk, possess longer protection period, have higher efficacy, be domestically produced, and have lower costs to increase the COVID-19 vaccination coverage. Our current study findings from this study provide insights and recommendations for not only COVID-19 vaccine design but also vaccine attribute preferences to increase vaccine uptake in potential future pandemics.
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Affiliation(s)
- Fengyun Yu
- Interdisciplinary Centre for Scientific Computing, University of Heidelberg, Heidelberg, Germany
| | - Lirui Jiao
- Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Qiushi Chen
- The Harold and Inge Marcus Department of Industrial and Manufacturing Engineering, The Pennsylvania State University, University Park, Pennsylvania, United States of America
| | - Qun Wang
- Faculty of Humanities and Social Sciences, Dalian University of Technology, Dalian, China
| | - Manuela De Allegri
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany
| | - Zhong Cao
- State Key Lab of Intelligent Technologies and Systems, Department of Automation, Tsinghua University, Beijing, China
| | - Wenjin Chen
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Xuedi Ma
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Chao Wang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Jonas Wachinger
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany
| | - Zhangfeng Jin
- School of Economics, Zhejiang University of Technology, Hangzhou, China
| | - Aditi Bunker
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany
| | - Pascal Geldsetzer
- Department of Medicine, Division of Primary Care and Population Health, Stanford University School of Medicine, Stanford, California, United States of America
- Chan Zuckerberg Biohub – San Francisco, San Francisco, California, United States of America
| | - Juntao Yang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Lan Xue
- Institute for AI International Governance, Tsinghua University, Beijing, China
- School of Public Policy and Management, Tsinghua University, Beijing, China
| | - Till Bärnighausen
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Simiao Chen
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
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Shi J, Zhao F, Yang W, Zhu Y, Wang M, Yi B. The Status and Influencing Factors of COVID-19 Vaccination for 3-7-Year-Old Children Born Prematurely. Patient Prefer Adherence 2024; 18:787-796. [PMID: 38572223 PMCID: PMC10987788 DOI: 10.2147/ppa.s451654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Accepted: 03/14/2024] [Indexed: 04/05/2024] Open
Abstract
Objective To explore the status and influencing factors of COVID-19 vaccination for 3-7-year-old children born prematurely. Methods A questionnaire was administered to parents of preterm infants born between 1 January 2016 and 31 December 2019 in Gansu Maternal and Child Health Hospital using convenience sampling. Results It was found that 96.81% of 282 parents had known about COVID-19 vaccines and acquired COVID-19- and vaccine-related knowledge primarily through WeChat (104/282, 36.88%) and TikTok (91/282, 32.27%). Most parents of the group whose children were vaccinated with a COVID-19 vaccine believed that this approach was effective in preventing COVID-19 (49.75%), whereas most parents of the group whose children were not vaccinated were worried about the adverse reaction and safety of the vaccine (45.88%). According to the regression analysis, the risk factors of children born prematurely receiving a COVID-19 vaccine were no vaccination against COVID-19 in the mothers (odds ratio [OR]=48.489, 95% CI: 6.524-360.406) and in younger children (OR=12.157, 95% CI: 6.388-23.139). Previous history of referral (OR=0.229, 95% CI: 0.057-0.920), history of diseases (OR=0.130, 95% CI: 0.034-0.503) and high educational level of guardians (OR=0.142, 95% CI: 0.112-0.557) were protective factors for children born prematurely to receive COVID-19 vaccination. Conclusion There is a relatively high proportion of children born prematurely receiving COVID-19 vaccination, but some people still have concerns. Publicity in the later stage can be conducted through WeChat, TikTok and other social media platforms, with special attention paid to the populations with lower education levels.
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Affiliation(s)
- Jingyun Shi
- Department of NICU, Gansu Provincial Maternal and Child Care Hospital (Gansu Provincial Central Hospital), Lanzhou City, Gansu, 730050, People’s Republic of China
| | - Fangping Zhao
- Department of NICU, Gansu Provincial Maternal and Child Care Hospital (Gansu Provincial Central Hospital), Lanzhou City, Gansu, 730050, People’s Republic of China
| | - Wanyin Yang
- Department of NICU, Gansu University of Chinese Medicine, Lanzhou City, Gansu, 730050, People’s Republic of China
| | - Yuru Zhu
- Department of NICU, Gansu Provincial Maternal and Child Care Hospital (Gansu Provincial Central Hospital), Lanzhou City, Gansu, 730050, People’s Republic of China
| | - Min Wang
- Department of NICU, Gansu Provincial Maternal and Child Care Hospital (Gansu Provincial Central Hospital), Lanzhou City, Gansu, 730050, People’s Republic of China
| | - Bin Yi
- Department of NICU, Gansu Provincial Maternal and Child Care Hospital (Gansu Provincial Central Hospital), Lanzhou City, Gansu, 730050, People’s Republic of China
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Bateyi Mustafa SH, Kabamba M, Onyango RO. Determinants of parents' intention to vaccinate their children aged 12-17 years against COVID-19 in North Kivu (Democratic Republic of Congo). Hum Vaccin Immunother 2023; 19:2179788. [PMID: 36864602 PMCID: PMC10026875 DOI: 10.1080/21645515.2023.2179788] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/04/2023] Open
Abstract
Parents are facing tremendous stress in relation to the COVID-19 pandemic and the effectiveness of the COVID-19 vaccination program for children. We aimed to investigate parents' willingness to vaccinate their children against COVID-19 in North Kivu province, (Democratic Republic of Congo). A cross-sectional survey between 1 December 2021 to 20 January 2022 in six health zones (Goma, Karisimbi, Butembo, Beni, Kamango, and Katwa) was conducted in the province of North Kivu. In each health zone, we selected five clusters (Health area) using the method of probabilistic selection proportional to population size. In total, 522 parents participated in our study. Results: Overall, 32.8% of parents intended to vaccinate their children. In the multivariate analysis, a younger age of parents (aOR: 2.40, CI: [1.50-3.83]), a higher level of fear that "a member of my family" could contract COVID-19 (aOR: 2.35, CI: [1.38-4.02]), a higher level of perceived vulnerability to COVID-19 within the family (aOR: 1.70, CI: [1.005-2.2881]), a higher level of perceived susceptibility to COVID-19 within the family (aOR: 3.07, CI: [1.80-5.23]), and a history of vaccination against COVID-19 among parents (aOR: 16.47, CI: [8.39-32.33]), were all significantly associated with the intention of parents to have their children or adolescents vaccinated. According to the different explanatory factors of the will to have their children vaccinated, an emphasis on the health education of parents who are prone to refusal or hesitation of the vaccine, by addressing the common reasons for the refusal of the vaccine and highlight the vaccine's benefits.
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Affiliation(s)
- Stephane Hans Bateyi Mustafa
- Expanded Program on Immunization, Goma, Democratic Republic of the Congo
- Department of Public Health, Faculty of Health and Community Development, Great Lacs University of Kisumu, Kisumu, Kenya
| | - Michel Kabamba
- Expanded Program on Immunization, Kinshasa, Democratic Republic of the Congo
- Department of Public Health, Faculty of Medicine, University of Kamina, Kamina, Democratic Republic of Congo
| | - Rosebella O Onyango
- Department of Public Health, Faculty of Health and Community Development, Great Lacs University of Kisumu, Kisumu, Kenya
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Maneesriwongul W, Deesamer S, Butsing N. Parental Vaccine Literacy: Attitudes towards the COVID-19 Vaccines and Intention to Vaccinate Their Children Aged 5-11 Years against COVID-19 in Thailand. Vaccines (Basel) 2023; 11:1804. [PMID: 38140208 PMCID: PMC10747165 DOI: 10.3390/vaccines11121804] [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: 10/11/2023] [Revised: 11/24/2023] [Accepted: 11/29/2023] [Indexed: 12/24/2023] Open
Abstract
BACKGROUND High rates of population immunity are needed to control the COVID-19 pandemic. This study aimed to assess parents' intention to have their children, aged 5-11 years, vaccinated against COVID-19 and its influencing factors in Thailand. METHODS A cross-sectional online survey was conducted before the nationwide COVID-19 vaccine rollout for children aged 5-11 years in Thailand. A sample of 542 parents with children in this age group was recruited online. RESULTS In total, 58.8% of parents intended to vaccinate their child against COVID-19. Logistic regression analysis revealed that influencing factors include child age, parents' education, interactive/critical vaccine literacy, attitudes that the COVID-19 vaccine is safe and effective for children, that the vaccine can reduce the severity of COVID-19 in children, that there were other ways to prevent children from contracting COVID-19 superior to vaccination, and that COVID-19 vaccination in children can be fatal. The main reasons for having an intention to vaccinate their children included to reduce the severity of symptoms if infected with COVID-19 and to protect them from contracting COVID-19 when they go to school. CONCLUSIONS Our study provides evidence regarding factors influencing parents' intention to vaccinate their children. The findings can be used to design future interventions to promote COVID-19 vaccine uptake in children.
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Affiliation(s)
| | - Suhong Deesamer
- Ramathibodi School of Nursing, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand; (W.M.); (N.B.)
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Man SS, Wen H, Zhao L, So BCL. Role of Trust, Risk Perception, and Perceived Benefit in COVID-19 Vaccination Intention of the Public. Healthcare (Basel) 2023; 11:2589. [PMID: 37761786 PMCID: PMC10530888 DOI: 10.3390/healthcare11182589] [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: 06/28/2023] [Revised: 08/16/2023] [Accepted: 09/17/2023] [Indexed: 09/29/2023] Open
Abstract
COVID-19 vaccination is an effective method for dealing with the COVID-19 pandemic. This study proposed and validated a theoretical intention model for explaining the COVID-19 vaccination intention (CVI) of the public. The theoretical intention model incorporated trust in vaccines, two types of risk perception (risk perception of COVID-19 and risk perception of COVID-19 vaccination), and perceived benefit into a theory of planned behavior (TPB). Structural equation modeling was utilized to test the theoretical intention model with data collected from 816 Chinese adults in China. The results confirmed the crucial role of trust in vaccines, risk perception, and perceived benefit in shaping the CVI of the public. In addition, TPB was found to be applicable in a research context. The theoretical intention model accounted for 78.8% of the variance in CVI. Based on the findings, several practical recommendations for improving COVID-19 vaccination rates were discussed.
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Affiliation(s)
- Siu-Shing Man
- School of Design, South China University of Technology, Guangzhou 510641, China; (S.-S.M.); (H.W.)
| | - Huiying Wen
- School of Design, South China University of Technology, Guangzhou 510641, China; (S.-S.M.); (H.W.)
| | - Ligao Zhao
- Guangzhou Huadu Huacheng Community Health Service Centre, Guangzhou 510810, China;
| | - Billy Chun-Lung So
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
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Mudenda S, Meyer JC, Fadare JO, Ogunleye OO, Saleem Z, Matafwali SK, Daka V, Chabalenge B, Chama J, Mukosha M, Skosana P, Witika BA, Kalungia AC, Hamachila A, Mufwambi W, Godman B. COVID-19 vaccine uptake and associated factors among adolescents and youths: Findings and implications for future vaccination programmes. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0002385. [PMID: 37729153 PMCID: PMC10511127 DOI: 10.1371/journal.pgph.0002385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 08/22/2023] [Indexed: 09/22/2023]
Abstract
Adolescents and youths are a key part of the population that needs to be protected against the coronavirus disease 2019 (COVID-19). This is because they are more likely to spread the virus to vulnerable individuals. In view of these concerns, this study investigated the uptake of COVID-19 vaccines and associated factors among adolescents and youths attending secondary schools in Zambia. This cross-sectional study was conducted among 1500 school-going adolescents in Lusaka from September 2022 to November 2022. Overall, 1409 participants took part giving a response rate of 94%. Only 29.2% (n = 411) of the participants were vaccinated against COVID-19 at the time of the study. Compared to their unvaccinated counterparts, vaccinated adolescents and youths scored higher for knowledge (66.2% vs 57.8%) and attitudes (76.7% vs 39.4%) regarding COVID-19 vaccines. Healthcare workers, family/friends and social media were key sources of information regarding the vaccine. Factors associated with increased vaccine uptake were positive attitudes (AOR = 33.62, 95% CI: 19.92-56.73), indicating it was stressful to follow COVID-19 preventive measures (AOR = 1.47, 95% CI: 1.09-1.99), participants in Grade 12 (AOR = 3.39, 95% CI: 1.94-5.91), Grade 11 (AOR = 2.59, 95% CI: 1.94-5.91), Grade 10 (AOR = 3.48, 95% CI: 1.98-6.11) and Grade 9 (AOR = 3.04, 95% CI: 1.74-5.32) compared to Grade 8. This study found a relatively low uptake of COVID-19 vaccines among adolescents and youths in Zambia. There is a need to provide adequate strategies to address knowledge and attitude gaps regarding COVID-19 vaccines to improve uptake and reduce future morbidity and mortality.
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Affiliation(s)
- Steward Mudenda
- Department of Pharmacy, School of Health Sciences, University of Zambia, Lusaka, Zambia
| | - Johanna C. Meyer
- Department of Public Health Pharmacy and Management, School of Pharmacy, Sefako Makgatho Health Sciences University, Pretoria, South Africa
- South African Vaccination and Immunisation Centre, Sefako Makgatho Health Sciences University, Pretoria, South Africa
| | - Joseph O. Fadare
- Department of Pharmacology and Therapeutics, Ekiti State University, Ado Ekiti, Nigeria
- Department of Medicine, Ekiti State University Teaching Hospital, Ado Ekiti, Nigeria
| | - Olayinka O. Ogunleye
- Department of Pharmacology, Therapeutics and Toxicology, Lagos State University College of Medicine, Ikeja, Lagos, Nigeria
- Department of Medicine, Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria
| | - Zikria Saleem
- Department of Pharmacy Practice, Faculty of Pharmacy, Bahauddin Zakariya University, Multan, Pakistan
| | - Scott K. Matafwali
- Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene &Tropical Medicine, London, United Kingdom
| | - Victor Daka
- Department of Public Health, Michael Chilufya Sata School of Medicine, Copperbelt University, Ndola, Zambia
| | - Billy Chabalenge
- Department of Medicines Control, Zambia Medicines Regulatory Authority, Lusaka, Zambia
| | - Jacob Chama
- Department of Pharmacy, School of Health Sciences, University of Zambia, Lusaka, Zambia
| | - Moses Mukosha
- Department of Pharmacy, School of Health Sciences, University of Zambia, Lusaka, Zambia
- HIV and Women’s Health Research Group, University Teaching Hospital, Lusaka, Zambia
| | - Phumzile Skosana
- Department of Clinical Pharmacy, School of Pharmacy, Sefako Makgatho Health Sciences University, Pretoria, South Africa
| | - Bwalya A. Witika
- Department of Pharmaceutical Sciences, School of Pharmacy, Sefako Makgatho Health Sciences University, Pretoria, South Africa
| | - Aubrey C. Kalungia
- Department of Pharmacy, School of Health Sciences, University of Zambia, Lusaka, Zambia
| | - Audrey Hamachila
- Department of Pharmacy, School of Health Sciences, University of Zambia, Lusaka, Zambia
| | - Webrod Mufwambi
- Department of Pharmacy, School of Health Sciences, University of Zambia, Lusaka, Zambia
| | - Brian Godman
- Department of Public Health Pharmacy and Management, School of Pharmacy, Sefako Makgatho Health Sciences University, Pretoria, South Africa
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow, United Kingdom
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Limbu YB, Gautam RK. How Well the Constructs of Health Belief Model Predict Vaccination Intention: A Systematic Review on COVID-19 Primary Series and Booster Vaccines. Vaccines (Basel) 2023; 11:vaccines11040816. [PMID: 37112728 PMCID: PMC10141697 DOI: 10.3390/vaccines11040816] [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] [Received: 03/11/2023] [Revised: 04/02/2023] [Accepted: 04/04/2023] [Indexed: 04/29/2023] Open
Abstract
This systematic review synthesizes the findings of quantitative studies examining the relationships between Health Belief Model (HBM) constructs and COVID-19 vaccination intention. We searched PubMed, Medline, CINAHL, Web of Science, and Scopus using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and identified 109 eligible studies. The overall vaccination intention rate was 68.19%. Perceived benefits, perceived barriers, and cues to action were the three most frequently demonstrated predictors of vaccination intention for both primary series and booster vaccines. For booster doses, the influence of susceptibility slightly increased, but the impact of severity, self-efficacy, and cues to action on vaccination intention declined. The impact of susceptibility increased, but severity's effect declined sharply from 2020 to 2022. The influence of barriers slightly declined from 2020 to 2021, but it skyrocketed in 2022. Conversely, the role of self-efficacy dipped in 2022. Susceptibility, severity, and barriers were dominant predictors in Saudi Arabia, but self-efficacy and cues to action had weaker effects in the USA. Susceptibility and severity had a lower impact on students, especially in North America, and barriers had a lower impact on health care workers. However, cues to action and self-efficacy had a dominant influence among parents. The most prevalent modifying variables were age, gender, education, income, and occupation. The results show that HBM is useful in predicting vaccine intention.
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Affiliation(s)
- Yam B Limbu
- Feliciano School of Business, Montclair State University, 1 Normal Ave., Montclair, NJ 07043, USA
| | - Rajesh K Gautam
- Department of Anthropology, Dr. Harisingh Gour Central University, Sagar 470003, MP, India
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Alimoradi Z, Lin CY, Pakpour AH. Worldwide Estimation of Parental Acceptance of COVID-19 Vaccine for Their Children: A Systematic Review and Meta-Analysis. Vaccines (Basel) 2023; 11:vaccines11030533. [PMID: 36992117 DOI: 10.3390/vaccines11030533] [Citation(s) in RCA: 24] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Revised: 02/19/2023] [Accepted: 02/21/2023] [Indexed: 03/07/2023] Open
Abstract
Currently, the best method to well control the spread of COVID-19 without severe mental health problems is to reach herd immunity. Therefore, the vaccination rate of the COVID-19 vaccine is critical. Among the populations, children are the vulnerable ones to get vaccinated; therefore, it is important to assess parents’ and guardians’ willingness to have their children vaccinated. The present systematic review and meta-analysis synthesized evidence to estimate the parents’ acceptance rate of COVID-19 vaccination toward their children. Additionally, factors explaining the acceptance rate were investigated. Four academic databases (PubMed, Scopus, Web of Science, and ProQuest) together with Google Scholar were searched, and the references of the included publications were searched as well. Using the PECO-S framework (population, exposure, comparison, outcome, and study design), observational studies of cross-sectional, cohort, or case-control studies were included. The outcome was parents’ or guardians’ willingness to let their children be vaccinated. The studies included in the present review were restricted to English and peer-reviewed papers published between December 2019 and July 2022. A total of 98 papers across 69 different countries with 413,590 participants were included. The mean age of the parents was 39.10 (range: 18–70) years and that of their children was 8.45 (range: 0–18) years. The pooled estimated prevalence of parental acceptance to vaccinate their children with the COVID-19 vaccine was 57% (98 studies, 95% CI: 52–62%, I2: 99.92%, τ2: 0.06). Moreover, data collection time was a significant factor explaining parental willingness in the multivariable meta-regression, with a 13% decrease in parental willingness by each month increase in time, explaining 11.44% of variance. Qualitative synthesis results showed that parents’ COVID-19 vaccine knowledge, trust in theCOVID-19 vaccine, and facilitators in vaccination (e.g., low cost, good vaccine accessibility, and government incentive) were significant factors for higher willingness, while mental health problems (e.g., having worries and psychological distress) were significant factors for lower willingness. Given that the acceptance rate was relatively low (57%) and does not achieve the requirement of herd immunity (i.e., 70%), governments and healthcare authorities should try to elevate parents’ knowledge and trust in the COVID-19 vaccine, facilitate in vaccination, and reduce their mental difficulties to improve the overall vaccination rate among children.
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Affiliation(s)
- Zainab Alimoradi
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin 3415613911, Iran
| | - Chung-Ying Lin
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan 701401, Taiwan
- Biostatistics Consulting Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 701401, Taiwan
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan 701401, Taiwan
- Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan 701401, Taiwan
| | - Amir H Pakpour
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin 3415613911, Iran
- Department of Nursing, School of Health and Welfare, Jönköping University, SE-551 11 Jönköping, Sweden
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Fernandes Nehab M, Gonçalves Camacho K, Teixeira Reis A, Junqueira-Marinho MDF, Marques Abramov D, Almeida de Azevedo ZM, Dos Santos Salú M, Farias Meira de Vasconcelos Z, Dos Santos Gomes Junior SC, Carvalho da Silva Filho O, Candida de Oliveira Salvador PT, Andrade Alves KY, Silva de Carvalho KR, Campelo Batalha Cox Moore D. Willingness of Brazilian caregivers in having their children and adolescents vaccinated against Covid-19. Vaccine 2023; 41:735-743. [PMID: 36549940 PMCID: PMC9731931 DOI: 10.1016/j.vaccine.2022.11.077] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 11/10/2022] [Accepted: 11/27/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND The vaccination of children and adolescents for the prevention of Covid-19 is important to:decrease in deaths and hospitalizations, prevent multisystem inflammatory syndrome, avoid long-term complications and decrease the suspension of on-site classes. Despite of these benefits, some studies have shown that some caregivers are still hesitancy. METHODS This is a voluntary and anonymous online survey conducted from November 17 to December 14, 2021, in Brazil, through a free-of-charge platform with a link provided on social networks. A bivariate analysis was conducted with the independent variables, with vaccine hesitancy as the outcome variable, and a multivariate logistic model was used to calculated adjusted odds ratios. RESULTS The sample included 15,297 respondents. Approximately 13.3 % (2,028) of the caregivers were hesitant to vaccinate their children and adolescents against Covid-19 in at least one age group. The vaccination hesitanty rate of caregivers of children aged 0-4 years, 5-11 years and adolescents were 16 %, 13 %, 15 %, respectively. The principal factors associated with vaccine hesitancy were the following: belief that they need to wait longer, belief that children that had natural infection doesn't need to vaccinate and belief that vaccine has long term adverse effects. INTERPRETATION The present study showed that the willingness of caregivers to have their children and adolescents vaccinated in Brazil is high compared to data from adult and pediatric international studies. This study provides a profile of the hesitant caregivers considering their perspectives and beliefs regarding vaccines that can help the elaboration of strategies to increase vaccine adherence.
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Affiliation(s)
- Marcio Fernandes Nehab
- National Institute of Women, Children and Adolescents Health Fernandes Figueira, FIOCRUZ, Avenue Rui Barbosa, 716, Flamengo, Rio de Janeio, RJ zip code 22250-020, Brazil.
| | - Karla Gonçalves Camacho
- National Institute of Women, Children and Adolescents Health Fernandes Figueira, FIOCRUZ, Avenue Rui Barbosa, 716, Flamengo, Rio de Janeio, RJ zip code 22250-020, Brazil
| | - Adriana Teixeira Reis
- National Institute of Women, Children and Adolescents Health Fernandes Figueira, FIOCRUZ, Avenue Rui Barbosa, 716, Flamengo, Rio de Janeio, RJ zip code 22250-020, Brazil.
| | - Maria de Fátima Junqueira-Marinho
- National Institute of Women, Children and Adolescents Health Fernandes Figueira, FIOCRUZ, Avenue Rui Barbosa, 716, Flamengo, Rio de Janeio, RJ zip code 22250-020, Brazil
| | - Dimitri Marques Abramov
- National Institute of Women, Children and Adolescents Health Fernandes Figueira, FIOCRUZ, Avenue Rui Barbosa, 716, Flamengo, Rio de Janeio, RJ zip code 22250-020, Brazil.
| | - Zina Maria Almeida de Azevedo
- National Institute of Women, Children and Adolescents Health Fernandes Figueira, FIOCRUZ, Avenue Rui Barbosa, 716, Flamengo, Rio de Janeio, RJ zip code 22250-020, Brazil
| | - Margarida Dos Santos Salú
- National Institute of Women, Children and Adolescents Health Fernandes Figueira, FIOCRUZ, Avenue Rui Barbosa, 716, Flamengo, Rio de Janeio, RJ zip code 22250-020, Brazil
| | - Zilton Farias Meira de Vasconcelos
- National Institute of Women, Children and Adolescents Health Fernandes Figueira, FIOCRUZ, Avenue Rui Barbosa, 716, Flamengo, Rio de Janeio, RJ zip code 22250-020, Brazil.
| | - Saint Clair Dos Santos Gomes Junior
- National Institute of Women, Children and Adolescents Health Fernandes Figueira, FIOCRUZ, Avenue Rui Barbosa, 716, Flamengo, Rio de Janeio, RJ zip code 22250-020, Brazil
| | - Orli Carvalho da Silva Filho
- National Institute of Women, Children and Adolescents Health Fernandes Figueira, FIOCRUZ, Avenue Rui Barbosa, 716, Flamengo, Rio de Janeio, RJ zip code 22250-020, Brazil
| | | | - Kisna Yasmin Andrade Alves
- School of Health at the Federal University of Rio Grande do Norte, Avenue Senador Salgado Filho, s/n - Lagoa Nova, Natal, RN zip code: 59078-970, Brazil
| | | | - Daniella Campelo Batalha Cox Moore
- National Institute of Women, Children and Adolescents Health Fernandes Figueira, FIOCRUZ, Avenue Rui Barbosa, 716, Flamengo, Rio de Janeio, RJ zip code 22250-020, Brazil; Federal Fluminense University, Faculty of Medicine, Internal Medicine Department, Brazil.
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Maneesriwongul W, Butsing N, Deesamer S. Parental Hesitancy on COVID-19 Vaccination for Children Under Five Years in Thailand: Role of Attitudes and Vaccine Literacy. Patient Prefer Adherence 2023; 17:615-628. [PMID: 36926219 PMCID: PMC10012909 DOI: 10.2147/ppa.s399414] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 02/09/2023] [Indexed: 03/12/2023] Open
Abstract
INTRODUCTION Global vaccination efforts to control the COVID-19 pandemic may be impeded by vaccine hesitancy. Attitudes and vaccine literacy are important factors that reduce vaccine hesitancy. The role of attitudes and vaccine literacy of parents on COVID-19 vaccine intention for their children under five years was unknown. OBJECTIVE This study aimed to assess parents' characteristics, vaccine literacy, attitudes toward the COVID-19 vaccine, and vaccine intention/hesitancy and to determine factors influencing parents' vaccine intention for their children under five years of age. METHODS A cross-sectional study was conducted using an online self-administered questionnaire before the authorization of the COVID-19 vaccine for very young children in Thailand. The sample consisted of 455 parents with children under five years old. The online questionnaire included parents' sociodemographic data, vaccine literacy, attitudes toward COVID-19 vaccine, and vaccine intention to get their children vaccinated. RESULTS About 98% of the parents received their COVID-19 vaccination, whereas only 45.1% reported they would have their children under five years old get vaccinated. About 54.9% were either not sure or refused their child's COVID-19 vaccination. A multiple logistic regression model identified factors that increased the odds of parents' vaccine intention: parents aged > 35 years, attitudes on safety and efficacy of COVID-19 vaccine for children, advice about the COVID-19 vaccines from healthcare personnel, and the belief that COVID-19 vaccine is helpful for their children. Attitudes that COVID-19 vaccination in children could be fatal decreased parents' vaccine intention. Need for more information about the COVID-19 vaccine for children and concern about the vaccine's side effects were the most frequent reasons for vaccine hesitancy and refusal. CONCLUSION Parents should be provided with accurate information from healthcare personnel and media sources about the safety and effectiveness of the COVID-19 vaccine for young children under five years of age to overcome their hesitancy.
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Affiliation(s)
- Wantana Maneesriwongul
- Ramathibodi School of Nursing, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Nipaporn Butsing
- Ramathibodi School of Nursing, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
- Correspondence: Nipaporn Butsing, Ramathibodi School of Nursing, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 270 Rama VI Road, Thung Phaya Thai, Ratchathewi, Bangkok, 10400, Thailand, Email
| | - Suhong Deesamer
- Ramathibodi School of Nursing, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
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Hou Z, Song K, Wang Q, Zang S, Tu S, Chantler T, Larson HJ. Childhood COVID-19 vaccine acceptance and preference from caregivers and healthcare workers in China: A survey experiment. Prev Med 2022; 161:107138. [PMID: 35809825 PMCID: PMC9259187 DOI: 10.1016/j.ypmed.2022.107138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Revised: 06/14/2022] [Accepted: 07/02/2022] [Indexed: 11/28/2022]
Abstract
With approval of more COVID-19 vaccines for children, vaccine attributes may influence parental acceptance and choices. We aimed to assess effects of vaccine attributes and information on herd immunity on childhood COVID-19 vaccine acceptance. A survey experiment was conducted with caregivers of children aged 6 months to 11 years old and health care workers (HCWs) in China from September 14 to November 18, 2021. Respondents were randomly assigned to receive differing information on herd immunity (> 80% of the entire population must be vaccinated; or no information). Respondents then completed eight discrete choice tasks to assess vaccine acceptance based on attributes. 2331 (90.07%) of 2588 surveyed caregivers and 1576 (92.71%) of 1700 surveyed HCWs would accept COVID-19 vaccination for children, respectively. High Odds Ratios (OR) were found for acceptance of a vaccine with 90% over 50% efficacy (OR 6.70 [95% CI 6.11-7.35] for caregivers; 11.44 [10.12-12.95] for HCWs); and risk of adverse reactions to be 1 over 10 in 10,000 (3.96 [3.72-4.22] for caregivers; 2.98 [2.76-3.22] for HCWs). To achieve herd immunity target (> 80% vaccination coverage), vaccine efficacy should reach over 70% and risk of adverse reactions lower than 1 in 10,000. Knowledge on herd immunity target increased the odds of vaccine acceptance (1.82 [1.34-2.46] for caregivers; 2.42 [1.58-3.72] for HCWs). Childhood COVID-19 vaccine acceptance was high in China, independent of child's age, and depended on vaccine attributes.
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Affiliation(s)
- Zhiyuan Hou
- School of Public Health, NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China.
| | - Kuimeng Song
- School of Health Care Security, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, China
| | - Qian Wang
- School of Public Health, NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China
| | - Shujie Zang
- School of Public Health, NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China
| | - Shiyi Tu
- School of Public Health, NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China
| | - Tracey Chantler
- Department of Global Health and Development, London School of Hygiene & Tropical Medicine, UK
| | - Heidi J Larson
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, UK; Department of Health Metrics Sciences, University of Washington, Seattle, USA
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12
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Ma Y, Ren J, Zheng Y, Cai D, Li S, Li Y. Chinese parents' willingness to vaccinate their children against COVID-19: A systematic review and meta-analysis. Front Public Health 2022; 10:1087295. [PMID: 36590001 PMCID: PMC9798204 DOI: 10.3389/fpubh.2022.1087295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 11/29/2022] [Indexed: 12/23/2022] Open
Abstract
Introduction To evaluate Chinese parents' willingness to vaccinate their children against COVID-19, identify its predictors, and provide a reference for raising the COVID-19 vaccination rate for children. Method PubMed, Cochrane Library, Embase, and the databases in Chinese, including CNKI, WanFang, VIP, CBM, were searched from December 2019 to June 2022, and citation tracking was used to identify relevant studies. To calculate the rate with 95% confidence intervals (CI), a random-effects model was used. To explore sources of heterogeneity, sensitivity analysis and subgroup analysis were conducted. This analysis was registered on PROSPERO (CRD42022346866) and reported in compliance with the PRISMA guidelines. Result Overall, 80 studies were screened, and 13 studies with 47994 parents were included after removing duplicates and excluding 19 studies that did not meet the selection criteria by title, abstract and full-text screening. The pooled willingness rate of Chinese parents to vaccinate their children against COVID-19 was 70.0% (95% CI: 62.0~78.0%). Level of education, perceived susceptibility of children infected with COVID-19, and parental attitudes toward vaccination (such as perceived efficacy and safety of the COVID-19 vaccines, parental willingness to vaccinate themselves, parental vaccination hesitancy, and the history of children's vaccination against influenza) were the main predictors of parents' intention to vaccinate their children. Discussion Chinese parents' willingness to vaccinate their children against COVID-19 is moderate, and factors including parental education level, perceived susceptibility of children infected with COVID-19, and parental attitudes toward vaccination affect this decision. Fully identifying these factors and their mechanism will be essential to further raise the willingness rate. Systematic review registration https://www.crd.york.ac.uk/PROSPERO/, identifier: CRD42022346866.
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Affiliation(s)
- Yundi Ma
- Department of General Practice, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Jingjing Ren
- Department of General Practice, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
- *Correspondence: Jingjing Ren
| | - Yang Zheng
- Department of General Practice, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Dongping Cai
- The Healthcare Center for Shishan Street Community of Suzhou New District, Suzhou, Jiangsu, China
| | - Shuai Li
- Department of General Practice, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Yangni Li
- Department of General Practice, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
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