Attitudes of Swiss Health Care Providers Toward Childhood Immunizations

Factors influencing healthcare professionals' confidence in vaccination in Europe: a literature review

Health-care professionals (HCPs) have a fundamental role in vaccination, their own beliefs and attitudes affecting both their uptake and recommendation of vaccines. This literature review (n = 89) summarises evidence on HCPs’ perceptions of the risks and benefits of vaccination, trust, and perceptions of mandatory vaccination in Europe. HCPs across studies believed that vaccination is important to protect themselves and their patients. However, beliefs that some diseases such as influenza are less risky were reported by some HCPs as a reason for not getting vaccinated. Concerns about both short- and long-term side effects were identified among HCPs in most studies, such as those affecting the immune or neurological system. Mistrust toward health authorities and pharmaceutical industry was reported in some studies. The question of mandatory vaccination revealed mixed opinions, with some favoring self-determination and others viewing vaccination as a duty. This review highlights key factors influencing HCPs’ confidence in vaccination in Europe.

Multifactorial influences underpinning a decision on COVID-19 vaccination among healthcare workers: a qualitative analysis

COVID-19 vaccination in healthcare workers (HCW) is essential for improved patient safety and resilience of health systems. Despite growing body of literature on the perceptions of COVID vaccines in HCWs, existing studies tend to focus on reasons for 'refusing' the vaccines, using surveys almost exclusively. To gain a more nuanced understanding, we explored multifactorial influences underpinning a decision on vaccination and suggestions for decision support to improve vaccine uptake among HCWs in the early phase of vaccination rollout. Semi-structured interviews were undertaken with thirty-three HCWs in Singapore. Transcribed data was thematically analyzed. Decisions to accept vaccines were underpinned by a desire to protect patients primarily driven by a sense of professional integrity, collective responsibility to protect others, confidence in health authorities and a desire to return to a pre-pandemic way of life. However, there were prevailing concerns with respect to the vaccines, including long-term benefits, safety and efficacy, that hampered a decision. Inadequate information and social media representation of vaccination appeared to add to negative beliefs, impeding a decision to accept while low perceived susceptibility played a moderate role in the decision to delay or decline vaccination. Participants made valuable suggestions to bolster vaccination. Our findings support an approach to improving vaccine uptake in HCWs that features routine tracking and transparent updates on vaccination status, use of institutional platforms for sharing of experience, assuring contingency management plans and tailored communications to emphasize the duty of care and positive outlook associated with vaccination.

Childhood vaccinations: knowledge, attitudes and practices of paediatricians and factors associated with their confidence in addressing parental concerns, Italy, 2016

Background

Paediatrician recommendations are known to influence parental vaccine decisions.

Aim

Our aim was to examine vaccination knowledge, attitudes and practices among paediatricians in Italy and identify factors associated with their confidence in addressing parental questions.

Methods

An electronic questionnaire survey was conducted from February to March 2016, among a sample of Italian paediatricians.

Results

The survey was completed by 903 paediatricians (mean age: 56 years). Of 885 who responded to the specific question, 843 (95.3%) were completely favourable to vaccinations. Sixty-six per cent (570/862) felt sufficiently knowledgeable about vaccinations and vaccine-preventable diseases to confidently discuss them with parents. Paediatricians who were male, who were 55 years or older, who had participated in training courses in the last 5 years, who reported that taking courses and reading the scientific literature had contributed to their knowledge, or who had implemented vaccination promotion activities, felt more knowledgeable than other paediatricians. When asked to rate their level of agreement with statements about vaccine safety and effectiveness, only 8.9% (80/903) responded fully as expected. One third (294/878) did not systematically verify that their patients are up to date with the immunisation schedule. Only 5.4% (48/892) correctly identified all true and false contraindications.

Conclusions

The majority of paediatricians in Italy are favourable to vaccination but gaps were identified between their overall positive attitudes and their knowledge, beliefs and practices. Targeted interventions are needed aimed at increasing paediatricians’ confidence in addressing parents’ concerns, strengthening trust towards health authorities and improving systems barriers.

Policy and socio-cultural differences between cantons in Switzerland with high and low adolescent vaccination coverage for hepatitis B and HPV

Vaccination recommendations in Switzerland are national, but vaccine coverage varies greatly from one canton to another, particularly for vaccinations recommended in adolescence. To explain these differences, we studied vaccination practices and socio-cultural views from the vantage points of policy makers, healthcare providers and community adolescents and parents in 4 cantons with low (LVC) and 4 cantons with high (HVC) vaccination coverage for hepatitis B (HBV) and human papillomavirus (HPV) vaccines. In-depth semi-structured interviews were administered to a policy maker, a private practitioner and 4 to 7 community members (adolescents and parents of adolescents) from each of the 8 cantons. LVCs were notable for less government involvement in vaccination issues, more autonomy of municipalities for school health, lower density of pediatricians, less information about these vaccines, greater emphasis on individual rather than government responsibility for vaccinations and for anticipated community hesitancy. Doctors in HVCs more actively advocated for vaccines. Community views in HVCs were more collectivistic and reliant on schools as a source of information than in LVCs. In both groups, hesitancy and concerns about efficacy were greater for HPV than for HBV vaccine. Findings suggest more systematic involvement of health and school authorities will be appreciated by adolescents and their parents, and will improve vaccination coverage. Interventions focused only on community awareness and hesitancy are likely to be inadequate without efforts to reach policy makers and doctors.