Knowledge, attitudes, beliefs and barriers of healthcare professionals and adults ≥ 65 years about vaccine-preventable diseases in Spain: the ADult Vaccination drIverS and barriErs (ADVISE) study

Attitudes and practices to adult vaccination among physicians before and after COVID-19 pandemic in the United Arab Emirates

Introduction

Vaccination remains underutilised worldwide with low vaccine uptake rates across the board with many adults remaining unprotected. Across the Arab world, attitudes towards vaccines vary but high rates of vaccine hesitancy have been found. This study aims to explore the adult vaccination attitudes and practices by physicians in the UAE, both before and after the introduction of the COVID-19 vaccines.

Methodology

This cross-sectional, descriptive study used convenience and snowball sampling to collect comprehensive data from UAE physicians. A self-administered questionnaire was distributed in two stages: the first (pre-COVID-19 vaccines) between the months of June and October 2020 and the second between the months of November 2022 and March 2023.

Results

1000 responses, 500 from each time period, were collected. Nearly a third were family physicians or internists with more than 70% of the physicians working in governmental hospitals. 95% agreed that vaccines are safe in both cohorts but 74.4% reported not having enough time to advise about vaccines. 80.8% of physicians in the 2022 cohort reported safety concerns as the most common reason for patients to refuse vaccines. The most recommended vaccines were influenza (68.6%), Hepatitis B (66.0%) and HPV (61.4%), with pneumococcal coming in close at 57.8%. Family medicine physicians showed the highest utilisation of preventive practices across both cohorts. Nearly half of all family medicine physicians did not regularly evaluate both the influenza and general immunisation status of their patients. 54.6% of physicians reported having patients with VPDs in the last five years (not including COVID-19) in 2022.

Conclusion

Physicians have overly positive attitudes, but their practices reflect a more superficial appreciation of vaccines and lack of initiative. Physicians need to adopt a pro-vaccine stance, armed with the proper tools and the right mentality and beliefs.

Vaccine attitudes and acceptance among older adults in North Dakota: Understanding demographic characteristic variability

OBJECTIVES

Older adults face increased risks from infectious diseases which are often preventable with vaccines. The current study examines demographic variation in vaccine hesitancy among older adults in North Dakota.

METHODS

A mailed survey assessing age, gender, years of education, self-rated health, rurality, and political leaning as well as vaccine attitudes and vaccine acceptance was conducted with 739 older adults (65+), oversampled from rural counties.

RESULTS

Vaccine hesitant attitudes were significantly higher among rural and politically-conservative older adults; whereas, vaccine acceptance was significantly higher among older, healthier, and politically-liberal older adults. Vaccine attitudes were significantly associated with vaccine acceptance and mediated the association between political leaning and vaccine acceptance.

DISCUSSION

These findings highlight the demographic characteristics predictive of older adults' vaccine attitudes and acceptance. By better understanding the nuanced factors leading to hesitation to be vaccinated, practitioners can develop strategies to increase vaccination rates among this at-risk population.

Impact of COVID-19 Outbreak on Influenza and Pneumococcal Vaccination Uptake: A Multi-Center Retrospective Study

During the coronavirus disease 2019 (COVID-19) pandemic, global vaccination efforts declined due to the burden on health systems and community resistance to epidemic control measures. Influenza and pneumococcal vaccines have been recommended for vulnerable populations to prevent severe pneumonia. We investigated community response towards influenza and pneumococcal vaccines (pneumococcal conjugate vaccine and pneumococcal polysaccharide vaccine) after the COVID-19 outbreak in Taiwan. We retrospectively included adults who visited Chang Gung Memorial Hospital (CGMH) institutions for influenza or pneumococcal vaccination from January 2018 to December 2021. The first case of COVID-19 in Taiwan was detected in January 2020; therefore, in this study, hospitalized cases from January 2018 to December 2019 were defined as "before COVID-19 outbreak," and hospitalized cases from January 2020 to December 2021 were defined as "after COVID-19 outbreak". A total of 105,386 adults were enrolled in the study. An increase in influenza vaccination (n = 33,139 vs. n = 62,634) and pneumococcal vaccination (n = 3035 vs. n = 4260) were observed after the COVID-19 outbreak. In addition, there was an increased willingness to receive both influenza and pneumococcal vaccinations among women, adults without underlying disease and younger adults. The COVID-19 pandemic may have increased awareness of the importance of vaccination in Taiwan.

An organizational assessment of 101 Community-Based Adult Services centers to identify and address gaps in influenza vaccination among Medicare-Medicaid beneficiaries

INTRODUCTION

Medicare-Medicaid beneficiaries are at high risk of experiencing severe disease from influenza. Yet, immunization assessment followed by influenza vaccination (when needed) are not regularly performed at Community-Based Adult Services (CBAS) centers in/near medically underserved areas. To better understand this challenge, an organizational assessment was conducted in early 2020 to identify and examine modifiable factors that may impede or facilitate immunization assessment and influenza vaccination at CBAS centers in Los Angeles County (LAC), California.

METHODS

All 158 CBAS centers in LAC were asked to complete a 17-question survey. The survey asked about immunization assessment, gaps in communication with primary care providers, knowledge and use of the California Immunization Registry (CAIR), and institutional policies for influenza vaccination. In addition, the survey asked each center about its vaccination policy for staff and clients, including whether or not increasing vaccinations was an interest/priority for the center. Best subsets algorithms (regression models) were performed to identify factors that may influence CBAS centers' practices on immunization assessment and vaccination.

RESULTS

Of the 158 centers, 101 (66 %) completed the survey. A majority did not conduct immunization assessments for influenza (n = 59; 58 %); nearly-two-thirds (n = 70; 71 %) reported it would be feasible to do so if the practice is integrated as part of the individualized/nursing plan of care. Best subsets algorithms showed the strongest factors influencing whether CBAS centers assess for influenza vaccination were: center size, staff training on CAIR, presence of barriers to vaccination, and the belief that it is the center's responsibility to conduct immunization assessments and vaccinations.

CONCLUSIONS

Findings suggest that practice gaps in immunization assessment and influenza vaccination are common at LAC's CBAS centers. Closing these gaps may help LAC (and California) improve influenza vaccine uptake and other vaccinations (e.g., pneumococcal, COVID-19) among the most vulnerable of the state's aging populations, Medicare-Medicaid beneficiaries.

Vaccine Uptake to Prevent Meningitis and Encephalitis in Shanghai, China

Multiple vaccines may prevent meningitis and encephalitis (M/E). In China, the meningococcal vaccine and Japanese encephalitis vaccine (JEV) have been included in the expanded program of immunization (EPI). The pneumococcal vaccine, Haemophilus influenzae type b (Hib) vaccine, rotavirus vaccine, and enterovirus 71 (EV-71) vaccine are non-EPI vaccines and are self-paid. We aim to investigate the uptake of these M/E vaccines in children and the related knowledge and health beliefs among family caregivers. A total of 1011 family caregivers with children aged 1-6 years in Shanghai, China were included in the study. The uptake of the pneumococcal vaccine, Hib-containing vaccine, rotavirus vaccine, and EV-71 vaccine remained at 44.0-48.1% in children, compared with the higher uptake of the meningococcal vaccine (88.8%) and JEV (87.1%). Moreover, family caregivers had limited knowledge on the M/E pathogens and possible vaccines. Their health beliefs were moderate to high. Then, a health belief model (HBM) and a structural equation model were established. The uptake of four non-EPI vaccines was significantly influenced by family income (β = 0.159), knowledge (β = 0.354), self-efficacy (β = 0.584), and perceived susceptibility (β = 0.212) within an HBM. Therefore, it warrants further improving the uptake rate for these non-EPI vaccines to prevent potential M/E in children. A specific health promotion may empower the caregivers' decision-making on childhood vaccination.

Factors Associated with Willingness to Receive a COVID-19 Vaccine in Adult Polish Population-A Cross-Sectional Survey

Vaccinations are proven to be the most efficient in preventing COVID-19 disease. Nonetheless, some people are skeptical and hesitant. The study aimed to determine factors associated with willingness to receive a COVID-19 vaccine in the Polish adult population. An online survey consisting of questions regarding (1) demographic information and (2) health issues (the status of vaccination, comorbidities, receiving the flu vaccine and usage of health monitoring apps) was distributed between 13 January and 14 February 2022. Of the 7018 participants who met the study conditions, 76.89% (n = 5396) were females, 22.44% (n = 1575) were males and 0.67% (n = 47) did not specify gender. The median age was 31 years. Among them, 81.82% (n = 5742) were vaccinated and 18.18% (n = 1276) were not. 46.87% (n = 3289) had no chronic co-morbidities. Factors associated with lower odds to receive the vaccine were: being men (p = 0.02; OR = 0.83), having lower education status (p = 0.001, OR = 0.56−0.77), living in a smaller residence area (p < 0.001, OR = 0.47−0.73.), not receiving flu vaccination (p < 0.001, OR = 24.51) and not using health monitoring applications (p < 0.001, OR = 1.56). Health education and communication strategies are needed to achieve large-scale vaccine acceptability and finally herd immunity.