Vaccine myths

Assessing Trust in Physician and Vaccine Hesitancy Among Hispanic/Latinx Parents

Introduction: Representing the USA's largest ethnic/racial group, Hispanic/Latinx (HL) experience health challenges of proportional magnitude. This study investigates the prevalence of vaccine hesitancy among HL adults and trust in their child's pediatrician. Methods: HL parents of children who receive medical care at one of the largest Federally Qualified Health Centers in the United States completed a survey examining associations between physician trust, vaccine hesitancy, and demographics. Data were subjected to ANOVA via SAS9 version 9.0 (Cary, NC) and SPSS version 27 (Chicago, IL) software. Results: With a total of 500 surveys completed (51% response rate; 81% completion rate), the prevalence of vaccine hesitancy amounted to 15.4% (n = 77). Parents with university-level education displayed higher levels of trust and perceptions in favor of routine vaccination practices (p < .01). When medical visits were conducted in Spanish, parents exhibited lower levels of trust and were more vaccine-hesitant (p < .01). Conclusions: Vaccine literacy must be prioritized in early education to reach parents who may not achieve college degrees. Ensuring language concordance within patient-physician dyads may maximize the potential for vaccine uptake and physician trust.

The vaccination rate among children with nonprogressive neurodevelopmental disorders in Bosnia and Herzegovina: A single centre experience

PURPOSE

The aim of this study is to determine the factors influencing the decrease of the vaccination rate among children with nonprogressive neurodevelopmental disorders in Bosnia and Herzegovina.

METHODS

This study included 149 parents of children with nonprogressive neurodevelopmental disorders. The children were rehabilitated at the University Clinical Hospital Mostar, from October 2017 to February 2019.

RESULTS

The vaccination rate of children with nonprogressive neurodevelopmental disorders was 34.9% (P < 0.001). Based on the results of this study, physicians were the most common source of information on vaccines and vaccination procedures for parents (70.3%), whereas the media was rarely used as the source of the information (33%) (P < 0.001). Of the cases, 58.4% accepted the opinion of the pediatrician (P = 0.041). The vaccination of children was postponed on the physician's recommendation in 87.6% of the cases (P < 0.001). Among healthcare professionals, neuropediatricians or neurophysiatrists (P = 0.023), together with pediatricians (P < 0.001), most often suggested postponing the vaccination.

CONCLUSION

Overall, this study showed that the majority of children with nonprogressive neurodevelopmental disorders were unvaccinated. The majority of the parents trusted the physicians' opinion on vaccination. Neuropediatricians and neurophysiatrists most often postponed the regular vaccination of children.

Immune-mediated adverse reactions to vaccines

Vaccination continues to be the single most important and successful public health intervention, due to its prevention of morbidity and mortality from prevalent infectious diseases. Severe immunologically mediated reactions are rare and less common with the vaccine than the true infection. However, these events can cause public fearfulness and loss of confidence in the safety of vaccination. In this paper, we perform a systematic literature search and narrative review of immune-mediated vaccine adverse events and their known and proposed mechanisms, and outline directions for future research. Improving our knowledge base of severe immunologically mediated vaccine reactions and their management drives better vaccine safety and efficacy outcomes.

Determinants of Influenza and Pertussis Vaccination Uptake in Pregnancy: A Multicenter Questionnaire Study of Pregnant Women and Healthcare Professionals

INTRODUCTION

Uptake rates of antenatal vaccination remain suboptimal. Our aims were to determine (1) the acceptability of routine vaccination among pregnant women, (2) the confidence of maternity healthcare professionals (HCPs) discussing vaccination and (3) HCP opinion regarding the optimum healthcare site for vaccine administration.

METHODS

Separate questionnaires for pregnant women and HCPs were distributed within 4 national health service (NHS) trusts in South England (July 2017 to January 2018).

RESULTS

Responses from 314 pregnant women and 204 HCPs (18% obstetricians, 75% midwives, 7% unidentified) were analyzed. Previous/intended uptake of influenza and pertussis vaccination was 78% and 92%, respectively. The commonest reason for declining vaccination was feared side effects for their child. White British women (79%) were significantly more accepting of influenza [85% vs. 61%; odds ratio (OR) 3.25; 95% confidence interval [CI], 1.67-6.32] and pertussis vaccination (96% vs. 83%; OR 4.83; 95% CI: 1.77-13.19) compared with nonwhite British women. Among HCPs, 25% were slightly or not at all confident discussing vaccination. Obstetricians felt significantly more confident discussing pertussis vaccination than midwives (68% vs. 55% were very/moderately confident; OR 2.05; 95% CI: 1.02-4.12). Among HCPs, 53%, 25% and 16% thought vaccines should be administered in primary care (general practice), community midwifery and in hospital, respectively.

CONCLUSION

Misconceptions exist regarding safety/efficacy of antenatal vaccination, and framing information towards the child's safety may increase uptake. Education of HCPs is essential, and vaccine promotion should be incorporated into routine antenatal care, with an emphasis on women from ethnic minorities. Administration of vaccines in primary care presents logistical barriers; however, support for alternative sites appears low among HCPs.

Epidemic prevalence information on social networks can mediate emergent collective outcomes in voluntary vaccine schemes

The effectiveness of a mass vaccination program can engender its own undoing if individuals choose to not get vaccinated believing that they are already protected by herd immunity. This would appear to be the optimal decision for an individual, based on a strategic appraisal of her costs and benefits, even though she would be vulnerable during subsequent outbreaks if the majority of the population argues in this manner. We investigate how voluntary vaccination can nevertheless emerge in a social network of rational agents, who make informed decisions whether to be vaccinated, integrated with a model of epidemic dynamics. The information available to each agent includes the prevalence of the disease in their local network neighborhood and/or globally in the population, as well as the fraction of their neighbors that are protected against the disease. Crucially, the payoffs governing the decision of agents vary with disease prevalence, resulting in the vaccine uptake behavior changing in response to contagion spreading. The collective behavior of the agents responding to local prevalence can lead to a significant reduction in the final epidemic size, particularly for less contagious diseases having low basic reproduction number [Formula: see text]. Near the epidemic threshold ([Formula: see text]) the use of local prevalence information can result in divergent responses in the final vaccine coverage. Our results suggest that heterogeneity in the risk perception resulting from the spatio-temporal evolution of an epidemic differentially affects agents' payoffs, which is a critical determinant of the success of voluntary vaccination schemes.

Science is not a Social Opinion

Recently, the main American associations in the dental field reported concerns regarding a film on the Netflix, Amazon, Apple, and Vimeo platforms that reported that endodontic treatments of root canals are linked to serious systemic pathologies, against any scientific evidence. This extreme case highlights how information, in a social networking era, is dramatically conditioned by a small number of users, leading to large scale consequences in political opinions, alimentary choices, or even in healthcare policy. It is urgent to demonstrate a strong awareness by the academic, institutional, and associative bodies in order to restore the correct flow of information on mass media and social networks.

Mistrust in Medicine: The Rise and Fall of America's First Vaccine Institute

In 1813, the American government passed An Act to Encourage Vaccination, the first federal endorsement of a medical practice in American history. The law tasked a federal agent with maintaining a supply of the smallpox vaccine and distributing it nationwide. James Smith, a well-respected physician and proponent of vaccination, was appointed as vaccine agent. Smith was skeptical of claims that only well-trained physicians should be allowed to perform vaccination; he felt it was a simple procedure that should be available to all American citizens. In 1822, he made a tragic error that caused several deaths and left him vulnerable to criticism from political opponents and his medical peers. This ended Smith's professional career and led to the repeal of the act itself. In this article, we use the rise and fall of James Smith to provide a historical perspective on contemporary debates surrounding delayed vaccination schedules. We explain how physicians-in the 19th century and today-have worked to build public trust in vaccination in an American culture suspicious of medical expertise.

The influence of political ideology and trust on willingness to vaccinate

In light of the increasing refusal of some parents to vaccinate children, public health strategies have focused on increasing knowledge and awareness based on a "knowledge-deficit" approach. However, decisions about vaccination are based on more than mere knowledge of risks, costs, and benefits. Individual decision making about vaccinating involves many other factors including those related to emotion, culture, religion, and socio-political context. In this paper, we use a nationally representative internet survey in the U.S. to investigate socio-political characteristics to assess attitudes about vaccination. In particular, we consider how political ideology and trust affect opinions about vaccinations for flu, pertussis, and measles. Our findings demonstrate that ideology has a direct effect on vaccine attitudes. In particular, conservative respondents are less likely to express pro-vaccination beliefs than other individuals. Furthermore, ideology also has an indirect effect on immunization propensity. The ideology variable predicts an indicator capturing trust in government medical experts, which in turn helps to explain individual-level variation with regards to attitudes about vaccine choice.