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Tong WT, Seth A, Ng MPE, Tong SC, Lau A, Chen TYT, Ong SE, Yoong JSY. Factors Related to, and Effective Interventions for, Vaccination Uptake Among Older Adults in Two Asia-Pacific Countries: A Rapid Review. Asia Pac J Public Health 2024:10105395241258530. [PMID: 38869052 DOI: 10.1177/10105395241258530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2024]
Abstract
This rapid review aims to present a comprehensive overview of barriers, facilitators, and effective interventions that promote vaccination uptake by older adults in the Asia-Pacific region. Rapid review methodology was applied, using two databases (PubMed, Embase). Articles were included if studies were conducted in Australia, Singapore, Indonesia, and the Philippines; included human population ≥50 years of age, and was published from 2016 to August 2022. Related articles were not found from Indonesia and Philippines. A total of 23 articles met the inclusion criteria, with 19 reporting on barriers and facilitators, whereas, four articles reported effective interventions to promote vaccination uptake. Among the 19 studies that identified barriers and facilitators to vaccination uptake, the more common factors were social influences (n = 8/19), perceived benefits of vaccine (n = 7/19), and perceived vaccine safety (n = 6/19). Interventions that focused on supporting clinicians were found to be effective in leading them to recommend vaccinations among older adults, such as creating awareness on the low baseline vaccination rates among older adults, provision of structured health assessment, and nurse reminders. More studies are needed to ascertain the barriers and facilitators to uptake, as well as to identify effective interventions influencing vaccine uptake among older adults in the Asia-Pacific region.
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Affiliation(s)
- Wen Ting Tong
- Centre for Behavioural and Implementation Science Interventions, NUS Yong Loo Lin School of Medicine, Singapore
- Department of Primary Care Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Ananta Seth
- Centre for Behavioural and Implementation Science Interventions, NUS Yong Loo Lin School of Medicine, Singapore
- Asia-Pacific Immunization Coalition, Singapore
| | - Mary Pei Ern Ng
- Centre for Behavioural and Implementation Science Interventions, NUS Yong Loo Lin School of Medicine, Singapore
| | - Shao Chuen Tong
- Centre for Behavioural and Implementation Science Interventions, NUS Yong Loo Lin School of Medicine, Singapore
| | | | - Tina Yen-Ting Chen
- Centre for Behavioural and Implementation Science Interventions, NUS Yong Loo Lin School of Medicine, Singapore
| | | | - Joanne Su-Yin Yoong
- Centre for Behavioural and Implementation Science Interventions, NUS Yong Loo Lin School of Medicine, Singapore
- Research for Impact, Singapore
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Wilpstra CD, Morrell S, Mirza NA, Ralph JL. Consequences of COVID-19 Vaccine Hesitancy Among Healthcare Providers During the First 10 Months of Vaccine Availability: Scoping Review. Can J Nurs Res 2024:8445621241251711. [PMID: 38693882 DOI: 10.1177/08445621241251711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/03/2024] Open
Abstract
BACKGROUND Throughout the COVID-19 pandemic, healthcare providers (HCPs)-including nurses-have played important roles in the vaccination effort. It is expected that COVID-19 vaccine hesitancy among HCPs has numerous consequences; however, the scope of these consequences and their impacts on providers, patients, and the broader healthcare system remained unclear. PURPOSE To identify existing and emerging evidence to understand the state of knowledge of the consequences of COVID-19 vaccine hesitancy among HCPs. METHODS A scoping review was completed based upon the JBI scoping review methodology. The databases searched included OVID Medline, EBSCOhost CINAHL, ProQuest Nursing and Allied Health Source, ProQuest APA PsycInfo, and ProQuest Dissertations and Theses. The final literature search was completed on June 2, 2022. Studies were screened and retrieved based on predefined inclusion and exclusion criteria using Covidence reference management software. Data extraction followed criteria recommended in the JBI scoping review framework with additional relevant variables identified by the authors. RESULTS A total of 33 sources were included in the review. Consequences of HCP COVID-19 vaccine hesitancy were grouped under three themes and seven subthemes. Consequences affecting HCPs included health-related, psychosocial, and employment-related consequences. Consequences affecting patients pertained to COVID-19 vaccination communication and COVID-19 vaccination practices of HCPs. Consequences to the healthcare system involved consequences to coworkers and employment/attendance/staffing-related consequences. CONCLUSIONS Healthcare provider COVID-19 vaccine hesitancy was found to have numerous consequences. By understanding the scope and extent of these consequences, healthcare leaders, researchers, and HCPs can work together to protect providers, patients, and healthcare systems.
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Affiliation(s)
| | - Sherry Morrell
- Faculty of Nursing, University of Windsor, Windsor, Canada
| | - Noeman A Mirza
- Faculty of Nursing, University of Windsor, Windsor, Canada
| | - Jody L Ralph
- Faculty of Nursing, University of Windsor, Windsor, Canada
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3
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Simsekoglu N, Akyuz E, Guven R, Pasin O. Attitudes toward COVID-19 vaccines during pregnancy and breastfeeding. Front Public Health 2024; 12:1286891. [PMID: 38496391 PMCID: PMC10940332 DOI: 10.3389/fpubh.2024.1286891] [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: 08/31/2023] [Accepted: 02/20/2024] [Indexed: 03/19/2024] Open
Abstract
Background Although vaccination is one of the most effective means of controlling the spread of COVID-19, public concerns and indecision about vaccination still continue. Because pregnant and breastfeeding individuals are at high risk for severe outcomes in case of infections, determining their level of hesitation and attitude toward COVID-19 vaccines will guide the management of the disease. This study aimed to determine pregnant and breastfeeding women's levels of hesitation and attitude toward COVID-19 vaccines as well as their related factors. Methods The sample of this descriptive research consisted of 103 pregnant or breastfeeding individuals who were seen at the obstetrics and gynecology outpatients clinic of a state hospital in Istanbul, Turkey. The data were collected using a 'demographic data form', the 'Vaccine Hesitancy Scale in Pandemic', and the 'Attitudes toward COVID-19 Vaccine Scale'. The research data were analyzed with appropriate statistical methods. Results The mean age of the participants was 29.71 ± 4.75, 51% were pregnant, and 74.8% had received the COVID-19 vaccine. The mean score of the 'Vaccination Hesitancy Scale in Pandemic' was 30.83 ± 6.91, and the mean score for the 'Attitude Scale toward the COVID-19 Vaccine' was 25.50 ± 5.20. A significant difference was found between the total score of the 'Vaccine Hesitation Scale in the Pandemic' and the mean score of the 'Lack of Confidence' sub-dimension between the 'working status' and the 'influenza vaccination' status. In terms of the mean score of the 'Risk' sub-dimension, a significant difference was found between the 'period of vaccination' (p < 0.05). According to the mean total score of the 'Attitude Towards COVID-19 Vaccine Scale', there was a significant difference between the 'smoking' status. There was a significant difference in the 'Positive Attitude' sub-dimension in terms of the 'flu vaccination' status. There was a significant difference in the 'Negative Attitude' sub-dimension in terms of the 'chronic disease' status. A positive correlation was found between the total scores of the scales. Conclusion It was concluded that although the participants had a high level of hesitation toward the COVID-19 vaccine, they had a positive attitude. The results obtained will be guided in determining the strategies to be developed for these specific groups in future pandemics.
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Affiliation(s)
- Nesibe Simsekoglu
- Department of Home Patient Care, Hamidiye Vocational School of Health Services, University of Health Sciences, Istanbul, Turkey
| | - Enes Akyuz
- Department of Biophysics, Faculty of International Medicine, University of Health Sciences, Istanbul, Turkey
| | - Rabia Guven
- Division of Obstetrics and Gynaecology, Beykoz State Hospital, Istanbul, Turkey
| | - Ozge Pasin
- Department of Biostatistics, Faculty of Medicine, Bezmialem University, Istanbul, Turkey
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Liu Shiu Cheong D, Tran J, Chong W, May S, Carlson SJ, Salter SM, Attwell K. Attitudes, perceptions, and experiences of Western Australians towards vaccine safety surveillance systems following COVID-19 vaccines: A qualitative descriptive study. Aust N Z J Public Health 2024; 48:100108. [PMID: 38141591 DOI: 10.1016/j.anzjph.2023.100108] [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: 01/16/2023] [Revised: 07/27/2023] [Accepted: 11/07/2023] [Indexed: 12/25/2023] Open
Abstract
OBJECTIVE Concerns regarding adverse events following immunisation are a barrier to vaccine uptake. Health professionals use vaccine safety surveillance systems (VSSSs) to monitor vaccines and inform the public of safety data. With little known about public attitudes, perceptions, and experiences with VSSS, we examined them in the context of COVID-19 vaccinations in Western Australia. METHODS Researchers conducted 158 qualitative interviews between March 2021 and May 2022 within the broader [name redacted] project. Data regarding VSSS were coded in NVivo using the deductive and inductive methods. RESULTS Despite some not knowing about VSSS, participants expected follow-up post COVID-19 vaccination. Vaccine hesitant or refusing participants knew about VSSS and regarded these systems positively. Additional considerations concerned the reliability of data collected by VSSS. CONCLUSION Perceptions of VSSS signal a lack of understanding about how these systems work. Future studies should further explore the public's understanding of VSSS, whether VSSS improves vaccine confidence, and how governments can better communicate to the public about VSSS. IMPLICATIONS FOR PUBLIC HEALTH Lack of understanding of how VSSS operate may be stymying attempts to build public vaccine confidence. Healthcare providers and governments could build public knowledge and understanding of VSSS to mitigate concerns of adverse events following immunisation.
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Affiliation(s)
- Denis Liu Shiu Cheong
- School of Allied Health, The University of Western Australia, Perth, Western Australia, Australia
| | - Jayden Tran
- School of Allied Health, The University of Western Australia, Perth, Western Australia, Australia
| | - Wyitt Chong
- School of Allied Health, The University of Western Australia, Perth, Western Australia, Australia
| | - Scott May
- School of Allied Health, The University of Western Australia, Perth, Western Australia, Australia
| | - Samantha J Carlson
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, Western Australia, Australia; School of Social Sciences, University of Western Australia, Perth, Western Australia, Australia
| | - Sandra M Salter
- School of Allied Health, The University of Western Australia, Perth, Western Australia, Australia
| | - Katie Attwell
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, Western Australia, Australia; School of Social Sciences, University of Western Australia, Perth, Western Australia, Australia.
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Driedger SM, Maier R, Capurro G, Jardine C, Tustin J, Chartrand F, Sanguins J, Kloss O. "There's a little bit of mistrust": Red River Métis experiences of the H1N1 and COVID-19 pandemics. RISK ANALYSIS : AN OFFICIAL PUBLICATION OF THE SOCIETY FOR RISK ANALYSIS 2024. [PMID: 38286593 DOI: 10.1111/risa.14274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 11/24/2023] [Accepted: 12/28/2023] [Indexed: 01/31/2024]
Abstract
We examined the perspectives of the Red River Métis citizens in Manitoba, Canada, during the H1N1 and COVID-19 pandemics and how they interpreted the communication of government/health authorities' risk management decisions. For Indigenous populations, pandemic response strategies play out within the context of ongoing colonial relationships with government institutions characterized by significant distrust. A crucial difference between the two pandemics was that the Métis in Manitoba were prioritized for early vaccine access during H1N1 but not for COVID-19. Data collection involved 17 focus groups with Métis citizens following the H1N1 outbreak and 17 focus groups during the COVID-19 pandemic. Métis prioritization during H1N1 was met with some apprehension and fear that Indigenous Peoples were vaccine-safety test subjects before population-wide distribution occurred. By contrast, as one of Canada's three recognized Indigenous nations, the non-prioritization of the Métis during COVID-19 was viewed as an egregious sign of disrespect and indifference. Our research demonstrates that both reactions were situated within claims that the government does not care about the Métis, referencing past and ongoing colonial motivations. Government and health institutions must anticipate this overarching colonial context when making and communicating risk management decisions with Indigenous Peoples. In this vein, government authorities must work toward a praxis of decolonization in these relationships, including, for example, working in partnership with Indigenous nations to engage in collaborative risk mitigation and communication that meets the unique needs of Indigenous populations and limits the potential for less benign-though understandable-interpretations.
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Affiliation(s)
- S Michelle Driedger
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Ryan Maier
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Gabriela Capurro
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Cindy Jardine
- Faculty of Health Sciences, University of the Fraser Valley, Chilliwack, British Columbia, Canada
| | - Jordan Tustin
- School of Occupational and Public Health, Toronto Metropolitan University, Toronto, Ontario, Canada
| | - Frances Chartrand
- Health & Wellness Department, Manitoba Métis Federation, Winnipeg, Manitoba, Canada
| | - Julianne Sanguins
- Health & Wellness Department, Manitoba Métis Federation, Winnipeg, Manitoba, Canada
| | - Olena Kloss
- Health & Wellness Department, Manitoba Métis Federation, Winnipeg, Manitoba, Canada
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Déom N, Vanderslott S, Kingori P, Martin S. Online on the frontline: A longitudinal social media analysis of UK healthcare workers' attitudes to COVID-19 vaccines using the 5C framework. Soc Sci Med 2023; 339:116313. [PMID: 37984178 DOI: 10.1016/j.socscimed.2023.116313] [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: 09/30/2022] [Revised: 09/07/2023] [Accepted: 10/05/2023] [Indexed: 11/22/2023]
Abstract
This paper explores vaccine hesitancy among healthcare workers (HCWs) in the UK, where different COVID-19 vaccines were being rolled out through a national vaccination campaign from 2020 to 2022, consisting of a first and second dose programme. Through a mixed-method approach using qualitative discourse analysis and network analysis of Twitter data, we assessed HCW perceptions and views about the administration and delivery of COVID-19 vaccines in the United Kingdom (UK). We were also interested in exploring HCWs' personal experiences and attitudes towards taking COVID-19 vaccines themselves. We drew upon sociology, ethics, communication studies and used research methods concentrating on social media and media analysis. By employing the '5C framework' of 'confidence, complacency, constraints, calculation, and collective responsibility' we evaluated a longitudinal selection of tweets to capture relevant factors driving vaccination views and behaviours among HCWs. We found differing positions expressed about COVID-19 vaccines and policy during the first dose compared with the second, through a drop in confidence compounded by supply and access issues, as well the news of a vaccine mandate for HCWs by the UK government in 2021. HCWs asked calculation questions to the community or brought forward competing pieces of information about vaccine policy and guidelines. Constraint levels in access issues were noted, especially for those with work and caregiving responsibilities, and student nurses found they did not have equal vaccination access. HCWs also displayed collective responsibility on social platforms to both encourage vaccination and express concerns through the organisation of social action against vaccine mandates.
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Affiliation(s)
- Noémie Déom
- Department of Targeted Intervention, University College London, London, UK; Oxford Vaccine Group, Department of Paediatrics, Oxford University, Oxford, UK
| | - Samantha Vanderslott
- Oxford Vaccine Group, Department of Paediatrics, Oxford University, Oxford, UK; NIHR Oxford Biomedical Research Centre, Oxford, Oxfordshire, UK.
| | - Patricia Kingori
- Wellcome Centre for Ethics and Humanities, University of Oxford, Oxford, UK
| | - Sam Martin
- Department of Targeted Intervention, University College London, London, UK; Oxford Vaccine Group, Department of Paediatrics, Oxford University, Oxford, UK
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7
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Walliar T, Khan B, Newstead S, Al-Assadi G, Salter SM, Seubert L, Carlson SJ, Attwell K. "Fighting the pandemic!" Western Australian pharmacists' perspectives on COVID-19 vaccines: A qualitative study. Vaccine 2023; 41:7234-7243. [PMID: 37891049 DOI: 10.1016/j.vaccine.2023.10.045] [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: 12/12/2021] [Revised: 08/28/2023] [Accepted: 10/16/2023] [Indexed: 10/29/2023]
Abstract
BACKGROUND In Western Australia, community pharmacists are authorized to administer a range of vaccines without a prescription. Since mid-July 2021, pharmacists can also administer Coronavirus Disease 2019 (COVID-19) vaccines. Little is known about how pharmacists think and feel about giving and receiving COVID-19 vaccines and how they discuss it with patients. AIM This study aimed to explore Western Australian pharmacists' perceptions on being vaccinated with, administering, and communicating about COVID-19 vaccines. METHODS Semi structured interviews were conducted with 20 pharmacists from metropolitan and regional areas of Western Australia across a two-week period in July and early August 2021. Interview transcripts were coded using NVivo 20 and data was thematically analyzed using the framework method. RESULTS Most pharmacists (n = 16, 80 %) had received at least one dose of a COVID-19 vaccine. Some expressed difficulty accessing the vaccine while two unvaccinated pharmacists were hesitant to receive it due to concerns about vaccine development. The majority of pharmacists spoke positively about administering the vaccines, discussing perceived facilitators such as designated vaccination days but also perceived barriers such as inadequate financial reimbursement compared to other healthcare providers. Many pharmacists obtained their information from Australian government sources and training modules. Pharmacists were only passively promoting COVID-19 vaccines, with conversations mostly initiated by patients. Most pharmacists specified they would highlight the common side effects when administering the vaccine and would provide patients with written information. CONCLUSION The majority of pharmacists were willing to administer and be vaccinated with COVID-19 vaccines. Since pharmacists play an important role in increasing vaccine uptake, governments should provide equitable reimbursement to pharmacists in line with other vaccinators such as General Practitioners. We welcome the recent resources produced by governments and pharmacy professional organizations to help pharmacists actively promote the vaccines since this work was undertaken.
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Affiliation(s)
- Taaiba Walliar
- Pharmacy Discipline, School of Allied Health, The University of Western Australia, Perth, Western Australia, Australia
| | - Basil Khan
- Pharmacy Discipline, School of Allied Health, The University of Western Australia, Perth, Western Australia, Australia
| | - Sophie Newstead
- Pharmacy Discipline, School of Allied Health, The University of Western Australia, Perth, Western Australia, Australia
| | - Ghoufran Al-Assadi
- Pharmacy Discipline, School of Allied Health, The University of Western Australia, Perth, Western Australia, Australia
| | - Sandra M Salter
- Pharmacy Discipline, School of Allied Health, The University of Western Australia, Perth, Western Australia, Australia
| | - Liza Seubert
- Pharmacy Discipline, School of Allied Health, The University of Western Australia, Perth, Western Australia, Australia
| | - Samantha J Carlson
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Nedlands, Western Australia, Australia; School of Social Sciences, The University of Western Australia, Perth, Western Australia, Australia
| | - Katie Attwell
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Nedlands, Western Australia, Australia; School of Social Sciences, The University of Western Australia, Perth, Western Australia, Australia.
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Man SS, Wen H, Zhao L, So BCL. Role of Trust, Risk Perception, and Perceived Benefit in COVID-19 Vaccination Intention of the Public. Healthcare (Basel) 2023; 11:2589. [PMID: 37761786 PMCID: PMC10530888 DOI: 10.3390/healthcare11182589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 08/16/2023] [Accepted: 09/17/2023] [Indexed: 09/29/2023] Open
Abstract
COVID-19 vaccination is an effective method for dealing with the COVID-19 pandemic. This study proposed and validated a theoretical intention model for explaining the COVID-19 vaccination intention (CVI) of the public. The theoretical intention model incorporated trust in vaccines, two types of risk perception (risk perception of COVID-19 and risk perception of COVID-19 vaccination), and perceived benefit into a theory of planned behavior (TPB). Structural equation modeling was utilized to test the theoretical intention model with data collected from 816 Chinese adults in China. The results confirmed the crucial role of trust in vaccines, risk perception, and perceived benefit in shaping the CVI of the public. In addition, TPB was found to be applicable in a research context. The theoretical intention model accounted for 78.8% of the variance in CVI. Based on the findings, several practical recommendations for improving COVID-19 vaccination rates were discussed.
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Affiliation(s)
- Siu-Shing Man
- School of Design, South China University of Technology, Guangzhou 510641, China; (S.-S.M.); (H.W.)
| | - Huiying Wen
- School of Design, South China University of Technology, Guangzhou 510641, China; (S.-S.M.); (H.W.)
| | - Ligao Zhao
- Guangzhou Huadu Huacheng Community Health Service Centre, Guangzhou 510810, China;
| | - Billy Chun-Lung So
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
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Chen Y, Prichard R, Mason M, Tower M, Zimmerman PA, Sparke V, Layh J, Mehdi AM, Lin FF. Barriers and facilitators to COVID-19 vaccine uptake among Australian health professional students during the pandemic: a nationwide study. J Public Health Policy 2023; 44:400-414. [PMID: 37330562 PMCID: PMC10485127 DOI: 10.1057/s41271-023-00422-9] [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] [Accepted: 05/31/2023] [Indexed: 06/19/2023]
Abstract
Using a cross-sectional online survey we investigated knowledge, attitudes, and risk perception about COVID-19 vaccination and identified factors influencing vaccine uptake among Australian health professional students from October 2021 to January 2022. We analysed data from 1114 health professional students from 17 Australian universities. Most participants were enrolled in nursing programs (n = 958, 86.8%), and 91.6% (n = 858) of the participants received COVID-19 vaccination. Approximately 27% believed COVID-19 was no more serious than seasonal influenza and that they had a low risk of acquiring COVID-19. Nearly 20% disagreed that COVID-19 vaccines in Australia were safe and perceived they were at higher-risk of acquiring COVID infection than the general population. Higher-risk perception viewing vaccination as their professional responsibility, and vaccine mandate strongly predicted vaccination behaviour. Participants consider COVID-19 information from health professionals, government websites, and World Health Organization as the most trusted information sources. The findings highlight that healthcare decision-makers and university administrators need to monitor students' hesitancy with vaccination to improve students' promotion of the vaccination to the general population.
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Affiliation(s)
- Yingyan Chen
- School of Health, University of the Sunshine Coast, Sunshine Coast, Australia
- School of Health and Human Sciences, Southern Cross University, Gold Coast, Australia
| | - Roslyn Prichard
- School of Health, University of the Sunshine Coast, Sunshine Coast, Australia
| | - Matt Mason
- School of Health, University of the Sunshine Coast, Sunshine Coast, Australia
| | - Marion Tower
- School of Nursing and Midwifery, Griffith University, Nathan, Australia
- School of Nursing, Midwifery & Social Work, The University of Queensland, Brisbane, Australia
| | | | - Vanessa Sparke
- Nursing and Midwifery, College of Healthcare Sciences, James Cook University, Cairns, Australia
| | - Janice Layh
- School of Health, University of the Sunshine Coast, Sunshine Coast, Australia
| | - Ahmed M Mehdi
- QCIF Bioinformatics, Queensland Cyber Infrastructure Foundation Ltd, Brisbane, Australia
| | - Frances Fengzhi Lin
- School of Health, University of the Sunshine Coast, Sunshine Coast, Australia.
- Sunshine Coast Health Institute, Sunshine Coast, Australia.
- College of Nursing and Health Sciences, Flinders University, Level 1, Room N103, Sturt North Sturt Road, Bedford Park, South Australia, 5042, Australia.
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Abdi I, Bolsewicz K, Bullivant B, Marques MD, Steffens MS. Understanding the factors that influence communication about COVID-19 vaccines with patients: Perspectives of Australian immunisation providers. Vaccine X 2023; 14:100304. [PMID: 37091729 PMCID: PMC10108559 DOI: 10.1016/j.jvacx.2023.100304] [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: 12/22/2022] [Revised: 04/12/2023] [Accepted: 04/12/2023] [Indexed: 04/25/2023] Open
Abstract
Background COVID-19 immunisation providers have been at the forefront of the pandemic, and their ability to communicate effectively with patients is key to encouraging COVID-19 vaccine acceptance and uptake. This study explored providers' perspectives on the factors influencing communication with patients about COVID-19 vaccines. Methods We used an explanatory-sequential mixed-methods approach to conduct the study between December 2021 and March 2022. Phase I involved a cross-sectional survey with immunisation providers in New South Wales (n = 341; 189 general practitioners, 118 nurses and 34 pharmacists), followed by Phase II: semi-structured, in-depth qualitative interviews (n = 19; 10 nurses, 9 pharmacists). We generated descriptive results for the survey. We analysed the qualitative data thematically using an inductive approach. Results Almost half of survey participants reported communicating often with people who were hesitant about COVID-19 vaccines (49 %; 166/341), however, 21 % (71/341) reported inadequate time to address concerns during consultations. Interview participants reported communication challenges, including time constraints, difficulties addressing and eliciting patient concerns, and keeping up to date with changing information. Conversely, interview participants reported that easy access to government information resources, time to learn about COVID-19 vaccines proactively, knowing about and being able to use tailored strategies to support Aboriginal and Torres Strait Islander and CALD patients were helpful when communicating with patients. Conclusions Immunisation providers play an important role in patient vaccine acceptance and uptake. Our findings indicate that whilst providers were largely confident in their interactions with patients, further communication support would strengthen providers' skills in communicating with patients who have questions and concerns about COVID-19 vaccines.
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Affiliation(s)
- Ikram Abdi
- National Centre for Immunisation Research and Surveillance, Westmead, NSW, Australia
- The Children's Hospital at Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Katarzyna Bolsewicz
- National Centre for Immunisation Research and Surveillance, Westmead, NSW, Australia
- The Children's Hospital at Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Bianca Bullivant
- National Centre for Immunisation Research and Surveillance, Westmead, NSW, Australia
- The Children's Hospital at Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Mathew D Marques
- School of Psychology and Public Health, La Trobe University, Bundoora, Victoria, Australia
| | - Maryke S Steffens
- National Centre for Immunisation Research and Surveillance, Westmead, NSW, Australia
- The Children's Hospital at Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
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11
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Hilton Z, Hoq M, Danchin M, Kaufman J. Reducing COVID-19 Vaccine Decisional Conflict in Parents of 5-11-Year-Old Children in Australia: A Single Arm Pre-Post Study. Vaccines (Basel) 2023; 11:1296. [PMID: 37631864 PMCID: PMC10458235 DOI: 10.3390/vaccines11081296] [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: 05/31/2023] [Revised: 07/17/2023] [Accepted: 07/23/2023] [Indexed: 08/27/2023] Open
Abstract
COVID-19 vaccine uptake among 5-11-year-olds is significantly lower than that of the 12+ age group. Some parents may have decided against vaccinating their children for COVID-19; others may be undecided and may be seeking more information to support their decision. We aimed to assess the effect of a decision support tool on parents' level of decisional conflict, vaccine hesitancy, and intention to vaccinate. We conducted a single-arm, cross-sectional online pre-post intervention survey of parents from Victoria, Australia, who had not yet vaccinated their 5-11-year-old child for COVID-19. We measured change in decisional conflict, intention, and hesitancy towards COVID-19 vaccines for children before and after viewing a decision support tool. We used logistic regression to identify characteristics associated with reduced decisional conflict. Between May and September 2022, 108 parents took part in the study. The tool reduced decision conflict in 25% (27/107) of parents, with reduced decisional conflict more likely among parents initially undecided about vaccinating, compared to parents who did not intend to vaccinate their child (OR, 12.58 95% CI 3.21 to 9.30). For most parents, hesitancy (83%, 90/108) and intention (89%, 96/108) remained the same. The decision support tool was modestly effective at reducing decisional conflict, particularly among undecided parents.
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Affiliation(s)
- Zephaniah Hilton
- Vaccine Uptake Group, Murdoch Children’s Research Institute, Parkville 3052, Australia (M.D.); (J.K.)
| | - Monsurul Hoq
- Vaccine Uptake Group, Murdoch Children’s Research Institute, Parkville 3052, Australia (M.D.); (J.K.)
- The National Child Health Poll, The Royal Children’s Hospital, Parkville 3052, Australia
- Clinical Epidemiology and Biostatistics Unit, Murdoch Children’s Research Institute, Melbourne 3052, Australia
| | - Margie Danchin
- Vaccine Uptake Group, Murdoch Children’s Research Institute, Parkville 3052, Australia (M.D.); (J.K.)
- Department of General Medicine, The Royal Children’s Hospital, Parkville 3052, Australia
- Department of Paediatrics, The University of Melbourne, Parkville 3052, Australia
| | - Jessica Kaufman
- Vaccine Uptake Group, Murdoch Children’s Research Institute, Parkville 3052, Australia (M.D.); (J.K.)
- Department of Paediatrics, The University of Melbourne, Parkville 3052, Australia
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12
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Dubé E, Trottier ME, Gagnon D, Bettinger JA, Greyson D, Graham J, MacDonald NE, MacDonald SE, Meyer SB, Witteman HO, Driedger SM. Exploring parents' views of the use of narratives to promote childhood vaccination online. PLoS One 2023; 18:e0284107. [PMID: 37467300 DOI: 10.1371/journal.pone.0284107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 03/23/2023] [Indexed: 07/21/2023] Open
Abstract
BACKGROUND Negative information about vaccines that spreads online may contribute to parents' vaccine hesitancy or refusal. Studies have shown that false claims about vaccines that use emotive personal narratives are more likely to be shared and engaged with on social media than factual evidence-based public health messages. The aim of this study was to explore parents' views regarding the use of positive narratives to promote childhood vaccination. METHODS We identified three ∼4-minute video narratives from social media that counter frequent parental concerns about childhood vaccination: parents and informed decision-making (online misinformation about vaccines); a paediatrician's clinical experience with vaccine-preventable diseases (prevention of still existing diseases); and a mother's experience with vaccine-preventable disease (risks of the disease). Focus group discussions were held with parents of children aged 0 to 5 years to assess their views on these three narratives and their general opinion on the use of narratives as a vaccine promotion intervention. RESULTS Four focus groups discussions were virtually held with 15 parents in December 2021. In general, parents trusted both health care provider's and parent's narratives, but participants identified more with stories having a parent as the main character. Both narratives featuring personal stories with vaccine-preventable diseases were preferred by parents, while the story about informed decision-making was perceived as less influential. Parents expressed the need for reliable and nuanced information about vaccines and diseases and felt that a short video format featuring a story was an efficient vaccine promotion intervention. However, many mentioned that they generally are not watching such videos while navigating the Web. CONCLUSION While vaccine-critical stories are widely shared online, evidence on how best public health could counter these messages remains scarce. The use of narratives to promote vaccination was well-perceived by parents. Future studies are needed to assess reach and impact of such an intervention.
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Affiliation(s)
- Eve Dubé
- Department of Anthropology, Laval University, Quebec, Quebec, Canada
- Department of Biohazard, Quebec National Institute of Public Health, Quebec, Quebec, Canada
| | - Marie-Eve Trottier
- 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
| | - Julie A Bettinger
- Department of Pediatrics, Vaccine Evaluation Center, BC Children's Hospital Research Institute, University of British Columbia, Vancouver, British Columbia, Canada
| | - Devon Greyson
- Department of Pediatrics, Vaccine Evaluation Center, BC Children's Hospital Research Institute, University of British Columbia, Vancouver, British Columbia, Canada
| | - Janice Graham
- Department of Pediatrics, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Noni E MacDonald
- Department of Pediatrics, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Shannon E MacDonald
- Faculty of Nursing, University, University of Alberta, Edmonton, Alberta, Canada
| | - Samantha B Meyer
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - Holly O Witteman
- Department of Family Medicine, Laval University, Quebec, Quebec, Canada
| | - S Michelle Driedger
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
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13
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Bullivant B, Bolsewicz KT, King C, Steffens MS. COVID-19 vaccination acceptance among older adults: A qualitative study in New South Wales, Australia. PUBLIC HEALTH IN PRACTICE 2023; 5:100349. [PMCID: PMC9737511 DOI: 10.1016/j.puhip.2022.100349] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 11/22/2022] [Accepted: 12/05/2022] [Indexed: 12/14/2022] Open
Abstract
Objectives The COVID-19 pandemic has had a severe impact on people across the world, particularly older adults who have a higher risk of death and health complications. We aimed to explore older adults’ intention towards COVID-19 vaccination and factors that influenced their motivation to get vaccinated. Study design A qualitative study was conducted in New South Wales, Australia (April 2021), involving interviews with older adults (aged 70 years and older). Methods In-depth interviews were carried out with 14 older adults on their perceptions around COVID-19 vaccination. The COVID-19 vaccination program had just commenced at the time of data collection. We thematically analysed interviews and organised the themes within the Behavioural and Social Drivers of Vaccination (BeSD) Framework. Results We found that most participants were accepting of COVID-19 vaccination. Participants’ motivation to get vaccinated was influenced by the way they thought and felt about COVID-19 disease and vaccination (including perceptions of vaccine safety, effectiveness, benefits, COVID-19 disease risk, and vaccine brand preferences) and social influences (including healthcare provider recommendation, and influential others). The uptake of COVID-19 vaccination was also mediated by practical issues such as access and affordability. Conclusions Efforts to increase COVID-19 vaccination acceptance in this population should focus on highlighting the benefits of vaccination. Support should be given to immunisation providers to enhance efforts to discuss and recommend vaccination to this high-risk group.
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Affiliation(s)
- Bianca Bullivant
- National Centre for Immunisation Research and Surveillance, Kids Research, Sydney Children's Hospitals Network, Cnr Hawkesbury Rd & Hainsworth St., Westmead, NSW, 2145, Australia,The Children's Hospital at Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia,Corresponding author. National Centre for Immunisation Research and Surveillance, Kids Research, Sydney Children's Hospitals Network, Cnr Hawkesbury Rd & Hainsworth St., Westmead, NSW, 2145, Australia
| | - Katarzyna T. Bolsewicz
- National Centre for Immunisation Research and Surveillance, Kids Research, Sydney Children's Hospitals Network, Cnr Hawkesbury Rd & Hainsworth St., Westmead, NSW, 2145, Australia,The Children's Hospital at Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia,Hunter New England Local Health District, Health Protection, Wallsend Hospital Campus, Wallsend, NSW, 2287, Australia
| | - Catherine King
- National Centre for Immunisation Research and Surveillance, Kids Research, Sydney Children's Hospitals Network, Cnr Hawkesbury Rd & Hainsworth St., Westmead, NSW, 2145, Australia,The Children's Hospital at Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia,Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Maryke S. Steffens
- National Centre for Immunisation Research and Surveillance, Kids Research, Sydney Children's Hospitals Network, Cnr Hawkesbury Rd & Hainsworth St., Westmead, NSW, 2145, Australia,The Children's Hospital at Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
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14
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Kaufman J, Steffens MS, Hoq M, King C, Marques MD, Mao K, Bullivant B, Danchin M. Effect of persuasive messaging about COVID-19 vaccines for 5- to 11-year-old children on parent intention to vaccinate. J Paediatr Child Health 2023; 59:686-693. [PMID: 36807943 DOI: 10.1111/jpc.16374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 01/28/2023] [Accepted: 01/30/2023] [Indexed: 02/20/2023]
Abstract
AIM Uptake of COVID-19 vaccines for children aged 5-11 years old in Australia has plateaued. Persuasive messaging is an efficient and adaptable potential intervention to promote vaccine uptake, but evidence for its effectiveness is varied and dependent on context and cultural values. This study aimed to test persuasive messages to promote COVID-19 vaccines for children in Australia. METHODS A parallel, online, randomised control experiment was conducted between 14 and 21 January 2022. Participants were Australian parents of a child aged 5-11 years who had not vaccinated their child with a COVID-19 vaccine. After providing demographic details and level of vaccine hesitancy, parents viewed either the control message or one of four intervention texts emphasising (i) personal health benefits; (ii) community health benefits; (iii) non-health benefits; or (iv) personal agency. The primary outcome was parents' intention to vaccinate their child. RESULTS The analysis included 463 participants, of whom 58.7% (272/463) were hesitant about COVID-19 vaccines for children. Intention to vaccinate was higher in the community health (7.8%, 95% confidence interval (CI) -5.3% to 21.0%) and non-health (6.9%, 95% CI -6.4% to 20.3%) groups, and lower in the personal agency group (-3.9, 95% CI -17.7 to 9.9) compared to control, but these differences did not reach statistical significance. The effects of the messages among hesitant parents were similar to the overall study population. CONCLUSION Short, text-based messages alone are unlikely to influence parental intention to vaccinate their child with the COVID-19 vaccine. Multiple strategies tailored for the target audience should also be utilised.
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Affiliation(s)
- Jessica Kaufman
- Vaccine Uptake Group, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
| | - Maryke S Steffens
- National Centre for Immunisation Research and Surveillance, Kids Research, Sydney Children's Hospitals Network, Sydney, New South Wales, Australia.,The Children's Hospital at Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Monsurul Hoq
- Vaccine Uptake Group, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,Clinical Epidemiology and Biostatistics Unit, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Catherine King
- National Centre for Immunisation Research and Surveillance, Kids Research, Sydney Children's Hospitals Network, Sydney, New South Wales, Australia.,The Children's Hospital at Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Mathew D Marques
- School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia
| | - Kevin Mao
- Vaccine Uptake Group, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Bianca Bullivant
- National Centre for Immunisation Research and Surveillance, Kids Research, Sydney Children's Hospitals Network, Sydney, New South Wales, Australia.,The Children's Hospital at Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Margie Danchin
- Vaccine Uptake Group, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia.,Department of General Medicine, Royal Children's Hospital, Melbourne, Victoria, Australia
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15
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Grech L, Kwok A, Nguyen M, Winkel A, Butler E, Allan M, Bain N, Segelov E. COVID-19 Vaccine Status, Intent, Hesitancy, and Disease-Related Beliefs in People with Multiple Sclerosis. Vaccines (Basel) 2023; 11:vaccines11020410. [PMID: 36851287 PMCID: PMC9964563 DOI: 10.3390/vaccines11020410] [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] [Received: 01/10/2023] [Revised: 01/31/2023] [Accepted: 02/08/2023] [Indexed: 02/15/2023] Open
Abstract
BACKGROUND People with multiple sclerosis (MS) are susceptible to severe COVID-19 outcomes. They were included as a priority group for the Australian COVID-19 vaccine roll-out in early 2021. However, vaccine hesitancy remains a complex barrier to vaccination in this population group, which may be partly related to disease relapse concerns following COVID-19 vaccination. This study examined the COVID-19 vaccination status, intent, hesitancy, and disease-related beliefs in people with MS. METHODS An online survey was conducted with people with MS receiving care at two Australian health services between September and October 2021. It collected sociodemographic and disease-specific characteristics and responses to validated scales that assessed vaccine hesitancy and general and MS-related vaccine beliefs. RESULTS Of the 281 participants [mean age 47.7 (SD 12.8) years; 75.8% females], most (82.9%) had received at least one COVID-19 vaccine dose. Younger participants were less likely to be vaccinated, as were those within 1-5 years of disease duration. After controlling for age, disease duration was not associated with vaccination status. Unvaccinated participants were more likely to report less willingness to receive the COVID-19 vaccine, higher vaccine complacency and lower vaccine confidence, greater MS-related vaccine complacency, and higher MS and treatment interaction concerns. CONCLUSIONS People with MS reported a high vaccination rate, despite general and MS-specific COVID-19 vaccine concerns. Greater MS-specific concerns were reported by those who indicated that their MS was not well-controlled and their MS impacted their daily activities. By understanding the factors that influence vaccine hesitancy and their interplay with MS disease course and treatment concerns, this can inform tailored interventions and educational messages to address these concerns in people with MS. Clinicians, governments, and community organisations are key partners in delivering these interventions and messages, as ongoing booster doses are needed for this vulnerable population.
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Affiliation(s)
- Lisa Grech
- Department of Medicine, School of Clinical Sciences, Monash University, Clayton, VIC 3168, Australia
- Correspondence:
| | - Alastair Kwok
- Department of Medicine, School of Clinical Sciences, Monash University, Clayton, VIC 3168, Australia
- Department of Oncology, Monash Health, Clayton, VIC 3168, Australia
| | - Mike Nguyen
- Department of Medicine, School of Clinical Sciences, Monash University, Clayton, VIC 3168, Australia
- Department of Oncology, Monash Health, Clayton, VIC 3168, Australia
| | - Antony Winkel
- Department of Neurology, Sunshine Coast Hospital and Health Service, Birtinya, QLD 4575, Australia
- School of Medicine, Griffith University, Birtinya, QLD 4575, Australia
| | - Ernest Butler
- Department of Medicine, School of Clinical Sciences, Monash University, Clayton, VIC 3168, Australia
- Monash Neurology, Monash Health, Clayton, VIC 3168, Australia
| | - Michelle Allan
- Monash Neurology, Monash Health, Clayton, VIC 3168, Australia
| | - Nathan Bain
- Department of Oncology, Monash Health, Clayton, VIC 3168, Australia
| | - Eva Segelov
- Department of Medicine, School of Clinical Sciences, Monash University, Clayton, VIC 3168, Australia
- Department of Oncology, Monash Health, Clayton, VIC 3168, Australia
- Department of Clinical Research, Faculty of Medicine, University of Bern, 3012 Bern, Switzerland
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16
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Roberts L, Deml MJ, Attwell K. 'COVID Is Coming, and I'm Bloody Scared': How Adults with Co-Morbidities' Threat Perceptions of COVID-19 Shape Their Vaccination Decisions. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2953. [PMID: 36833657 PMCID: PMC9957419 DOI: 10.3390/ijerph20042953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 02/02/2023] [Accepted: 02/03/2023] [Indexed: 06/18/2023]
Abstract
Adults with comorbidities have faced a high risk from COVID-19 infection. However, Western Australia experienced relatively few infections and deaths from 2020 until early 2022 compared with other OECD countries, as hard border policies allowed for wide-scale vaccination before mass infections began. This research investigated the thoughts, feelings, risk perceptions, and practices of Western Australian adults with comorbidities aged 18-60 years in regard to COVID-19 disease and COVID-19 vaccines. We conducted 14 in-depth qualitative interviews between January and April 2022, just as the disease was starting to circulate. We coded results inductively and deductively, combining the Extended Parallel Process Model (EPPM) and vaccine belief models. Non-hesitant participants believed COVID-19 vaccines were safe and effective at mitigating COVID-19's threat and subsequently got vaccinated. Vaccine hesitant participants were less convinced the disease was severe or that they were susceptible to it; they also did not consider the vaccines to be sufficiently safe. Yet, for some hesitant participants, the exogenous force of mandates prompted vaccination. This work is important to understand how people's thoughts and feelings about their comorbidities and risks from COVID-19 influence vaccine uptake and how mandatory policies can affect uptake in this cohort.
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Affiliation(s)
- Leah Roberts
- School of Social Sciences, The University of Western Australia, Perth, WA 6009, Australia
| | - Michael J. Deml
- School of Social Sciences, The University of Western Australia, Perth, WA 6009, Australia
- Institute of Sociological Research, University of Geneva, 1211 Geneva, Switzerland
- Division of Social and Behavioural Sciences, School of Public Health, University of Cape Town, Cape Town 7925, South Africa
| | - Katie Attwell
- School of Social Sciences, The University of Western Australia, Perth, WA 6009, Australia
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, WA 6009, Australia
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17
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Abstract
OBJECTIVES The discovery and subsequent manufacture of various types of COVID-19 vaccines were considered a breakthrough in the fight against the COVID-19 pandemic. Initially, limited supplies of COVID-19 vaccines warranted vulnerable populations such as people living with chronic non-communicable diseases and the elderly to be prioritised for vaccination. Nevertheless, the uptake of the COVID-19 vaccines among these populations was suboptimal. In this study, we aimed to describe the drivers of COVID-19 vaccine hesitancy among people living with chronic non-communicable diseases in Ibadan, Nigeria. METHOD We applied qualitative methods to explore the feelings and thoughts of people living with chronic non-communicable diseases towards COVID-19 vaccines, at a tertiary hospital in Ibadan, Nigeria. Data were obtained from 25 people living with chronic conditions through in-depth interviews. We thematically analysed the transcripts inductively and deductively. Dedoose qualitative data management software was used to manage the data. FINDINGS Emerging subthemes were grouped into two major themes: Hesitancy towards the COVID-19 vaccine related to biological concerns and those related to sociopolitical issues. Hesitancy towards the COVID-19 vaccine associated with biological factors included: (1) concerns over the COVID-19 vaccine worsening the underlying chronic condition; (2) fear of harmful physiological consequences; (3) concerns over insufficient testing of vaccine for safety and (4) perceived vaccine infectiveness. Sociopolitical factors were related to (1) misconceptions of vaccines as a treatment for those with COVID-19; (2) mistrust of manufacturers ('the whites'); (3) mistrust of government and (4) COVID-19 misinformation. CONCLUSION Public health education on the nature and benefits of the COVID-19 vaccine is urgently needed among people living with chronic non-communicable diseases. These measures could improve COVID-19 vaccine uptake and healthcare usage in general. Paying attention to these factors could have implications for the management of the next global pandemic requiring mass vaccination.
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Affiliation(s)
- Lucia Y Ojewale
- Department of Nursing, University of Ibadan, Ibadan, Oyo State, Nigeria
| | - Ferdinand C Mukumbang
- School of Public Health, University of the Western Cape, Bellville, South Africa
- Department of Global Health, University of Washington Seattle Campus, Seattle, Washington, USA
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18
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Lupton D. Attitudes to COVID-19 Vaccines Among Australians During the Delta Variant Wave: A Qualitative Interview Study. Health Promot Int 2023; 38:7026242. [PMID: 36738451 DOI: 10.1093/heapro/daac192] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Since the outbreak of COVID-19 globally, a range of vaccines has been developed and delivered to reduce viral transmission and prevent COVID cases. This article reports findings from a qualitative research project involving telephone interviews with a diverse group of 40 adult Australians about their experiences of the COVID crisis. Interviews were conducted in late 2021 when Australians were dealing with the Delta variant outbreak and following a major effort on the part of government authorities to improve COVID-19 vaccination supplies and take-up. Responses to a question about COVID vaccines revealed that attitudes to and acceptance of COVID vaccines among this group were overwhelmingly positive. All participants had received at least one vaccine dose and the majority expressed views in support of mass vaccination against COVID. People who were hesitant or cautious about accepting COVID vaccination referred to the vaccines' novelty and potential side effects. While many people were aware of debates about vaccine safety in the news media, trust in science and medical advice about COVID vaccines was strong. Participants wanted to protect themselves and others by accepting the recommended doses. Participants' locale was a major factor in shaping experiences and stances on vaccines. The setting of government targets and mandates for vaccination was a key motivating factor. The goal of 'getting back to normal' was expressed as another reason for accepting vaccination, particularly for those living in areas that had been badly affected by high COVID cases and prolonged lockdowns.
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Affiliation(s)
- Deborah Lupton
- Vitalities Lab, Centre for Social Research in Health and Social Policy Research Centre, Goodsell Building, University of New South Wales (UNSW), Sydney 2052, Australia
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19
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Valero-Martínez C, Martínez-Rivera C, Zhen-Duan J, Fukuda M, Alegría M. Attitudes toward COVID-19 Vaccine Uptake: A Qualitative Study of Mostly Immigrant Racial/Ethnic Minority Older Adults. Geriatrics (Basel) 2023; 8:17. [PMID: 36826359 PMCID: PMC9956127 DOI: 10.3390/geriatrics8010017] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 01/16/2023] [Accepted: 01/18/2023] [Indexed: 01/22/2023] Open
Abstract
(1) Background: Few qualitative studies address diverse older adults' perceptions of COVID-19 vaccination in the United States, including non-English speakers and immigrant populations. This study aims to understand the attitudes of diverse, primarily immigrant older adults in the U.S. toward the COVID-19 vaccine and its influences on their vaccination decision-making. (2) Methods: The research team conducted semi-structured interviews (N = 100) in 2021 focused on understanding ethnically/racially diverse older adults' perceptions of the COVID-19 vaccine. Interviews were recorded, coded, and analyzed using a thematic analysis approach. (3) Results: Thematic analyses identified three themes. (1) Older adults showed mixed attitudes toward the COVID-19 vaccine associated with information consumed and trust in healthcare systems; (2) health concerns and underlying medical conditions were the most influential factors of vaccine uptake; and (3) systemic barriers and trusted figures impacted vaccination decision-making of older adults. (4) Conclusions: Accessible information in diverse languages tailored to the community's fears is needed to combat vaccine mistrust. Vaccine rollout programs need to tackle the fear of vaccine side effects. Attitudes of religious leaders, family members, and physicians considerably influenced vaccine uptake, suggesting their role as trusted members for vaccine messaging for older, primarily immigrant adults. Systemic barriers, namely lack of transportation and inaccessible vaccination sites, contributed to vaccine deterrence.
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Affiliation(s)
- Carla Valero-Martínez
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital, Boston, MA 02114, USA
- Department of Psychology, Faculty of Social Sciences, Río Piedras Campus, University of Puerto Rico, San Juan, PR 00925, USA
| | - Christopher Martínez-Rivera
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital, Boston, MA 02114, USA
- School of Medicine, Ponce Health Sciences University, Ponce, PR 00716, USA
| | - Jenny Zhen-Duan
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital, Boston, MA 02114, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA 02215, USA
| | - Marie Fukuda
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Margarita Alegría
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital, Boston, MA 02114, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA 02215, USA
- Department of Medicine, Harvard Medical School, Boston, MA 02115, USA
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20
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Factors Influencing COVID-19 Vaccine Hesitancy among Patients with Serious Chronic Illnesses during the Initial Australian Vaccine Rollout: A Multi-Centre Qualitative Analysis Using the Health Belief Model. Vaccines (Basel) 2023; 11:vaccines11020239. [PMID: 36851117 PMCID: PMC9963130 DOI: 10.3390/vaccines11020239] [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] [Received: 12/23/2022] [Revised: 01/18/2023] [Accepted: 01/19/2023] [Indexed: 01/24/2023] Open
Abstract
Background: People with chronic illnesses have increased morbidity and mortality associated with COVID-19 infection. The influence of a person's serious and/or comorbid chronic illness on COVID-19 vaccine uptake is not well understood. Aim: To undertake an in-depth exploration of factors influencing COVID-19 vaccine uptake among those with various serious and/or chronic diseases in the Australian context, using secondary data analysis of a survey study. Methods: Adults with cancer, diabetes and multiple sclerosis (MS) were recruited from 10 Australian health services to undertake a cross-sectional online survey (30 June to 5 October 2021) about COVID-19 vaccine uptake, vaccine hesitancy, confidence and complacency and disease-related decision-making impact. Free-text responses were invited regarding thoughts and feelings about the interaction between the participant's disease, COVID-19, and vaccination. Qualitative thematic analysis was undertaken using an iterative process and representative verbatim quotes were chosen to illustrate the themes. Results: Of 4683 survey responses (cancer 3560, diabetes 842, and MS 281), 1604 (34.3%) included free-text comments for qualitative analysis. Participants who provided these were significantly less likely to have received a COVID-19 vaccination than those who did not comment (72.4% and 86.2%, respectively). People with diabetes were significantly less likely to provide free-text comments than those with cancer or MS (29.0%, 35.1% and 39.9%, respectively). Four key themes were identified from qualitative analysis, which were similar across disease states: (1) having a chronic disease heightened perceived susceptibility to and perceived severity of COVID-19; (2) perceived impact of vaccination on chronic disease management and disease-related safety; (3) uncertain benefits of COVID-19 vaccine; and (4) overwhelming information overload disempowering patients. Conclusions: This qualitative analysis highlights an additional layer of complexity related to COVID-19 vaccination decision making in people with underlying health conditions. Appreciation of higher susceptibility to severe COVID-19 outcomes appears to be weighed against uncertain impacts of the vaccine on the progression and management of the comorbid disease. Interactions by clinicians addressing individual factors may alleviate concerns and maximise vaccine uptake in people with significant underlying health conditions.
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21
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Attwell K, McKenzie L, Tomkinson S, Carlson SJ, Blyth CC. Parents' COVID-19 vaccine intentions for children under 5 years: Brief reflections from a qualitative study. J Paediatr Child Health 2023; 59:453-457. [PMID: 36637082 DOI: 10.1111/jpc.16312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 12/08/2022] [Accepted: 12/11/2022] [Indexed: 01/14/2023]
Abstract
AIM Australian authorities made COVID-19 vaccines available for children aged under 5 years old with serious comorbidities in August 2022. There is presently no universal programme for young children, but crucial to any rollout's success is whether parents are motivated and able to vaccinate. By examining parents' vaccine intentions, this study aims to inform current and future COVID-19 vaccine roll-outs for children aged under 5 years. METHODS As part of the mixed methods project 'Coronavax: Preparing Community and Government' we interviewed 18 Western Australian parents of young children about their intentions in late 2021. RESULTS Two thirds intended to vaccinate if and when they could, with one third intending to delay for reasons including risk and safety perceptions, fears about side effects and influence from their social networks. However, even those choosing to delay were waiting rather than refusing. CONCLUSIONS To improve uptake, targeted messaging should emphasise that COVID-19 can be a serious disease in young children, with such messaging drawing on the reputability and esteem of scientific and technical authorities. Such messaging should be oriented towards parents of children with serious comorbidities at the present time. It will be important to emphasise that government vaccine recommendations are based on supporting families to protect their children and keep them healthy.
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Affiliation(s)
- Katie Attwell
- School of Social Sciences, The University of Western Australia, Perth, Western Australia, Australia.,Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, Western Australia, Australia
| | - Lara McKenzie
- School of Social Sciences, The University of Western Australia, Perth, Western Australia, Australia
| | - Sian Tomkinson
- School of Social Sciences, The University of Western Australia, Perth, Western Australia, Australia
| | - Samantha J Carlson
- School of Social Sciences, The University of Western Australia, Perth, Western Australia, Australia.,Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, Western Australia, Australia
| | - Christopher C Blyth
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, Western Australia, Australia
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22
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Williams SN, Armitage CJ, Dienes K, Drury J, Tampe T. Public decisions about COVID-19 vaccines: A UK-based qualitative study. PLoS One 2023; 18:e0277360. [PMID: 36877671 PMCID: PMC9987765 DOI: 10.1371/journal.pone.0277360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 10/26/2022] [Indexed: 03/07/2023] Open
Abstract
OBJECTIVE To explore UK public decisions around whether or not to get COVID-19 vaccines, and the facilitators and barriers behind participants' decisions. DESIGN This qualitative study consisted of six online focus groups conducted between 15th March and 22nd April 2021. Data were analysed using a framework approach. SETTING Focus groups took place via online videoconferencing (Zoom). PARTICIPANTS Participants (n = 29) were a diverse group (by ethnicity, age and gender) UK residents aged 18 years and older. RESULTS We used the World Health Organization's vaccine hesitancy continuum model to look for, and explore, three main types of decisions related to COVID-19 vaccines: vaccine acceptance, vaccine refusal and vaccine hesitancy (or vaccine delay). Two reasons for vaccine delay were identified: delay due to a perceived need for more information and delay until vaccine was "required" in the future. Nine themes were identified: three main facilitators (Vaccination as a social norm; Vaccination as a necessity; Trust in science) and six main barriers (Preference for "natural immunity"; Concerns over possible side effects; Perceived lack of information; Distrust in government;; Conspiracy theories; "Covid echo chambers") to vaccine uptake. CONCLUSION In order to address vaccine uptake and vaccine hesitancy, it is useful to understand the reasons behind people's decisions to accept or refuse an offer of a vaccine, and to listen to them and engage with, rather than dismiss, these reasons. Those working in public health or health communication around vaccines, including COVID-19 vaccines, in and beyond the UK, might benefit from incorporating the facilitators and barriers found in this study.
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Affiliation(s)
- Simon N. Williams
- School of Psychology, Swansea University, Swansea, Wales, United Kingdom
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, United States of America
- * E-mail:
| | - Christopher J. Armitage
- Manchester Centre for Health Psychology, University of Manchester, Manchester, United Kingdom
- Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, United Kingdom
- NIHR Greater Manchester Patient Safety Translational Research Centre, University of Manchester, Manchester, United Kingdom
| | - Kimberly Dienes
- School of Psychology, Swansea University, Swansea, Wales, United Kingdom
- Manchester Centre for Health Psychology, University of Manchester, Manchester, United Kingdom
| | - John Drury
- University of Sussex, School of Psychology, Falmer, United Kingdom
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Biezen R, Kaufman J, Hoq M, Manski-Nankervis JA, Sanci L, Bell JS, Leask J, Seale H, Munro J, Suryawijaya Ong D, Oliver J, Jos C, Tuckerman J, Bagot K, Danchin M. Factors impacting COVID-19 vaccine decision making in older adults and people with underlying conditions in Victoria, Australia: A cross-sectional survey. Hum Vaccin Immunother 2022; 18:2147770. [PMID: 36573307 PMCID: PMC9891679 DOI: 10.1080/21645515.2022.2147770] [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] [Indexed: 12/28/2022] Open
Abstract
Australia's COVID-19 vaccine rollout included prioritizing older adults and those with underlying conditions. However, little was known around the factors impacting their decision to accept the vaccine. This study aimed to assess vaccine intentions, information needs, and preferences of people prioritized to receive the COVID-19 vaccine at the start of the Australian vaccine rollout. A cross-sectional online survey of people aged ≥70 years or 18-69 with chronic or underlying conditions was conducted between 12 February and 26 March 2021 in Victoria, Australia. The World Health Organization Behavioural and Social Drivers of COVID-19 vaccination framework and items informed the survey design and framing of results. Bivariate logistic regression was used to investigate the association between intention to accept a COVID-19 vaccine and demographic characteristics. In total, 1828 eligible people completed the survey. Intention to vaccinate was highest among those ≥70 years (89.6%, n = 824/920) versus those aged 18-69 years (83.8%, n = 761/908), with 91% (n = 1641/1803) of respondents agreeing that getting a COVID-19 vaccine was important to their health. Reported vaccine safety (aOR 1.4, 95% CI 1.1 to 1.8) and efficacy (aOR 1.9, 95% CI 1.5 to 2.3) were associated with intention to accept a COVID-19 vaccine. Concerns around serious illness, long-term effects, and insufficient vaccine testing were factors for not accepting a COVID-19 vaccine. Preferred communication methods included discussion with healthcare providers, with primary care providers identified as the most trusted information source. This study identified factors influencing the prioritized public's COVID-19 vaccine decision-making, including information preferences. These details can support future vaccination rollouts.
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Affiliation(s)
- Ruby Biezen
- Department of General Practice, University of Melbourne, Melbourne, Australia,CONTACT Ruby Biezen Department of General Practice, The University of Melbourne, 780 Elizabeth Street, Melbourne, Vic3004, Australia
| | - Jessica Kaufman
- Vaccine Uptake Group, Murdoch Children’s Research Institute, Melbourne, Australia,Department of Paediatrics, University of Melbourne, Melbourne, Australia
| | - Monsurul Hoq
- Vaccine Uptake Group, Murdoch Children’s Research Institute, Melbourne, Australia,Department of Paediatrics, University of Melbourne, Melbourne, Australia
| | | | - Lena Sanci
- Department of General Practice, University of Melbourne, Melbourne, Australia
| | - J. Simon Bell
- Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, Australia
| | - Julie Leask
- Susan Wakil School of Nursing and Midwifery, University of Sydney, Sydney, Australia
| | - Holly Seale
- School of Population Health, University of New South Wales, Australia
| | - Jane Munro
- Vaccine Uptake Group, Murdoch Children’s Research Institute, Melbourne, Australia
| | | | - Jane Oliver
- Vaccine Uptake Group, Murdoch Children’s Research Institute, Melbourne, Australia,The Peter Doherty Institute for Infection and Immunity, University of Melbourne, Australia
| | - Carol Jos
- Vaccine Uptake Group, Murdoch Children’s Research Institute, Melbourne, Australia
| | - Jane Tuckerman
- Vaccine Uptake Group, Murdoch Children’s Research Institute, Melbourne, Australia,Department of Paediatrics, University of Melbourne, Melbourne, Australia
| | - Kathleen Bagot
- Vaccine Uptake Group, Murdoch Children’s Research Institute, Melbourne, Australia
| | - Margie Danchin
- Vaccine Uptake Group, Murdoch Children’s Research Institute, Melbourne, Australia,Department of Paediatrics, University of Melbourne, Melbourne, Australia,Department of General Medicine, The Royal Children’s Hospital, Melbourne, Australia
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24
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Allen K, Lambert SB, Yuen A, Pourmarzi D. Factors associated with COVID-19 booster vaccine willingness among migrants from the Eastern Mediterranean living in Australia: a cross-sectional study. BMC Public Health 2022; 22:2205. [DOI: 10.1186/s12889-022-14608-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 11/14/2022] [Indexed: 11/29/2022] Open
Abstract
Abstract
Background
Migrants have been disproportionally affected by COVID-19 in Australia. Vaccination against COVID-19 is a key pillar of Australia's public health response, but little is known about the willingness to receive booster vaccinations among migrants. This study aimed to assess the factors associated with a willingness to receive a COVID-19 booster vaccine among migrants living in Australia born in the World Health Organization’s Eastern Mediterranean Region (EMRO).
Methods
A cross-sectional survey was conducted from September to November 2021 (n = 300). Participants were questioned on booster vaccine willingness, sociodemographic characteristics, COVID-19 vaccine information needs and sources, and perceptions of COVID-19 vaccines. Univariate and multivariate logistic regression were used to assess factors associated with booster willingness.
Results
Most respondents (87%) had received two doses of COVID-19 vaccine, of which 81% were willing to receive a booster dose. About half of the participants reported high or very high needs for receiving information about “COVID-19 vaccines’ safety monitoring in Australia”, “COVID-19 vaccines protection against illness”, “Safety of COVID-19 vaccines used in Australia”, and “The Australian COVID-19 vaccination program”. People who were willing to receive a boost dose had significantly higher self-estimated knowledge of COVID-19 vaccines, confidence in COVID-19 vaccines and trust in the Australian government’s vaccine recommendations, and perceived COVID-19 as a greater risk compared to those who were unsure/hesitant. Both groups reported similar perceptions of their personal risks from COVID-19 but diverged on their views of COVID-19 as a broader health problem. There were no statistically significant differences between the two groups in terms of channels used to find information about COVID-19 vaccines. Factors associated with willingness to receive a COVID-19 booster vaccine in the multivariate logistic regression were age (aOR 1.07 95% CI 1.02–1.12), and no exposure to concerning news about COVID-19 vaccines (aOR 3.71 95% CI 1.51–9.09).
Conclusion
Vaccine acceptance and reported booster willingness was high. The results suggest the news and information seen may impact willingness to receive booster doses, even among those who have already received doses of COVID-19 vaccine. Addressing vaccine concerns and transparent communication about uncertainty should be a priority in the current and in future pandemics.
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25
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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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26
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Bain N, Nguyen M, Grech L, Day D, McCartney A, Webber K, Kwok A, Harris S, Chau H, Chan B, Nott L, Hamad N, Tognela A, Underhill C, Loe BS, Freeman D, Segelov E. COVID-19 Vaccine Hesitancy in Australian Patients with Solid Organ Cancers. Vaccines (Basel) 2022; 10:vaccines10091373. [PMID: 36146450 PMCID: PMC9503648 DOI: 10.3390/vaccines10091373] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 08/16/2022] [Accepted: 08/17/2022] [Indexed: 02/07/2023] Open
Abstract
Background: Vaccination is the cornerstone of the global public health response to the COVID-19 pandemic. Excess morbidity and mortality of COVID-19 infection is seen in people with cancer. COVID-19 vaccine hesitancy has been observed in this medically vulnerable population, although associated attitudes and beliefs remain poorly understood. Methods: An online cross-sectional survey of people with solid organ cancers was conducted through nine health services across Australia. Demographics, cancer-related characteristics and vaccine uptake were collected. Perceptions and beliefs regarding COVID-19 vaccination were assessed using the Oxford COVID-19 Vaccine Hesitancy Scale, the Oxford COVID-19 Vaccine Confidence and Complacency Scale and the Disease Influenced Vaccine Acceptance Scale-6. Results: Between June and October 2021, 2691 people with solid organ cancers completed the survey. The median age was 62.5 years (SD = 11.8; range 19–95), 40.9% were male, 71.3% lived in metropolitan areas and 90.3% spoke English as their first language. The commonest cancer diagnoses were breast (36.6%), genitourinary (18.6%) and gastrointestinal (18.3%); 59.2% had localized disease and 56.0% were receiving anti-cancer therapy. Most participants (79.7%) had at least one COVID-19 vaccine dose. Vaccine uptake was higher in people who were older, male, metropolitan, spoke English as a first language and had a cancer diagnosis for more than six months. Vaccine hesitancy was higher in people who were younger, female, spoke English as a non-dominant language and lived in a regional location, and lower in people with genitourinary cancer. Vaccinated respondents were more concerned about being infected with COVID-19 and less concerned about vaccine safety and efficacy. Conclusions: People with cancer have concerns about acquiring COVID-19, which they balance against vaccine-related concerns about the potential impact on their disease progress and/or treatment. Detailed exploration of concerns in cancer patients provides valuable insights, both for discussions with individual patients and public health messaging for this vulnerable population.
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Affiliation(s)
- Nathan Bain
- Department of Oncology, Monash Health, Clayton, VIC 3168, Australia
| | - Mike Nguyen
- Department of Oncology, Monash Health, Clayton, VIC 3168, Australia
- Department of Medicine, School of Clinical Sciences, Monash University, Melbourne, VIC 3168, Australia
- Correspondence: ; Tel.: +61-3-8572-2392
| | - Lisa Grech
- Department of Medicine, School of Clinical Sciences, Monash University, Melbourne, VIC 3168, Australia
| | - Daphne Day
- Department of Oncology, Monash Health, Clayton, VIC 3168, Australia
- Department of Medicine, School of Clinical Sciences, Monash University, Melbourne, VIC 3168, Australia
| | - Amelia McCartney
- Department of Oncology, Monash Health, Clayton, VIC 3168, Australia
- Department of Medicine, School of Clinical Sciences, Monash University, Melbourne, VIC 3168, Australia
| | - Kate Webber
- Department of Oncology, Monash Health, Clayton, VIC 3168, Australia
- Department of Medicine, School of Clinical Sciences, Monash University, Melbourne, VIC 3168, Australia
| | - Alastair Kwok
- Department of Oncology, Monash Health, Clayton, VIC 3168, Australia
- Department of Medicine, School of Clinical Sciences, Monash University, Melbourne, VIC 3168, Australia
| | - Sam Harris
- Department of Medical Oncology, Bendigo Health, Bendigo, VIC 3550, Australia
| | - Hieu Chau
- Department of Oncology, Latrobe Regional Hospital, Traralgon, VIC 3844, Australia
| | - Bryan Chan
- Department of Oncology, Sunshine Coast Hospital and Health Service, Birtinya, QLD 4575, Australia
- School of Medicine, Griffith University, Birtinya, QLD 4575, Australia
| | - Louise Nott
- Icon Cancer Centre Hobart, Hobart, TAS 7000, Australia
| | - Nada Hamad
- Department of Hematology, St Vincent’s Hospital Sydney, Darlinghurst, NSW 2010, Australia
- School of Clinical Medicine, Medicine & Health, University of New South Wales, Kensington, NSW 2052, Australia
- School of Medicine, University of Notre Dame Australia, Chippendale, NSW 2007, Australia
| | - Annette Tognela
- Macarthur Cancer Therapy Centre, Campbelltown Hospital, Campbelltown, NSW 2560, Australia
| | - Craig Underhill
- Border Medical Oncology Research Unit, Albury, NSW 2640, Australia
- Rural Medical School, University of New South Wales, Albury, NSW 2640, Australia
| | - Bao Sheng Loe
- The Psychometrics Centre, University of Cambridge, Cambridge CB2 1AG, UK
| | - Daniel Freeman
- Department of Psychiatry, University of Oxford, Oxford OX3 7JX, UK
- Oxford Health National Health Service Foundation Trust, Oxford OX3 7JX, UK
| | - Eva Segelov
- Department of Oncology, Monash Health, Clayton, VIC 3168, Australia
- Department of Medicine, School of Clinical Sciences, Monash University, Melbourne, VIC 3168, Australia
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27
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Attwell K, Roberts L, Ji J. COVID-19 Vaccine Mandates: Attitudes and Effects on Holdouts in a Large Australian University Population. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10130. [PMID: 36011769 PMCID: PMC9408755 DOI: 10.3390/ijerph191610130] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 07/27/2022] [Accepted: 08/11/2022] [Indexed: 06/15/2023]
Abstract
Many governments and institutions mandated COVID-19 vaccines. In late 2021, we sought to ascertain the perspectives of staff and students from The University of Western Australia about the State or the University mandating COVID-19 vaccines. The survey captured vaccination status and intentions along with attitudes towards mandates and potential types of exemptions with 2878 valid responses which were quantitatively analysed and 2727 which were qualitatively analysed. The study found generally high levels of vaccination or intent, and strong support for mandates, underpinned by beliefs that vaccination is a moral duty and that mandates make campus feel safer. These sentiments were not more prevalent amongst individuals with comorbidities; often healthy individuals supported mandates to reduce their risk of transmitting disease to vulnerable family members. Individuals with comorbidities were, however, more supportive of excluding the unvaccinated from campus. Most opponents were unvaccinated, and many indicated that mandate policies would backfire, making them less likely to vaccinate. Despite the strong overall support, 41% of respondents did not want to see non-compliant staff or students lose their positions, and only 35% actively sought this. Institutions or governments introducing mandates should emphasise community concerns about catching COVID-19 and becoming sick or transmitting the disease to vulnerable loved ones.
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Affiliation(s)
- Katie Attwell
- School of Social Science, University of Western Australia, Crawley, WA 6009, Australia
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Subiaco, WA 6008, Australia
- Immunisation Alliance of Western Australia, Cockburn Integrated Health and Community Facility, Suite 14, 11 Wentworth Parade, Success, WA 6164, Australia
| | - Leah Roberts
- School of Social Science, University of Western Australia, Crawley, WA 6009, Australia
| | - Julie Ji
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Subiaco, WA 6008, Australia
- School of Psychological Science, University of Western Australia, Crawley, WA 6009, Australia
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28
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Lupton D. Understandings and practices related to risk, immunity and vaccination during the Delta variant COVID-19 outbreak in Australia: An interview study. Vaccine X 2022; 11:100183. [PMID: 35722522 PMCID: PMC9192109 DOI: 10.1016/j.jvacx.2022.100183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Revised: 06/02/2022] [Accepted: 06/03/2022] [Indexed: 12/04/2022] Open
Abstract
Background The aim of this study was to use indepth social research to better understand the relationships and intersections between understandings and practices of COVID-19 risk, immunity and vaccination in lay people’s accounts. Methods This article reports findings from a qualitative research project involving semi-structured telephone interviews with a diverse group of 40 adults from around Australia about their experiences of the COVID crisis, conducted in late 2021 during the Delta variant outbreak. The participants’ responses to questions about COVID risk, COVID vaccines and how they thought they could best protect their health were analysed using an inductive thematic approach. Results A notion of ‘communal risk’ was expressed together with ‘individual risk’. Relatedly, people’s understandings of what might be characterised as ‘communal immunity’ as well as individual immunity also dominated in their accounts. Both communal risk and communal immunity are influenced by a range of constantly changing and interrelated factors. Locale was a strong factor in shaping people’s experiences and stances related to COVID risk. The participants referred to aspects such as their community’s geographical location; the number of COVID cases and the level of COVID vaccination by others living in their state or territory; adoption of preventive measures; vaccine availability, scheduling and take-up; viral testing and tracing reporting; and the extent and timing of viral spread in the population. These factors were continually related back to highly specific conditions and practices in their community or state of residence. Conclusions Understandings and practices related to COVID risk, immunity and vaccination were based both on individual experiences and broader ideas about the role of community. Spatial contexts are influential but there is also a strong temporality to these understandings and practices. There is a fine balance to be maintained between individual-level protection from COVID risk and community-level actions.
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Affiliation(s)
- Deborah Lupton
- Vitalities Lab, Centre for Social Research in Health and Social Policy Research Centre, Goodsell Building, University of New South Wales (UNSW), Sydney, Australia
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29
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Aguilar Perez F, Vohra J, von Kaufmann F. Improving our communication around vaccines. Perspect Public Health 2022; 142:189-190. [PMID: 35833549 DOI: 10.1177/17579139221108863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
| | - Jyotsna Vohra
- Director of Policy and Public Affairs, Royal Society for Public Health, London, UK
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30
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El Gamal M, Siddiqua A, Abdul WK, Almurshidi BH, Howari FM. Investigation of factors affecting COVID-19 vaccine acceptance among communities of universities in the United Arab Emirates. Hum Vaccin Immunother 2022; 18:2068930. [PMID: 35594545 PMCID: PMC9302497 DOI: 10.1080/21645515.2022.2068930] [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] [Indexed: 11/15/2022] Open
Abstract
The COVID-19 pandemic affected the lives of people living across the world and the development of vaccines against SARS-CoV-2 is considered to be one of the most promising solutions to contain the COVID-19 pandemic. In several countries, we are witnessing hesitancy toward COVID-19 vaccines, which is a complex phenomenon influenced by a variety of factors. A cross-sectional study was performed to comprehensively investigate the impact of factors like demography, COVID-19 pandemic-induced behavior, and vaccine attitude on COVID-19 vaccine acceptance (VA) among communities of five different universities in the United Arab Emirates (UAE). To investigate the effect of demography and COVID-19 pandemic-induced behavioral factors, Analysis of Variance was perfomed. The effect of COVID-19 vaccine attitudes on COVID-19 VA was examined through partial least squares-structural equations modeling. The results of the study showed no difference among the population in accepting COVID-19 vaccines due to their demographic factors. The effect of pandemic-induced behavioral factors on COVID-19 VA suggested that the people of UAE accepted COVID-19 vaccines irrespective of the movement and travel restrictions imposed due to the pandemic. The results on the effect of vaccine attitudes on COVID-19 VA showed that vaccine benefit attitudes, safety concerns, and trust in health-care professionals (TrHP) were found to be significant factors in VA. Furthermore, TrHP was found to reduce the negative effect of safety concerns related to COVID-19 VA. The findings broadly highlight that COVID-19 VA in the UAE was not hampered by demographic factors and the pandemic-induced behavioral constraints. The study also showed that people with co-morbidities had lower level of COVID-19 VA than people with no co-morbidities. To improve COVID-19 VA, the perceived benefits with COVID-19 vaccine and TrHP must be enhanced and simultaneously safety concerns of the vaccines need to be addressed.
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Affiliation(s)
- Maisa El Gamal
- College of Natural and Health Sciences, Zayed University, Abu Dhabi, UAE
| | - Ayisha Siddiqua
- College of Natural and Health Sciences, Zayed University, Abu Dhabi, UAE
| | | | | | - Fares M Howari
- College of Natural and Health Sciences, Zayed University, Abu Dhabi, UAE
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31
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Hamilton EM, Oversby S, Ratsch A, Kitchener S. COVID-19 Vaccination: An Exploratory Study of the Motivations and Concerns Detailed in the Medical Records of a Regional Australian Population. Vaccines (Basel) 2022; 10:vaccines10050657. [PMID: 35632413 PMCID: PMC9144970 DOI: 10.3390/vaccines10050657] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 04/19/2022] [Accepted: 04/20/2022] [Indexed: 11/16/2022] Open
Abstract
Understanding motivations and concerns surrounding COVID-19 vaccine uptake is important to reduce vaccine hesitancy and inform strategies to mitigate concerns and increase vaccine uptake. This study aimed to explore motivations and concerns associated with COVID-19 vaccination among adults seeking their first COVID-19 vaccine in a regional Australian community with low prevalence of COVID-19, who received a medical consult prior to vaccination. Medical records from consults were audited and the modified Framework Method was used to conduct qualitative content analysis of data, generating themes and overall core concepts related to motivations for COVID-19 vaccination and associated concerns. There were 102 people included in the study, 81% of whom were aged ≥60 years. Concerns surrounding COVID-19 vaccination included five core concepts: 1. Perceived vaccine risks, 2. Perceived vaccine performance, 3. Uncertainty, 4. Autonomy, and 5. Fairness in access; and a further five core concepts were generated from motivations to seek vaccination: 1. Protection, 2. Occupational or facility responsibility or requirement, 3. Trust in primary healthcare physician, 4. Autonomy, and 5. Civic duty. These motivating factors and concerns can be used to inform strategies and education to increase vaccine uptake in ongoing and future vaccine rollouts.
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Affiliation(s)
- Elizabeth M Hamilton
- Wide Bay Hospital and Health Service, Hervey Bay, QLD 4655, Australia; (S.O.); (A.R.); (S.K.)
- Rural Clinical School, The University of Queensland, Saint Lucia, QLD 4072, Australia
- Correspondence:
| | - Shannen Oversby
- Wide Bay Hospital and Health Service, Hervey Bay, QLD 4655, Australia; (S.O.); (A.R.); (S.K.)
| | - Angela Ratsch
- Wide Bay Hospital and Health Service, Hervey Bay, QLD 4655, Australia; (S.O.); (A.R.); (S.K.)
- Rural Clinical School, The University of Queensland, Saint Lucia, QLD 4072, Australia
| | - Scott Kitchener
- Wide Bay Hospital and Health Service, Hervey Bay, QLD 4655, Australia; (S.O.); (A.R.); (S.K.)
- Rural Clinical School, The University of Queensland, Saint Lucia, QLD 4072, Australia
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32
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Kaufman J, Bagot KL, Hoq M, Leask J, Seale H, Biezen R, Sanci L, Manski-Nankervis JA, Bell JS, Munro J, Jos C, Ong DS, Oliver J, Tuckerman J, Danchin M. Factors Influencing Australian Healthcare Workers' COVID-19 Vaccine Intentions across Settings: A Cross-Sectional Survey. Vaccines (Basel) 2021; 10:3. [PMID: 35062664 PMCID: PMC8781521 DOI: 10.3390/vaccines10010003] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Revised: 12/17/2021] [Accepted: 12/17/2021] [Indexed: 12/21/2022] Open
Abstract
Healthcare workers' COVID-19 vaccination coverage is important for staff and patient safety, workforce capacity and patient uptake. We aimed to identify COVID-19 vaccine intentions, factors associated with uptake and information needs for healthcare workers in Victoria, Australia. We administered a cross-sectional online survey to healthcare workers in hospitals, primary care and aged or disability care settings (12 February-26 March 2021). The World Health Organization Behavioural and Social Drivers of COVID-19 vaccination framework informed survey design and framing of results. Binary regression results adjusted for demographics provide risk differences between those intending and not intending to accept a COVID-19 vaccine. In total, 3074 healthcare workers completed the survey. Primary care healthcare workers reported the highest intention to accept a COVID-19 vaccine (84%, 755/898), followed by hospital-based (77%, 1396/1811) and aged care workers (67%, 243/365). A higher proportion of aged care workers were concerned about passing COVID-19 to their patients compared to those working in primary care or hospitals. Only 25% felt they had sufficient information across five vaccine topics, but those with sufficient information had higher vaccine intentions. Approximately half thought vaccines should be mandated. Despite current high vaccine rates, our results remain relevant for booster programs and future vaccination rollouts.
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Affiliation(s)
- Jessica Kaufman
- Vaccine Uptake Group, Murdoch Children’s Research Institute, Melbourne 3052, Australia; (K.L.B.); (M.H.); (J.M.); (C.J.); (D.S.O.); (J.O.); (J.T.); (M.D.)
- Department of Paediatrics, University of Melbourne, Melbourne 3052, Australia
| | - Kathleen L. Bagot
- Vaccine Uptake Group, Murdoch Children’s Research Institute, Melbourne 3052, Australia; (K.L.B.); (M.H.); (J.M.); (C.J.); (D.S.O.); (J.O.); (J.T.); (M.D.)
| | - Monsurul Hoq
- Vaccine Uptake Group, Murdoch Children’s Research Institute, Melbourne 3052, Australia; (K.L.B.); (M.H.); (J.M.); (C.J.); (D.S.O.); (J.O.); (J.T.); (M.D.)
- Department of Paediatrics, University of Melbourne, Melbourne 3052, Australia
| | - Julie Leask
- Susan Wakil School of Nursing and Midwifery, University of Sydney, Sydney 2052, Australia;
| | - Holly Seale
- School of Population Health, University of New South Wales, Sydney 2052, Australia;
| | - Ruby Biezen
- Department of General Practice, University of Melbourne, Carlton 3010, Australia; (R.B.); (L.S.); (J.-A.M.-N.)
| | - Lena Sanci
- Department of General Practice, University of Melbourne, Carlton 3010, Australia; (R.B.); (L.S.); (J.-A.M.-N.)
| | - Jo-Anne Manski-Nankervis
- Department of General Practice, University of Melbourne, Carlton 3010, Australia; (R.B.); (L.S.); (J.-A.M.-N.)
| | - J. Simon Bell
- Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne 3052, Australia;
| | - Jane Munro
- Vaccine Uptake Group, Murdoch Children’s Research Institute, Melbourne 3052, Australia; (K.L.B.); (M.H.); (J.M.); (C.J.); (D.S.O.); (J.O.); (J.T.); (M.D.)
- Department of Paediatrics, University of Melbourne, Melbourne 3052, Australia
- The Royal Children’s Hospital, Melbourne 3052, Australia
| | - Carol Jos
- Vaccine Uptake Group, Murdoch Children’s Research Institute, Melbourne 3052, Australia; (K.L.B.); (M.H.); (J.M.); (C.J.); (D.S.O.); (J.O.); (J.T.); (M.D.)
| | - Darren Suryawijaya Ong
- Vaccine Uptake Group, Murdoch Children’s Research Institute, Melbourne 3052, Australia; (K.L.B.); (M.H.); (J.M.); (C.J.); (D.S.O.); (J.O.); (J.T.); (M.D.)
| | - Jane Oliver
- Vaccine Uptake Group, Murdoch Children’s Research Institute, Melbourne 3052, Australia; (K.L.B.); (M.H.); (J.M.); (C.J.); (D.S.O.); (J.O.); (J.T.); (M.D.)
- The Peter Doherty Institute for Infection and Immunity, University of Melbourne, Melbourne 3000, Australia
| | - Jane Tuckerman
- Vaccine Uptake Group, Murdoch Children’s Research Institute, Melbourne 3052, Australia; (K.L.B.); (M.H.); (J.M.); (C.J.); (D.S.O.); (J.O.); (J.T.); (M.D.)
- Department of Paediatrics, University of Melbourne, Melbourne 3052, Australia
| | - Margie Danchin
- Vaccine Uptake Group, Murdoch Children’s Research Institute, Melbourne 3052, Australia; (K.L.B.); (M.H.); (J.M.); (C.J.); (D.S.O.); (J.O.); (J.T.); (M.D.)
- Department of Paediatrics, University of Melbourne, Melbourne 3052, Australia
- The Royal Children’s Hospital, Melbourne 3052, Australia
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