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Srivastav A, Lu PJ, Amaya A, Dever JA, Stanley M, Franks JL, Scanlon PJ, Fisher AM, Greby SM, Nguyen KH, Black CL. Prevalence of influenza-specific vaccination hesitancy among adults in the United States, 2018. Vaccine 2023; 41:2572-2581. [PMID: 36907734 PMCID: PMC10941755 DOI: 10.1016/j.vaccine.2023.03.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 01/17/2023] [Accepted: 03/05/2023] [Indexed: 03/12/2023]
Abstract
BACKGROUND The role of vaccine hesitancy on influenza vaccination is not clearly understood. Low influenza vaccination coverage in U.S. adults suggests that a multitude of factors may be responsible for under-vaccination or non-vaccination including vaccine hesitancy. Understanding the role of influenza vaccination hesitancy is important for targeted messaging and intervention to increase influenza vaccine confidence and uptake. The objective of this study was to quantify the prevalence of adult influenza vaccination hesitancy (IVH) and examine association of IVH beliefs with sociodemographic factors and early-season influenza vaccination. METHODS A four-question validated IVH module was included in the 2018 National Internet Flu Survey. Weighted proportions and multivariable logistic regression models were used to identify correlates of IVH beliefs. RESULTS Overall, 36.9% of adults were hesitant to receive an influenza vaccination; 18.6% expressed concerns about vaccination side effects; 14.8% personally knew someone with serious side effects; and 35.6% reported that their healthcare provider was not the most trusted source of information about influenza vaccinations. Influenza vaccination ranged from 15.3 to 45.2 percentage points lower among adults self-reporting any of the four IVH beliefs. Being female, age 18-49 years, non-Hispanic Black, having high school or lower education, being employed, and not having primary care medical home were associated with hesitancy. CONCLUSIONS Among the four IVH beliefs studied, being hesitant to receiving influenza vaccination followed by mistrust of healthcare providers were identified as the most influential hesitancy beliefs. Two in five adults in the United States were hesitant to receive an influenza vaccination, and hesitancy was negatively associated with vaccination. This information may assist with targeted interventions, personalized to the individual, to reduce hesitancy and thus improve influenza vaccination acceptance.
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Affiliation(s)
- Anup Srivastav
- Leidos Incorporated, Atlanta, GA, USA; Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Peng-Jun Lu
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | | | - Jill A Dever
- RTI International, District of Columbia, WA, USA.
| | | | | | - Paul J Scanlon
- Division of Research and Methodology, National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD, USA.
| | - Allison M Fisher
- Office of Health Communications, Office of the Director, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Stacie M Greby
- Division of Global HIV and TB, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Kimberly H Nguyen
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Carla L Black
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA.
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Meghani M, Razzaghi H, Kahn KE, Hung MC, Srivastav A, Lu PJ, Ellington S, Zhou F, Weintraub E, Black CL, Singleton JA. Surveillance Systems for Monitoring Vaccination Coverage with Vaccines Recommended for Pregnant Women, United States. J Womens Health (Larchmt) 2023; 32:260-270. [PMID: 36884385 DOI: 10.1089/jwh.2022.0445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2023] Open
Abstract
Pregnant women* and their infants are at increased risk for serious influenza, pertussis, and COVID-19-related complications, including preterm birth, low-birth weight, and maternal and fetal death. The advisory committee on immunization practices recommends pregnant women receive tetanus-toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccine during pregnancy, and influenza and COVID-19 vaccines before or during pregnancy. Vaccination coverage estimates and factors associated with maternal vaccination are measured by various surveillance systems. The objective of this report is to provide a detailed overview of the following surveillance systems that can be used to assess coverage of vaccines recommended for pregnant women: Internet panel survey, National Health Interview Survey, National Immunization Survey-Adult COVID Module, Behavioral Risk Factor Surveillance System, Pregnancy Risk Assessment Monitoring System, Vaccine Safety Datalink, and MarketScan. Influenza, Tdap, and COVID-19 vaccination coverage estimates vary by data source, and select estimates are presented. Each surveillance system differs in the population of pregnant women, time period, geographic area for which estimates can be obtained, how vaccination status is determined, and data collected regarding vaccine-related knowledge, attitudes, behaviors, and barriers. Thus, multiple systems are useful for a more complete understanding of maternal vaccination. Ongoing surveillance from the various systems to obtain vaccination coverage and information regarding disparities and barriers related to vaccination are needed to guide program and policy improvements.
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Affiliation(s)
- Mehreen Meghani
- CDC Foundation, Atlanta, Georgia, USA.,Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA
| | - Hilda Razzaghi
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, Georgia, USA
| | - Katherine E Kahn
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, Georgia, USA.,Leidos, Inc., Atlanta, Georgia, USA
| | - Mei-Chuan Hung
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, Georgia, USA.,Leidos, Inc., Atlanta, Georgia, USA
| | - Anup Srivastav
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, Georgia, USA.,Leidos, Inc., Atlanta, Georgia, USA
| | - Peng-Jun Lu
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, Georgia, USA
| | - Sascha Ellington
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA
| | - Fangjun Zhou
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, Georgia, USA
| | - Eric Weintraub
- Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infections, CDC, Atlanta, Georgia, USA
| | - Carla L Black
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, Georgia, USA
| | - James A Singleton
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, Georgia, USA
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Singal AG, Masica A, Esselink K, Murphy CC, Dever JA, Reczek A, Bensen M, Mack N, Stutts E, Ridenhour JL, Galt E, Brainerd J, Kopplin N, Yekkaluri S, Rubio C, Anderson S, Jan K, Whitworth N, Wagner J, Allen S, Muthukumar AR, Tiro J. Population-based correlates of COVID-19 infection: An analysis from the DFW COVID-19 prevalence study. PLoS One 2022; 17:e0278335. [PMID: 36454745 PMCID: PMC9714738 DOI: 10.1371/journal.pone.0278335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 11/14/2022] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND COVID-19 has resulted in over 1 million deaths in the U.S. as of June 2022, with continued surges after vaccine availability. Information on related attitudes and behaviors are needed to inform public health strategies. We aimed to estimate the prevalence of COVID-19, risk factors of infection, and related attitudes and behaviors in a racially, ethnically, and socioeconomically diverse urban population. METHODS The DFW COVID-19 Prevalence Study Protocol 1 was conducted from July 2020 to March 2021 on a randomly selected sample of adults aged 18-89 years, living in Dallas or Tarrant Counties, Texas. Participants were asked to complete a 15-minute questionnaire and COVID-19 PCR and antibody testing. COVID-19 prevalence estimates were calculated with survey-weighted data. RESULTS Of 2969 adults who completed the questionnaire (7.4% weighted response), 1772 (53.9% weighted) completed COVID-19 testing. Overall, 11.5% of adults had evidence of COVID-19 infection, with a higher prevalence among Hispanic and non-Hispanic Black persons, essential workers, those in low-income neighborhoods, and those with lower education attainment compared to their counterparts. We observed differences in attitudes and behaviors by race and ethnicity, with non-Hispanic White persons being less likely to believe in the importance of mask wearing, and racial and ethnic minorities more likely to attend social gatherings. CONCLUSION Over 10% of an urban population was infected with COVID-19 early during the pandemic. Differences in attitudes and behaviors likely contribute to sociodemographic disparities in COVID-19 prevalence.
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Affiliation(s)
- Amit G. Singal
- University of Texas Southwestern Medical Center, Dallas, Texas, United States of America
| | - Andrew Masica
- Texas Health Resources, Fort Worth, Texas, United States of America
| | - Kate Esselink
- University of Texas Southwestern Medical Center, Dallas, Texas, United States of America
| | - Caitlin C. Murphy
- University of Texas Southwestern Medical Center, Dallas, Texas, United States of America
| | - Jill A. Dever
- RTI International, Washington, District of Columbia, United States of America
| | - Annika Reczek
- University of Texas Southwestern Medical Center, Dallas, Texas, United States of America
| | - Matthew Bensen
- RTI International Headquarters, Research Triangle Park, North Carolina, United States of America
| | - Nicole Mack
- RTI International Headquarters, Research Triangle Park, North Carolina, United States of America
| | - Ellen Stutts
- RTI International Headquarters, Research Triangle Park, North Carolina, United States of America
| | - Jamie L. Ridenhour
- RTI International Headquarters, Research Triangle Park, North Carolina, United States of America
| | - Evan Galt
- University of Texas Southwestern Medical Center, Dallas, Texas, United States of America
| | - Jordan Brainerd
- University of Texas Southwestern Medical Center, Dallas, Texas, United States of America
| | - Noa Kopplin
- University of Texas Southwestern Medical Center, Dallas, Texas, United States of America
| | - Sruthi Yekkaluri
- University of Texas Southwestern Medical Center, Dallas, Texas, United States of America
| | - Chris Rubio
- University of Texas Southwestern Medical Center, Dallas, Texas, United States of America
| | - Shelby Anderson
- University of Texas Southwestern Medical Center, Dallas, Texas, United States of America
| | - Kathryn Jan
- University of Texas Southwestern Medical Center, Dallas, Texas, United States of America
| | | | | | - Stephen Allen
- Texas Health Resources, Fort Worth, Texas, United States of America
| | - Alagar R. Muthukumar
- University of Texas Southwestern Medical Center, Dallas, Texas, United States of America
| | - Jasmin Tiro
- University of Texas Southwestern Medical Center, Dallas, Texas, United States of America
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