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Gagneur A, Gutnick D, Berthiaume P, Diana A, Rollnick S, Saha P. From vaccine hesitancy to vaccine motivation: A motivational interviewing based approach to vaccine counselling. Hum Vaccin Immunother 2024; 20:2391625. [PMID: 39187772 DOI: 10.1080/21645515.2024.2391625] [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: 05/07/2024] [Revised: 07/30/2024] [Accepted: 08/09/2024] [Indexed: 08/28/2024] Open
Abstract
The COVID-19 pandemic highlighted Vaccine Hesitancy (VH) as an accelerating global phenomenon that must be addressed. According to the WHO, thirty to fifty percent of the world's population are VH. Motivational Interviewing (MI) is an evidence-based communication style demonstrated to significantly reduce VH. MI guides people toward change through the expression of empathy and by respecting an individual's autonomy. Healthcare providers (HCPs) are the primary implementors of vaccine policies and the most trusted advisors and influencers of vaccination intention at the individual patient level. Training HCPs in MI is one of the most effective strategies to overcome VH. Many countries are currently implementing HCP training programs and population-based MI interventions to improve vaccine uptake. MI conversations are 'the heart' of vaccine decision-making processes. Understanding individual patient-level drivers of hesitancy allows clinicians to efficiently provide tailored, accurate information that reinforces a person's own motivation and confidence in their own decision. This paper describes a 4-step practical framework designed to support HCPs in their dialogue with vaccine-hesitant patients. (1) Engaging to establish a trustful relationship and safety to freely express opinions, beliefs, and knowledge gaps; (2) Understanding what matters most to the individual; (3) Offering Information to co-build accurate knowledge in order to guide the individual toward vaccine intention (4) Clarifying and Accepting to validate an individual's decision-making autonomy. We believe that our pragmatic approach can contribute to greater acceptability of COVID-19 and other vaccines, and enable rapid deployment of practical MI skills across care systems.
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Affiliation(s)
- Arnaud Gagneur
- Department of Pediatrics, Université de Sherbrooke, Quebec, Canada
- Centre de recherche du Centre hospitalier universitaire de Sherbrooke, Quebec, Canada
| | - Damara Gutnick
- Department of Epidemiology & Population Health, The Albert Einstein College of Medicine, Bronx, NY, USA
| | | | - Alessandro Diana
- IUMFE - Institute of Primary care Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Paediatric Center, Grangettes Hirslanden Clinic, Geneva, Switzerland
| | | | - Prantik Saha
- Vagelos College of Physicians & Surgeons, Columbia University Irving Medical Center, New York, NY, USA
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Jiang M, Yan X, Jiang W, Ma H, Zhou S, Ying X. From both sides of the needle: Understanding effective interventions for facilitating non-national immunization program vaccine decision making in China. Hum Vaccin Immunother 2024; 20:2389578. [PMID: 39171499 PMCID: PMC11346547 DOI: 10.1080/21645515.2024.2389578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2024] [Revised: 07/17/2024] [Accepted: 08/04/2024] [Indexed: 08/23/2024] Open
Abstract
Vaccination decisions are influenced by various psychological and practical factors. In China, non-National Immunization Program (non-NIP) vaccines, which are voluntary and self-paid, add uncertainty and autonomy to the decision-making process. Effective communication between providers and recipients is crucial but understudied. This study aims to integrate their perspectives, identify strategies for facilitating vaccination decisions, and analyze their mechanisms. From July to December 2023, semi-structured interviews were conducted with 17 caregivers and 12 vaccination providers across five Chinese provinces. Participants shared their experiences and decision-making processes regarding non-NIP vaccines. The Behaviour Change Wheel framework guided the analysis, utilizing iterative coding and directed content analysis. Thirteen Behavior Change Techniques were identified, with feedback, monitoring, and environmental restructuring being the most common. Key intervention functions included Persuasion, Education, and Training. We further mapped how these interventions influence non-NIP vaccine decisions. Capability was enhanced through education and effective communication, providing necessary knowledge and skills. Opportunity was increased via infrastructural improvements and societal support, making vaccines more accessible and endorsed by the community. Motivation was driven by clear communication of vaccination benefits and risks, reinforced by societal norms through public health messaging. By understanding the mechanisms influencing vaccination behaviors and interacting with stakeholders, tailored strategies can be developed. Healthcare providers can enhance service accessibility and offer evidence-based guidance with reminders, monitoring, and incentives to ensure compliance. For recipients, reliable information, sustained engagement, timely communication, and motivational opportunities are essential. A multi-dimensional approach involving multiple stakeholders is crucial for promoting non-NIP vaccine uptake.
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Affiliation(s)
- Mingzhu Jiang
- School of Public Health, Fudan University, Shanghai, China
| | - Xuanxuan Yan
- School of Public Health, Fudan University, Shanghai, China
| | - Weixi Jiang
- School of Public Health, Fudan University, Shanghai, China
| | - Haifeng Ma
- School of Public Health, Fudan University, Shanghai, China
| | - Sijuan Zhou
- School of Public Health, Fudan University, Shanghai, China
| | - Xiaohua Ying
- School of Public Health, Fudan University, Shanghai, China
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3
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Brohman I, Blank G, Mitchell H, Dubé E, Bettinger JA. Opportunities for HPV vaccine education in school-based immunization programs in British Columbia, Canada: A qualitative study. Hum Vaccin Immunother 2024; 20:2326779. [PMID: 38517252 PMCID: PMC10962613 DOI: 10.1080/21645515.2024.2326779] [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: 10/10/2023] [Accepted: 03/01/2024] [Indexed: 03/23/2024] Open
Abstract
Despite the availability of school-based immunization programs (SBIPs) in Canada, human papillomavirus (HPV) vaccine uptake remains suboptimal. Vaccine education may improve vaccine uptake among adolescents. The objective of this qualitative study was to identify opportunities for HPV vaccine education in British Columbia, Canada, by exploring the perspectives of students, parents, school staff, and public health nurses on the current SBIP. Individual semi-structured interviews were conducted with adult participants and focus groups were conducted with grade 6 students between November 2019 and May 2020. The interviews and focus groups were transcribed and then analyzed using reflexive thematic analysis. Opportunities for HPV vaccine education were identified in three themes: 1) making SBIPs student-centered; 2) adopting a collaborative and interdisciplinary approach to vaccine education; and 3) actualizing parent education opportunities. Broad support existed for a formal, collaborative HPV grade 6 vaccine curriculum delivered by teachers and public health nurses to provide evidence-based health information. Participants voiced that the curriculum should integrate students' perspectives on topics of interest and address needle associated pain and anxiety. Parents were identified as the primary vaccine decisionmakers, therefore, participants stated it was crucial to also provide parent-directed vaccine education as part of SBIP. Our findings support the development of a collaborative HPV vaccine curriculum directed to and informed by students and parents to buttress current SBIPs in British Columbia.
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Affiliation(s)
- Isabella Brohman
- Vaccine Evaluation Center, BC Children’s Hospital Research Institute, University of British Columbia, Vancouver, BC, Canada
- Faculty of Medicine, School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - Gabriel Blank
- Vaccine Evaluation Center, BC Children’s Hospital Research Institute, University of British Columbia, Vancouver, BC, Canada
- Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada
| | - Hana Mitchell
- Vaccine Evaluation Center, BC Children’s Hospital Research Institute, University of British Columbia, Vancouver, BC, Canada
- Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada
| | - Eve Dubé
- Department of Anthropology, Laval University, Laval, QC, Canada
| | - Julie A. Bettinger
- Vaccine Evaluation Center, BC Children’s Hospital Research Institute, University of British Columbia, Vancouver, BC, Canada
- Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada
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Dube E, Trottier ME, Greyson D, MacDonald NE, Meyer SB, MacDonald SE, Driedger SM, Witteman HO, Ouakki M, Gagnon D. Use of narratives to enhance childhood vaccine acceptance: Results of an online experiment among Canadian parents. Hum Vaccin Immunother 2024; 20:2379093. [PMID: 39044701 PMCID: PMC11271131 DOI: 10.1080/21645515.2024.2379093] [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: 05/01/2024] [Revised: 06/18/2024] [Accepted: 07/09/2024] [Indexed: 07/25/2024] Open
Abstract
Identifying effective interventions to promote children's vaccination acceptance is crucial for the health and wellbeing of communities. Many interventions can be implemented to increase parental awareness of the benefits of vaccination and positively influence their confidence in vaccines and vaccination services. One potential approach is using narratives as an intervention. This study aims to evaluate the effects of a narrative-based intervention on parents' attitudes and vaccination intentions. In a pre-post experiment, 2,000 parents of young children recruited from an online pan-Canadian panel were randomly exposed to one of the three videos presenting narratives to promote childhood vaccination or a control condition video about the importance and benefits of physical activity in children. Pre-post measures reveal a relatively modest but positive impact of the narratives on parents' attitudes and intention to vaccinate their child(ren). The results also suggest that narratives with more emotional content may be more effective in positively influencing vaccine attitudes than the more factual narrative. Using narratives to promote vaccination can positively influence parents' views and intentions toward childhood vaccines, but research is still required to identify the best components of such interventions.
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Affiliation(s)
- Eve Dube
- Department of Anthropology, Laval University, Quebec, Quebec, Canada
| | - Marie-Eve Trottier
- Department of Biohazard, Quebec National Institute of Public Health, Quebec, Quebec, Canada
| | - Devon Greyson
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Noni E. MacDonald
- Department of Pediatrics, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Samantha B. Meyer
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - Shannon E. MacDonald
- Faculty of Nursing, University, University of Alberta, Edmonton, Alberta, Canada
| | - S. Michelle Driedger
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Holly O. Witteman
- Department of Family Medicine, Laval University, Quebec, Quebec, Canada
| | - Manale Ouakki
- Department of Biohazard, Quebec National Institute of Public Health, Quebec, Quebec, Canada
| | - Dominique Gagnon
- Department of Biohazard, Quebec National Institute of Public Health, Quebec, Quebec, Canada
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Camargo ELS, de Sousa ÁFL, dos Reis AS, Fortunato MDR, Gouveia IDS, Mendes IAC, Ventura CAA. Determining factors for COVID-19 vaccine hesitancy among Brazilians: a study using structural equation modeling. Rev Bras Enferm 2024; 77Suppl 2:e20240112. [PMID: 39230099 PMCID: PMC11370770 DOI: 10.1590/0034-7167-2024-0112] [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: 03/22/2024] [Accepted: 04/18/2024] [Indexed: 09/05/2024] Open
Abstract
OBJECTIVES to investigate the factors influencing vaccine hesitancy against COVID-19 among Brazilians. METHODS this research employed an observational and analytical approach, utilizing a web-based survey. Data collection took place in 2020, and data analysis was conducted using structural equation modeling. RESULTS the prevalence of vaccine hesitancy was found to be 27.5% (1182 individuals). There is a negative correlation between belief in conspiracy theories and social influence. Among the various beliefs associated with vaccination intentions, only conspiracy beliefs exhibited significant predictive value. Thus, the findings suggest that personal beliefs significantly impact hesitancy towards vaccination, and also indicate that trust in governmental bodies is inversely related to hesitancy. CONCLUSIONS vaccine hesitancy emerges as a multifaceted phenomenon influenced by a complex array of factors, including personal beliefs, trust in governmental bodies, and healthcare systems.
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Affiliation(s)
| | - Álvaro Francisco Lopes de Sousa
- Instituto Sírio-Libanês de Ensino e Pesquisa. São Paulo, São Paulo, Brazil
- University Lisbon, Public Health Research Center, Comprehensive Health Research Center. Cidade Universitária, Alameda da Universidade Lisbon, Potugal
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Anderson S, Kuter BJ, Brien K, Bauerle Bass S, Gutierrez L, Winters S, Whitfield C, Moser CA, Faig W. Perceptions of vaccine requirements among students at four Pennsylvania universities. Vaccine 2024:S0264-410X(24)00801-6. [PMID: 39025697 DOI: 10.1016/j.vaccine.2024.07.039] [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: 04/17/2024] [Revised: 07/08/2024] [Accepted: 07/11/2024] [Indexed: 07/20/2024]
Abstract
BACKGROUND University students have a unique perspective on vaccination because of their recent or perhaps newly acquired autonomy and ability to make health-related decisions. The development of the COVID-19 vaccine in 2020 and its implementation over the past few years was accompanied by much information and communication about vaccination requirements and safety, which may have affected students' perspectives on vaccination and vaccine requirements more broadly. This analysis describes current vaccine policies at several universities and evaluates student respondents' perceptions of and agreement with university vaccine requirements. METHODS A 32-question survey was administered to undergraduate, graduate, and professional students attending four Pennsylvania universities in March-May 2023; 2,223 students responded to the survey. The survey included questions about vaccine requirements, agreement with vaccine requirements, and knowledge of selected vaccines. These responses were compared with the actual vaccine requirements and recommendations of the four universities. RESULTS Most respondents agreed with university vaccine requirements, though knowledge of those requirements varied, with many unaware of which were required. University requirement of the COVID-19 vaccine was not associated with being vaccinated for COVID-19. However, while the requirement itself was not related to vaccine uptake, respondents' perception of a requirement was. Respondents were more likely to report COVID-19 vaccination and influenza vaccination if they believed their university required those vaccines. Respondents were more likely to approve of a vaccine requirement if their perception was that their university required that vaccine. CONCLUSIONS Overall, student respondents were supportive of their institution's vaccine requirements, but many lacked information about those requirements. Clear messaging using multiple modes of communication about vaccines and vaccine requirements may improve students' knowledge of vaccines and result in a corresponding increase in vaccine uptake.
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Affiliation(s)
| | - Barbara J Kuter
- Vaccine Education Center, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Kate Brien
- Vaccine Education Center, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | | | | | | | | | - Charlotte A Moser
- Vaccine Education Center, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Walter Faig
- Research Institute, Children's Hospital of Philadelphia, Philadelphia, PA, USA
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Weitzman ER, Pierce SE, Blakemore LM, Murdock A, Angelidou A, Dowling DJ, Levy O, Levy S. Need for strategic communications and stakeholder engagement to advance acceptability of an overdose preventing vaccine targeting fentanyl. Vaccine 2024:S0264-410X(24)00722-9. [PMID: 38991914 DOI: 10.1016/j.vaccine.2024.06.049] [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: 03/11/2024] [Revised: 05/23/2024] [Accepted: 06/12/2024] [Indexed: 07/13/2024]
Abstract
BACKGROUND Fentanyl is a synthetic opioid, exposure to which has led to hundreds of thousands of overdose deaths. Novel vaccines are being developed that might protect against fentanyl overdose. Proactive attention to strategic communications and stakeholder engagement may smooth uptake of a novel vaccine given known challenges around vaccine hesitancy and concern for stigma related to substance use. METHODS Qualitative interviews (N = 74) with a purposive sample of adolescents/young adults with opioid use disorder (OUD), family members of persons with OUD, experts in substance use treatment and harm reduction, and community members were conducted and thematically analyzed to discern attitudes toward a fentanyl vaccine, and directions for communications and engagement. RESULTS Major themes reflected personal concerns for biomedical risk and system-level concerns for alignment and integration of an overdose preventing vaccine with prevailing beliefs about addiction and associated frameworks and philosophies for treatment and response. CONCLUSION Acceptability and implementation of a novel fentanyl vaccine targeting overdose will need precision communications that address biomedical, moral/spiritual, and structural perspectives about the nature of addiction. Education about the purpose and limits of a fentanyl vaccine, partnerships with diverse stakeholders from throughout the opioid response ecosystem and interweaving of a vaccine strategy into comprehensive prevention and treatment are recommended.
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Affiliation(s)
- Elissa R Weitzman
- Division of Addiction Medicine, Boston Children's Hospital, 300 Longwood Ave, Boston, MA 02115, United States; Department of Pediatrics, Harvard Medical School, 25 Shattuck St, Boston, MA 02115, United States.
| | - Sydney E Pierce
- Division of Addiction Medicine, Boston Children's Hospital, 300 Longwood Ave, Boston, MA 02115, United States.
| | - Laura M Blakemore
- Division of Addiction Medicine, Boston Children's Hospital, 300 Longwood Ave, Boston, MA 02115, United States.
| | - Andrew Murdock
- Division of Addiction Medicine, Boston Children's Hospital, 300 Longwood Ave, Boston, MA 02115, United States.
| | - Asimenia Angelidou
- Department of Pediatrics, Harvard Medical School, 25 Shattuck St, Boston, MA 02115, United States; Precision Vaccines Program, Department of Pediatrics, Boston Children's Hospital, 300 Longwood Ave, Boston, MA 02115, United States; Department of Neonatology, Beth Israel Deaconess Medical Center, 330 Brookline Ave, Boston, MA 02215, United States.
| | - David J Dowling
- Department of Pediatrics, Harvard Medical School, 25 Shattuck St, Boston, MA 02115, United States; Precision Vaccines Program, Department of Pediatrics, Boston Children's Hospital, 300 Longwood Ave, Boston, MA 02115, United States.
| | - Ofer Levy
- Department of Pediatrics, Harvard Medical School, 25 Shattuck St, Boston, MA 02115, United States; Precision Vaccines Program, Department of Pediatrics, Boston Children's Hospital, 300 Longwood Ave, Boston, MA 02115, United States; Broad Institute of MIT & Harvard, 415 Main St, Cambridge, MA 02142, United States.
| | - Sharon Levy
- Division of Addiction Medicine, Boston Children's Hospital, 300 Longwood Ave, Boston, MA 02115, United States; Department of Pediatrics, Harvard Medical School, 25 Shattuck St, Boston, MA 02115, United States.
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Murali A, Sojati J, Levochkina M, Pressimone C, Griffith K, Fan E, Dakroub A. A Cross-Sectional Analysis of Community Perceptions of Flu and COVID-19 Vaccines at Turtle Creek Primary Care Center. COMMUNITY HEALTH EQUITY RESEARCH & POLICY 2024; 44:439-451. [PMID: 37837451 DOI: 10.1177/2752535x231205665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/16/2023]
Abstract
BACKGROUND Influenza (flu) and COVID-19 vaccination rates are subpar across the US, especially in racial and/or socioeconomic minority groups who are understudied in public health literature. OBJECTIVE The objective of this mixed-methods study was to elucidate attitudes of patients at the Turtle Creek Primary Care Center, a clinic that cares for ∼70% non-white patients, towards flu and COVID-19 vaccines, with the goal of establishing vaccine education gaps and increasing vaccine uptake in minority communities. DESIGN/PATIENTS This study was conducted as a cross-sectional analysis. Authors completed 123 patient phone surveys of patients cared for at the Turtle Creek clinic inquiring about flu and COVID-19 infection status and vaccination uptake (August 26-October 10, 2021). APPROACH/KEY RESULTS We found that rates of vaccination were subpar in the Turtle Creek community, with only 54% having received the COVID-19 vaccine and only 44% receiving the flu vaccine regularly. There was a strong association between COVID-19 and flu vaccine acceptance and a notable correlation between vaccine acceptance and age. When assessing how vaccine acceptance was influenced by trusted sources of information, those who cited trusting "medical professionals" and "word of mouth" had higher odds of COVID-19 vaccine acceptance but those who cited trusting "social media" had decreased odds of acceptance. Finally, we uncovered 14 common factors for either vaccine acceptance or refusal that clustered into four overarching themes of trust, need, safety, and availability. CONCLUSION These data highlight the necessity of improved vaccine education and reveal targetable populations and approaches for disseminating vaccine information.
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Affiliation(s)
- Anjana Murali
- School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Jorna Sojati
- School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Marina Levochkina
- School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | | | - Kobi Griffith
- School of Pharmacy, University of Pittsburgh, Pittsburgh, PA, USA
| | - Erica Fan
- School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Allie Dakroub
- Department of General Internal Medicine, University of Pittsburgh, Pittsburgh, PA, USA
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Melnikow J, Padovani A, Zhang J, Miller M, Gosdin M, Loureiro S, Daniels B. Patient concerns and physician strategies for addressing COVID-19 vaccine hesitancy. Vaccine 2024; 42:3300-3306. [PMID: 38627148 DOI: 10.1016/j.vaccine.2024.04.025] [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: 08/18/2023] [Revised: 03/19/2024] [Accepted: 04/04/2024] [Indexed: 05/12/2024]
Abstract
OBJECTIVE COVID-19 vaccination is critical for reducing serious illness and hospitalizations, yet many remain hesitant. We conducted a survey of frontline physicians to identify patient concerns and physician strategies to address COVID-19 vaccine-hesitancy. METHODS A national random sample of physicians in frontline specialties selected from a comprehensive list of practicing physicians in the U.S. were emailed a survey in August 2021. Multiple choice and open-ended questions inquired about patient concerns related to the COVID-19 vaccines and strategies used by physicians to counter vaccine misinformation and encourage vaccine-hesitant patients. Weighting was applied to achieve representativeness and reduce non-response bias. Network analysis examined co-occurring patient concerns. Open-ended responses on communication strategies were coded via thematic analysis. Multi-variable logistic regression examined associations between physician and pandemic characteristics with patient concerns and use of communication strategies. RESULTS 531 physicians responded: primary care (241); emergency medicine (142); critical care (84); hospitalists (34); and infectious disease (30). Weighted response balance statistics showed excellent balance between respondents and nonrespondents. On average, physicians reported four patient vaccine concerns. Safety, side effects, vaccine misinformation, and mistrust in government were most common, and often co-occurring. 297 physicians described communication strategies: 180 (61 %) provided vaccine education and 94 (32 %) created a safe space for vaccine discussion. Narrative responses from physicians provided compelling examples of both successes and communication challenges arising from misinformation. Compared with emergency medicine, critical care (OR 2.45, 95 % CI 1.14, 5.24), infectious disease (OR 2.45, 95 % CI 1.00, 6.02), and primary care physicians (OR 1.66, 95 % CI 1.02, 2.70) were more likely to provide communication strategies. CONCLUSIONS Many physicians engage with vaccine hesitant patients using a variety of strategies. Dissemination of effective system and physician-level communication interventions could enhance physician success.
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Affiliation(s)
- Joy Melnikow
- Center for Healthcare Policy and Research, University of California, Davis, CA, USA.
| | | | - Jingwen Zhang
- Department of Communication, University of California, Davis, CA, USA.
| | - Marykate Miller
- Center for Healthcare Policy and Research, University of California, Davis, CA, USA.
| | - Melissa Gosdin
- Center for Healthcare Policy and Research, University of California, Davis, CA, USA.
| | - Sabrina Loureiro
- Center for Global Health, Weill Cornell Medicine, New York, NY, USA.
| | - Brock Daniels
- Department of Emergency Medicine, Weill Cornell Medicine, New York Presbyterian Hospital, New York, NY, USA.
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Bhatt A, Monk V, Bhatti A, Eiden AL, Hermany L, Hansen N, Connolly MP, Baxter L, Vanderslott S, Mitrovich R, Slater R. Identifying factors that can be used to assess a country's readiness to deploy a new vaccine or improve uptake of an underutilised vaccine: a scoping review. BMJ Open 2024; 14:e080370. [PMID: 38719292 PMCID: PMC11086410 DOI: 10.1136/bmjopen-2023-080370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Accepted: 02/28/2024] [Indexed: 05/12/2024] Open
Abstract
OBJECTIVES Identifying whether a country is ready to deploy a new vaccine or improve uptake of an existing vaccine requires knowledge of a diverse range of interdependent, context-specific factors. This scoping review aims to identify common themes that emerge across articles, which include tools or guidance that can be used to establish whether a country is ready to deploy a new vaccine or increase uptake of an underutilised vaccine. DESIGN Scoping review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews guidelines. DATA SOURCES Embase, CINAHL, Cochrane Library, Google Scholar, MEDLINE, PsycINFO and Web of Science were searched for articles published until 9 September 2023. Relevant articles were also identified through expert opinion. ELIGIBILITY CRITERIA Articles published in any year or language that included tools or guidance to identify factors that influence a country's readiness to deploy a new or underutilised vaccine. DATA EXTRACTION AND SYNTHESIS Two independent reviewers screened records and performed data extraction. Findings were synthesised by conducting a thematic analysis. RESULTS 38 articles met our inclusion criteria; these documents were created using methodologies including expert review panels and Delphi surveys and varied in terms of content and context-of-use. 12 common themes were identified relevant to a country's readiness to deploy a new or underutilised vaccine. These themes were as follows: (1) legal, political and professional consensus; (2) sociocultural factors and communication; (3) policy, guidelines and regulations; (4) financing; (5) vaccine characteristics and supply logistics; (6) programme planning; (7) programme monitoring and evaluation; (8) sustainable and integrated healthcare provision; (9) safety surveillance and reporting; (10) disease burden and characteristics; (11) vaccination equity and (12) human resources and training of professionals. CONCLUSIONS This information has the potential to form the basis of a globally applicable evidence-based vaccine readiness assessment tool that can inform policy and immunisation programme decision-makers.
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Affiliation(s)
- Aomesh Bhatt
- Department of Paediatrics, University of Oxford, Oxford, UK
| | - Vaneesha Monk
- Department of Paediatrics, University of Oxford, Oxford, UK
| | | | - Amanda L Eiden
- Center for Observational and Real-World Evidence (CORE), Merck & Co Inc, North Wales, Pennsylvania, USA
| | | | | | | | - Luke Baxter
- Department of Paediatrics, University of Oxford, Oxford, UK
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11
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Aljabali AAA, Obeid MA, El-Tanani M, Mishra V, Mishra Y, Tambuwala MM. Precision epidemiology at the nexus of mathematics and nanotechnology: Unraveling the dance of viral dynamics. Gene 2024; 905:148174. [PMID: 38242374 DOI: 10.1016/j.gene.2024.148174] [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: 11/28/2023] [Revised: 01/10/2024] [Accepted: 01/16/2024] [Indexed: 01/21/2024]
Abstract
The intersection of mathematical modeling, nanotechnology, and epidemiology marks a paradigm shift in our battle against infectious diseases, aligning with the focus of the journal on the regulation, expression, function, and evolution of genes in diverse biological contexts. This exploration navigates the intricate dance of viral transmission dynamics, highlighting mathematical models as dual tools of insight and precision instruments, a theme relevant to the diverse sections of Gene. In the context of virology, ethical considerations loom large, necessitating robust frameworks to protect individual rights, an aspect essential in infectious disease research. Global collaboration emerges as a critical pillar in our response to emerging infectious diseases, fortified by the predictive prowess of mathematical models enriched by nanotechnology. The synergy of interdisciplinary collaboration, training the next generation to bridge mathematical rigor, biology, and epidemiology, promises accelerated discoveries and robust models that account for real-world complexities, fostering innovation and exploration in the field. In this intricate review, mathematical modeling in viral transmission dynamics and epidemiology serves as a guiding beacon, illuminating the path toward precision interventions, global preparedness, and the collective endeavor to safeguard human health, resonating with the aim of advancing knowledge in gene regulation and expression.
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Affiliation(s)
- Alaa A A Aljabali
- Faculty of Pharmacy, Department of Pharmaceutics & Pharmaceutical Technology, Yarmouk University, Irbid 21163, Jordan.
| | - Mohammad A Obeid
- Faculty of Pharmacy, Department of Pharmaceutics & Pharmaceutical Technology, Yarmouk University, Irbid 21163, Jordan
| | - Mohamed El-Tanani
- College of Pharmacy, Ras Al Khaimah Medical and Health Sciences University, Ras Al Khaimah, United Arab Emirates.
| | - Vijay Mishra
- School of Pharmaceutical Sciences, Lovely Professional University, Phagwara, Punjab 144411, India
| | - Yachana Mishra
- School of Bioengineering and Biosciences, Lovely Professional University, Phagwara, Punjab 144411, India
| | - Murtaza M Tambuwala
- Lincoln Medical School, University of Lincoln, Brayford Pool Campus, Lincoln LN6 7TS, United Kingdom.
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Haq ZU, Yunus S, Jafri N. Building confidence in the COVID-19 vaccine in a polio-endemic country: strategic communication lessons from Pakistan. BMJ Glob Health 2024; 9:e015200. [PMID: 38599665 PMCID: PMC11015175 DOI: 10.1136/bmjgh-2024-015200] [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: 01/29/2024] [Accepted: 03/31/2024] [Indexed: 04/12/2024] Open
Abstract
In a health emergency, governments rely on public trust in their policy, and anticipate its compliance to protect health and save lives. Vaccine hesitancy compromises this process when an emergency involves infections. The prevailing discourse on vaccine hesitancy often describes it as a static phenomenon, ignoring its expanse and complexity, and neglecting the exploration of tools to address it. This article diverges from the conventional perspective by explaining the case of Pakistan and its communication strategy for the COVID-19 vaccine. Decades of polio vaccine hesitancy, rooted in the country's fight against terrorism, constitute its history. On the other hand, the first-ever launch of typhoid conjugate vaccine involving 35 million kids during 2019-2021 was a success. Against this backdrop, the country considered vaccine hesitancy as a dynamic phenomenon, interwoven with the social ecology and the responsiveness of the healthcare system. Its communication strategy facilitated those willing to receive the vaccine, while being responsive to the information needs of those still in the decision-making process. In the face of both hesitancy and a scarcity of vaccine doses, the country successfully inoculated nearly 70% (160 million) of its population in just over 1 year. People's perceptions about the COVID-19 vaccine also improved over time. This achievement offers valuable insights and tools for policymakers and strategists focused on the demand side of vaccine programmes. The lessons can significantly contribute to the global discourse on improving vaccine confidence and bolstering global health security.
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Affiliation(s)
| | | | - Naveed Jafri
- Expanded Programme on Immunisation, Pakistan Ministry of National Health Services Regulations and Coordination, Islamabad, Pakistan
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Rafaqat W, Abiad M, Lagazzi E, Argandykov D, Velmahos GC, Hwabejire JO, Parks JJ, Luckhurst CM, Kaafarani HMA, DeWane MP. From admission to vaccination: COVID-19 vaccination patterns and their relationship with hospitalization in trauma patients. Surgery 2024; 175:1212-1216. [PMID: 38114393 DOI: 10.1016/j.surg.2023.11.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 10/27/2023] [Accepted: 11/21/2023] [Indexed: 12/21/2023]
Abstract
BACKGROUND COVID-19 vaccination rates in the hospitalized trauma population are not fully characterized and may lag behind the general population. This study aimed to outline COVID-19 vaccination trends in hospitalized trauma patients and examine how hospitalization influences COVID-19 vaccination rates. METHODS We conducted a retrospective institutional study using our trauma registry paired with the COVID-19 vaccination ENCLAVE registry. We included patients ≥18 years admitted between April 21, 2021 and November 30, 2022. Our primary outcome was the change in vaccination posthospitalization, and secondary analyzed outcomes included temporal trends of vaccination in trauma patients and predictors of non-vaccination. We compared pre and posthospitalization weekly vaccination rates. We performed joinpoint regression to depict temporal trends and multivariate regression for predictors of nonvaccination. RESULTS The rate of administration of the first vaccine dose increased in the week after hospitalization (P = .018); however, this increase was not sustained in the following weeks. The percentage of unvaccinated patients declined faster in the general population in Massachusetts compared to the hospitalized trauma population. By the conclusion of the study, 27.1% of the trauma population was unvaccinated, whereas <5% of the Massachusetts population was unvaccinated. Urban residence, having multiple hospitalizations, and experiencing moderate to severe frailty were associated with vaccination. Conversely, being in the age groups 18 to 45 years and 46 to 64 years, as well as having Medicaid or self-pay insurance, were linked to being unvaccinated. CONCLUSION Hospitalization initially increased the rate of administration of the first vaccine dose in trauma patients, but the effect was not sustained. By the conclusion of the study period, a greater percentage of trauma patients were unvaccinated compared to the general population of Massachusetts. Strategies for sustained health care integration need to be developed to address this ongoing challenge in the high-risk trauma population.
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Affiliation(s)
- Wardah Rafaqat
- Division of Trauma, Emergency General Surgery, and Surgical Critical Care, Massachusetts General Hospital, Cambridge, MA. https://twitter.com/RafaqatWardah
| | - May Abiad
- Division of Trauma, Emergency General Surgery, and Surgical Critical Care, Massachusetts General Hospital, Cambridge, MA. https://twitter.com/AbiadMay
| | - Emanuele Lagazzi
- Division of Trauma, Emergency General Surgery, and Surgical Critical Care, Massachusetts General Hospital, Cambridge, MA
| | - Dias Argandykov
- Division of Trauma, Emergency General Surgery, and Surgical Critical Care, Massachusetts General Hospital, Cambridge, MA. https://twitter.com/argandykov
| | - George C Velmahos
- Division of Trauma, Emergency General Surgery, and Surgical Critical Care, Massachusetts General Hospital, Cambridge, MA
| | - John O Hwabejire
- Division of Trauma, Emergency General Surgery, and Surgical Critical Care, Massachusetts General Hospital, Cambridge, MA
| | - Jonathan J Parks
- Division of Trauma, Emergency General Surgery, and Surgical Critical Care, Massachusetts General Hospital, Cambridge, MA
| | - Casey M Luckhurst
- Division of Trauma, Emergency General Surgery, and Surgical Critical Care, Massachusetts General Hospital, Cambridge, MA
| | - Haytham M A Kaafarani
- Division of Trauma, Emergency General Surgery, and Surgical Critical Care, Massachusetts General Hospital, Cambridge, MA. https://twitter.com/hayfarani
| | - Michael P DeWane
- Division of Trauma, Emergency General Surgery, and Surgical Critical Care, Massachusetts General Hospital, Cambridge, MA.
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14
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Lin SC, Donney JF, Lebrun-Harris LA. Lessons Learned From Adolescent COVID-19 Vaccine Administration in Medically Underserved Communities. Public Health Rep 2024; 139:241-251. [PMID: 38240272 PMCID: PMC10851897 DOI: 10.1177/00333549231218723] [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] [Indexed: 02/09/2024] Open
Abstract
OBJECTIVES In May 2021, the Health Resources and Services Administration Health Center COVID-19 Vaccine Program (HCCVP) began supporting the national adolescent vaccination rollout for a safe return to in-person learning for children and adolescents from medically underserved communities. To understand the initial implementation of adolescent vaccinations, we estimated the number of vaccines administered through the HCCVP at the national and state level to adolescents aged 12-17 years, and we examined challenges and solutions in vaccine deployment. METHODS We analyzed data on vaccine administration, challenges, and solutions from the Health Center COVID-19 Survey during May 14-August 27, 2021, and we analyzed data on patients served from the 2019 Uniform Data System. National adolescent COVID-19 vaccination and population data came from CDC's COVID Data Tracker and the US Census Bureau's 2019 Current Population Survey. RESULTS HCCVP health centers administered >485 000 COVID-19 vaccine doses to adolescents during the study period, with variations across states. Health centers in 13 states and territories (Arizona, California, Colorado, Connecticut, Delaware, Maine, Massachusetts, Missouri, Nebraska, Nevada, Oregon, Virginia, and Puerto Rico) vaccinated more adolescents than their share of prepandemic adolescent patients. The most frequently reported challenges in vaccine administration were vaccine confidence and staffing availability. CONCLUSIONS This assessment of the initial months of COVID-19 vaccine administration among adolescent health center patients suggests rapid response by health centers in several states, reaching beyond their adolescent patient population to support state-level pandemic response. Future research could examine processes to optimize strategic activation of health centers in public health emergency responses.
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Affiliation(s)
- Sue C. Lin
- Office of Quality Improvement, Bureau of Primary Health Care, Health Resources and Services Administration, US Department of Health and Human Services, Rockville, MD, USA
| | - Julie Fife Donney
- Office of Epidemiology and Research, Maternal and Child Health Bureau, Health Resources and Services Administration, US Department of Health and Human Services, Rockville, MD, USA
| | - Lydie A. Lebrun-Harris
- Office of Epidemiology and Research, Maternal and Child Health Bureau, Health Resources and Services Administration, US Department of Health and Human Services, Rockville, MD, USA
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15
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Dooley CE, Saif NT, Hodorowicz MT, Doyle ML, Gucer PW, Edwards LA, Cloeren M. Occupational Health Providers' Perceptions of Employee Vaccine Hesitancy. J Occup Environ Med 2024; 66:e42-e47. [PMID: 37871581 DOI: 10.1097/jom.0000000000003006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2023]
Abstract
OBJECTIVE This study examined the perspectives of occupational health providers (OHPs) on the most frequently encountered clinically relevant reasons for employee vaccine hesitancy. METHODS We conducted an anonymous, online, cross-sectional survey of US OHPs ( N = 217). The survey asked OHPs about the major reasons that employees cite for being unwilling to receive the following three categories of vaccines: COVID-19, annual influenza, and others relevant to the workplace. RESULTS Concern about adverse effects was the most frequently reported reason for employee vaccine hesitancy for each vaccine category. Mistrust was reported more frequently for COVID-19 than for the influenza vaccine or other vaccines (χ 2P < 0.05). Targets of employee mistrust included government and researchers or scientists, but mistrust of healthcare providers was uncommon. CONCLUSIONS These results can be used to inform interventions to address vaccine hesitancy in the occupational health setting.
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Affiliation(s)
- Cara E Dooley
- From the University of Maryland School of Medicine, Baltimore, Maryland (C.D., N.T.S., P.W.G., M.C.); University of Maryland School of Social Work, Baltimore, Maryland (M.T.H.); Johns Hopkins Education and Research Center for Occupational Safety and Health, Baltimore, Maryland (M.L.D.); and University of Maryland School of Nursing, Baltimore, Maryland (L.A.E.)
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16
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Montero DA, Vidal RM, Velasco J, Carreño LJ, Torres JP, Benachi O. MA, Tovar-Rosero YY, Oñate AA, O'Ryan M. Two centuries of vaccination: historical and conceptual approach and future perspectives. Front Public Health 2024; 11:1326154. [PMID: 38264254 PMCID: PMC10803505 DOI: 10.3389/fpubh.2023.1326154] [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: 10/22/2023] [Accepted: 12/13/2023] [Indexed: 01/25/2024] Open
Abstract
Over the past two centuries, vaccines have been critical for the prevention of infectious diseases and are considered milestones in the medical and public health history. The World Health Organization estimates that vaccination currently prevents approximately 3.5-5 million deaths annually, attributed to diseases such as diphtheria, tetanus, pertussis, influenza, and measles. Vaccination has been instrumental in eradicating important pathogens, including the smallpox virus and wild poliovirus types 2 and 3. This narrative review offers a detailed journey through the history and advancements in vaccinology, tailored for healthcare workers. It traces pivotal milestones, beginning with the variolation practices in the early 17th century, the development of the first smallpox vaccine, and the continuous evolution and innovation in vaccine development up to the present day. We also briefly review immunological principles underlying vaccination, as well as the main vaccine types, with a special mention of the recently introduced mRNA vaccine technology. Additionally, we discuss the broad benefits of vaccines, including their role in reducing morbidity and mortality, and in fostering socioeconomic development in communities. Finally, we address the issue of vaccine hesitancy and discuss effective strategies to promote vaccine acceptance. Research, collaboration, and the widespread acceptance and use of vaccines are imperative for the continued success of vaccination programs in controlling and ultimately eradicating infectious diseases.
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Affiliation(s)
- David A. Montero
- Departamento de Microbiología, Facultad de Ciencias Biológicas, Universidad de Concepción, Concepción, Chile
- Centro Integrativo de Biología y Química Aplicada, Universidad Bernardo O'Higgins, Santiago, Chile
| | - Roberto M. Vidal
- Programa de Microbiología y Micología, Instituto de Ciencias Biomédicas, Facultad de Medicina, Universidad de Chile, Santiago, Chile
- Instituto Milenio de Inmunología e Inmunoterapia, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - Juliana Velasco
- Unidad de Paciente Crítico, Clínica Hospital del Profesor, Santiago, Chile
- Programa de Formación de Especialista en Medicina de Urgencia, Universidad Andrés Bello, Santiago, Chile
| | - Leandro J. Carreño
- Instituto Milenio de Inmunología e Inmunoterapia, Facultad de Medicina, Universidad de Chile, Santiago, Chile
- Programa de Inmunología, Instituto de Ciencias Biomédicas, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - Juan P. Torres
- Departamento de Pediatría y Cirugía Pediátrica, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - Manuel A. Benachi O.
- Área de Biotecnología, Tecnoacademia Neiva, Servicio Nacional de Aprendizaje, Regional Huila, Neiva, Colombia
| | - Yenifer-Yadira Tovar-Rosero
- Departamento de Biología, Facultad de Ciencias Naturales, Exactas y de la Educación, Universidad del Cauca, Popayán, Colombia
| | - Angel A. Oñate
- Departamento de Microbiología, Facultad de Ciencias Biológicas, Universidad de Concepción, Concepción, Chile
| | - Miguel O'Ryan
- Programa de Microbiología y Micología, Instituto de Ciencias Biomédicas, Facultad de Medicina, Universidad de Chile, Santiago, Chile
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Tabll AA, Sohrab SS, Ali AA, Petrovic A, Steiner Srdarevic S, Siber S, Glasnovic M, Smolic R, Smolic M. Future Prospects, Approaches, and the Government's Role in the Development of a Hepatitis C Virus Vaccine. Pathogens 2023; 13:38. [PMID: 38251345 PMCID: PMC10820710 DOI: 10.3390/pathogens13010038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 12/27/2023] [Accepted: 12/28/2023] [Indexed: 01/23/2024] Open
Abstract
Developing a safe and effective vaccine against the hepatitis C virus (HCV) remains a top priority for global health. Despite recent advances in antiviral therapies, the high cost and limited accessibility of these treatments impede their widespread application, particularly in resource-limited settings. Therefore, the development of the HCV vaccine remains a necessity. This review article analyzes the current technologies, future prospects, strategies, HCV genomic targets, and the governmental role in HCV vaccine development. We discuss the current epidemiological landscape of HCV infection and the potential of HCV structural and non-structural protein antigens as vaccine targets. In addition, the involvement of government agencies and policymakers in supporting and facilitating the development of HCV vaccines is emphasized. We explore how vaccine development regulatory channels and frameworks affect research goals, funding, and public health policy. The significance of international and public-private partnerships in accelerating the development of an HCV vaccine is examined. Finally, the future directions for developing an HCV vaccine are discussed. In conclusion, the review highlights the urgent need for a preventive vaccine to fight the global HCV disease and the significance of collaborative efforts between scientists, politicians, and public health organizations to reach this important public health goal.
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Affiliation(s)
- Ashraf A. Tabll
- Microbial Biotechnology Department, Biotechnology Research Institute, National Research Centre, Cairo 12622, Egypt
- Egypt Centre for Research and Regenerative Medicine (ECRRM), Cairo 11517, Egypt
| | - Sayed S. Sohrab
- Special Infectious Agents Unit, King Fahd Medical Research Center, King Abdulaziz University, Jeddah 21589, Saudi Arabia;
- Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Ahmed A. Ali
- Molecular Biology Department, Biotechnology Research Institute, National Research Centre, Cairo 12622, Egypt;
| | - Ana Petrovic
- Faculty of Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia; (A.P.); (S.S.S.); (S.S.); (M.G.); (R.S.)
| | - Sabina Steiner Srdarevic
- Faculty of Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia; (A.P.); (S.S.S.); (S.S.); (M.G.); (R.S.)
| | - Stjepan Siber
- Faculty of Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia; (A.P.); (S.S.S.); (S.S.); (M.G.); (R.S.)
| | - Marija Glasnovic
- Faculty of Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia; (A.P.); (S.S.S.); (S.S.); (M.G.); (R.S.)
| | - Robert Smolic
- Faculty of Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia; (A.P.); (S.S.S.); (S.S.); (M.G.); (R.S.)
| | - Martina Smolic
- Faculty of Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia; (A.P.); (S.S.S.); (S.S.); (M.G.); (R.S.)
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18
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Al-Aghbari AA, Naanyu V, Luchters S, Irungu E, Baalawy K, Bärnighausen T, Mauti J. Reducing Barriers to COVID-19 Vaccination Uptake: Community Ideas from Urban and Rural Kenya. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:7093. [PMID: 38063523 PMCID: PMC10705992 DOI: 10.3390/ijerph20237093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 10/13/2023] [Accepted: 10/23/2023] [Indexed: 12/18/2023]
Abstract
Following the rapid development of COVID-19 vaccines, addressing vaccine hesitancy and optimizing uptake have emerged as critical challenges, emphasizing the importance of reducing barriers toward COVID-19 vaccination. This study investigates ideas on ways to reduce barriers to COVID-19 vaccination uptake. It explores methods that can overcome COVID-19 vaccination barriers through qualitative research: interviews and group discussions involving healthcare providers, administration personnel, teachers, and individuals with chronic conditions across urban (Mombasa) and rural (Kilifi) Kenya. Audio-recorded discussions were transcribed and thematically analyzed across locations. Five themes emerged in our results regarding the reduction in barriers to COVID-19 vaccination in the context of Kenya, including awareness campaigns, engaging diverse stakeholders, using various communication techniques, capacity building to increase vaccination centers and trained staff, and lastly, revising relevant government health policies and guidelines. These results indicate the importance of adopting multiple approaches, as no single strategy can boost vaccine acceptance. Moreover, this study provides recommendations for conceiving actionable interventions to potentially boost vaccine demand and maintain routine immunization in Kenya.
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Affiliation(s)
- Ahmed Asa’ad Al-Aghbari
- Heidelberg Institute of Global Health, Heidelberg University Hospital, Im Neuenheimer Feld 130.3, 69120 Heidelberg, Germany; (T.B.); (J.M.)
| | - Violet Naanyu
- School of Arts and Social Sciences, Moi University, Eldoret, Kenya;
| | - Stanley Luchters
- Centre for Sexual Health and HIV AIDS Research (CeSHHAR), Harare 0002, Zimbabwe;
- Department of International Public Health, Liverpool School of Tropical Medicine (LSTM), Liverpool L3 5QA, UK
- Department of Public Health and Preventive Medicine, Ghent University, 9000 Ghent, Belgium
| | - Eunice Irungu
- The Aga Khan Hospital Mombasa, Mumbasa, Kenya; (E.I.); (K.B.)
| | - Kawthar Baalawy
- The Aga Khan Hospital Mombasa, Mumbasa, Kenya; (E.I.); (K.B.)
| | - Till Bärnighausen
- Heidelberg Institute of Global Health, Heidelberg University Hospital, Im Neuenheimer Feld 130.3, 69120 Heidelberg, Germany; (T.B.); (J.M.)
| | - Joy Mauti
- Heidelberg Institute of Global Health, Heidelberg University Hospital, Im Neuenheimer Feld 130.3, 69120 Heidelberg, Germany; (T.B.); (J.M.)
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Kaufmann SHE. Vaccine development against tuberculosis before and after Covid-19. Front Immunol 2023; 14:1273938. [PMID: 38035095 PMCID: PMC10684952 DOI: 10.3389/fimmu.2023.1273938] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 10/16/2023] [Indexed: 12/02/2023] Open
Abstract
Coronavirus disease (Covid-19) has not only shaped awareness of the impact of infectious diseases on global health. It has also provided instructive lessons for better prevention strategies against new and current infectious diseases of major importance. Tuberculosis (TB) is a major current health threat caused by Mycobacterium tuberculosis (Mtb) which has claimed more lives than any other pathogen over the last few centuries. Hence, better intervention measures, notably novel vaccines, are urgently needed to accomplish the goal of the World Health Organization to end TB by 2030. This article describes how the research and development of TB vaccines can benefit from recent developments in the Covid-19 vaccine pipeline from research to clinical development and outlines how the field of TB research can pursue its own approaches. It begins with a brief discussion of major vaccine platforms in general terms followed by a short description of the most widely applied Covid-19 vaccines. Next, different vaccination regimes and particular hurdles for TB vaccine research and development are described. This specifically considers the complex immune mechanisms underlying protection and pathology in TB which involve innate as well as acquired immune mechanisms and strongly depend on fine tuning the response. A brief description of the TB vaccine candidates that have entered clinical trials follows. Finally, it discusses how experiences from Covid-19 vaccine research, development, and rollout can and have been applied to the TB vaccine pipeline, emphasizing similarities and dissimilarities.
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Affiliation(s)
- Stefan H. E. Kaufmann
- Max Planck Institute for Infection Biology, Berlin, Germany
- Systems Immunology, Max Planck Institute for Multidisciplinary Sciences, Göttingen, Germany
- Hagler Institute for Advanced Study, Texas A&M University, College Station, TX, United States
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Lehrer L, Hellmann L, Temme H, Otten L, Hübenthal J, Geiger M, Jenny MA, Betsch C. Communicating climate change and health to specific target groups. JOURNAL OF HEALTH MONITORING 2023; 8:36-56. [PMID: 38105792 PMCID: PMC10722519 DOI: 10.25646/11773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 10/20/2023] [Indexed: 12/19/2023]
Abstract
Background The German status report on climate change and health 2023 identifies numerous health risks that are caused or exacerbated by climate change. One recommendation arising from the report is to strengthen education, information, and communication in the field. This article aims to serve as a basis for this. Methods Based on four survey waves (2022/2023) of the PACE study (Planetary Health Action Survey, n=3,845, online), the status of risk perception as well as the Readiness to Act against climate change in the adult population in Germany is examined and a target group analysis is carried out. Results Some health risks due to the climate crisis are perceived as comparatively low (e.g. mental health problems). People with higher risk perception show a higher Readiness to Act. Younger people, men, people with low education, and those living in smaller communities are identified as relevant target groups as they have a lower Readiness to Act. One third state that they never or hardly ever seek out specific information on climate change. Media use differs depending on target group. Conclusions Target group-specific communication can help to educate people about the health impacts of the climate crisis. In the discussion of this article, implications from existing literature are discussed in detail, which offer practical guidance for effective climate change communication.
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Affiliation(s)
- Lena Lehrer
- Bernhard Nocht Institute for Tropical Medicine, Implementation Research, Health Communication Working Group, Hamburg, Germany
- Institute for Planetary Health Behaviour, University of Erfurt, Germany, Health Communication
| | - Lennart Hellmann
- Bernhard Nocht Institute for Tropical Medicine, Implementation Research, Health Communication Working Group, Hamburg, Germany
- Institute for Planetary Health Behaviour, University of Erfurt, Germany, Health Communication
| | - Hellen Temme
- Bernhard Nocht Institute for Tropical Medicine, Implementation Research, Health Communication Working Group, Hamburg, Germany
- Institute for Planetary Health Behaviour, University of Erfurt, Germany, Health Communication
| | - Leonie Otten
- Bernhard Nocht Institute for Tropical Medicine, Implementation Research, Health Communication Working Group, Hamburg, Germany
- Institute for Planetary Health Behaviour, University of Erfurt, Germany, Health Communication
| | - Johanna Hübenthal
- Bernhard Nocht Institute for Tropical Medicine, Implementation Research, Health Communication Working Group, Hamburg, Germany
- Institute for Planetary Health Behaviour, University of Erfurt, Germany, Health Communication
| | - Mattis Geiger
- Bernhard Nocht Institute for Tropical Medicine, Implementation Research, Health Communication Working Group, Hamburg, Germany
- Institute for Planetary Health Behaviour, University of Erfurt, Germany, Health Communication
| | - Mirjam A. Jenny
- Bernhard Nocht Institute for Tropical Medicine, Implementation Research, Health Communication Working Group, Hamburg, Germany
- Institute for Planetary Health Behaviour, University of Erfurt, Germany, Health Communication
- Institute of Psychology, University of Bamberg, Germany
- Harding Center for Risk Literacy, University of Potsdam, Germany
| | - Cornelia Betsch
- Bernhard Nocht Institute for Tropical Medicine, Implementation Research, Health Communication Working Group, Hamburg, Germany
- Institute for Planetary Health Behaviour, University of Erfurt, Germany, Health Communication
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Wu Y, Brennan-Ing M. Information Consumption, Trust Dynamics and COVID-19 Vaccine Hesitancy among Older Adults: Implications for Health Messaging. Vaccines (Basel) 2023; 11:1668. [PMID: 38006000 PMCID: PMC10675093 DOI: 10.3390/vaccines11111668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Revised: 10/24/2023] [Accepted: 10/29/2023] [Indexed: 11/26/2023] Open
Abstract
Staying well informed about the evolving COVID-19 pandemic and vaccine recommendations is vital for older adults, especially for low-income older adults, who have been disproportionately impacted by the pandemic. However, the overwhelming infodemic poses a significant challenge, affecting vaccine decision-making. This study explores how a group of predominantly low-income older adults navigate health information and how their trust in information and vaccines evolves throughout the pandemic. Our objective is to provide insights that will guide future public health messaging for this demographic. Analyzing qualitative data from 77 older adults (aged 65 to 94) collected through focus groups and interviews, our findings reveal that participants' experiences with information overload eroded their trust in authority, leading to vaccine hesitancy. Moreover, the need for a booster has affected belief in vaccine safety and efficacy. As participants lost faith in the media and authoritative sources, they increasingly leaned on personal networks for guidance. These results underscore the urgent necessity for clear, unambiguous ongoing vaccine guidance to restore institutional trust among older adults. Additionally, recognizing the influential role of direct networks in vaccine decisions, integrating care workers, service providers, and peer-to-peer support into health messaging mechanisms could prove valuable.
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Affiliation(s)
- Yiyi Wu
- Brookdale Center for Healthy Aging, Hunter College, The City University of New York, New York, NY 10035, USA;
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22
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Lo Moro G, Ferrara M, Langiano E, Accortanzo D, Cappelletti T, De Angelis A, Esposito M, Prinzivalli A, Sannella A, Sbaragli S, Vuolanto P, Siliquini R, De Vito E. Countering vaccine hesitancy: a systematic review of interventions to strengthen healthcare professionals' action. Eur J Public Health 2023; 33:905-915. [PMID: 37581903 PMCID: PMC10567238 DOI: 10.1093/eurpub/ckad134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/16/2023] Open
Abstract
BACKGROUND Vaccine hesitancy is relevant for healthcare professionals (HCPs) who face challenges in building trusting relationships with patients. Accordingly, the VAX-TRUST project has been developed to improve experiences of HCPs and patients dealing with vaccinations. To support VAX-TRUST, this work aimed to identify latest interventions targeted at HCPs to address hesitancy and increase vaccine uptake. METHODS A systematic review was conducted according to PRISMA by searching PubMed, Scopus and Embase. The protocol was registered on PROSPERO. Articles were eligible if evaluated interventions directly targeted at HCPs/healthcare students. The search was run on 26 January 2022. Articles published in 2016 or after were included. RESULTS A total of 17 492 records were identified; 139 articles were selected. Most articles were set in USA (n = 110). Over half had a pre-post design without a control group (n = 78). A total of 41 articles focused on single-component interventions, 60 on multi-component interventions involving only HCPs and/or students and 38 on multi-component interventions involving also other professionals. Main components were in-person education (n = 76), synchronous (n = 10) and asynchronous (n = 23) online learning, educational materials (n = 26), performance assessment and feedback (n = 33), electronic record changes (n = 30), role play/simulation (n = 21) and online games/apps (n = 5). Educational sessions were mainly about scientific update or communication. Outcomes of interventions were grouped in: vaccination rates (n = 69), knowledge (n = 32), attitudes (n = 26), confidence in counselling (n = 30) and acceptability (n = 16). CONCLUSIONS Apps, gaming, role play/simulations could represent innovative interventions. This review highlighted the need of delving into communication strategies and using more robust evaluations, longer follow-up and standardized measurements.
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Affiliation(s)
- Giuseppina Lo Moro
- Department of Public Health Sciences and Paediatrics, University of Turin, Turin, Italy
| | - Maria Ferrara
- Department of Human, Social and Health Sciences, University of Cassino and Southern Lazio, Cassino, Italy
| | - Elisa Langiano
- Department of Human, Social and Health Sciences, University of Cassino and Southern Lazio, Cassino, Italy
| | - Davide Accortanzo
- Department of Public Health Sciences and Paediatrics, University of Turin, Turin, Italy
| | - Toni Cappelletti
- Department of Public Health Sciences and Paediatrics, University of Turin, Turin, Italy
| | - Aldo De Angelis
- Department of Public Health Sciences and Paediatrics, University of Turin, Turin, Italy
| | - Maurizio Esposito
- Department of Human, Social and Health Sciences, University of Cassino and Southern Lazio, Cassino, Italy
| | | | - Alessandra Sannella
- Department of Human, Social and Health Sciences, University of Cassino and Southern Lazio, Cassino, Italy
| | - Sara Sbaragli
- Department of Human, Social and Health Sciences, University of Cassino and Southern Lazio, Cassino, Italy
| | - Pia Vuolanto
- Research Centre for Knowledge, Science, Technology and Innovation Studies of Tampere University, Tampere, Finland
| | - Roberta Siliquini
- Department of Public Health Sciences and Paediatrics, University of Turin, Turin, Italy
- AOU City of Health and Science of Turin, Turin, Italy
| | - Elisabetta De Vito
- Department of Human, Social and Health Sciences, University of Cassino and Southern Lazio, Cassino, Italy
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23
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Montuori P, Gentile I, Fiorilla C, Sorrentino M, Schiavone B, Fattore V, Coscetta F, Riccardi A, Villani A, Trama U, Pennino F, Triassi M, Nardone A. Understanding Factors Contributing to Vaccine Hesitancy in a Large Metropolitan Area. Vaccines (Basel) 2023; 11:1558. [PMID: 37896961 PMCID: PMC10610669 DOI: 10.3390/vaccines11101558] [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: 08/18/2023] [Revised: 09/13/2023] [Accepted: 09/28/2023] [Indexed: 10/29/2023] Open
Abstract
Vaccine hesitancy has become a major global concern, leading to a significant decrease in the vaccination rate, with the World Health Organization recognizing it as one of the top ten threats to public health. Moreover, the health cost generated is evaluated to be 27 billion dollars per year in the US alone. To investigate the association between demographic variables and knowledge, attitudes, and behaviours related to vaccination, a survey-based cross-sectional study was conducted with 1163 individuals. Three models were used to perform a multiple linear regression analysis. In Model I, knowledge about vaccinations was found to be associated with smoking habits, education, and marital status. In Model II, attitudes towards vaccinations were significantly associated with sex, smoking habits, education, marital status, and knowledge. In Model III, behaviours related to vaccination were associated with sex, smoking habits, having children, knowledge, and attitudes. One potential solution to improve behaviours related to vaccinations in the general population is to implement specific public health programs, which can be a cost-effective intervention. This study provides valuable insights into the determinants of knowledge, attitudes, and behaviours related to vaccinations in the general population.
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Affiliation(s)
- Paolo Montuori
- Department of Public Health, "Federico II" University, Via Sergio Pansini nº 5, 80131 Naples, Italy
| | - Immanuela Gentile
- Department of Public Health, "Federico II" University, Via Sergio Pansini nº 5, 80131 Naples, Italy
| | - Claudio Fiorilla
- Department of Public Health, "Federico II" University, Via Sergio Pansini nº 5, 80131 Naples, Italy
| | - Michele Sorrentino
- Department of Public Health, "Federico II" University, Via Sergio Pansini nº 5, 80131 Naples, Italy
| | - Benedetto Schiavone
- Department of Public Health, "Federico II" University, Via Sergio Pansini nº 5, 80131 Naples, Italy
| | - Valerio Fattore
- Department of Public Health, "Federico II" University, Via Sergio Pansini nº 5, 80131 Naples, Italy
| | - Fabio Coscetta
- Department of Public Health, "Federico II" University, Via Sergio Pansini nº 5, 80131 Naples, Italy
| | - Alessandra Riccardi
- Department of Public Health, "Federico II" University, Via Sergio Pansini nº 5, 80131 Naples, Italy
| | - Antonio Villani
- Department of Public Health, "Federico II" University, Via Sergio Pansini nº 5, 80131 Naples, Italy
| | - Ugo Trama
- General Directorate of Health, Campania Region, Centro Direzionale C3, 80143 Naples, Italy
| | - Francesca Pennino
- Department of Public Health, "Federico II" University, Via Sergio Pansini nº 5, 80131 Naples, Italy
| | - Maria Triassi
- Department of Public Health, "Federico II" University, Via Sergio Pansini nº 5, 80131 Naples, Italy
| | - Antonio Nardone
- Department of Public Health, "Federico II" University, Via Sergio Pansini nº 5, 80131 Naples, Italy
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24
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Chung SJ, Han K, Kim C, Kim J. Factors associated with COVID-19 vaccination hesitancy in South Korea: A cross-sectional study. Nurs Health Sci 2023; 25:332-340. [PMID: 37497789 DOI: 10.1111/nhs.13031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 06/05/2023] [Accepted: 06/09/2023] [Indexed: 07/28/2023]
Abstract
Vaccination against COVID-19 has been promoted as a way to protect oneself and others from infection. To ensure the comprehensive acceptance of COVID-19 vaccines, the factors that affect COVID-19 vaccination hesitancy should be examined. This study aimed to identify the factors that affect COVID-19 vaccination hesitancy among Korean adults, focusing on COVID-19 knowledge and attitudes toward vaccination. This was a cross-sectional study conducted with 2286 Korean adults aged 20-64 years. Demographic characteristics, knowledge regarding COVID-19, and attitudes toward vaccination were assessed. A generalized linear model with Poisson regression was used to identify factors associated with COVID-19 vaccination hesitancy. Approximately 67% of the COVID-19 knowledge-related questions were correctly answered. A neutral attitude toward vaccination and relatively low vaccination hesitancy were found. COVID-19 vaccination hesitancy was affected by individuals' attitudes toward vaccination, as well as their gender and age, but not by their knowledge. Interventions or policies considering gender and age could be helpful in reducing COVID-19 vaccination hesitancy. Strategies to disseminate more accurate and novel information related to the COVID-19 vaccines should be implemented.
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Affiliation(s)
| | - Kihye Han
- Department of Nursing, Chung-Ang University, Seoul, South Korea
| | - Chaehee Kim
- Department of Nursing, Chung-Ang University Graduate School, Seoul, South Korea
| | - Jieun Kim
- Department of Nursing, Chung-Ang University, Seoul, South Korea
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25
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Lenart C, Prager M, Sachs M, Steininger C, Fernandes C, Thannesberger J. Tackling Vaccine Hesitancy and Increasing Vaccine Willingness Among Parents of Unvaccinated Children in Austria. Int J Public Health 2023; 68:1606042. [PMID: 37701049 PMCID: PMC10493290 DOI: 10.3389/ijph.2023.1606042] [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: 03/29/2023] [Accepted: 08/09/2023] [Indexed: 09/14/2023] Open
Abstract
Objectives: In autumn 2021, there was a surge of COVID-19 infections in Austria, and vaccination coverage stagnated at a below-average level compared to the rest of Europe. Surveys showed that both children and adolescents were the main drivers of the rising infection rates and that vaccination numbers were particularly low in this age group. This was due to widespread vaccination skepticism and hesitancy among parents of unvaccinated children and adolescents. Methods: Here, we describe a novel intervention concept that allowed us to efficiently tackle parental vaccine hesitancy. We designed an intervention series that followed a reproducible format based on online face-to-face seminars in groups of a maximum of twenty people. Each seminar included an anonymous online questionnaire for internal quality control. Moreover, we assessed the motives of parental vaccine hesitancy and asked participants to rate subjective vaccine willingness for their children on a scale of zero to ten. Results: Within 8 weeks, more than 580 people participated in the seminar series. We found that concerns about the side effects of the vaccine were the predominant motive of vaccination hesitancy among the study population. Overall, the intervention could successfully increase the median parental vaccination willingness of participants from a score of five to eight. We identified tree hesitancy motives (distrust towards the pharmaceutical industry, the government, or feelings of restriction from personal freedom) that were associated with below-average vaccination willingness and significant lower increase. Conclusion: With this study we analyzed motives driving COVID-19 vaccination hesitancy among parents of unvaccinated children and reasons of parents to restrain their children from getting vaccinated. The intervention method described here, could effectively address individual concerns on a personal level while at the same time reach a large number of people across geographical and language barriers. Thereby we could significantly increase subjective vaccination willingness of the participants. Our approach is easy to apply, highly cost-effective, and can be used to tackle any kind of medical misinformation.
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Affiliation(s)
- Christian Lenart
- Division of Infectious Diseases, Department of Medicine 1, Medical University of Vienna, Vienna, Austria
- Department of Emergency Medicine, Clinic Hietzing, Vienna, Austria
| | - Marlene Prager
- Department of Emergency Medicine, Clinic Donaustadt, Vienna, Austria
| | - Marlene Sachs
- Department of Emergency Medicine, Clinic Donaustadt, Vienna, Austria
| | - Christoph Steininger
- Division of Infectious Diseases, Department of Medicine 1, Medical University of Vienna, Vienna, Austria
| | | | - Jakob Thannesberger
- Division of Infectious Diseases, Department of Medicine 1, Medical University of Vienna, Vienna, Austria
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26
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Gilbert-Esparza E, Brady A, Haas S, Wittstruck H, Miller J, Kang Q, Mulcahy ER. Vaccine Hesitancy in College Students. Vaccines (Basel) 2023; 11:1243. [PMID: 37515058 PMCID: PMC10385752 DOI: 10.3390/vaccines11071243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 07/12/2023] [Accepted: 07/13/2023] [Indexed: 07/30/2023] Open
Abstract
(1) Background: Following the COVID-19 pandemic, vaccine hesitancy has become an increasingly important topic and has created significant concerns in public health. It is important to explore vaccine hesitancy among college students as they have been identified to be a high-risk group for COVID-19 transmission. This study aims to investigate COVID-19 vaccine hesitancy in college students on a midsized midwestern university campus. (2) Methods: Data were collected from 311 undergraduate and graduate college students during June and July 2021. Participants completed a survey on COVID-19 vaccine behaviors, perceptions, and opinions. Quantitative and qualitative analysis was performed to identify vaccine hesitancy and influencing factors in the student population. (3) Results: The results of this study demonstrated significant relationships between older and younger undergraduate students (OR > 1, p < 0.05), students who received a yearly influenza vaccine and those that did not (p < 0.05), and students who had a previous COVID-19 infection and those that did not (OR > 1, p < 0.05). We also determined a significant difference between some racial/ethnic groups and vaccine hesitancy status. (4) Conclusions: COVID-19 vaccine hesitancy exists on college campuses, and is influenced by age and student status, influenza vaccination status, previous COVID-19 infection, and race/ethnicity.
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Affiliation(s)
| | - Amelia Brady
- Master of Public Health Program, College of Veterinary Medicine, Kansas State University, Manhattan, KS 66506, USA
| | - Sierrah Haas
- Master of Public Health Program, College of Veterinary Medicine, Kansas State University, Manhattan, KS 66506, USA
| | - Heather Wittstruck
- Master of Public Health Program, College of Veterinary Medicine, Kansas State University, Manhattan, KS 66506, USA
| | - Jennifer Miller
- Kansas Department of Health and Environment, Topeka, KS 66612, USA
| | - Qing Kang
- Department of Statistics, Kansas State University, Manhattan, KS 66506, USA
| | - Ellyn R Mulcahy
- Master of Public Health Program, College of Veterinary Medicine, Kansas State University, Manhattan, KS 66506, USA
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27
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Baral P, Ahmed T, Amor Fernandez P, Peters MA, Drouard SHP, Muhoza P, Mwinnyaa G, Mwansambo C, Nzelu C, Tassembedo M, Uddin MH, Wesseh CS, Yansane ML, Bergeron JR, Karibwami AD, Lopez Chicheri TIODZ, Ogunlayi MIA, Sieleunou I, Hashemi T, Hansen PM, Shapira G. Vaccine hesitancy among healthcare workers in low- and middle-income countries during the COVID-19 pandemic: Results from facility surveys across six countries. PLoS One 2023; 18:e0288124. [PMID: 37418435 DOI: 10.1371/journal.pone.0288124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 06/20/2023] [Indexed: 07/09/2023] Open
Abstract
BACKGROUND Vaccine hesitancy remains a critical barrier in mitigating the effects of the ongoing COVID-19 pandemic. The willingness of health care workers (HCWs) to be vaccinated, and, in turn, recommend the COVID-19 vaccine for their patient population is an important strategy. This study aims to understand the uptake of COVID-19 vaccines and the reasoning for vaccine hesitancy among facility-based health care workers (HCWs) in LMICs. METHODS We conducted nationally representative phone-based rapid-cycle surveys across facilities in six LMICs to better understand COVID-19 vaccine hesitancy. We gathered data on vaccine uptake among facility managers, their perceptions of vaccine uptake and hesitancy among the HCWs operating in their facilities, and their perception of vaccine hesitancy among the patient population served by the facility. RESULTS 1,148 unique public health facilities participated in the study, with vaccines being almost universally offered to facility-based respondents across five out of six countries. Among facility respondents who have been offered the vaccine, more than 9 in 10 survey respondents had already been vaccinated at the time of data collection. Vaccine uptake among other HCWs at the facility was similarly high. Over 90% of facilities in Bangladesh, Liberia, Malawi, and Nigeria reported that all or most staff had already received the COVID-19 vaccine when the survey was conducted. Concerns about side effects predominantly drive vaccine hesitancy in both HCWs and the patient population. CONCLUSION Our findings indicate that the opportunity to get vaccinated in participating public facilities is almost universal. We find vaccine hesitancy among facility-based HCWs, as reported by respondents, to be very low. This suggests that a potentially effective effort to increase vaccine uptake equitably would be to channel promotional activities through health facilities and HCWs.However, reasons for hesitancy, even if limited, are far from uniform across countries, highlighting the need for audience-specific messaging.
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Affiliation(s)
- Prativa Baral
- The World Bank, United States of America
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, United States of America
| | - Tashrik Ahmed
- Global Financing Facility for Women, Children, and Adolescents, United States of America
| | | | | | | | | | - George Mwinnyaa
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, United States of America
- Global Financing Facility for Women, Children, and Adolescents, United States of America
| | | | | | | | | | | | | | - Julie Ruel Bergeron
- Global Financing Facility for Women, Children, and Adolescents, United States of America
| | - Alain-Desire Karibwami
- Global Financing Facility for Women, Children, and Adolescents, United States of America
| | | | | | - Isidore Sieleunou
- Global Financing Facility for Women, Children, and Adolescents, United States of America
| | - Tawab Hashemi
- Global Financing Facility for Women, Children, and Adolescents, United States of America
| | - Peter M Hansen
- Global Financing Facility for Women, Children, and Adolescents, United States of America
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28
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Beressa TB, Tafa M, Geresu GD, Bacha AJ, Gadisa DA. COVID-19 vaccine acceptance and its determinants among residents of Ambo Town, West Shewa, Oromia Region, Ethiopia: cross-sectional survey. Ther Adv Vaccines Immunother 2023; 11:25151355231178150. [PMID: 37377465 PMCID: PMC10291218 DOI: 10.1177/25151355231178150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 05/09/2023] [Indexed: 06/29/2023] Open
Abstract
Background Vaccines against COVID-19 are critical for preventing and managing COVID-19 because immunization is one of the most active and cost-effective health strategies for infectious disease prevention. Knowing the community's willingness and factors affecting COVID-19 vaccine acceptance will support the design of effective promotion strategies. Therefore, this study was aimed at assessing COVID-19 vaccine acceptance and its determinants among the Ambo Town community. Method A community-based, cross-sectional study was conducted using structured questionnaires from 1 to 28 February 2022. Four kebeles were selected randomly, and the systematic random sampling procedure was used to select the households. SPSS-25 software was used for data analysis. Ethical approval was received from the Institutional Review Committee of the College of Medicine and Health Sciences of Ambo University, and data were kept confidential. Result Of the 391 participants, 385 (98.5%) of the respondents were not vaccinated for COVID-19, and around 126 (32.2%) of the respondents said that they would receive the vaccine if the government provided it. The multivariate logistic regression analysis revealed that males were 1.8 times more likely to accept the COVID-19 vaccine (adjusted odds ratio (AOR) = 1.8, 95% CI: 1.074-3.156) as compared to females. The acceptance of the COVID-19 vaccine was lower by 60% in those who tested for COVID-19 as compared to those who were not tested (AOR = 0.4, 95% CI: 0.27-0.69). Moreover, the participants who had chronic diseases were two times more likely to accept the vaccine. Acceptance of the vaccine was reduced by half among those who believed that there was a scarcity of data on its safety (AOR = 0.5, 95% CI: 0.26-0.80). Conclusion The prevalence of COVID-19 vaccination acceptance was low. To enhance the acceptance of the COVID-19 vaccine, the government and different stakeholders should strengthen public education using mass media about the advantages of getting the COVID-19 vaccination.
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Affiliation(s)
| | - Milkessa Tafa
- Department of Pharmacy, College of Medicine and Health Sciences, Ambo University, Ambo, Ethiopia
| | - Gudeta Duga Geresu
- Department of Pharmacy, College of Medicine and Health Sciences, Ambo University, Ambo, Ethiopia
| | - Amente Jorise Bacha
- Department of Pharmacy, College of Medicine and Health Sciences, Ambo University, Ambo, Ethiopia
| | - Diriba Alemayehu Gadisa
- Department of Pharmacy, College of Medicine and Health Sciences, Ambo University, Ambo, Ethiopia
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29
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Mondal P, Sinharoy A. The influence of pediatricians' recommendation on caregivers' COVID-19 vaccine acceptance for children: A nationwide cross-sectional survey study from USA. Front Pediatr 2023; 11:1149125. [PMID: 37228435 PMCID: PMC10203465 DOI: 10.3389/fped.2023.1149125] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Accepted: 04/03/2023] [Indexed: 05/27/2023] Open
Abstract
Background The influence of pediatricians on parental acceptance of COVID-19 vaccine for children has not been well studied. We designed a survey to estimate the impact of pediatricians' recommendations on caregivers' vaccine acceptance while accounting for participants' socio-demographic and personal characteristics. The secondary objectives were to compare childhood vaccination rates among different age groups and categorize caregivers' concerns about vaccinating young (under-five) children. Overall, the study aimed to provide insight into potential pro-vaccination strategies that could integrate pediatricians to alleviate parental vaccine hesitancy. Methods We conducted an online cross-sectional survey study using Redcap, in August 2022. We enquired COVID-19 vaccination status of the children in the family (≥five years). The survey questionnaire included socio-demographic and personal characteristics: age, race, sex, education, financial status, residence, healthcare worker, COVID-19 vaccination status and side effects, children's influenza vaccination status, and pediatricians' recommendations (1-5 scale). Logistic regression and neural network models were used to estimate the influence of socio-demographic determinants on children's vaccine status and build predictors' ranking. Results The participants (N = 2,622) were predominantly white, female, middle-class, and vaccinated against COVID-19 (89%). The logistic regression model was significant vs. the null (likelihood-ratio χ2 = 514.57, p < 0.001, pseudo-R2 = .440). The neural network model also demonstrated strong prediction ability with a correct prediction rates of 82.9% and 81.9% for the training and testing models, respectively. Both models identified pediatricians' recommendations, self-COVID-19 vaccination status, and post-vaccination side effects as dominant predictors of caregivers' vaccine acceptance. Among the pediatricians, 70.48% discussed and had an affirmative opinion about COVID-19 vaccine for children. Vaccine acceptance was lower for children aged 5-8 years compared to older age groups (9-12 and 13-18 years), and acceptance varied significantly among the three cohorts of children (χ2 = 65.62, p < 0.001). About half of the participants were concerned about inadequate availability of vaccine safety information for under-five children. Conclusions Pediatricians' affirmative recommendation was significantly associated with caregivers' COVID-19 vaccine acceptance for children while accounting for participants' socio-demographic characteristics. Notably, vaccine acceptance was lower among younger compared to older children, and caregivers' uncertainty about vaccine safety for under-five children was prevalent. Thus, pro-vaccination strategies might incorporate pediatricians to alleviate parental concerns and optimize poor vaccination rate among under-five children.
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Affiliation(s)
- Pritish Mondal
- Department of Pediatrics, Penn State College of Medicine, Hershey, PA, United States
| | - Ankita Sinharoy
- Heart and Vascular Institute, Penn State College of Medicine, Hershey, PA, United States
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30
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Kumari M, Mondal H, Marndi G, Juhi A. Evaluation of the Effectiveness of a Structured Educational Program on Improving the Knowledge of COVID-19 Among the Vaccine-Reluctant Population in a Block of Jharkhand, India. Cureus 2023; 15:e38628. [PMID: 37284394 PMCID: PMC10241108 DOI: 10.7759/cureus.38628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/05/2023] [Indexed: 06/08/2023] Open
Abstract
Background Low vaccination uptake is a major public health concern and is more prevalent in rural areas. Educational interventions have been proposed as an effective strategy to increase vaccine acceptance. The objective of this study was to assess the impact of an educational program on acquiring knowledge for promoting vaccination uptake among a sample of participants. Methodology This study was conducted in a rural area in the state of Jharkhand, India. The study period was from July 2022 to September 2022. The area was surveyed for COVID-19 vaccination and a total of 510 people did not take any dose or took only the first dose and then skipped the second dose. An educational program was designed in the local language. The knowledge of the sample was assessed before and after a week of intervention with a surveyor-administered questionnaire. The vaccination status before and after the intervention was also recorded. We used the chi-square test, Fisher's exact test, and binomial test for comparing the categorical variables. Results A total of 178 participants' data were analyzed. The majority of the participants were in the age group of 18-25 years. The pre-intervention score regarding the knowledge of COVID-19 and vaccination was 18.93 ± 5.10 which significantly increased after the intervention to 25.06 ± 4.35 (p <0.0001). The number of individuals receiving vaccination significantly increased. Before the program, 95 participants did not take the vaccine and 83 received the first dose and did not take the second dose. After the program, 17 participants did not take the vaccine, 161 completed the first dose, and 112 completed the second dose (p <0.0001). Conclusions The educational program was successful in improving knowledge and awareness about vaccination, leading to an increase in the number of individuals receiving vaccination. These findings suggest the importance of educational interventions in the local language in promoting vaccination uptake and can be used to design effective public health campaigns to increase vaccine acceptance.
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Affiliation(s)
- Muskan Kumari
- Physiology, All India Institute of Medical Sciences, Deoghar, Deoghar, IND
| | - Himel Mondal
- Physiology, All India Institute of Medical Sciences, Deoghar, Deoghar, IND
| | - Gujaram Marndi
- Pharmacology, Dharanidhar Medical College and Hospital, Keonjhar, Kendujhar, IND
| | - Ayesha Juhi
- Physiology, All India Institute of Medical Sciences, Deoghar, Deoghar, IND
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Amjad Z, Maryam I, Munir M, Salman M, Baraka MA, Mustafa ZU, Khan YH, Mallhi TH, Hasan SS, Meyer JC, Godman B. COVID-19 Vaccines Status, Acceptance and Hesitancy among Maintenance Hemodialysis Patients: A Cross-Sectional Study and the Implications for Pakistan and Beyond. Vaccines (Basel) 2023; 11:vaccines11050904. [PMID: 37243008 DOI: 10.3390/vaccines11050904] [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: 03/20/2023] [Revised: 04/17/2023] [Accepted: 04/25/2023] [Indexed: 05/28/2023] Open
Abstract
COVID-19 vaccine hesitancy continues to be a widespread problem in Pakistan due to various conspiracy beliefs, myths and misconceptions. Since the hemodialysis population is at a higher risk of contracting infections, we sought to investigate the current COVID-19 immunization status and reasons for any vaccine hesitancy among these patients in Pakistan. This cross-sectional study was conducted among maintenance hemodialysis patients at six hospitals in the Punjab Province of Pakistan. Data were collected anonymously using a questionnaire. A total of 399 hemodialysis patients took part in the survey, the majority of them were male (56%) and aged 45-64 years. A calculated 62.4% of the patients reported receiving at least one dose of the COVID-19 vaccine. Of those vaccinated (249), 73.5% had received two doses and 16.9% had received a booster dose. The most common reasons for vaccination were "being aware they were at high risk" (89.6%), "fear of getting infected" (89.2%) and "willingness to fight against COVID-19-pandemic" (83.9%). Of the 150 patients who had not yet been vaccinated, only 10 showed a willingness to take the COVID-19 vaccine. The major reasons for refusal included "COVID-19 is not a real problem" (75%), the "corona vaccine is a conspiracy (72.1%)" and "I don't need the vaccine" (60.7%). Our study revealed that only 62% patients receiving hemodialysis were partially or completely vaccinated against COVID-19. Consequently, there is a need to initiate aggressive approaches to educate this high-risk population in order to address their concerns with vaccine safety and efficacy as well as correct current myths and misconceptions to improve the COVID-19 immunization status in this population.
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Affiliation(s)
- Zara Amjad
- Department of Paediatrics, District Head Quarter (DHQ), Bhakkar 30000, Pakistan
| | - Iqra Maryam
- Department of Medicine, Jinnah Hospital Lahore, Lahore 54000, Pakistan
| | - Maria Munir
- Department of Medicine, Faisalabad Medical University, Faisalabad 38000, Pakistan
| | - Muhammad Salman
- Institute of Pharmacy, Faculty of Pharmaceutical and Allied Health Sciences, Lahore College for Women University, Lahore 54000, Pakistan
| | - Mohamed A Baraka
- Clinical Pharmacy Program, College of Pharmacy, Al Ain Campus, Al Ain University, Abu Dhabi P.O. Box 64141, United Arab Emirates
- Clinical Pharmacy Department, College of Pharmacy, Al-Azhar University, Cairo 11651, Egypt
| | - Zia Ul Mustafa
- Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Gelugor 11800, Penang, Malaysia
- Department of Pharmacy Services, District Headquarter (DHQ) Hospital, Pakpattan 57400, Pakistan
| | - Yusra Habib Khan
- Department of Clinical Pharmacy, College of Pharmacy, Jouf University, Sakaka 72388, Saudi Arabia
| | - Tauqeer Hussain Mallhi
- Department of Clinical Pharmacy, College of Pharmacy, Jouf University, Sakaka 72388, Saudi Arabia
| | - Syed Shahzad Hasan
- Department of Pharmacy, School of Applied Sciences, University of Huddersfield, Huddersfield HD1 3DH, UK
| | - Johanna C Meyer
- Department of Public Health Pharmacy and Management, School of Pharmacy, Sefako Makgatho Health Sciences University, Ga-Rankuwa 0208, South Africa
- South African Vaccination and Immunisation Centre, Sefako Makgatho Health Sciences University, Molotlegi Street, Ga-Rankuwa 0208, South Africa
| | - Brian Godman
- Department of Public Health Pharmacy and Management, School of Pharmacy, Sefako Makgatho Health Sciences University, Ga-Rankuwa 0208, South Africa
- Centre of Medical and Bio-Allied Health Sciences Research, Ajman University, Ajman P.O. Box 346, United Arab Emirates
- Strathclyde Institute of Pharmacy and Biomedical Science (SIPBS), University of Strathclyde, Glasgow G4 0RE, UK
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Mahameed H, Al-Mahzoum K, AlRaie LA, Aburumman R, Al-Naimat H, Alhiary S, Barakat M, Al-Tammemi AB, Salim NA, Sallam M. Previous Vaccination History and Psychological Factors as Significant Predictors of Willingness to Receive Mpox Vaccination and a Favorable Attitude towards Compulsory Vaccination. Vaccines (Basel) 2023; 11:vaccines11050897. [PMID: 37243001 DOI: 10.3390/vaccines11050897] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Revised: 04/17/2023] [Accepted: 04/24/2023] [Indexed: 05/28/2023] Open
Abstract
During the ongoing multi-country monkeypox (Mpox) outbreak, healthcare workers (HCWs) have represented a key group in mitigating disease spread. The current study aimed to evaluate the attitude of nurses and physicians in Jordan towards Mpox vaccination, as well as their attitude towards compulsory vaccination against coronavirus disease 2019 (COVID-19), influenza, and Mpox. An online survey was distributed in January 2023 based on the previously validated 5C scale for psychological determinants of vaccination. Previous vaccination behavior was assessed by inquiring about the history of getting the primary and booster COVID-19 vaccination, influenza vaccine uptake during COVID-19, and any history of influenza vaccine uptake. The study sample consisted of 495 respondents: nurses (n = 302, 61.0%) and physicians (n = 193, 39.0%). Four hundred and thirty respondents (86.9%) had heard of Mpox before the study, and formed the final sample considered for Mpox knowledge analysis. Deficiencies in Mpox knowledge were reflected in a mean knowledge score of 13.3 ± 2.7 (out of 20.0 as the maximum score), with significantly lower knowledge among nurses and females. The intention to receive Mpox vaccination was reported by 28.9% of the participants (n = 143), while 33.3% were hesitant (n = 165), and 37.8% were resistant (n = 187). In multivariate analysis, Mpox vaccine acceptance was significantly associated with previous vaccination behavior, reflected in higher vaccine uptake and with higher 5C scores, while Mpox knowledge was not correlated with Mpox vaccination intention. The overall attitude towards compulsory vaccination was neutral, while a favorable attitude towards compulsory vaccination was associated with higher 5C scores and a history of previous vaccination uptake. The current study showed a low intention to get Mpox vaccination in a sample of nurses and physicians practicing in Jordan. The psychological factors and previous vaccination behavior appeared as the most significant determinants of Mpox vaccine acceptance and of attitudes towards compulsory vaccination. The consideration of these factors is central to policies and strategies aiming to promote vaccination among health professionals in efforts to prepare for future infectious disease epidemics.
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Affiliation(s)
- Haneen Mahameed
- Department of Pathology, Microbiology and Forensic Medicine, School of Medicine, The University of Jordan, Amman 11942, Jordan
| | | | | | | | - Hala Al-Naimat
- School of Medicine, The University of Jordan, Amman 11942, Jordan
| | - Sakher Alhiary
- Nursing Department, Jordan University Hospital, Amman 11942, Jordan
| | - Muna Barakat
- Department of Clinical Pharmacy and Therapeutics, Faculty of Pharmacy, Applied Science Private University, Amman 11931, Jordan
- MEU Research Unit, Middle East University, Amman 11831, Jordan
| | - Ala'a B Al-Tammemi
- Migration Health Division, International Organization for Migration (IOM), The UN Migration Agency, Amman 11953, Jordan
| | - Nesreen A Salim
- Prosthodontic Department, School of Dentistry, The University of Jordan, Amman 11942, Jordan
- Prosthodontic Department, Jordan University Hospital, Amman 11942, Jordan
| | - Malik Sallam
- Department of Pathology, Microbiology and Forensic Medicine, School of Medicine, The University of Jordan, Amman 11942, Jordan
- Department of Clinical Laboratories and Forensic Medicine, Jordan University Hospital, Amman 11942, Jordan
- Department of Translational Medicine, Faculty of Medicine, Lund University, 22184 Malmö, Sweden
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Tan NC, Pang J, Koh E. The Impact of a Revised National Childhood Immunization Schedule on Vaccination Defaulters. Vaccines (Basel) 2023; 11:vaccines11040859. [PMID: 37112771 PMCID: PMC10145191 DOI: 10.3390/vaccines11040859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Revised: 04/08/2023] [Accepted: 04/12/2023] [Indexed: 04/29/2023] Open
Abstract
Immunization schedules affect community vaccine uptake rates, especially in children who have defaulted on their regular immunization timelines. In 2020, Singapore revised its National Childhood Immunization Schedule (NCIS) to incorporate two new combination vaccines: the hexavalent hepatitis, diphtheria, acellular pertussis, tetanus (DTaP), hemophilus influenzae b (Hib), inactivated poliovirus (IPV) (6-in-1), and the quadrivalent measles, mumps, rubella, and varicella (MMRV) vaccines, thus reducing the mean number of clinic visits and vaccine doses by two. Our database study aims to evaluate the impact of the 2020 NCIS on catch-up vaccination uptake rates in children at 18 and 24 months of age and the catch-up immunization rates of individual vaccines at two years. Vaccination data from two cohorts, in 2018 (n = 11,371) and in 2019 (n = 11,719), were extracted from the Electronic Medical Records. Catch-up vaccination rates increased by 5.2% and 2.6% in children on the new NCIS at 18 and 24 months, respectively. The uptake of individual 5-in-1 (DTaP, IPV, Hib), MMR, and pneumococcal vaccines increased by 3.7%, 4.1%, and 1.9% at 18 months. Reduced vaccination doses and visits in the new NCIS bring direct and indirect benefits to parents and promote vaccination adherence for their children. These findings highlight the importance of timelines in improving catch-up vaccination rates in any NCIS.
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Affiliation(s)
- Ngiap Chuan Tan
- SingHealth Polyclinics, Singapore 150167, Singapore
- SingHealth Duke-NUS Family Medicine Academic Clinical Programme, Singapore 150167, Singapore
| | - Jeremy Pang
- Duke-NUS Medical School, Singapore 169857, Singapore
| | - Eileen Koh
- SingHealth Duke-NUS Family Medicine Academic Clinical Programme, Singapore 150167, Singapore
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Gordon SF, Lam J, Vasquez JT, Cercone R, Tenneti N, Hart J, Chisholm M, Heland M, Hoq M, Kaufman J, Danchin M. A tailored COVID-19 vaccination pathway for children 5-11 years in Victoria, Australia. Vaccine 2023; 41:3436-3445. [PMID: 37120401 PMCID: PMC10106821 DOI: 10.1016/j.vaccine.2023.04.032] [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: 10/04/2022] [Revised: 03/09/2023] [Accepted: 04/11/2023] [Indexed: 05/01/2023]
Abstract
BACKGROUND Procedural anxiety was anticipated in children 5-11 years during the COVID-19 vaccine rollout in Victoria, Australia, as children in this age group receive few routine vaccines. Therefore, the Victorian state government designed a tailored, child-friendly vaccine program. This study aimed to assess parental satisfaction with elements of the bespoke vaccination pathway. METHODS The Victorian government and state-run vaccination hubs in Victoria facilitated an online immunisation plan to help parents identify their child's support needs, and utilised experienced paediatric staff and additional supports for children with severe needle distress and/or disability. All parents/guardians of children 5-11 years who received a COVID-19 vaccine in a vaccination hub were sent a 16-item feedback survey via text message. RESULTS Between 9 February and 31 May 2022 there were 9203 responses; 865 children (9.4%) had a first language other than English, 499 (5.4%) had a disability or special needs, and 142 (1.5%) were Aboriginal or Torres Strait Islander. Most parents (94.4%; 8687/9203) rated their satisfaction with the program as very good or excellent. The immunisation plan was used by 13.5% (1244/9203) of respondents, with usage more common for Aboriginal or Torres Strait Islander children (26.1%; 23/88) or families with a first language other than English (23.5%; 42/179). The child-friendly staff (88.5%, 255/288) and themed environment (66.3%, 191/288) were the most valued measures for vaccination. Additional support measures were required by 1.6% (150/9203) of children in the general population and 7.9%, (17/261) of children with a disability and/or special needs. CONCLUSION A tailored COVID-19 vaccination program for children 5-11 years, with additional support for children with severe needle distress and/or disability, had high parental satisfaction. This model could be utilised for COVID-19 vaccination in pre-school children and for routine childhood vaccination programs to provide optimal support to children and their families.
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Affiliation(s)
- S F Gordon
- COVID-19 Vaccination Program, Department of Health, 50 Lonsdale Street, Melbourne, Victoria 3000, Australia; Vaccine Uptake Group, Murdoch Children's Research Institute, 50 Flemington Road, Parkville, Melbourne, Victoria 3052, Australia.
| | - J Lam
- COVID-19 Vaccination Program, Department of Health, 50 Lonsdale Street, Melbourne, Victoria 3000, Australia
| | - J T Vasquez
- COVID-19 Vaccination Program, Department of Health, 50 Lonsdale Street, Melbourne, Victoria 3000, Australia
| | - R Cercone
- COVID-19 Vaccination Program, Department of Health, 50 Lonsdale Street, Melbourne, Victoria 3000, Australia
| | - N Tenneti
- COVID-19 Vaccination Program, Department of Health, 50 Lonsdale Street, Melbourne, Victoria 3000, Australia
| | - J Hart
- COVID-19 Vaccination Program, Department of Health, 50 Lonsdale Street, Melbourne, Victoria 3000, Australia
| | - M Chisholm
- COVID-19 Vaccination Program, Department of Health, 50 Lonsdale Street, Melbourne, Victoria 3000, Australia
| | - M Heland
- COVID-19 Vaccination Program, Department of Health, 50 Lonsdale Street, Melbourne, Victoria 3000, Australia
| | - M Hoq
- Vaccine Uptake Group, Murdoch Children's Research Institute, 50 Flemington Road, Parkville, Melbourne, Victoria 3052, Australia; Department of Paediatrics, The University of Melbourne, Grattan Street, Parkville, Melbourne, Victoria 3010, Australia
| | - J Kaufman
- Vaccine Uptake Group, Murdoch Children's Research Institute, 50 Flemington Road, Parkville, Melbourne, Victoria 3052, Australia; Department of Paediatrics, The University of Melbourne, Grattan Street, Parkville, Melbourne, Victoria 3010, Australia
| | - M Danchin
- COVID-19 Vaccination Program, Department of Health, 50 Lonsdale Street, Melbourne, Victoria 3000, Australia; Vaccine Uptake Group, Murdoch Children's Research Institute, 50 Flemington Road, Parkville, Melbourne, Victoria 3052, Australia; Department of Paediatrics, The University of Melbourne, Grattan Street, Parkville, Melbourne, Victoria 3010, Australia; Department of General Medicine, Royal Children's Hospital, 50 Flemington Road, Parkville, Melbourne, Victoria 3052, Australia
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Abstract
Vaccine acceptance by parents and caregivers remains a public health challenge that can potentially be addressed via community-based strategies. Such strategies might augment current vaccine hesitancy interventions occurring within medical homes. This article reviews the key challenges and advantages of evidence-based community strategies for overcoming parent/caregiver vaccine hesitancy, specifically (1) community-participatory vaccine hesitancy measurement, (2) communication approaches, (3) reinforcement techniques (eg, incentives, mandates), and (4) community-engaged partnerships (eg, vaccine champion training, vaccination in community settings). This article also discusses important considerations when vaccinating children and adolescents in non-primary care settings (school-based health centers, pharmacies, community events).
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Affiliation(s)
- Lori E Crosby
- Division of Behavioral Medicine, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, MLC 7039, Cincinnati, OH 45229, USA; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
| | - Francis J Real
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA; Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, MLC 2011, Cincinnati, OH 45229, USA
| | - Jodi Cunnigham
- The Community Builders, Inc., 3635 Reading Road, Cincinnati, OH 45229, USA
| | - Monica Mitchell
- Division of Behavioral Medicine, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, MLC 7039, Cincinnati, OH 45229, USA; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA; Community Relations, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, MLC 7039, Cincinnati, OH 45229, USA
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Betsch C, Schmid P, Verger P, Lewandowsky S, Soveri A, Hertwig R, Fasce A, Holford D, De Raeve P, Gagneur A, Vuolanto P, Correia T, Tavoschi L, Declich S, Marceca M, Linos A, Karnaki P, Karlsson L, Garrison A. A call for immediate action to increase COVID-19 vaccination uptake to prepare for the third pandemic winter. Nat Commun 2022; 13:7511. [PMID: 36473855 PMCID: PMC9726862 DOI: 10.1038/s41467-022-34995-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 11/15/2022] [Indexed: 12/12/2022] Open
Affiliation(s)
- Cornelia Betsch
- University of Erfurt, Erfurt, Germany.
- Bernhard-Nocht-Institute for Tropical Medicine, Hamburg, Germany.
| | - Philipp Schmid
- University of Erfurt, Erfurt, Germany
- Bernhard-Nocht-Institute for Tropical Medicine, Hamburg, Germany
| | - Pierre Verger
- Faculty of Medicine, Southeastern Regional Health Observatory, Marseille, France
| | | | | | - Ralph Hertwig
- Max Planck Institute for Human Development, Berlin, Germany
| | | | - Dawn Holford
- School of Psychological Science, University of Bristol, Bristol, UK
| | - Paul De Raeve
- European Federation of Nurses Associations, Brussels, Belgium
| | - Arnaud Gagneur
- Faculté de Médecine et des Sciences de la Santé, University of Sherbrooke, Sherbrooke, QC, Canada
| | | | - Tiago Correia
- Global Health and Tropical Medicine, GHTM, Instituto de Higiene e Medicina Tropical, IHMT, Universidade Nova de Lisboa, Lisbon, Portugal
| | - Lara Tavoschi
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Silvia Declich
- Istituto Superiore di Sanità, Italian National Institute of Health, Rome, Italy
| | - Maurizio Marceca
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | | | | | | | - Amanda Garrison
- Faculty of Medicine, Southeastern Regional Health Observatory, Marseille, France
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Oliver J, Kaufman J, Bagot K, Bradfield Z, Homer C, Gibney K, Danchin M. Drivers of COVID-19 vaccine hesitancy among women of childbearing age in Victoria, Australia: A descriptive qualitative study. Vaccine X 2022; 12:100240. [PMCID: PMC9678207 DOI: 10.1016/j.jvacx.2022.100240] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 08/25/2022] [Accepted: 11/14/2022] [Indexed: 11/23/2022] Open
Abstract
Objective Women of childbearing age, including pregnant and breastfeeding women, report higher COVID-19 vaccine hesitancy, but reasons for this hesitancy are unknown. We explored factors influencing vaccine decision-making among women of childbearing age in Victoria, Australia to inform strategies to increase COVID-19 vaccine uptake. Methods Twenty-four women aged 18-40 years were interviewed July-October 2021. Interview data were analyzed thematically using an inductive, constructivist approach. Results Of 24 participants, 14 (57%) were vaccine-hesitant, of whom 10/14 pregnant or breastfeeding. Six key themes were identified: weighing up perceived risks for self and baby; availability of information; change and contradictions; vaccination above everything; practical issues – hurdles of inconvenience. Vaccine-hesitant women’s concerns included safety in pregnancy, breastfeeding and fertility effects. Some participants expressed a loss of trust in healthcare providers following vaccine mandates. Conclusions Public health campaigns and communication should be tailored to address specific concerns to increase COVID-19 vaccine uptake and prevent negative COVID-19 outcomes for women of childbearing age. Findings suggest that effective strategies to address hesitancy in this group may include providing robust short- and long-term safety data across fertility, birth outcomes and child development following COVID-19 vaccination. Other supportive strategies may include systemic changes like making childcare available at vaccination points (where practical), and using data linkage infrastructure to track post-vaccination outcomes.
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Affiliation(s)
- J. Oliver
- Murdoch Children’s Research Institute, The Royal Children's Hospital, 50 Flemington Road, Parkville, Victoria 3052 Australia,The Peter Doherty Institute for Infection and Immunity, Department of Infectious Diseases, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, 792 Elizabeth St, Melbourne, Victoria 3000 Australia,Corresponding author
| | - j. Kaufman
- Murdoch Children’s Research Institute, The Royal Children's Hospital, 50 Flemington Road, Parkville, Victoria 3052 Australia
| | - k. Bagot
- Murdoch Children’s Research Institute, The Royal Children's Hospital, 50 Flemington Road, Parkville, Victoria 3052 Australia
| | - Z. Bradfield
- School of Nursing, Faculty of Health Sciences, Curtin University, Kent St, Bentley, Western Australia 6102 Australia
| | - C. Homer
- Burnet Institute, 85 Commercial Rd, Melbourne, Victoria 3004 Australia
| | - K.B. Gibney
- The Peter Doherty Institute for Infection and Immunity, Department of Infectious Diseases, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, 792 Elizabeth St, Melbourne, Victoria 3000 Australia
| | - M. Danchin
- Murdoch Children’s Research Institute, The Royal Children's Hospital, 50 Flemington Road, Parkville, Victoria 3052 Australia,Department of Paediatrics, Melbourne Medical School, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Cnr Grattan Street & Royal Parade, University of Melbourne VIC 3010,Department of General Medicine, The Royal Children's Hospital, 50 Flemington Road, Parkville, Victoria 3052 Australia
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