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Aggarwal B, Al-Moamary M, Allehebi R, Alzaabi A, Al-Ahmad M, Amin M, Damayanti T, Van Tho N, Quyen PTL, Sriprasart T, Poachanukoon O, Yu-Lin AB, Ismail AI, Limpin MEB, Koenig S, Levy G, Phansalkar A, Rafih F, Silvey M, Miriams L, Milligan G. APPaRENT 3: Asthma Patients' and Physicians' Perspectives on the Burden and Management of Asthma in Seven Countries. Adv Ther 2024; 41:3089-3118. [PMID: 38874879 PMCID: PMC11263244 DOI: 10.1007/s12325-024-02900-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Accepted: 05/13/2024] [Indexed: 06/15/2024]
Abstract
INTRODUCTION Asthma management is strongly dependent on physician and patient beliefs and perceptions about the disease and its long-term treatment. The APPaRENT 3 study was conducted to explore factors influencing treatment choice and to understand patients' and physicians' attitudes and perspectives on the use of controller inhalers in regular versus flexible dosing for asthma management. METHODS This cross-sectional survey of patients with asthma and treating physicians was conducted in seven countries: Indonesia, Malaysia, Philippines, Thailand, Vietnam (patient survey only), Saudi Arabia, and the United Arab Emirates. Assessment was carried out through an online/face-to-face questionnaire, where patients' viewpoints were focused on their attitudes and beliefs about asthma and treatment adherence, whereas physicians' viewpoints were gathered on their attitudes and beliefs about asthma management, knowledge of and adherence to asthma treatment guidelines, and asthma treatment regimens. RESULTS Overall, 1400 patients (mean age, 34 years) and 599 physicians (mean age, 43 years) were included in the survey. Physicians similarly prioritised symptom control (39%) and exacerbation reduction (40%) in moderate asthma, whereas patients prioritised symptom control (41%) over exacerbation reduction (22%). Although both groups (physicians, 86%; patients, 84%) perceived asthma as well-controlled, poor management was evident based on Asthma Control Test (ACT) scores (mean, 15.7; standard deviation, 4.14; 82% had an ACT score < 20) and high symptom burden (39% reported nighttime awakenings or early mornings ≥ 2 nights/week). Most patients (76%) with moderate asthma were prescribed regular dosing, with the most common treatment being inhaled corticosteroid (ICS)/long-acting β2-agonist (LABA) with as-needed inhaled short-acting β2-agonist (SABA; 20%). Among patients on maintenance and reliever therapy, 93% of patients received a separate inhaled reliever. CONCLUSIONS Despite high symptom burden, patients overestimated their level of asthma control. Physicians prioritised controlling symptoms and reducing exacerbations as treatment goals for moderate asthma, often prescribing regular dosing with ICS/LABA with as-needed inhaled SABA.
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Affiliation(s)
- Bhumika Aggarwal
- General Medicines, GSK, 23 Rochester Park, #06-01, GSK Asia House, Singapore, 139234, Singapore.
| | - Mohamed Al-Moamary
- Department of Medicine, College of Medicine, King Saudi Bin Abdulaziz University for Health Sciences, Riyadh, Kingdom of Saudi Arabia
| | - Riyad Allehebi
- Department of Pulmonology, King Fahad Medical City, Riyadh, Kingdom of Saudi Arabia
- College of Medicine, Alfaisal University, Riyadh, Kingdom of Saudi Arabia
| | - Ashraf Alzaabi
- Internal Medicine Department, College of Medicine and Health Sciences, UAE University, Abu Dhabi, United Arab Emirates
- Respirology Division, Zayed Military Hospital, Abu Dhabi, United Arab Emirates
| | - Mona Al-Ahmad
- Microbiology Department, College of Medicine, Kuwait University, Kuwait City, Kuwait
| | - Muhammad Amin
- Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Airlangga Hospital, Surabaya, Indonesia
| | - Triya Damayanti
- Department of Pulmonology and Respiratory Medicine, Faculty of Medicine Universitas Indonesia, Persahabatan Hospital National Respiratory Center, Jakarta, Indonesia
| | - Nguyen Van Tho
- Department of Tuberculosis and Lung Diseases, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | | | - Thitiwat Sriprasart
- Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
| | - Orapan Poachanukoon
- Center of Excellence for Allergy, Asthma and Pulmonary Diseases and Department of Pediatrics, Thammasat University, Pathum Thani, Thailand
| | - Andrea Ban Yu-Lin
- Respiratory Unit, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | | | - Maria Encarnita B Limpin
- Pulmonary and Critical Care Medicine Division, Philippine Heart Center, Quezon City, Philippines
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Wang X, Shang S, Zhang E, Dai Z, Xing Y, Hu J, Gao Y, Fang Q. Unraveling Herpes Zoster Vaccine Hesitancy, Acceptance, and Its Predictors: Insights From a Scoping Review. Public Health Rev 2024; 45:1606679. [PMID: 39113825 PMCID: PMC11303218 DOI: 10.3389/phrs.2024.1606679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 07/09/2024] [Indexed: 08/10/2024] Open
Abstract
Objectives Herpes zoster vaccination is critical in preventing herpes zoster virus infection and its associated consequences. Despite its relevance, global herpes zoster immunisation coverage remains alarmingly low. Understanding the factors that drive vaccine scepticism and acceptance is crucial for increasing immunisation rates and improving public health outcomes. Methods This scoping review, following Joanna Briggs Institute guidelines, included 18 studies examining vaccine hesitancy, acceptance, and associated factors. Meticulous data analysis revealed hesitancy's intricate dynamics across countries and demographics. Results Studies displayed a wide range of acceptance rates (2.8%-89.02%), showcasing the complex interplay of attitudes and behaviors towards vaccination. Reasons for vaccine refusal were repeatedly identified in this setting, including worries about potential adverse effects, views of vaccine necessity, and vaccine supply constraints. Notably, individuals' patterns of vaccine acceptance and hesitancy differed among countries, vaccines, and vaccination-related factors. Conclusion Addressing acceptance hurdles by improving accessibility, providing accurate information, and strengthening healthcare recommendations is crucial. Understanding the multifaceted factors influencing hesitancy allows for targeted interventions, elevating immunization rates and enhancing public health globally.
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Affiliation(s)
- Xiaolong Wang
- School of Nursing, Shanghai Jiao Tong University, Shanghai, China
| | - Shuhui Shang
- School of Nursing, Shanghai Jiao Tong University, Shanghai, China
| | - Enming Zhang
- School of Nursing, Shanghai Jiao Tong University, Shanghai, China
| | - Zhengyue Dai
- School of Nursing, Shanghai Jiao Tong University, Shanghai, China
| | - Yufei Xing
- School of Nursing, Shanghai Jiao Tong University, Shanghai, China
| | - Jiale Hu
- College of Health Professions, Virginia Commonwealth University, Richmond, VA, United States
| | - Yaojuan Gao
- Nursing Department, Shanghai Integrated Traditional Chinese and Western Medicine Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Qiong Fang
- School of Nursing, Shanghai Jiao Tong University, Shanghai, China
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Felzer JR, Montgomery AJ, LeMahieu AM, Finney Rutten LJ, Juhn YJ, Wi CI, Jacobson RM, Kennedy CC. Disparities in Influenza, Pneumococcal, COVID-19 Vaccine Coverage in High-Risk Adults Aged 19 to 64 Years in Southeastern Minnesota, 2010-2021. Chest 2024; 166:49-60. [PMID: 38342164 PMCID: PMC11251077 DOI: 10.1016/j.chest.2024.01.049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 12/17/2023] [Accepted: 01/24/2024] [Indexed: 02/13/2024] Open
Abstract
BACKGROUND Despite effective vaccines against influenza, pneumococcus, and COVID-19, uptake has been suboptimal. RESEARCH QUESTION Although disparities in vaccination by race and ethnicity have been observed, what is the role of other sociodemographic factors in US vaccine uptake? STUDY DESIGN AND METHODS We conducted a population-based study using the Rochester Epidemiology Project (REP), a comprehensive medical records linkage system, to assess effects of sociodemographic factors including race, ethnicity, individual-level socioeconomic status (SES) via the housing-based socioeconomic status index, education, population density (urban or nonurban), and marital status with uptake of influenza, pneumococcal, and COVID-19 vaccination in high-risk adults. Adults at high risk of invasive pneumococcal disease residing in four counties in southeastern Minnesota who were aged 19 to 64 years were identified. Vaccination data were obtained from the Minnesota Immunization Information Connection and REP from January 1, 2010, through December 31, 2021. RESULTS We identified 45,755 residents. Most were White (82%), non-Hispanic (94%), married (56%), and living in an urban setting (81%), with three-quarters obtaining at least some college education (74%). Although 45.1% were up to date on pneumococcal vaccines, 60.1% had completed the primary COVID-19 series. For influenza and COVID-19, higher SES, living in an urban setting, older age, and higher education positively correlated with vaccination. Magnitude of differences in race, education, and SES widened with booster vaccines. INTERPRETATION This high-risk population is undervaccinated against preventable respiratory diseases, especially influenza and pneumococcus. Although national data reported improvement of disparities in COVID-19 vaccination uptake observed early in the pandemic, our data demonstrated gaps related to race, education level, SES, and age that widened with booster vaccines. Communities with high social vulnerabilities often show increased risk of severe disease outcomes, yet demonstrate lower uptake of preventive services. This highlights the need to understand better vaccine compliance and access in rural, lower SES, less-educated, Black, Hispanic, and younger populations, each of which were associated independently with decreased vaccination.
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Affiliation(s)
- Jamie R Felzer
- Division of Pulmonary & Critical Care, Department of Medicine, Mayo Clinic, Rochester, MN; Respiratory Health Equity Clinical Research Laboratory, Mayo Clinic, Rochester, MN
| | | | - Allison M LeMahieu
- Division of Clinical Trials and Biostatistics, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN
| | - Lila J Finney Rutten
- Division of Epidemiology, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN
| | - Young J Juhn
- Divisions of Community Pediatric and Adolescent Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN
| | - Chung-Il Wi
- Divisions of Community Pediatric and Adolescent Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN
| | - Robert M Jacobson
- Division of Epidemiology, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN; Divisions of Community Pediatric and Adolescent Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN; Division of Pediatric Infectious Diseases, Department of Pediatric and Adolescent Medicine
| | - Cassie C Kennedy
- Division of Pulmonary & Critical Care, Department of Medicine, Mayo Clinic, Rochester, MN; Division of Health Care Delivery Research, Mayo Clinic, Rochester, MN; Respiratory Health Equity Clinical Research Laboratory, Mayo Clinic, Rochester, MN.
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Doucette EJ, Fullerton MM, Pateman M, Lip A, Houle SKD, Kellner JD, Leal J, MacDonald SE, McNeil D, Tyerman J, Luctkar-Flude M, Davidson S, Constantinescu C. Development and evaluation of virtual simulation games to increase the confidence and self-efficacy of healthcare learners in vaccine communication, advocacy, and promotion. BMC MEDICAL EDUCATION 2024; 24:190. [PMID: 38403639 PMCID: PMC10895736 DOI: 10.1186/s12909-024-05169-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 02/12/2024] [Indexed: 02/27/2024]
Abstract
BACKGROUND Although healthcare providers (HCPs) are the most trusted source of vaccine information, there is a paucity of easily accessible, multidisciplinary educational tools on vaccine communication for them. Virtual simulation games (VSGs) are innovative yet accessible and effective tools in healthcare education. The objectives of our study were to develop VSGs to increase HCP confidence and self-efficacy in vaccine communication, advocacy, and promotion, and evaluate the VSGs' effectiveness using a pre-post self-assessment pilot study. METHODS A multidisciplinary team of experts in medicine, nursing, pharmacy, and simulation development created three VSGs for HCP learners focused on addressing conversations with vaccine hesitant individuals. We evaluated the VSGs with 24 nursing students, 30 pharmacy students, and 18 medical residents who completed surveys and 6-point Likert scale pre-post self-assessments to measure changes in their confidence and self-efficacy. RESULTS There were no significant differences in baseline confidence and self-efficacy across the three HCP disciplines, despite varied levels of education. Post-VSG confidence and self-efficacy (median: 5) were significantly higher than pre-VSG (median: 4-5) for all three HCP disciplines (P ≤ 0.0005), highlighting the effectiveness of the VSGs. Medical residents reported significantly lower post-VSG confidence and self-efficacy than nursing and pharmacy learners despite completing the most significant amount of education. CONCLUSIONS Following the completion of the VSGs, learners in medicine, nursing, and pharmacy showed significant improvement in their self-assessed confidence and self-efficacy in holding vaccine conversations. The VSGs as an educational tool, in combination with existing clinical immunization training, can be used to increase HCP confidence and engagement in vaccine discussions with patients, which may ultimately lead to increased vaccine confidence among patients.
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Affiliation(s)
- Emily J Doucette
- Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
| | - Madison M Fullerton
- Faculty of Nursing, University of Calgary, Calgary, AB, Canada
- 19 to Zero Inc, Rocky Mountain House, AB, Canada
| | - Margaret Pateman
- Faculty of Nursing, University of Calgary, Calgary, AB, Canada
- 19 to Zero Inc, Rocky Mountain House, AB, Canada
| | - Alyssa Lip
- Division of Respirology, Department of Medicine, University of Calgary, Calgary, AB, Canada
| | | | - James D Kellner
- Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada
| | - Jenine Leal
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Microbiology, Immunology and Infectious Diseases, University of Calgary, Calgary, AB, Canada
- O'Brien Institute for Public Health, University of Calgary, Calgary, AB, Canada
- Infection Prevention and Control, Alberta Health Services, Calgary, AB, Canada
- Antimicrobial Resistance - One Health Consortium, University of Calgary, Calgary, AB, Canada
- Real World Evidence Consortium, University of Calgary, Calgary, AB, Canada
| | - Shannon E MacDonald
- Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
| | - Deborah McNeil
- Faculty of Nursing, University of Calgary, Calgary, AB, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- O'Brien Institute for Public Health, University of Calgary, Calgary, AB, Canada
- Alberta Health Services, Maternal Newborn Child and Youth Strategic Clinical Network, Calgary, AB, Canada
| | - Jane Tyerman
- School of Nursing, University of Ottawa, Ottawa, ON, Canada
- Canadian Alliance of Nurse Educators using Simulation (CAN-Sim), Kingston, ON, Canada
| | - Marian Luctkar-Flude
- Canadian Alliance of Nurse Educators using Simulation (CAN-Sim), Kingston, ON, Canada
- School of Nursing, Queen's University, Kingston, ON, Canada
| | - Sandra Davidson
- Faculty of Nursing, University of Calgary, Calgary, AB, Canada
| | - Cora Constantinescu
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Pediatric Infectious Diseases, Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
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Madkour A, Elsayed AM, Sweed H, Ebrashy IE, Abdelhamid M, Zidan M. Adult vaccination against respiratory infections in Egypt: a review of expert opinions. Expert Rev Vaccines 2024; 23:561-569. [PMID: 38695193 DOI: 10.1080/14760584.2024.2348608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 04/24/2024] [Indexed: 05/15/2024]
Abstract
INTRODUCTION Lower respiratory tract infection is one of the leading causes of morbidity and mortality all over the world, with a substantial impact on healthcare costs. In Egypt, local consensus on its burden, diagnosis, and vaccination is scarce. This expert opinion is the first to address the local recommendations for vaccinating adults against respiratory infection. It sheds light on the growing need to understand the barriers and underpublicized concept of adult vaccination in Egypt. AREAS COVERED A collaborative multidisciplinary panel from Egypt developed an expert opinion-based suggestions/points, including epidemiology, microbiology, and highlights on vaccination in Egypt, as well as challenges and recommendations regarding adult vaccination. EXPERT OPINION Adult vaccinations against respiratory infections are now recommended for high-risk people by all healthcare regulatory bodies. However, it was acknowledged that there may be hesitancy and concerns among patients; in addition, healthcare professionals' awareness about vaccination guidelines and benefits needs improvement. There are several strategies that could be implemented to enhance vaccine adherence in Egypt. These approaches encompass conducting community education programs, addressing the concerns of patients, and enhancing awareness among healthcare professionals through education, policy changes, and periodical reminders in each healthcare setting.
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Affiliation(s)
- Ashraf Madkour
- Department of Chest Diseases, Ain Shams University, Cairo, Egypt
| | - Adel M Elsayed
- Department of Internal Medicine and Rheumatology, Ain Shams University, Cairo, Egypt
| | - Hala Sweed
- Department of Geriatrics & Gerontology, Ain Shams University, Cairo, Egypt
| | - Ibrahim El Ebrashy
- Department of Internal Medicine and Endocrinology, Cairo University, Cairo, Egypt
| | | | - Mohamed Zidan
- Department of Chest Diseases, Alexandria University, Alexandria, Egypt
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Prieto-Campo Á, Batista AD, Magalhães Silva T, Herdeiro MT, Roque F, Figueiras A, Zapata-Cachafeiro M. Understanding vaccination hesitation among health professionals: a systematic review of qualitative studies. Public Health 2024; 226:17-26. [PMID: 37980837 DOI: 10.1016/j.puhe.2023.10.029] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 10/04/2023] [Accepted: 10/12/2023] [Indexed: 11/21/2023]
Abstract
OBJECTIVES In terms of vaccination, people trust healthcare professionals (HCPs) more than any other source of information. They are the cornerstone of vaccination as they can move undecided populations not only towards vaccination but also towards non-vaccination. The aim of this systematic review was to explore the knowledge, beliefs, attitudes, and barriers associated with own vaccination and patient recommendation in HCPs. STUDY DESIGN This study incorporated a systematic review. METHODS A systematic review of studies published from January 1, 2000, to June 1, 2020, was conducted by searching PubMed and EMBASE electronic databases. Qualitative studies reporting outcomes related to knowledge, attitudes, or barriers related to vaccination/recommendation by healthcare personnel were included. The guidelines in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses were followed. RESULTS From a total of 2916 studies identified, 36 articles met the inclusion criteria. Some of the factors cited by the HCP that may contribute to vaccine hesitancy were (a) concerns regarding safety or efficacy of vaccines (23 articles); (b) time constraints (21 articles); (c) lack of knowledge about the vaccination/vaccine (19 articles); (d) costs (13 articles); (e) distrust of pharmaceutical industry (8 articles); and (f) considering oneself insusceptible (7 articles), stock shortage (7 articles), lack of personnel (5 articles), and feelings of unnecessary vaccination (5 articles). CONCLUSIONS Our review suggests that interventions to combat vaccine hesitancy should increase HCP education on vaccine efficacy and safety, as well as intervene on health system factors such as cost and time per visit. In this way, we could tackle the problem of vaccine hesitancy, which seriously threatens global public health.
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Affiliation(s)
- Á Prieto-Campo
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, 15786, Santiago de Compostela, Spain
| | - A D Batista
- Department of Medical Sciences, University of Aveiro, 3810-193, Aveiro, Portugal
| | - T Magalhães Silva
- Institute of Biomedicine (iBiMED), Department of Medical Sciences, University of Aveiro, Campus Universitário de Santiago, 3810-193, Aveiro, Portugal
| | - M T Herdeiro
- Institute of Biomedicine (iBiMED), Department of Medical Sciences, University of Aveiro, Campus Universitário de Santiago, 3810-193, Aveiro, Portugal
| | - F Roque
- Research Unit for Inland Development, Polytechnic of Guarda (UDI-IPG), Avenida Dr. Francisco Sá Carneiro, no. ° 50, 6300-559, Guarda, Portugal; Health Sciences Research Centre, University of Beira Interior (CICS-UBI), Av. Infante D. Henrique, 6200-506, Covilhã, Portugal; Escola Superior de Saúde, Instituto Politécnico da Guarda Rua da Cadeia, 6300-035, Guarda, Portugal.
| | - A Figueiras
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, 15786, Santiago de Compostela, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), Santiago de Compostela, Spain; Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - M Zapata-Cachafeiro
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, 15786, Santiago de Compostela, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), Santiago de Compostela, Spain; Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain.
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Lan C, Chen YC, Chang YI, Chuang PC. Impact of COVID-19 Outbreak on Influenza and Pneumococcal Vaccination Uptake: A Multi-Center Retrospective Study. Vaccines (Basel) 2023; 11:986. [PMID: 37243090 PMCID: PMC10223787 DOI: 10.3390/vaccines11050986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 05/10/2023] [Accepted: 05/11/2023] [Indexed: 05/28/2023] Open
Abstract
During the coronavirus disease 2019 (COVID-19) pandemic, global vaccination efforts declined due to the burden on health systems and community resistance to epidemic control measures. Influenza and pneumococcal vaccines have been recommended for vulnerable populations to prevent severe pneumonia. We investigated community response towards influenza and pneumococcal vaccines (pneumococcal conjugate vaccine and pneumococcal polysaccharide vaccine) after the COVID-19 outbreak in Taiwan. We retrospectively included adults who visited Chang Gung Memorial Hospital (CGMH) institutions for influenza or pneumococcal vaccination from January 2018 to December 2021. The first case of COVID-19 in Taiwan was detected in January 2020; therefore, in this study, hospitalized cases from January 2018 to December 2019 were defined as "before COVID-19 outbreak," and hospitalized cases from January 2020 to December 2021 were defined as "after COVID-19 outbreak". A total of 105,386 adults were enrolled in the study. An increase in influenza vaccination (n = 33,139 vs. n = 62,634) and pneumococcal vaccination (n = 3035 vs. n = 4260) were observed after the COVID-19 outbreak. In addition, there was an increased willingness to receive both influenza and pneumococcal vaccinations among women, adults without underlying disease and younger adults. The COVID-19 pandemic may have increased awareness of the importance of vaccination in Taiwan.
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Affiliation(s)
- Chieh Lan
- Department of Family Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 83301, Taiwan;
| | - Yi-Chun Chen
- Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 83301, Taiwan;
| | - Ye-In Chang
- Department of Computer Science and Engineering, National Sun Yat-sen University, Kaohsiung 80424, Taiwan;
| | - Po-Chun Chuang
- Department of Computer Science and Engineering, National Sun Yat-sen University, Kaohsiung 80424, Taiwan;
- Department of Emergency Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 83301, Taiwan
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Sakr R, Helou M, Hamieh C, Estephan M, Chrabieh R, Salameh P, Khazen G, Kolanjian H, Jabbour E, Husni R. Perception of the Lebanese Adults about Vaccination: A Survey. Vaccines (Basel) 2023; 11:vaccines11030621. [PMID: 36992205 DOI: 10.3390/vaccines11030621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Revised: 02/27/2023] [Accepted: 03/01/2023] [Indexed: 03/12/2023] Open
Abstract
Introduction: With the continuous spread and emergence of transmissible diseases, focusing on preventive measures is essential to decrease their incidence and spread. In addition to behavioral measures, vaccination is an optimal way to protect the population and eradicate infectious diseases. The majority are aware of children’s vaccinations, while many might not know that adult vaccinations are also essential. Objectives: This study aims to understand the perception of Lebanese adults towards vaccination and their knowledge and awareness of its importance. This is a national cross-sectional study, conducted between January 2020 and January 2021. Results: the data were collected from 1023 subjects, the majority being Lebanese, previously healthy, and with a graduate or post-graduate level of education. Out of these participants, 44.9% were advised to take vaccines, half of them by healthcare workers. The most common vaccine received during adult life is the Flu vaccine. Overall, 25.6% of the participants were unaware that they needed vaccines and 27.9% thought it is not indicated. Participants’ knowledge about vaccination is variable. In total, 39.4% agree or are uncertain whether vaccines contain harmful chemicals and 48.4% believe that vaccines will trigger diseases. The level of education and occupation significantly enhances knowledge about vaccination. Some participants 27.3% are concerned about the vaccine’s side effects. The group of young participants, graduates, and nonsmokers think that the vaccine is a necessity and had a positive attitude towards vaccination. Conclusions: Many Lebanese lack knowledge about adult vaccination protection and its benefits in the community. It is essential that the country’s health ministry department collaborate with the healthcare system to launch awareness campaigns about adult vaccination in the country to overcome the barriers and ensure better coverage.
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Affiliation(s)
- Rania Sakr
- Lebanese American University Medical Center Rizk Hospital, Division of Family Medicine, Lebanese American University School of Medicine, Beirut 1102 2801, Lebanon
| | - Mariana Helou
- Lebanese American University Medical Center Rizk Hospital, Division of Emergency Medicine, Lebanese American University School of Medicine, Beirut 1102 2801, Lebanon
| | - Cima Hamieh
- Lebanese American University Medical Center Rizk Hospital, Division of Family Medicine, Lebanese American University School of Medicine, Beirut 1102 2801, Lebanon
| | - Michelle Estephan
- Lebanese American University Medical Center Rizk Hospital, Division of Emergency Medicine, Lebanese American University School of Medicine, Beirut 1102 2801, Lebanon
| | - Remie Chrabieh
- Department of Dermatology, Lebanese American University Medical Center Rizk Hospital, Beirut 1102 2801, Lebanon
| | - Pascale Salameh
- Faculty of Medicine, Lebanese American University, Beirut 1102 2801, Lebanon
| | - Georges Khazen
- Computer Science and Mathematics Department, Lebanese American University, Beirut 1102 2801, Lebanon
| | - Harout Kolanjian
- Faculty of Medicine, Lebanese American University, Beirut 1102 2801, Lebanon
| | - Elsy Jabbour
- Lebanese American University Medical Center Rizk Hospital, Division of Emergency Medicine, Lebanese American University School of Medicine, Beirut 1102 2801, Lebanon
| | - Rola Husni
- Lebanese American University Medical Center Rizk Hospital, Division of Infectious Diseases, Lebanese American University School of Medicine, Beirut 1102 2801, Lebanon
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Wang Q, Yang L, Li L, Liu C, Jin H, Lin L. Willingness to Vaccinate Against Herpes Zoster and Its Associated Factors Across WHO Regions: Global Systematic Review and Meta-Analysis. JMIR Public Health Surveill 2023; 9:e43893. [PMID: 36892937 PMCID: PMC10037179 DOI: 10.2196/43893] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 12/25/2022] [Accepted: 01/19/2023] [Indexed: 03/10/2023] Open
Abstract
BACKGROUND A life-course immunization approach would enhance the quality of life across all age groups and improve societal well-being. The herpes zoster (HZ) vaccine is highly recommended for older adults to prevent HZ infection and related complications. The proportions of willingness to receive the HZ vaccine varies across countries, and various kinds of factors, including sociodemographics and individual perceptions, influence the willingness to vaccinate. OBJECTIVE We aim to estimate the HZ vaccination willingness rate and identify factors associated with vaccine uptake willingness across all World Health Organization (WHO) regions. METHODS A global systematic search was performed on PubMed, Web of Science, and the Cochrane Library for all papers related to the HZ vaccine published until June 20, 2022. Study characteristics were extracted for each included study. Using double arcsine transformation, vaccination willingness rates with 95% CIs were pooled and reported. The willingness rate and associated factors were analyzed by geographical context. Associated factors were also summarized based on Health Belief Model (HBM) constructs. RESULTS Of the 26,942 identified records, 13 (0.05%) papers were included, covering 14,066 individuals from 8 countries in 4 WHO regions (Eastern Mediterranean Region, European Region, Region of the Americas, and Western Pacific Region). The pooled vaccination willingness rate was 55.74% (95% CI 40.85%-70.13%). Of adults aged ≥50 years, 56.06% were willing to receive the HZ vaccine. After receiving health care workers' (HCWs) recommendations, 75.19% of individuals were willing to get the HZ vaccine; without HCWs' recommendations, the willingness rate was only 49.39%. The willingness rate was more than 70% in the Eastern Mediterranean Region and approximately 55% in the Western Pacific Region. The willingness rate was the highest in the United Arab Emirates and the lowest in China and the United Kingdom. The perception of HZ severity and susceptibility was positively associated with vaccination willingness. The perceived barriers to vaccination willingness (main reasons for unwillingness) included low trust in the effectiveness of the HZ vaccine, concerns about safety, financial concerns, and being unaware of the HZ vaccine's availability. Older individuals, those having lower education, or those having lower income levels were less likely to willing to be vaccinated. CONCLUSIONS Only 1 in 2 individuals showed a willingness to be vaccinated against HZ. The willingness rate was the highest in the Eastern Mediterranean Region. Our findings show the critical role HCWs play in promoting HZ vaccination. Monitoring HZ vaccination willingness is necessary to inform public health decision-making. These findings provide critical insights for designing future life-course immunization programs.
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Affiliation(s)
- Qiang Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Liuqing Yang
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China
| | - Lan Li
- Centre for Digital Public Health in Emergencies, Institute for Risk and Disaster Reduction, University College London, London, United Kingdom
| | - Chang Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China
| | - Hui Jin
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, China
| | - Leesa Lin
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Laboratory of Data Discovery for Health, Hong Kong Science Park, Hong Kong, China
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
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10
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Factors Affecting Vaccine Attitudes Influenced by the COVID-19 Pandemic. Vaccines (Basel) 2023; 11:vaccines11030516. [PMID: 36992100 DOI: 10.3390/vaccines11030516] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 02/20/2023] [Accepted: 02/21/2023] [Indexed: 02/25/2023] Open
Abstract
The development of vaccines has significantly contributed to the success of disease prevention. However, there has been a sharp decline in immunization rates since COVID-19 spread globally. Seemingly overnight, the world shut down and most non-essential medical procedures were postponed. Since the COVID-19 vaccine became available, and the world started going back to normal these vaccine rates have not recovered. In this paper, we review the published literature to explore how convenience factors, perceived risk of vaccination, media or anti-vaccination ideals/movements, and healthcare professionals affect an individual’s compliance to be vaccinated to better understand the factors that contribute to the change in overall vaccination rates.
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11
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Lip A, Pateman M, Fullerton MM, Chen HM, Bailey L, Houle S, Davidson S, Constantinescu C. Vaccine hesitancy educational tools for healthcare providers and trainees: A scoping review. Vaccine 2023; 41:23-35. [PMID: 36437208 PMCID: PMC9688224 DOI: 10.1016/j.vaccine.2022.09.093] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 09/27/2022] [Accepted: 09/29/2022] [Indexed: 11/27/2022]
Abstract
In the era of vaccine hesitancy, highlighted by the current SARS-CoV2 pandemic, there is an acute need to develop an approach to reduce and address apprehension towards vaccinations. We sought to map and present an overview of existing educational interventions for healthcare providers (HCPs) on strategies to engage in effective vaccine discussion. We applied the Joanna Briggs Institute methodology framework in this scoping review. We searched five relevant databases (MEDLINE, CINAHL, EMBASE, PsycInfo, and SCOPUS) and grey literature through the Google search engine using keywords and subject headings that were systematically identified. We identified 3384 citations in peer-reviewed literature and 41 citations in grey literature. After screening for our inclusion criteria, we included 28 citations from peer reviewed literature and 16 citations from grey literature for analysis. We identified a total of 41 unique education interventions. Interventions were available from multiple disciplines, training levels, clinical settings, and diseases/vaccines. Interventions predominantly centered around two foci: knowledge sharing and communication training. Most interventions identified from peer-reviewed literature were facilitated and were applied with multiple modes of delivery. Interventions from grey literature were more topical and generally self-directed. We identified several gaps in knowledge. Firstly, accessibility and generalizability of interventions was limited. Secondly, distribution of interventions did not adequately address nursing and pharmacy disciplines, and did not cover the breadth of medical specialties for whom vaccine discussions apply. Thirdly, no interventions addressed self monitoring and the clinicians' recognition and management of emotions during difficult conversations. There is a need to address this gap and provide available, credible and comprehensive educational interventions that will support our healthcare providers in effective communication with vaccine hesitant patients.
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Affiliation(s)
- A Lip
- Division of Respirology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada.
| | - M Pateman
- Faculty of Nursing, University of Calgary, Calgary, Alberta, Canada; 19 to Zero Inc., Rocky Mountain House, Alberta, Canada
| | - M M Fullerton
- Faculty of Nursing, University of Calgary, Calgary, Alberta, Canada; 19 to Zero Inc., Rocky Mountain House, Alberta, Canada
| | - H M Chen
- 19 to Zero Inc., Rocky Mountain House, Alberta, Canada
| | - L Bailey
- School of Nursing, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - S Houle
- School of Pharmacy, Faculty of Science, University of Waterloo, Waterloo, Ontario, Canada
| | - S Davidson
- Faculty of Nursing, University of Calgary, Calgary, Alberta, Canada
| | - C Constantinescu
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Pediatric Infectious Diseases, Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
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12
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Di Castri AM, Halperin DM, Ye L, MacKinnon-Cameron D, Kervin M, Isenor JE, Halperin SA. Healthcare provider awareness, attitudes, beliefs, and behaviors regarding the role of pharmacists as immunizers. Hum Vaccin Immunother 2022; 18:2147356. [PMID: 36472081 PMCID: PMC9762776 DOI: 10.1080/21645515.2022.2147356] [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: 12/12/2022] Open
Abstract
We explored perceptions of healthcare providers in Nova Scotia and New Brunswick about pharmacists as immunizers. Pharmacists' scopes of practice are increasingly broadening to include immunization, and providers and policymakers may find meaning in the lessons we learned. Invitations to participate in our online survey were circulated by professional associations, health authorities, and in social media posts. A total of 204 healthcare providers completed our survey, of whom 59.3% were pharmacists, 17.6% were nurses, and 23.0% were physicians. Nurses (30.6%) and physicians (34.0%) experienced fewer logistical barriers to immunizing compared to pharmacists, 71.1% of whom identified practice logistics as a determinant in offering vaccines to patients (p < .001). Pharmacists were most supportive of the expansion of their own scope of practice to include the provision of vaccines to adults (95.9%) and children as young as five years (92.6%) compared to nurses (72.2% and 69.4%) and physicians (61.7% and 40.4%) (p < .001). Diversity of opinion was evident even among pharmacists about whether they should be permitted to vaccinate children younger than five years. Nurse and physician respondents had lower odds of thinking pharmacists have enough training to vaccinate (p < .001), that vaccines should be given in a pharmacy (p < .001), and of supporting the expansion of pharmacists' scope of practice (p < .001) than pharmacists did in the multivariable analyses. Pharmacists are well-positioned and willing to vaccinate and generally have support from their nurse and physician peers, but logistical challenges and interprofessional complexities persist as barriers to optimizing immunization by pharmacists.
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Affiliation(s)
- Antonia M. Di Castri
- Canadian Center for Vaccinology, Dalhousie University, IWK Health Centre, and Nova Scotia Health, Halifax, NS, Canada
| | - Donna M. Halperin
- Canadian Center for Vaccinology, Dalhousie University, IWK Health Centre, and Nova Scotia Health, Halifax, NS, Canada,Rankin School of Nursing, St. Francis Xavier University, Antigonish, NS, Canada,CONTACT Donna M. Halperin Canadian Center for Vaccinology, Dalhousie University, IWK Health, and Nova Scotia Health, Halifax, NS, Canada; Rankin School of Nursing, St. Francis Xavier University, PO Box 5000, Antigonish, Nova Scotia, B2G 2W5, Canada
| | - Lingyun Ye
- Canadian Center for Vaccinology, Dalhousie University, IWK Health Centre, and Nova Scotia Health, Halifax, NS, Canada
| | - Donna MacKinnon-Cameron
- Canadian Center for Vaccinology, Dalhousie University, IWK Health Centre, and Nova Scotia Health, Halifax, NS, Canada
| | - Melissa Kervin
- Canadian Center for Vaccinology, Dalhousie University, IWK Health Centre, and Nova Scotia Health, Halifax, NS, Canada
| | - Jennifer E. Isenor
- Canadian Center for Vaccinology, Dalhousie University, IWK Health Centre, and Nova Scotia Health, Halifax, NS, Canada,College of Pharmacy, Dalhousie University, Halifax, NS, Canada
| | - Scott A. Halperin
- Canadian Center for Vaccinology, Dalhousie University, IWK Health Centre, and Nova Scotia Health, Halifax, NS, Canada,Department of Pediatrics, Dalhousie University, Halifax, NS, Canada,Department of Microbiology and Immunology, Dalhousie University, Halifax, NS, Canada
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13
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Uncovering Public Perceptions of Older Adults' Vaccines in Canada: A Study of Online Discussions from National Media Sources. Can J Aging 2022; 41:657-666. [PMID: 35403587 DOI: 10.1017/s0714980822000010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
This study explored how a subsection of Canadians perceive older adults' vaccines through a qualitative analysis of comments posted in response to national online news articles. We used reflexive thematic analysis to analyse 147 comments from 31 news article comments sections published between 2015 and 2020 from five different national online news sources (CBC, National Post, Global News, Globe & Mail, and Huffington Post Canada) that focused on three older adults' diseases and vaccines: influenza, pneumococcal pneumonia, and herpes-zoster. Three themes encompassed the similarities and differences in how these three diseases were discussed: (1) the importance of personal experiences on stated stance in vaccine uptake or refusal, (2) questioning vaccine research and recommendations, and (3) criticisms of the government's unequal vaccine opportunities across different Canadian provinces. Our findings identified that perceptions regarding older adult vaccination were dependent on the vaccine type, and, therefore, we make suggestions for future researchers to build on our findings, particularly the need not to treat the research subject of "older adults' vaccines" as one entity. Gaining a better understanding of how older adults' vaccines are perceived in Canada will enable public health professionals to develop effective communication strategies that should ultimately improve vaccination rates for older adults.
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14
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Wennekes MD, Eilers R, Caputo A, Gagneux-Brunon A, Gavioli R, Nicoli F, Vokó Z, Timen A. Focus group study on perceptions and information needs regarding vaccines targeting the older population: a cross-country comparison in four European countries. GeroScience 2022; 45:871-887. [PMID: 36413259 PMCID: PMC9684753 DOI: 10.1007/s11357-022-00682-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 10/26/2022] [Indexed: 11/23/2022] Open
Abstract
The increasing life expectancy leads to more older adults suffering from infectious diseases. Vaccines are available against diverse infections such as influenza, pneumococcal disease, herpes zoster and tetanus. However, vaccine acceptance is crucial for optimal preventive effect. The objective of the study is to perform a cross-country analysis of the perceptions and decision-making behaviour of older adults regarding vaccinations and their information needs. Focus groups with older adults were conducted in four countries: France, Hungary, Italy and the Netherlands. Data were analysed using thematic analysis. Demographic characteristics of participants were gathered with a questionnaire. Influenza and tetanus vaccines were commonly known, as was the disease influenza. On the contrary, the awareness of the vaccines against pneumococcal disease and herpes zoster were low. Participants also expressed a need for more information on vaccines, such as possible side effects, contra-indications and duration of protection, emphasizing that information is a condition for decision-making on vaccination. General practitioners were found to be the most important in information provision on vaccines. Perceptions on vaccines, such as effectiveness, side effects and safety, as well as perceptions on infectious diseases, such as severity, susceptibility and experiencing an infectious disease, played a role in the decision-making of older adults on vaccines. More awareness of the information needs among older adults with regard to vaccines should be raised among general practitioners and other healthcare providers. This requires appropriate knowledge about the vaccines among healthcare providers as well as communication skills to meet the information needs of older adults.
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Affiliation(s)
- Manuela Dominique Wennekes
- National Coordination Centre for Communicable Disease Control, National Institute of Public Health and the Environment (RIVM), Bilthoven, the Netherlands.
- Athena Institute, VU University Amsterdam, Amsterdam, the Netherlands.
| | - Renske Eilers
- National Coordination Centre for Communicable Disease Control, National Institute of Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Antonella Caputo
- Department of Chemical, Pharmaceutical and Agricultural Sciences, University of Ferrara, Ferrara, Italy
| | - Amandine Gagneux-Brunon
- Centre International de Recherche en Infectiologie, Team GIMAP, INSERM, U1111, CNRS, UMR530, Université de Lyon, Saint-Etienne, France
- Department of infectious Diseases, University Hospital of Saint-Etienne, Saint-Etienne, France
- Chaire PreVacCI, Université Jean Monnet, Saint-Etienne, France
- CIC-INSERM 1408 Vaccinologie, CHU de Saint-Etienne, Université Jean Monnet, Saint-Etienne, France
| | - Riccardo Gavioli
- Department of Chemical, Pharmaceutical and Agricultural Sciences, University of Ferrara, Ferrara, Italy
| | - Francesco Nicoli
- Department of Chemical, Pharmaceutical and Agricultural Sciences, University of Ferrara, Ferrara, Italy
| | - Zoltán Vokó
- Syreon Research Institute, Budapest, Hungary
- Center for Health Technology Assessment, Semmelweis University, Budapest, Hungary
| | - Aura Timen
- National Coordination Centre for Communicable Disease Control, National Institute of Public Health and the Environment (RIVM), Bilthoven, the Netherlands
- Athena Institute, VU University Amsterdam, Amsterdam, the Netherlands
- Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, the Netherlands
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15
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Sulis G, Rodrigue V, Wolfson C, McMillan JM, Kirkland SA, Andrew MK, Basta NE. Pneumococcal vaccination uptake and missed opportunities for vaccination among Canadian adults: A cross-sectional analysis of the Canadian Longitudinal Study on Aging (CLSA). PLoS One 2022; 17:e0275923. [PMID: 36240132 PMCID: PMC9565727 DOI: 10.1371/journal.pone.0275923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 09/26/2022] [Indexed: 11/05/2022] Open
Abstract
Introduction In Canada, pneumococcal vaccination is recommended to all adults aged ≥65 and those <65 who have one or more chronic medical conditions (CMCs). Understanding vaccine uptake and its determinants among eligible groups has important implications for reducing the burden of pneumococcal disease. Methods Using data from a large national cohort of Canadian residents aged ≥47 years between 2015–2018, we calculated self-reported pneumococcal vaccine uptake among eligible groups, estimated associations between key factors and non-vaccination, assessed missed opportunities for vaccination (MOV) and examined risk factors for MOV. Adjusted odds ratios (aORs) and 95% confidence intervals (CIs) for relevant associations were estimated through logistic regression. Results 45.8% (95% CI: 45.2–46.5) of 22,246 participants aged ≥65 and 81.3% (95% CI: 80.5–82.0) of 10,815 individuals aged 47–64 with ≥1 CMC reported never having received a pneumococcal vaccine. Receipt of influenza vaccination in the previous year was associated with the lowest odds of pneumococcal non-vaccination (aOR = 0.14 [95% CI: 0.13–0.15] for older adults and aOR = 0.23 [95% CI: 0.20–0.26] for those aged 47–64 with ≥1 CMC). Pneumococcal vaccine uptake was also more likely in case of contact with a family doctor in the previous year (versus no contact), increased with age and varied widely across provinces. Among individuals recently vaccinated against influenza, 32.6% (95% CI: 31.9–33.4) of those aged ≥65 and 71.1% (95% CI: 69.9–72.3) of those aged 47–64 with ≥1 CMC missed an opportunity to get a pneumococcal vaccine. Among individuals who had contact with a family doctor, 44.8% (95% CI: 44.1–45.5) of those aged ≥65 and 80.4% (95% CI: 79.6–81.2) of those aged 47–64 with ≥1 CMC experienced a MOV. Conclusions Pneumococcal vaccine uptake remains suboptimal among at-risk Canadian adults who are eligible for vaccination. Further research is needed to clarify the reasons behind missed opportunities for vaccination and adequately address the main barriers to pneumococcal vaccination.
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Affiliation(s)
- Giorgia Sulis
- Department of Epidemiology, Biostatistics and Occupational Health, School of Population and Global Health, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
- * E-mail:
| | - Valérie Rodrigue
- Department of Epidemiology, Biostatistics and Occupational Health, School of Population and Global Health, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
| | - Christina Wolfson
- Department of Epidemiology, Biostatistics and Occupational Health, School of Population and Global Health, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
- Department of Medicine, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
- Research Institute of the McGill University Health Centre, Montreal, QC, Canada
| | - Jacqueline M. McMillan
- Department of Medicine, Faculty of Medicine, University of Calgary, Calgary, AB, Canada
- O’Brien Institute for Public Health, University of Calgary, Calgary, AB, Canada
| | - Susan A. Kirkland
- Department of Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
- Division of Geriatric Medicine, Department of Medicine, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
| | - Melissa K. Andrew
- Division of Geriatric Medicine, Department of Medicine, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
| | - Nicole E. Basta
- Department of Epidemiology, Biostatistics and Occupational Health, School of Population and Global Health, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
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16
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Blasi F, Aliberti S. Vaccinations: What's best? Pulmonology 2022; 28:419-420. [PMID: 36180351 DOI: 10.1016/j.pulmoe.2022.07.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Accepted: 07/18/2022] [Indexed: 10/14/2022] Open
Affiliation(s)
- F Blasi
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Pathophysiology and Transplantation University of Milan, Milan, Italy.
| | - S Aliberti
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20072 Pieve Emanuele, Milan, Italy; IRCCS Humanitas Research Hospital, Respiratory Unit, Via Manzoni 56, 20089 Rozzano, Milan, Italy
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17
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Vaccinating Front-Line Healthcare Workers: Results of a Pre-Pandemic Cross-Sectional Study from North-Eastern Italy on First Responders. Vaccines (Basel) 2022; 10:vaccines10091492. [PMID: 36146570 PMCID: PMC9503083 DOI: 10.3390/vaccines10091492] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 08/26/2022] [Accepted: 09/06/2022] [Indexed: 11/16/2022] Open
Abstract
First responders are front-line healthcare workers who are potentially exposed to different infectious agents. Characterizing their knowledge, attitudes, and practices (KAP) towards immunization, therefore, has the potential to significantly improve occupational health and safety. A cross-sectional study was performed in October 2018 using a sample of 161 first responders from the Parma Province (mean age 45.1 ± 14.1 years; seniority 10.8 ± 8.6 years). The participants were questioned on three recommended vaccinations (i.e., the seasonal influenza, measles, and pertussis vaccines) and on meningococcal vaccines (not officially recommended for first responders). The participant’s knowledge status and risk perception were assessed as percentage values through a specifically designed questionnaire. Adjusted odds ratios (aOR) for factors associated with vaccination status were calculated by means of a binary logistic regression analysis. The internal consistency result, calculated using a general knowledge test, was good (Cronbach’s alpha = 0.894), but the corresponding score was unsatisfying (46.5% ± 32.4), evidencing uncertainties surrounding the recommendations for measles and meningococcal vaccines (39.1% and 34.2% incorrect answers, respectively). While the large majority of respondents were favorable towards the meningococcal (89.4%), measles (87.5%), and pertussis vaccines (83.0%), 55.3% exhibited a favorable attitude toward the seasonal influenza vaccine, the uptake of which in 2018, was reported by 28.0% of respondents, compared to the self-reported lifetime status for meningitis (26.1%), measles (42.2%), and pertussis (34.8%). Not coincidentally, all assessed infections were associated with a low-risk perception score, particularly influenza (33.9% ± 18.4). Interestingly enough, neither knowledge status nor risk perception were associated with vaccination rates. More precisely, the main predictor for being vaccinated against seasonal influenza in 2018 was a seniority of ≥10 years (aOR 3.26, 95% confidence interval [95% CI] 1.35–7.91), while both pertussis and measles were positively associated with higher educational achievement (aOR 3.27, 95%CI 1.29–8.30; and aOR 2.69, 95%CI 1.09–6.65, respectively). The reasons for vaccination gaps among the sampled first responders, apparently, did not find their roots in inappropriate knowledge status and risk perception alone. However, the very low rates of sampled immunization lead us to recommend stronger and more appropriate information campaigns.
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18
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Mahmud S, Mohsin M, Hossain S, Islam MM, Muyeed A. The acceptance of COVID-19 vaccine at early stage of development and approval: A global systematic review and meta-analysis. Heliyon 2022; 8:e10728. [PMID: 36168558 PMCID: PMC9499991 DOI: 10.1016/j.heliyon.2022.e10728] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 10/27/2021] [Accepted: 09/15/2022] [Indexed: 12/03/2022] Open
Abstract
Background Vaccination seems to be the most effective way to prevent and control the spread of COVID-19, a disease that has adversely impacted the lives of over 7 billion people across the globe. Vaccine hesitancy represents an important threat to combat infectious diseases worldwide. This study aims to inspect the COVID-19 vaccine acceptance rate worldwide and the regional variation of the acceptance rates among the general population and healthcare workers across different territories of the world. In addition, it compares the vaccine acceptance rates between the pre- and post-vaccine approval periods. Method A comprehensive systematic review was conducted using PRISMA statements. After quality evaluation, the data from eligible studies were analyzed using the random effect model. Q-test andI 2 statistics were used to search for heterogeneity. The publication bias was assessed by using Egger's test and funnel plot. Results The combined COVID-19 vaccine acceptance rate among the general population and healthcare workers (n = 1,581,562) was estimated at 62.79% (95% CI: 58.98-66.60). The acceptance rate substantially decreased from 66.29% (95% CI: 61.24-71.35) to 56.69% (95% CI: 48.68-64.71) among the general population from the pre-to post-vaccine approval periods but remained almost constant at 58.25% (95% CI: 46.52-69.97) among healthcare workers. The acceptance rates also varied in different regions of the world. The highest acceptance rate was found in the South-East Asia region at 70.18% (95% CI: 58.12-82.25) and the lowest was found in African Region at 39.51% (95% CI: 23.42-55.59). Conclusion Low COVID-19 vaccine acceptance rate might be a massive barrier to controlling the pandemic. More research is needed to address the responsible factors influencing the low global rate of COVID-19 vaccine acceptance. Integrated global efforts are required to remove the barriers.
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Affiliation(s)
- Sultan Mahmud
- Institute of Statistical Research and Training, University of Dhaka, Dhaka, Bangladesh
| | - Md Mohsin
- Institute of Statistical Research and Training, University of Dhaka, Dhaka, Bangladesh
| | - Sorif Hossain
- Institute of Statistical Research and Training, University of Dhaka, Dhaka, Bangladesh
| | - Md Mynul Islam
- Institute of Statistical Research and Training, University of Dhaka, Dhaka, Bangladesh
| | - Abdul Muyeed
- Department of Statistics, Jatiya Kabi Kazi Nazrul Islam University, Trishal, Mymensingh-2224, Bangladesh
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19
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Pringle W, Greyson D, Graham JE, Dubé È, Mitchell H, Trottier MÈ, Berman R, Russell ML, MacDonald SE, Bettinger JA. Suitable but requiring support: How the midwifery model of care offers opportunities to counsel the vaccine hesitant pregnant population. Vaccine 2022; 40:5594-5600. [PMID: 35989134 DOI: 10.1016/j.vaccine.2022.07.055] [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: 07/15/2021] [Revised: 06/02/2022] [Accepted: 07/27/2022] [Indexed: 11/28/2022]
Abstract
Uptake of vaccination during pregnancy in Canada is lower than comparator countries. A recommendation from a trusted perinatal healthcare provider is a key opportunity to promote vaccine uptake and improve confidence. This study aims to identify barriers and opportunities to vaccination in midwifery care. Seventeen semi-structured telephone interviews with practicing midwives, educators and public health professionals with immunization training experiences were conducted. Documents pertaining to the midwifery profession (approx. 50) were reviewed. Inductive thematic analysis identified logistical, interprofessional, and information barriers preventing Canadian midwives from administering vaccines and counseling clients about vaccination, as well as opportunities to address each barrier. Key interventions at the level of logistics, training, and client information materials would help address barriers to the integration of midwives into the provision and recommendation of vaccines in perinatal care across Canada.
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Affiliation(s)
- Wendy Pringle
- Vaccine Evaluation Center, University of British Columbia, 950 W 28th Ave, Vancouver, British Columbia V5Z 4H4, Canada.
| | - Devon Greyson
- Department of Communication, University of Massachusetts Amherst, Integrative Learning Center, 650 N Pleasant St, Amherst, Massachusetts 01003, USA; School of Population and Public Health, University of British Columbia, 2206 East Mall, Vancouver, British Columbia V6T 1Z3, Canada.
| | - Janice E Graham
- Department of Pediatrics, Dalhousie University, 5849 University Ave, C-309, P.O. Box 15000, Halifax, Nova Scotia B3H 4H7, Canada.
| | - Ève Dubé
- Quebec National Institute of Public Health, 945, av Wolfe, Quebec City, Quebec G1V 5B3, Canada.
| | - Hana Mitchell
- Vaccine Evaluation Center, University of British Columbia, 950 W 28th Ave, Vancouver, British Columbia V5Z 4H4, Canada; Department of Pediatrics, UBC Faculty of Medicine, Rm 2D19, 4480 Oak Street, BC Children's Hospital, Vancouver, BC V6H 3V4, Canada.
| | - Marie-Ève Trottier
- Quebec National Institute of Public Health, 945, av Wolfe, Quebec City, Quebec G1V 5B3, Canada.
| | - Robyn Berman
- Ottawa Birth and Wellness Centre, 2260 Walkley Rd, Ottawa, Ontario K1G 6A8, Canada.
| | - Margaret L Russell
- Cumming School of Medicine, University of Calgary, 3330 Hospital Dr NW, Calgary, Alberta T2N 4N1, Canada.
| | - Shannon E MacDonald
- Faculty of Nursing, University of Alberta, Level 3, Edmonton Clinic Health Academy, 11405-87 Ave, Edmonton, Alberta T6G 1C9, Canada.
| | - Julie A Bettinger
- Vaccine Evaluation Center, University of British Columbia, 950 W 28th Ave, Vancouver, British Columbia V5Z 4H4, Canada; Department of Pediatrics, UBC Faculty of Medicine, Rm 2D19, 4480 Oak Street, BC Children's Hospital, Vancouver, BC V6H 3V4, Canada.
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Nasreen S, Gebretekle GB, Lynch M, Kurdina A, Thomas M, Fadel S, Houle SKD, Waite NM, Crowcroft NS, Allin S. Understanding predictors of pneumococcal vaccine uptake in older adults aged 65 years and older in high-income countries across the globe: A scoping review. Vaccine 2022; 40:4380-4393. [PMID: 35781171 DOI: 10.1016/j.vaccine.2022.06.056] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 05/31/2022] [Accepted: 06/20/2022] [Indexed: 01/05/2023]
Abstract
BACKGROUND Pneumococcal disease causes substantial morbidity and mortality in older adults. Pneumococcal polysaccharide vaccine (PPV23) is routinely recommended to reduce the disease burden in this population. However, the vaccination coverage in older adults remains suboptimal in high-income countries. OBJECTIVES We sought to understand the current landscape of published literature on the predictors of pneumococcal vaccine uptake in older adults aged 65 years and older in high-income countries, and to identify the gaps in literature to inform future research. METHODS We conducted a scoping review employing the Arksey and O'Malley framework and Joanna Briggs Methods. We searched Medline, EMBASE, CINAHL, PsycInfo and Cochrane databases. We included quantitative and qualitative studies on predictors of pneumococcal vaccination in older adults that reported older adult- and pneumococcal vaccine-specific results, conducted in high-income settings, and published in English between January 2015 and April 2020. We excluded studies assessing interventions to improve vaccine uptake. We followed the Strategic Advisory Group of Experts on Immunization Working Group Vaccine Hesitancy Determinants Matrix to map the predictors within contextual, individual and social group, and vaccine and vaccination-specific influence determinants. Studies on providers and institutions were also included and results summarized separately. RESULTS We included 52 publications in our review. Most of the predictors in 39 quantitative studies belonged to the individual and social group influences (n = 12), followed by contextual influences (n = 11) and vaccine and vaccination-specific issues (n = 3). Few qualitative studies explored the barriers to pneumococcal vaccination. Only five studies examined predictors from the healthcare providers' perspective. Three studies examined the institutional characteristics as the predictors of pneumococcal vaccination in older adults. CONCLUSIONS We identified enablers and barriers of pneumococcal vaccination among older adults in high-income settings. We also identified gaps in the literature and provide recommendations for future research to address the gaps.
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Affiliation(s)
- Sharifa Nasreen
- Centre for Vaccine Preventable Diseases, University of Toronto, Toronto, Ontario, Canada; Dalla Lana School of Public Health, University of Toronto, Ontario, Canada.
| | - Gebremedhin B Gebretekle
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; Toronto Health Economics and Technology Assessment (THETA) Collaborative, University Health Network, Toronto, Ontario, Canada
| | - Meghan Lynch
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Anna Kurdina
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Madeleine Thomas
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Shaza Fadel
- Centre for Vaccine Preventable Diseases, University of Toronto, Toronto, Ontario, Canada; Dalla Lana School of Public Health, University of Toronto, Ontario, Canada
| | | | - Nancy M Waite
- School of Pharmacy, University of Waterloo, Waterloo, Ontario, Canada
| | - Natasha S Crowcroft
- Centre for Vaccine Preventable Diseases, University of Toronto, Toronto, Ontario, Canada; Dalla Lana School of Public Health, University of Toronto, Ontario, Canada
| | - Sara Allin
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
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21
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Knowledge, attitudes, and practices regarding vaccination among community pharmacists. Prim Health Care Res Dev 2022; 23:e38. [PMID: 35866296 PMCID: PMC9309755 DOI: 10.1017/s1463423622000330] [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: 11/26/2022] Open
Abstract
Background: Healthcare professionals’ vaccine recommendation is the most effective method to increase vaccination rates of the community. The vaccine counseling and recommendation behavior of pharmacists, who are among the easily accessible healthcare professionals, are influenced by their knowledge and attitudes about vaccines. Aim: It was aimed to investigate community pharmacists’ knowledge, attitudes, and practices regarding commonly used vaccines. Methods: A cross-sectional study was conducted as an online survey with a sample of 1100 community pharmacists in Turkey. Pharmacists were invited to participate in the study by phone calls. A structured survey, which consists of 40 questions to assess the knowledge, attitudes, and practices regarding vaccines, was sent to the e-mail addresses of pharmacists who volunteered to participate in the study. Findings: A total of 430 pharmacists completed the survey. Thirty percent of pharmacists had lack of knowledge about vaccination during pregnancy, whereas 52.2% and 31.4% of pharmacists believed that tetanus and influenza vaccines should be provided during pregnancy, respectively. Nearly 89% of pharmacists recommended vaccines to patients, mainly for influenza vaccine (83.9%). Only 31.5% of pharmacists had been vaccinated against influenza in the last season, whereas 50.5% had never been vaccinated. Pharmacists who had been vaccinated with influenza vaccine had a high rate of recommending influenza vaccines to the patients. Conclusion: The present study found that vaccination among pharmacists in Turkey and their knowledge on vaccination during pregnancy were low. Further education of pharmacists to improve their knowledge and attitudes toward vaccines is needed.
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22
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Stratoberdha D, Gobis B, Ziemczonek A, Yuen J, Giang A, Zed PJ. Barriers to adult vaccination in Canada: A qualitative systematic review. Can Pharm J (Ott) 2022; 155:206-218. [PMID: 35813527 PMCID: PMC9266373 DOI: 10.1177/17151635221090212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 02/18/2022] [Accepted: 02/28/2022] [Indexed: 11/23/2022]
Abstract
Background: In recent years, Canadian health care professionals have observed an increase in vaccine refusal. The objective of this study is to review published literature and identify the main themes related to vaccine hesitancy and barriers to vaccination in Canadian adults and recent immigrants. Methods: A qualitative systematic review was performed. A comprehensive search of MEDLINE (1946 to January 2021) and EMBASE (1974 to January 2021) was conducted to identify existing literature that addressed the primary research question. Studies were eligible for inclusion if the study population involved 1) the general population, 2) Indigenous populations, 3) recent immigrants to Canada or 4) Canadian health care professionals. Results: Thirty-four studies were included with a focus on the general population (n = 22), health care professionals (n = 10) and recent immigrant populations (n = 2). The most frequently reported barriers were lack of vaccine information (41%), lack of access to vaccination (38%), fear of adverse reactions (38%), financial reasons (29%), lack of awareness of vaccine existence (29%), antivaccine sentiments (24%), notion that older adults do not need vaccination (18%), misconceptions on vaccine effectiveness (12%), potential sexual health promotion stigma (6%) and fear of needles (3%). Interpretation: Barriers to vaccination among Canadians and recent immigrants continue to be a challenge in the health care system. Conclusions: The greatest yield in improving vaccination rates is likely to come from supporting vaccine-hesitant individuals in shifting their thinking to greater vaccine acceptance. Pharmacists are well positioned to address vaccine hesitancy and involvement through education, facilitation and administration of vaccines. Can Pharm J (Ott) 2022;155:xx-xx.
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Affiliation(s)
- Doris Stratoberdha
- Faculty of Pharmaceutical Sciences, the University of British Columbia, Vancouver, BC
| | - Barbara Gobis
- Faculty of Pharmaceutical Sciences, the University of British Columbia, Vancouver, BC
| | - Adrian Ziemczonek
- Faculty of Pharmaceutical Sciences, the University of British Columbia, Vancouver, BC
| | - Jamie Yuen
- Faculty of Pharmaceutical Sciences, the University of British Columbia, Vancouver, BC
| | - Annita Giang
- Faculty of Pharmaceutical Sciences, the University of British Columbia, Vancouver, BC
| | - Peter J. Zed
- Faculty of Pharmaceutical Sciences and the Faculty of Medicine, the University of British Columbia, Vancouver, BC
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23
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Choi K, Chang J, Luo YX, Lewin B, Munoz-Plaza C, Bronstein D, Rondinelli J, Bruxvoort K. "Still on the Fence": A Mixed Methods Investigation of COVID-19 Vaccine Confidence Among Health Care Providers. Workplace Health Saf 2022; 70:285-297. [PMID: 35311397 DOI: 10.1177/21650799211049811] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND There is evidence of disparities in COVID-19 vaccine acceptance among health care providers. The purpose of this study was to examine confidence receiving and recommending COVID-19 vaccines by health care provider type and race/ethnicity. METHODS This mixed methods study involved a cross-sectional survey and qualitative, semi-structured interviews from March to May 2021 among a sample of physicians, advanced practice providers, nurses, and pharmacists. These workers were recruited through voluntary response sampling from an integrated health system in Southern California. The primary dependent variables were (a) confidence in vaccine safety, (b) confidence in vaccine effectiveness, and (c) intent to recommend the vaccine to others. The primary independent variables were health care provider type and race/ethnicity. FINDINGS A total of 2,948 providers completed the survey. Nurses relative to physicians were 15% less likely to perceive the COVID-19 vaccine to be safe (risk ratio [RR] = 0.85; 95% confidence interval [CI] = 0.83-0.87); 27% less likely to perceive the vaccine to prevent COVID-19 (RR = 0.73; 95% CI = 0.69-0.76); and 11% less likely to recommend the vaccine to others (RR = 0.89; 95% CI = 0.87-0.91). Hispanic/Latinx providers were 10% less likely to perceive the vaccine to prevent COVID-19 (RR = 0.90; 95% CI = 0.83-0.98) relative to White providers. Qualitative themes included: No need for vaccine; distrusting vaccine research and roll-out; caretaking barriers; uncertainty and potential to change one's mind; framing vaccine decisions around personal beliefs. CONCLUSIONS & APPLICATION TO PRACTICE Health care workplaces should consider interventions to increase COVID-19 vaccination among their workers, including education and mandatory vaccination policies.
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Affiliation(s)
| | | | - Yi X Luo
- Kaiser Permanente Southern California
| | - Bruno Lewin
- Southern California Permanente Medical Group
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24
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Czerwińska E, Nittner-Marszalska M, Zaryczański J, Gąszczyk G, Mastalerz-Migas A, Szenborn L. Influenza and Other Prophylactic Vaccination Coverage in Polish Adult Patients Undergoing Allergen Immunotherapy-A Survey Study among Patients and Physicians. Vaccines (Basel) 2022; 10:vaccines10040576. [PMID: 35455327 PMCID: PMC9027432 DOI: 10.3390/vaccines10040576] [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: 03/08/2022] [Revised: 04/06/2022] [Accepted: 04/06/2022] [Indexed: 02/04/2023] Open
Abstract
Vaccines against infectious diseases may raise safety concerns in patients undergoing allergen immunotherapy (AIT). The objective of our study was to investigate influenza vaccine and other selected prophylactic vaccines coverage in patients treated with AIT and the attitude of physicians towards vaccinations in this group of patients. We conducted a questionnaire-based study among patients undergoing AIT and physicians. The patients’ survey evaluated influenza and other prophylactic vaccines coverage. The physicians’ survey assessed their experience and opinions on prophylactic vaccinations during AIT. In total, 176 patients (aged 18−79 years) and 120 doctors filled the questionnaires. Patients were assigned to two groups—inhaled allergens group (n = 101) and insect venoms group (n = 68). The number of patients who received any dose (36% and 45%, p = 0.26), as well as two or more doses (17% and 22%, p = 0.43) of influenza vaccine was comparable between two groups. However, in both groups there was a significant (p < 0.0001) decrease in influenza vaccine uptake after the beginning of AIT. Patients from the inhaled allergens group declared a higher tetanus vaccine rate (41% vs. 19%, p = 0.004). The groups did not differ in the pneumococcal and tick-borne encephalitis vaccination coverage. A majority of doctors believe that prophylactic vaccinations in patients undergoing AIT are safe and effective (96% and 94%, respectively); however, as many as 87% of them identify with the need to create clear recommendations regarding vaccinating patients undergoing AIT. Prophylactic vaccine coverage is not satisfactory among Polish adult patients undergoing AIT. Polish doctors are convinced of the validity of prophylactic vaccinations during AIT.
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Affiliation(s)
- Ewa Czerwińska
- Clinical Department of Paediatrics and Infectious Diseases, Wroclaw Medical University, 50-368 Wroclaw, Poland;
- Correspondence:
| | - Marita Nittner-Marszalska
- Clinical Department of Internal Medicine, Pneumology and Allergology, Wroclaw Medical University, 50-369 Wroclaw, Poland;
| | - Janusz Zaryczański
- Department of Pediatrics, University Clinical Hospital in Opole, 45-040 Opole, Poland;
| | - Grzegorz Gąszczyk
- Department of Allergology, Medical Centre in Karpacz, 58-540 Karpacz, Poland;
| | | | - Leszek Szenborn
- Clinical Department of Paediatrics and Infectious Diseases, Wroclaw Medical University, 50-368 Wroclaw, Poland;
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25
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Verger P, Botelho-Nevers E, Garrison A, Gagnon D, Gagneur A, Gagneux-Brunon A, Dubé E. Vaccine hesitancy in health-care providers in Western countries: a narrative review. Expert Rev Vaccines 2022; 21:909-927. [PMID: 35315308 DOI: 10.1080/14760584.2022.2056026] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
INTRODUCTION Vaccine hesitancy (VH) is a leading cause of suboptimal vaccine uptake rates worldwide. The interaction between patients and health-care providers (HCPs) is the keystone in addressing VH. However, significant proportions of HCPs, including those who administer vaccines, are personally and professionally vaccine-hesitant. AREAS COVERED This narrative review sought to characterize the nature, extent, correlates, and consequences of VH among HCPs. We included 39 quantitative and qualitative studies conducted in Western countries, published since 2015, that assessed VH among HCPs in general, for several vaccines. Studies were reviewed using the WHO 3Cs model - (lack of) confidence, complacency, and (lack of) convenience. EXPERT OPINION Despite the lack of validated tools and substantial heterogeneity in the methods used to measure VH among HCPs, this review confirms its presence in this population, at frequencies that vary by country, profession type, setting, and level of medical education. Lack of knowledge and mistrust in health authorities/pharmaceutical industry/experts were among its principal drivers. Improving the content about vaccination in HCPs' training programs, facilitating access to reliable information for use during consultations, and developing and validating instruments to measure HCPs' VH and its determinants are key to addressing VH among HCPs.
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Affiliation(s)
- Pierre Verger
- ORS Paca, Southeastern Health Regional Observatory, Marseille, France.,Faculty of Medicine, Aix-Marseille University, Marseille, France
| | - Elisabeth Botelho-Nevers
- Department of Infectious Diseases, University Hospital of Saint-Etienne, Saint-Etienne, France.,CIRI - Centre International de Recherche en Infectiologie, Lyon, France.,Univ Lyon, Jean Monnet University, Saint-Etienne, France.,Chair PreVacCi, Presage Institut, Jean Monnet University, Saint-Etienne, France
| | - Amanda Garrison
- ORS Paca, Southeastern Health Regional Observatory, Marseille, France.,Faculty of Medicine, Aix-Marseille University, Marseille, France
| | - Dominique Gagnon
- Direction des risques biologiques et de la santé au travail, Institut national de santé publique du Québec, Quebec, Canada
| | - Arnaud Gagneur
- Department of Pediatrics, Centre de Recherche du CHUS, Quebec, Canada.,Faculté de médecine et des sciences de la santé, Département de pédiatrie, Université de Sherbrooke-Campus de la Santé, Quebec, Canada
| | - Amandine Gagneux-Brunon
- Department of Infectious Diseases, University Hospital of Saint-Etienne, Saint-Etienne, France.,CIRI - Centre International de Recherche en Infectiologie, Lyon, France.,Univ Lyon, Jean Monnet University, Saint-Etienne, France.,Chair PreVacCi, Presage Institut, Jean Monnet University, Saint-Etienne, France.,CIC INSERM Vaccinology, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - Eve Dubé
- Deptartment of Anthropology, Laval University, Quebec, Canada
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26
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Seyman D, Keskin AS, Küçükateş E, Ceylan MR, Kul G, Tosun S, Oğuzöncül AF, Gazel ÖZ, Uzar H, Uysal S, Aliravcı ID, Kaya SY, Uğuz M, Can M, Demirkıran BÇ, Kul H, Şölen EY, Can H, Deniz M, Altuntaş B. Healthcare personnel's attitude and coverage about tetanus vaccination in Turkey: a multicenter study. Hum Vaccin Immunother 2022; 18:2014732. [PMID: 35172681 PMCID: PMC8973359 DOI: 10.1080/21645515.2021.2014732] [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: 12/02/2022] Open
Abstract
The tetanus vaccine is not routinely given to Turkish adults. Protective tetanus immunity decreases with age. Health-care personnel (HCPs), who are role models in the field of health, are a target group in order to achieve a higher rate of tetanus vaccination in the community. This study was designed to evaluate attitudes and coverage regarding tetanus vaccination among a large sample of Turkish HCPs. This cross-sectional epidemiologic study was conducted from July to August 2019. A questionnaire was sent to HCPs using social media. Of the 10,644 HCPs included in the study, 65% were female. Overall, the tetanus vaccination coverage (TVC) among HCPs was 78.5% (95% CI: 77.7%-79.3%). TVC was significantly higher among physicians [83.4% (95% CI: 82%-84.6%); p < .001] compared with all other HCPs except nurses. Older age (≥40 years) and length of professional experience were significantly correlated with TVC. Of the 8353 HCPs who received tetanus vaccines during their lifetime, 73.03% received tetanus vaccination in the past 10 years. The self-vaccination rate for protection against tetanus was 13.1%. Acute injuries (25.42%) and pregnancy (23.9%) were the most common reasons for having the tetanus vaccine. One-third (33.7%) of HCPs did not have information about whether pregnant women could receive tetanus vaccinations. This survey study provided excellent baseline information about HCPs’ coverage rates and attitudes regarding tetanus vaccination. The present results suggested that tetanus boosters for HCPs should be established as soon as possible, and revealed that the HCPs younger than 30 years with relatively less professional experience and all other HCPs except nurses and physicians should be identified as the target population for future intervention programs.
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Affiliation(s)
- Derya Seyman
- Antalya Education and Research Hospital, Department of Infectious Diseases and Clinical Microbiology, Health Sciences University, Antalya, Turkey
| | - Ayşegül Seremet Keskin
- Antalya Education and Research Hospital, Department of Infectious Diseases and Clinical Microbiology, Health Sciences University, Antalya, Turkey
| | - Emine Küçükateş
- Cerrahpasa Cardiology Institution, Department of Medical Microbiology, Istanbul University, Istanbul, Turkey
| | - Mehmet Reşat Ceylan
- Department of Infectious Diseases and Clinical Microbiology, Harran University Medical Faculty, Şanlıurfa, Turkey
| | - Gülnur Kul
- Department of Infectious Diseases and Clinical Microbiology, Kırıkhan State Hospital, Hatay, Turkey
| | - Selma Tosun
- Department of Infectious Diseases and Clinical Microbiology, Bozyaka Education and Research Hospital, İzmir, Turkey
| | | | - Özlem Zanapalıoğlu Gazel
- Department of Infectious Diseases and Clinical Microbiology, Gaziantep Cengiz Gökçek Maternity and Children Hospital, Gaziantep, Turkey
| | - Hanife Uzar
- Department of Infectious Diseases and Clinical Microbiology, Viranşehir State Hospital, Şanlıurfa, Turkey
| | - Serhat Uysal
- Department of Infectious Diseases and Clinical Microbiology, Balıkesir University Medical Faculty, Balıkesir, Turkey
| | - Işıl Deniz Aliravcı
- Department of Infectious Diseases and Clinical Microbiology, Manavgat State Hospital, Antalya, Turkey
| | - Sibel Yıldız Kaya
- Department of Infectious Diseases and Clinical Microbiology, Sungurlu State Hospital, Çorum, Turkey
| | - Mustafa Uğuz
- Department of Infectious Diseases and Clinical Microbiology, Mersin City Education and Research Hospital, Mersin, Turkey
| | - Müçteba Can
- Department of Anaesthesiology and Intensive Care Medicine, Ankara City Hospital, Ankara, Turkey
| | - Burcu Çalışkan Demirkıran
- Department of Infectious Diseases and Clinical Microbiology, Gülhane Education and Research Hospital, Ankara, Turkey
| | - Halil Kul
- Department of Neurosurgery, Hatay State Hospital, Hatay, Turkey
| | - Emine Yeşilyurt Şölen
- Department of Medical Microbiology, Bozok University Medical Faculty, Yozgat, Turkey
| | - Hüseyin Can
- Departments of Family Medicine, Private Aymira Nursing Home and Elderly Care Center, İzmir, Turkey
| | - Mustafa Deniz
- Antalya Education and Research Hospital, Department of Infectious Diseases and Clinical Microbiology, Health Sciences University, Antalya, Turkey
| | - Bülent Altuntaş
- Departments of Family Medicine, Şişli Hamidiye Etfal Education and Research Hospital, İstanbul, Turkey
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27
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Redondo Margüello E, Trilla A, Munguira ILB, Jaramillo López-Herce A, Cotarelo Suárez M. Knowledge, attitudes, beliefs and barriers of healthcare professionals and adults ≥ 65 years about vaccine-preventable diseases in Spain: the ADult Vaccination drIverS and barriErs (ADVISE) study. Hum Vaccin Immunother 2022; 18:2025007. [PMID: 35172691 PMCID: PMC8993072 DOI: 10.1080/21645515.2021.2025007] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Since 2018, Spanish National Immunization Guidelines include vaccination recommendations for adults ≥65 years. To determine whether health-care professionals and the ≥65 years target group value the need for these recommendations, a cross-sectional study was conducted to capture and describe their knowledge, attitudes, beliefs and behaviors about vaccination. Online surveys were administered to representative groups of general practitioners (GPs), primary care nurses and adults ≥65 years from six major cities (and surrounding rural areas) in Spain. Main topics were attitudes and awareness of vaccines, perceptions about vaccination in adults ≥65 years, and impact of the COVID-19 pandemic on vaccination uptake. A total of 286 health-care professionals (185 GPs, 101 nurses) and 400 adults aged ≥65 years participated in the survey. GP and nurse groups agreed strongly about the importance of influenza and pneumococcal vaccination in the target population. Longer patient visit times were identified as a key factor toward promoting vaccination. The ≥65 years sample group, especially those ≥75+ years and/or with chronic diseases, was reasonably positive about the effectiveness and benefits of vaccines. Lower vaccination rates for the pneumococcal than influenza vaccine (29% vs. 80%) in the ≥65 years sample group suggest that efforts are needed to improve pneumococcal vaccine uptake. Aligning with other published works, GPs have a key role in promoting vaccination in the target population. The COVID-19 pandemic appears to have heightened awareness about the importance of vaccination among health-care professionals and adults ≥65 years.
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Affiliation(s)
| | - Antoni Trilla
- Servicio de Medicina Preventiva del Hospital Clinic de Barcelona, Barcelona, Spain
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28
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Lin J, Dobbins T, Wood JG, Hall JJ, Liu B. Impact of a structured older persons health assessment on herpes zoster vaccine uptake in Australian primary care. Prev Med 2022; 155:106946. [PMID: 34973282 DOI: 10.1016/j.ypmed.2021.106946] [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: 07/22/2021] [Revised: 11/15/2021] [Accepted: 12/25/2021] [Indexed: 10/19/2022]
Abstract
Vaccine uptake in adult immunisation programs is often suboptimal. We aimed to assess the impact of the structured older persons health assessment (health assessment) on herpes zoster (zoster) vaccine uptake in Australia. We used national general practice electronic medical records (MedicineInsight) of encounters with patients aged 75-79 years because these patients were age-eligible for both free zoster vaccines and health assessments in the two years following the addition of zoster vaccine to the national immunisation program (Nov 2016-Dec 2018). Due to repeated encounters, we used generalized estimating equations with each patient treated as a clustering variable to analyse the comparison of rates of zoster vaccine administration during encounters where a health assessment was provided versus encounters where the health assessment was not provided. In analyses there were 31,876 patients with a total of 266,204 eligible general practice encounters. Of the 5018 encounters where a health assessment was provided, 592 zoster vaccinations also occurred on the same day (118.0/1000 encounters); for the 261,186 encounters where no health assessment was provided, 9226 zoster vaccinations occurred (35.3/1000 encounters). Zoster vaccine was more likely to be administered during a general practice encounter with a health assessment compared to encounters without one (adjusted odds ratio 2.99; 95% CI: 2.76-3.23). In conclusion, the structured older persons health assessment, which acts as both an incentive and a reminder for healthcare providers to recommend vaccinations in adults improves uptake of zoster vaccine in eligible adults. Such interventions may have a role in improving vaccine uptake among older adults.
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Affiliation(s)
- Jialing Lin
- School of Population Health, University of New South Wales, Sydney, NSW 2052, Australia.
| | - Timothy Dobbins
- School of Population Health, University of New South Wales, Sydney, NSW 2052, Australia
| | - James G Wood
- School of Population Health, University of New South Wales, Sydney, NSW 2052, Australia
| | - John J Hall
- School of Population Health, University of New South Wales, Sydney, NSW 2052, Australia
| | - Bette Liu
- School of Population Health, University of New South Wales, Sydney, NSW 2052, Australia
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Joyal-Desmarais K, Stojanovic J, Kennedy EB, Enticott JC, Boucher VG, Vo H, Košir U, Lavoie KL, Bacon SL, Granana N, Losada AV, Boyle J, Shawon SR, Dawadi S, Teede H, Kautzky-Willer A, Dash A, Cornelio ME, Karsten M, Matte DL, Reichert F, Abou-Setta A, Aaron S, Alberga A, Barnett T, Barone S, Bélanger-Gravel A, Bernard S, Birch LM, Bondy S, Booij L, Da Silva RB, Bourbeau J, Burns R, Campbell T, Carlson L, Charbonneau É, Corace K, Drouin O, Ducharme F, Farhadloo M, Falk C, Fleet R, Fournier M, Garber G, Gauvin L, Gordon J, Grad R, Gupta S, Hellemans K, Herba C, Hwang H, Jedwab J, Kakinami L, Kim S, Liu J, Norris C, Pelaez S, Pilote L, Poirier P, Presseau J, Puterman E, Rash J, Ribeiro PAB, Sadatsafavi M, Chaudhuri PS, Suarthana E, Tse S, Vallis M, Caceres NB, Ortiz M, Repetto PB, Lemos-Hoyos M, Kassianos A, Rod NH, Beraneck M, Ninot G, Ditzen B, Kubiak T, Codjoe S, Kpobi L, Laar A, Skoura T, Francis DL, Devi NK, Meitei S, Nethan ST, Pinto L, Saraswathy KN, Tumu D, Lestari S, Wangge G, Byrne M, Durand H, McSharry J, Meade O, Molloy G, Noone C, Levine H, Zaidman-Zait A, Boccia S, Hoxhaj I, Paduano S, Raparelli V, Zaçe D, Aburub A, Akunga D, Ayah R, Barasa C, Godia PM, Kimani-Murage EW, Mutuku N, Mwoma T, Naanyu V, Nyamari J, Oburu H, Olenja J, Ongore D, Ziraba A, Bandawe C, Yim L, Ajuwon A, Shar NA, Usmani BA, Martínez RMB, Creed-Kanashiro H, Simão P, Rutayisire PC, Bari AZ, Vojvodic K, Nagyova I, Bantjes J, Barnes B, Coetzee B, Khagee A, Mothiba T, Roomaney R, Swartz L, Cho J, Lee MG, Berman A, Stattin NS, Fischer S, Hu D, Kara Y, Şimşek C, Üzmezoğlu B, Isunju JB, Mugisha J, Byrne-Davis L, Griffiths P, Hart J, Johnson W, Michie S, Paine N, Petherick E, Sherar L, Bilder RM, Burg M, Czajkowski S, Freedland K, Gorin SS, Holman A, Lee J, Lopez G, Naar S, Okun M, Powell L, Pressman S, Revenson T, Ruiz J, Sivaram S, Thrul J, Trudel-Fitzgerald C, Yohannes A, Navani R, Ranakombu K, Neto DH, Ben-Porat T, Dragomir A, Gagnon-Hébert A, Gemme C, Jamil M, Käfer LM, Vieira AM, Tasbih T, Woods R, Yousefi R, Roslyakova T, Priesterroth L, Edelstein S, Snir R, Uri Y, Alyami M, Sanuade C, Crescenzi O, Warkentin K, Grinko K, Angne L, Jain J, Mathur N, Mithe A, Nethan S. How well do covariates perform when adjusting for sampling bias in online COVID-19 research? Insights from multiverse analyses. Eur J Epidemiol 2022; 37:1233-1250. [PMID: 36335560 PMCID: PMC9638233 DOI: 10.1007/s10654-022-00932-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 10/06/2022] [Indexed: 11/07/2022]
Abstract
COVID-19 research has relied heavily on convenience-based samples, which-though often necessary-are susceptible to important sampling biases. We begin with a theoretical overview and introduction to the dynamics that underlie sampling bias. We then empirically examine sampling bias in online COVID-19 surveys and evaluate the degree to which common statistical adjustments for demographic covariates successfully attenuate such bias. This registered study analysed responses to identical questions from three convenience and three largely representative samples (total N = 13,731) collected online in Canada within the International COVID-19 Awareness and Responses Evaluation Study ( www.icarestudy.com ). We compared samples on 11 behavioural and psychological outcomes (e.g., adherence to COVID-19 prevention measures, vaccine intentions) across three time points and employed multiverse-style analyses to examine how 512 combinations of demographic covariates (e.g., sex, age, education, income, ethnicity) impacted sampling discrepancies on these outcomes. Significant discrepancies emerged between samples on 73% of outcomes. Participants in the convenience samples held more positive thoughts towards and engaged in more COVID-19 prevention behaviours. Covariates attenuated sampling differences in only 55% of cases and increased differences in 45%. No covariate performed reliably well. Our results suggest that online convenience samples may display more positive dispositions towards COVID-19 prevention behaviours being studied than would samples drawn using more representative means. Adjusting results for demographic covariates frequently increased rather than decreased bias, suggesting that researchers should be cautious when interpreting adjusted findings. Using multiverse-style analyses as extended sensitivity analyses is recommended.
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Affiliation(s)
- Keven Joyal-Desmarais
- Department of Health, Kinesiology and Applied Physiology, Concordia University, 7141 Sherbrooke Street West, Montreal, QC H4B 1R6 Canada ,Montreal Behavioural Medicine Centre, CIUSSS-NIM, Montreal, Canada
| | - Jovana Stojanovic
- Montreal Behavioural Medicine Centre, CIUSSS-NIM, Montreal, Canada ,Canadian Agency for Drugs and Technologies in Health, Ottawa, Canada
| | - Eric B. Kennedy
- Disaster and Emergency Management, York University, Toronto, Canada
| | - Joanne C. Enticott
- Department of General Practice, Monash University, Melbourne, Australia ,Monash Partners, Advanced Health Research and Translation Centre, Melbourne, Australia
| | | | - Hung Vo
- Austin Health, Victoria, Australia
| | - Urška Košir
- Department of Health, Kinesiology and Applied Physiology, Concordia University, 7141 Sherbrooke Street West, Montreal, QC H4B 1R6 Canada ,Montreal Behavioural Medicine Centre, CIUSSS-NIM, Montreal, Canada
| | - Kim L. Lavoie
- Montreal Behavioural Medicine Centre, CIUSSS-NIM, Montreal, Canada ,Département de Psychologie, Université du Québec à Montréal, Montreal, Canada
| | - Simon L. Bacon
- Department of Health, Kinesiology and Applied Physiology, Concordia University, 7141 Sherbrooke Street West, Montreal, QC H4B 1R6 Canada ,Montreal Behavioural Medicine Centre, CIUSSS-NIM, Montreal, Canada
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Draper M, Stergiopoulos S. Shingles vaccination uptake in Massachusetts adults aged 50 years and older. Vaccine 2021; 39:6781-6786. [PMID: 34625290 DOI: 10.1016/j.vaccine.2021.09.032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 09/08/2021] [Accepted: 09/13/2021] [Indexed: 12/30/2022]
Abstract
BACKGROUND Shingles (herpes zoster), a medical condition caused by reactivation of latent varicella zoster virus and characterized by painful rash, will affect almost one third of Americans during their lifetime. A licensed vaccine (zoster vaccine live [ZVL]) was recommended for individuals ≥ 60 years old in 2008 to reduce shingles incidence. The Healthy People (HP) 2020 target for shingles vaccination in ≥ 60 year-olds was 30%; in 2014, it stood at 31.8% and in 2017 at 34.9%. While the national coverage target is met, variability remains across age, gender and ethnicity. Understanding factors influencing patient acceptance of the shingles vaccination is needed to help guide program activities and improve vaccination coverage in the adult population. PURPOSE To understand Massachusetts consumers' knowledge, attitudes, behaviors, and barriers to obtaining a shingles vaccination. METHODS We performed a telephone survey using a stratified sample of Massachusetts residents ≥ 50 years-old who i) responded to the 2012 Massachusetts Behavioral Risk Factor Surveillance System (n = 10,822), ii) agreed to a follow-up survey (n = 6,873), and iii) reported awareness of the shingles vaccination (n = 1,000; n = 529 vaccinated respondents (VR) and n = 471 non-vaccinated respondents (NVR)). Multivariable logistic regression identified factors independently associated with receiving shingles vaccination. RESULTS Across both groups, most respondents (n = 989, 99%) were aware of shingles, perceived shingles as painful, and knew ofothers who had hadshingles. Multivariable logistic regression indicated an association between shingles vaccination and physician recommendation, influenza vaccination, and perception of shingles risk. CONCLUSIONS More than half of the sub-sample reported not knowing about shingles vaccine, therefore, opportunities to increase awareness should be prioritized. Since provider recommendation and flu vaccination receipt had the greatest odds of increasing shingles vaccination, standard practice should include adding shingles to flu vaccine recommendations for age-eligible patients.
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Affiliation(s)
- Marina Draper
- Graduate of Law and Public Policy Ph.D. Program, School of Public Policy and Urban Affairs, Northeastern University, 360 Huntington Ave, Boston, MA 02115, United States.
| | - Stella Stergiopoulos
- Tufts University School of Medicine, 136 Harrison Avenue, Boston, MA 02111, United States
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Bayraktar-Ekincioglu A, Kara E, Bahap M, Cankurtaran M, Demirkan K, Unal S. Does information by pharmacists convince the public to get vaccinated for pneumococcal disease and herpes zoster? Ir J Med Sci 2021; 191:2193-2200. [PMID: 34708289 PMCID: PMC8550811 DOI: 10.1007/s11845-021-02778-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Accepted: 09/08/2021] [Indexed: 11/24/2022]
Abstract
Background Pneumococcal diseases (PN) and herpes zoster (HZ) are preventable infections in the adult population. Aims This study aimed to identify the vaccination rates at 1 year after pharmacist-led provision of information in the community. The objectives were to reveal the reasons for not being vaccinated and to determine opinions and awareness of PN and HZ vaccination among public. Methods A prospective study was conducted in five social and solidarity centres in Turkey. Participants were educated by a pharmacist about PN and HZ diseases, vaccinations and reimbursement status, respectively. All participants were followed by telephone 1 year after to determine their vaccination status. Results A total of 155 participants (72.9% male; mean age was 68.72 ± 9.04 years) were included. With respect to PN and HZ vaccines, it was found that 40% and 12.7% of participants knew about the respective vaccines. Following the pharmacist’s educational session, 52.9% and 51.6% were willing to have the respective vaccine, but only 5.7% and 0.8% respectively got vaccinated 1 year after the educational session. Perceived disease severity, provision of information by a pharmacist, and reimbursement status of the vaccines were not associated with the vaccination rates. Conclusions The public obtain information on vaccines from friends and family members, which may result in misinformation and inappropriate behaviour in vaccination. Although educational sessions provided by pharmacists did not increase the actual vaccination rates for PN and HZ, public willingness to vaccination has increased.
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Affiliation(s)
| | - Emre Kara
- Faculty of Pharmacy, Department of Clinical Pharmacy, Hacettepe University, Ankara, Turkey
| | - Melda Bahap
- Faculty of Pharmacy, Department of Clinical Pharmacy, Hacettepe University, Ankara, Turkey
| | - Mustafa Cankurtaran
- Faculty of Medicine, Department of Internal Medicine, Division of Geriatrics, Hacettepe University, Ankara, Turkey
| | - Kutay Demirkan
- Faculty of Pharmacy, Department of Clinical Pharmacy, Hacettepe University, Ankara, Turkey
| | - Serhat Unal
- Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Hacettepe University, Ankara, Turkey
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Saleem SM, Bhattacharya S. Reducing the infectious diseases burden through "life course approach vaccination" in India-a perspective. AIMS Public Health 2021; 8:553-562. [PMID: 34395705 PMCID: PMC8334644 DOI: 10.3934/publichealth.2021045] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 08/01/2021] [Indexed: 11/29/2022] Open
Abstract
The burden of vaccine-preventable diseases is increasing day by day across all age groups. However as per the universal immunization programme, we vaccinate only under-fives and antenatal mothers, a large portion of the vulnerable population remain unvaccinated and the concept of “life course approach” regarding vaccination is missing. It increases the overall burden to the already constrained Indian health care system. As India, now has become the largest manufacturer of multiple vaccines, we have continuous chain healthcare points (primary-tertiary level), with dedicated manpower in the public health sector that is why in this paper we are proposing to expand the horizon of the vaccination process using a “life course approach”. It will not only directly benefit the vulnerable populations (individual level), but also it can benefit the nation, indirectly. Although we may face challenges at multiple phases (conception to implementation), they can be overcome by multisectoral and multipronged innovations.
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Glenton C, Carlsen B, Lewin S, Wennekes MD, Winje BA, Eilers R. Healthcare workers' perceptions and experiences of communicating with people over 50 years of age about vaccination: a qualitative evidence synthesis. Cochrane Database Syst Rev 2021; 7:CD013706. [PMID: 34282603 PMCID: PMC8407331 DOI: 10.1002/14651858.cd013706.pub2] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Infectious diseases are a major cause of illness and death among older adults. Vaccines can prevent infectious diseases, including against seasonal influenza, pneumococcal diseases, herpes zoster and COVID-19. However, the uptake of vaccination among older adults varies across settings and groups. Communication with healthcare workers can play an important role in older people's decisions to vaccinate. To support an informed decision about vaccination, healthcare workers should be able to identify the older person's knowledge gaps, needs and concerns. They should also be able to share and discuss information about the person's disease risk and disease severity; the vaccine's effectiveness and safety; and practical information about how the person can access vaccines. Therefore, healthcare workers need good communication skills and to actively keep up-to-date with the latest evidence. An understanding of their perceptions and experiences of this communication can help us train and support healthcare workers and design good communication strategies. OBJECTIVES To explore healthcare workers' perceptions and experiences of communicating with older adults about vaccination. SEARCH METHODS We searched MEDLINE, CINAHL and Scopus on 21 March 2020. We also searched Epistemonikos for related reviews, searched grey literature sources, and carried out reference checking and citation searching to identify additional studies. We searched for studies in any language. SELECTION CRITERIA We included qualitative studies and mixed-methods studies with an identifiable qualitative component. We included studies that explored the perceptions and experiences of healthcare workers and other health system staff towards communication with adults over the age of 50 years or their informal caregivers about vaccination. DATA COLLECTION AND ANALYSIS We extracted data using a data extraction form designed for this review. We assessed methodological limitations using a list of predefined criteria. We extracted and assessed data regarding study authors' motivations for carrying out their study. We used a thematic synthesis approach to analyse and synthesise the evidence. We used the GRADE-CERQual (Confidence in the Evidence from Reviews of Qualitative research) approach to assess our confidence in each finding. We examined each review finding to identify factors that may influence intervention implementation and we developed implications for practice. MAIN RESULTS We included 11 studies in our review. Most studies explored healthcare workers' views and experiences about vaccination of older adults more broadly but also mentioned communication issues specifically. All studies were from high-income countries. The studies focused on doctors, nurses, pharmacists and others working in hospitals, clinics, pharmacies and nursing homes. These healthcare workers discussed different types of vaccines, including influenza, pneumococcal and herpes zoster vaccines. The review was carried out before COVID-19 vaccines were available. We downgraded our confidence in several of the findings from high confidence to moderate, low or very low confidence. One reason for this was that some findings were based on only small amounts of data. Another reason was that the findings were based on studies from only a few countries, making us unsure about the relevance of these findings to other settings. Healthcare workers reported that older adults asked about vaccination to different extents, ranging from not asking about vaccines at all, to great demand for information (high confidence finding). When the topic of vaccination was discussed, healthcare workers described a lack of information, and presence of misinformation, fears and concerns about vaccines among older adults (moderate confidence). The ways in which healthcare workers discussed vaccines with older adults appeared to be linked to what they saw as the aim of vaccination communication. Healthcare workers differed among themselves in their perceptions of this aim and about their own roles and the roles of older adults in vaccine decisions. Some healthcare workers thought it was important to provide information but emphasised the right and responsibility of older adults to decide for themselves. Others used information to persuade and convince older adults to vaccinate in order to increase 'compliance' and 'improve' vaccination rates, and in some cases to gain financial benefits. Other healthcare workers tailored their approach to what they believed the older adult needed or wanted (moderate confidence). Healthcare workers believed that older adults' decisions could be influenced by several factors, including the nature of the healthcare worker-patient relationship, the healthcare worker's status, and the extent to which healthcare workers led by example (low confidence). Our review also identified factors that are likely to influence how communication between healthcare workers and older adults take place. These included issues tied to healthcare workers' views and experiences regarding the diseases in question and the vaccines; as well as their views and experiences of the organisational and practical implementation of vaccine services. AUTHORS' CONCLUSIONS There is little research focusing specifically on healthcare workers' perceptions and experiences of communication with older adults about vaccination. The studies we identified suggest that healthcare workers differed among themselves in their perceptions about the aim of this communication and about the role of older adults in vaccine decisions. Based on these findings and the other findings in our review, we have developed a set of questions or prompts that may help health system planners or programme managers when planning or implementing strategies for vaccination communication between healthcare workers and older adults.
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Affiliation(s)
- Claire Glenton
- Norwegian Institute of Public Health, Oslo, Norway
- TRS National Resource Centre for Rare Disorders, Sunnaas Rehabilitation Hospital, Nesoddtangen, Norway
| | - Benedicte Carlsen
- Department of Health Promotion and Development, University of Bergen, Bergen, Norway
| | - Simon Lewin
- Norwegian Institute of Public Health, Oslo, Norway
- Health Systems Research Unit, South African Medical Research Council, Cape Town, South Africa
| | - Manuela Dominique Wennekes
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, Netherlands
- Athena Institute, Free University, Amsterdam, Netherlands
| | - Brita Askeland Winje
- Norwegian Institute of Public Health, Oslo, Norway
- Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Renske Eilers
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, Netherlands
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Ledda C, Costantino C, Cuccia M, Maltezou HC, Rapisarda V. Attitudes of Healthcare Personnel towards Vaccinations before and during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18052703. [PMID: 33800187 PMCID: PMC7967435 DOI: 10.3390/ijerph18052703] [Citation(s) in RCA: 80] [Impact Index Per Article: 26.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 03/03/2021] [Accepted: 03/04/2021] [Indexed: 01/05/2023]
Abstract
Vaccines constitute highly effective tools for controlling and eliminating vaccine-preventable diseases (VPDs) and are assessed to avert between two to three million deaths per year globally. Healthcare personnel (HCP) constitute a priority group for several vaccinations. However, studies indicate significant rates of vaccine hesitancy among them and, therefore, of acceptance of vaccination recommendations. This cross-sectional study was conducted in a university hospital in Southern Italy to assess the knowledge and attitudes of HCP about VPDs before and during the COVID-19 pandemic, estimate their intention to get vaccinated against COVID-19, and search for determinants that may influence their choice. A self-administered questionnaire was used. HCP improved their knowledge about VPDs and were more favorable to vaccinations in September–December 2020 compared to January–December 2019. Overall, 75% of respondents would get a COVID-19 vaccine. Our findings indicate a potential role of the ongoing COVID-19 pandemic on Italian HCP’s knowledge and attitudes towards vaccines.
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Affiliation(s)
- Caterina Ledda
- Occupational Medicine, Department of Clinical and Experimental Medicine, University of Catania, Via Santa Sofia, 87 Edificio B Piano 0, 95123 Catania, Italy;
- Correspondence: ; Tel./Fax: +39-095-378-2049
| | - Claudio Costantino
- Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Excellence Specialties, University of Palermo, Via del Vespro 129, 90127 Palermo, Italy;
| | - Mario Cuccia
- Epidemiology and Prevention Unit, Provincial Health Authority of Catania, Via Tevere, San Gregorio di Catania, 95027 Catania, Italy;
| | - Helena C. Maltezou
- Directorate of Research, Studies and Documentation, National Public Health Organization, 3-5 Agrafon Street, 11523 Athens, Greece;
| | - Venerando Rapisarda
- Occupational Medicine, Department of Clinical and Experimental Medicine, University of Catania, Via Santa Sofia, 87 Edificio B Piano 0, 95123 Catania, Italy;
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Tomljenovic M, Petrovic G, Antoljak N, Hansen L. Vaccination attitudes, beliefs and behaviours among primary health care workers in northern Croatia. Vaccine 2020; 39:738-745. [PMID: 33386176 DOI: 10.1016/j.vaccine.2020.11.049] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2019] [Revised: 11/14/2020] [Accepted: 11/17/2020] [Indexed: 01/22/2023]
Abstract
Primary health care workers (HCWs) provide almost all vaccine services in Croatia, so they play an essential role in vaccine recommendations and uptake. The aim of this study was to determine the level of vaccine hesitancy among primary HCWs, to identify differences between nurses and physicians in attitudes, beliefs and behaviours towards vaccination, and to determine predictors of vaccine hesitancy among HCWs. We conducted a cross-sectional study from July to December in 2018 among physicians and nurses employed in the services of epidemiology, public health, school medicine, pediatrics and general practice/family medicine in Primorje-Gorski Kotar County, a primarily urban region with a population around 300 000 in the northern part of Croatia. The list of primary HCWs offices was obtained from the Croatian Health Insurance Fond website. We used a self-administered questionnaire on their attitudes, beliefs and behaviours relative to vaccination. Obtained response rate was 65.5% (324/495) of eligible primary HCWs; 64.1% (143/223) of physicians and 66.5% (181/272) of nurses. Seventeen percent of HCWs were identified as vaccine hesitant, and in univariate analysis, we observed an association between HCWs occupation and their own vaccination against flu (p = 0.001), measles (p = 0.016) and HPV (p = 0.025). Nurses and physicians differed (p < 0.001) in their general attitude, beliefs and behaviours towards vaccination, with a higher level of hesitancy among nurses. In multiple logistic regression, those more likely to be vaccine-hesitant were nurses (AOR = 5.73, 95%CI = 2.48-13.24), those who were uncertain or would never receive a vaccine against measles (AOR=11.13; 95%CI=5.37-23.10) and HPV (AOR=5.02; 95%CI=2.60-9.74), as well as those who had encountered a serious adverse event following immunization (AOR=7.55; 95%CI=3.13-19.18). As personal hesitancy may have a negative impact on vaccination education and recommendations, and therefore vaccine coverage, it is necessary to implement interventions to increase vaccination knowledge and confidence among primary health care workers, especially nurses.
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Affiliation(s)
- Morana Tomljenovic
- School of Medicine, University of Rijeka, Brace Branchetta 20/1, 51 000 Rijeka, Croatia; European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control, (ECDC), Gustav III:s Boulevard 40, Solna, Sweden.
| | - Goranka Petrovic
- Croatian Institute of Public Health, Rockefeller Street 7, 10 000 Zagreb, Croatia
| | - Nataša Antoljak
- Croatian Institute of Public Health, Rockefeller Street 7, 10 000 Zagreb, Croatia; School of Medicine, University of Zagreb, Salata 3, 10 000 Zagreb, Croatia
| | - Lisa Hansen
- National Institute for Public Health and the Environment, Antonie van Leeuwenhoeklaan 9, 3721 MA Bilthoven, Netherlands
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Yörük S, Türkmen H, Durgut A, Erbek M. Vaccine mistrust among family healthcare professionals and vaccine hesitancy in the communities they serve in Turkey in 2019: a cross-sectional study. Hum Vaccin Immunother 2020; 16:3155-3162. [PMID: 33121313 DOI: 10.1080/21645515.2020.1806671] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
AIM This study aims to determine the causes of vaccine mistrust among family healthcare professionals (FHP) in the unit where they serve and vaccine hesitancy of families. METHOD The study group consisted of 682 FHPs working in a primary health care institution. The data collection tools of the study included a sociodemographic data form and a vaccine hesitancy data form. Pearson's chi-square analysis and logistic regression analysis were performed to analyze the data. FINDINGS To the question of "Do you trust the active ingredient in the vaccines?", only 2.1% of FHPs responded "I do not trust" and 18.9% answered "I am indecisive". 70.7% of FHPs said that at least one vaccine hesitant family was in the unit where they served. The most important reasons stated by FHPs on behalf of such families were vaccine mistrust (73.2%), the belief that they may be harmful for the child (58.7%), and the belief that vaccines cause autism (55.6%). In the univariate analysis, vaccine mistrust was significantly higher in FHPs who were measles-hesitant and responded "The decision to get vaccinated or not should belong to the family voluntarily". From logistic regression analysis, vaccine mistrust in FHPs increased 2.8-fold for those who did not think vaccination should be compulsory, 2.7-fold for those who did not think that vaccination refusal should be legally enforced, and 1.61-fold for those under age 35 years. CONCLUSION It was observed that FHPs had high sensitivity and positive attitudes toward vaccination in general.
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Affiliation(s)
- Selda Yörük
- Balıkesir University, School of Health, Department of Midwifery, Cagis Campus , Balikesir, Turkey
| | - Hülya Türkmen
- Balıkesir University, School of Health, Department of Midwifery, Cagis Campus , Balikesir, Turkey
| | - Aysegul Durgut
- Altieylul 2 Number Family Health Center , Balikesir, Turkey
| | - Meliz Erbek
- Altieylul 2 Number Family Health Center , Balikesir, Turkey
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Mohanty P, Jena P, Patnaik L. Vaccination against Hepatitis B: A Scoping Review. Asian Pac J Cancer Prev 2020; 21:3453-3459. [PMID: 33369439 PMCID: PMC8046310 DOI: 10.31557/apjcp.2020.21.12.3453] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Indexed: 12/13/2022] Open
Abstract
Objective: Elimination of viral hepatitis by 2030 as one of the international Sustainable Development Goals puts the hepatitis B vaccination on the forefront. However, barriers to vaccination reported in various studies are of concern. This study explores the global barriers for effective uptake of Hepatitis-B vaccination. Methods: A scoping review of studies reporting hepatitis B vaccination barriers was done using PMC data base and Google scholar search engine. About 803 journal articles and reports on hepatitis B barriers were retrieved but only 36 most relevant items during last 10 years were identified, pile sorted, grouped and analyze. Results: Overall 74 barriers have been identified for effective uptake of hepatitis-B vaccines. Most studies focused on non-zero dose of hepatitis B vaccine, One-third of the barriers are related to system issues, one-fourth of the barriers were related to caregiver education or awareness, fear of side effect, migration etc., one-fifth barriers were related to service provider issues like poor out-reach, home visits, poor communication and/relation with the caregivers, failure to identify unimmunized children etc., and other barriers were social-cultural issues. The review reveals limited availability and accessibility to health-facility based immunization, lack of awareness among caregivers, poor communication by the healthcare workers and negative relationships with the beneficiaries, cost of vaccine in private sector, inconvenience time and place of vaccination etc. as the major barriers for hepatitis B vaccination. Barriers varied from country to country. Conclusion: Myriad barriers for reduced hepatitis-B vaccine uptake need to be addressed contextually as countries are at different stages of hepatitis-B vaccination implementation.
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Affiliation(s)
- Parimala Mohanty
- Department of Community Medicine, IMS & SUM Hospital, Siksha 'O' Anusandhan Deemed to be University, Bhubaneswar, India
| | - Pratap Jena
- School of Public Health, KIIT Deemed to be University, Bhubaneswar, India
| | - Lipilekha Patnaik
- Department of Community Medicine, IMS & SUM Hospital, Siksha 'O' Anusandhan Deemed to be University, Bhubaneswar, India
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Ozog N, Steenbeek A, Curran J, Kelly N, Campbell S. Attitudes Toward Influenza Vaccination Administration in the Emergency Department Among Patients: A Cross-Sectional Survey. J Emerg Nurs 2020; 46:802-813. [PMID: 32807401 DOI: 10.1016/j.jen.2020.05.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Revised: 05/20/2020] [Accepted: 05/26/2020] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Influenza is a serious, vaccine-preventable illness. The current vaccination rates in Canada are below target rates, highlighting the potential need for more convenient ways to receive vaccinations. Wait times to be seen in Canadian emergency departments are escalating, and using the time spent waiting to offer and administer an influenza vaccine could potentially improve ease of access to immunization for some Canadians. METHODS The aim of this cross-sectional study was to gauge public interest and identify perceived barriers and facilitators to influenza vaccine availability in a Canadian emergency and trauma center. Anonymous questionnaires were completed by a convenience sample of adult patients classified as low acuity (n = 151) as 1 arm of a 2-arm study. RESULTS Of the unvaccinated patients, 34.6% expressed willingness to be vaccinated in the emergency department. The patients who had received a vaccine in the previous year were significantly more willing to accept the vaccine in the emergency department (χ2 [1] = 23.78, P < 0.001). The 3 top factors associated with having received vaccination in the previous year include trust in vaccine information (χ2 [2] = 27.34, P < 0.001), immunity preferences (χ2 [2] = 32.25, P < 0.001), and beliefs about efficacy (χ2 [2] = 44.90, P < 0.001). DISCUSSION Patients classified as low acuity were supportive of ED influenza vaccination. In addition, some of the unvaccinated participants had unmet education needs (ie, regarding trustworthy sources of vaccine information, immunity, and vaccine efficacy) that would require addressing before they would likely consider receiving influenza vaccination in future during their ED visit.
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Ozog N, Steenbeek A, Curran J, Kelly N, Campbell S. Attitudes Toward Influenza Vaccination Administration in the Emergency Department Among Health Care Providers: A Cross-Sectional Survey. J Emerg Nurs 2020; 46:642-653. [PMID: 32653157 DOI: 10.1016/j.jen.2020.04.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Revised: 04/14/2020] [Accepted: 04/21/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Influenza is a burdensome and vaccine-preventable infectious disease. Lack of time was reported as a common barrier by Canadians who did not receive their influenza vaccine. Increasing convenient access to vaccination increases uptake, and a potential setting for vaccine administration is the emergency department, where long wait times are common. METHODS A cross-sectional survey to gauge health care provider support and perceived barriers and facilitators to delivering influenza vaccine was conducted at 1 emergency and trauma center in Halifax, Nova Scotia. Anonymous questionnaires were completed by a convenience sample of emergency nurses, physicians, and paramedics (n = 82). RESULTS In total, 86% (n = 68) of health care providers supported vaccination in the emergency department when sufficient staffing and resources were available. When asked to consider implementation of influenza vaccination in the emergency department based on current staffing and resources, only 59% (n = 48) supported making vaccination available. Most surveyed health care providers preferred screening for vaccination at triage (57%) and supported a nurse-initiated protocol for vaccine administration (74%). After Bonferroni correction, there was no significant association between preference for when to vaccinate and being a nurse or physician (χ2(2) = 6.208, P = 0.05). The highest risk patient groups with the lowest provider endorsement of vaccination were people involved in poultry culling (77%) and pregnant women (83%). DISCUSSION Surveyed health care providers were supportive of ED influenza vaccination. However, this study revealed additional barriers that need to be addressed to effectively launch such a program.
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Ecarnot F, Pedone C, Cesari M, Maggi S, Antonelli Incalzi R. Knowledge about vaccines and vaccination in older people: Results of a national survey by the Italian Society for Gerontology & Geriatrics. Vaccine 2020; 38:1535-1540. [PMID: 31822428 DOI: 10.1016/j.vaccine.2019.11.065] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Revised: 11/22/2019] [Accepted: 11/25/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND There is wide variation among physicians in the level of knowledge regarding vaccines and vaccination. We sought to compare the level of vaccine knowledge between qualified specialists and postgraduate residents. METHODS A questionnaire designed ad hoc by a consensus group was circulated to the Directors of 51 geriatrics internship programs in Italy. It investigated demographics, information sources, knowledge about influenza, pneumonococcal and herpes zoster vaccines and target groups. The proportion of correct responders was compared between residents and qualified specialists, and between best (top quartile) and worst (bottom quartile) performers. RESULTS A total of 459 questionnaires were analyzed; 245 (53%) were females; 253 (55%) were qualified specialists, 206 (45%) were residents. Mean age was 40.3 (SD: 12.8) years, almost 60% worked in acute care wards. On average, 33% of patients asked for information about vaccination. Residents answered significantly better on 7 out of 18 questions, and numerically albeit non-statistically higher correct response rates on a further 8 questions. There were significantly more men among the poor performers (p < 0.001), and significantly more residents among the best performers (p < 0.001). Overall, the rates of correct answers were low, with >50% of correct responses achieved on only 5 out of 18 questions (27.8%); for 2 questions, <20% responded correctly. CONCLUSIONS Postgraduate residents in training have an overall better level of knowledge of vaccines, vaccination indications and practices than qualified specialists. This study provides avenues to develop targeted interventions to ensure health care providers are up to date and providing accurate information to patients.
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Affiliation(s)
- Fiona Ecarnot
- Department of Cardiology, University Hospital Besancon, and EA3920, University of Franche-Comté, Besancon, France.
| | - Claudio Pedone
- Unit of Geriatrics, Università Campus Bio-Medico di Roma, Rome, Italy.
| | - Matteo Cesari
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy; Geriatric Unit, Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.
| | - Stefania Maggi
- CNR, Institute of Neuroscience - Aging Branch, Padua, Italy.
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Lopes JP, Dias TMR, Carvalho DBF, Oliveira JFD, Cavalcante RB, Oliveira VCD. Evaluation of digital vaccine card in nursing practice in vaccination room. Rev Lat Am Enfermagem 2019; 27:e3225. [PMID: 31826166 PMCID: PMC6896816 DOI: 10.1590/1518-8345.3058.3225] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Accepted: 09/07/2019] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVE develop and evaluate a vaccine application for mobile devices, with update integrated with the National Immunization Program Information System, for care in vaccination rooms. METHOD methodological research based on the Pressman System Development Life Cycle theory developed in three stages: integrative literature review, computational development, and application evaluation. The product was evaluated as to satisfaction, using a validated questionnaire, and as to usability by the System Usability Scale. RESULTS the application functionalities were based on the survey of technological Innovations on immunization, published in the scientific literature. It displays user vaccines directly from the National Immunization Program Information System, notifies about upcoming vaccines, and enables the inclusion of vaccine cards of dependents. The evaluation resulted in users' mean score of 90.5 ± 11.1 and health professionals' mean score of 84.2 ± 19.4. CONCLUSION the application is a technological tool with potential to improve the work process in vaccination rooms and to reach the goals of vaccine coverage. It synchronizes data with the National Immunization Program Information System, thus enabling the maintenance of people's vaccination history.
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Affiliation(s)
- Jéssica Pereira Lopes
- Universidade Federal de São João del-Rei, Campus Centro-Oeste Dona Lindu, Divinópolis, MG, Brazil.,Fundação de Amparo à Pesquisa de Minas Gerais (FAPEMIG), Brazil
| | | | | | | | | | - Valéria Conceição De Oliveira
- Universidade Federal de São João del-Rei, Campus Centro-Oeste Dona Lindu, Divinópolis, MG, Brazil.,Scholarship holder at the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), Brazil
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Houle SKD. Making it happen: Strategies to incorporate vaccinations into community pharmacy practice. Can Pharm J (Ott) 2019; 152:427-429. [DOI: 10.1177/1715163519877906] [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)
- Sherilyn K. D. Houle
- School of Pharmacy, University of Waterloo, and the International Travel & Immunizations Clinic, Centre for Family Medicine, Kitchener, ON
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Survey of Adult Influenza Vaccination Practices and Perspectives Among US Primary Care Providers (2016-2017 Influenza Season). J Gen Intern Med 2019; 34:2167-2175. [PMID: 31325130 PMCID: PMC6816593 DOI: 10.1007/s11606-019-05164-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 04/30/2019] [Accepted: 06/12/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Seasonal influenza vaccination is recommended for all adults; however, little is known about how primary care physicians can communicate effectively with patients about influenza vaccination. OBJECTIVE To assess among general internal medicine (GIM) and family physicians (FP) regarding adult influenza vaccination: (1) recommendation and administration practices, (2) barriers to discussing and perceived reasons for patient refusal, and (3) factors associated with physician self-efficacy in convincing patients to be vaccinated. DESIGN Email and mail survey conducted in February-March 2017 PARTICIPANTS: Nationally representative sample of GIM and FP MAIN MEASURES: Factor analysis was used to group similar items for multivariable analysis of barriers and strategies associated with high physician self-efficacy about convincing patients to be vaccinated (defined as disagreeing that they could do nothing to change resistant patients' minds). KEY RESULTS Response rate was 67% (620/930). Ninety-eight percent always/almost always recommended influenza vaccine to adults ≥ 65 years, 90% for adults 50-64 years, and 75% for adults 19-49 years. Standing orders (76%) and electronic alerts (64%) were the most commonly used practice-based immunization strategies. Frequently reported barriers to discussing vaccination were other health issues taking precedence (41%), time (29%), and feeling they were unlikely to change patients' minds (24%). Fifty-eight percent of physicians reported high self-efficacy about convincing patients to be vaccinated; these providers reported fewer patient belief barriers contributing to vaccine refusal (RR = 0.93 per item; 95% CI (0.89-0.98); Cronbach's α = 0.70), were more likely to report using both fact- (1.08/item; (1.03-1.14); 0.66) and personal experience-based (1.07/item; (1.003-1.15); 0.65) communication strategies, and were more likely to work in practices using patient reminders for influenza vaccine (1.32; (1.16-1.50)). CONCLUSIONS Physicians identified barriers to successfully communicating about adult influenza vaccination but few effective strategies to counter them. Interventions to promote self-efficacy in communication and under-utilized practice-based immunization strategies are needed.
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Stolpe S, Choudhry NK. Effect of Automated Immunization Registry-Based Telephonic Interventions on Adult Vaccination Rates in Community Pharmacies: A Randomized Controlled Trial. J Manag Care Spec Pharm 2019; 25:989-994. [PMID: 31456496 PMCID: PMC10398087 DOI: 10.18553/jmcp.2019.25.9.989] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Pharmacies have a unique opportunity to address suboptimal adult vaccination rates, but few solutions have proven effective. Such strategies are challenged by the lack of access that many pharmacies have to a patient's complete immunization history; consequently, they are unable to identify which of their patients actually require vaccination. A pharmacy-based strategy that leverages such information could enhance efforts to increase rates of guideline-based vaccination. OBJECTIVE To determine the effect on vaccination rates of an automated telephonic intervention for adults in need of either pneumococcal vaccination or herpes zoster vaccination, or both. METHODS Over a 1-year period, patients with identified vaccine gaps at 246 pharmacies of 3 pharmacy chains were randomly assigned to receive either usual care or an automated telephonic prompt for pneumococcal and/or herpes zoster vaccines based on patient records contained in state immunization registries and pharmacy data. The primary outcome was the proportion with administration of at least one of the vaccines offered between March 2016 and January 2017 based on intention-to-treat principles. Subgroup analyses included vaccination rates by age and sex. An as-treated analysis was also performed. RESULTS 21,971 patients were included in the study, 57% of whom were female, with a mean age of 63 years. Vaccine administration proportions were 0.0214 (236/11,009) in the intervention group, and 0.0205 (225/10,962) in the control group (OR = 1.05, 95% CI = 0.87-1.26). Results did not differ in subgroup analyses based on patient age, sex, or individual pharmacy chain. Among intervention patients, 3,666 (0.333) completed the call by listening to the entire prompt. In an as-treated analysis comparing individuals who completed calls versus control, the intervention increased the odds of vaccination by 26% (OR = 1.26, 95% CI = 1.00-1.61). CONCLUSIONS The automated prompt did not significantly increase vaccination rates. Potential barriers included intervention technical flaws, low rates of connecting with patients, insufficient follow-up by the pharmacy, and patients placing a relatively low priority on being vaccinated. DISCLOSURES This project was funded by Pfizer and Merck through a grant from the Pharmacy Quality Alliance. Stolpe was an employee of the Pharmacy Quality Alliance at the onset of this project and an employee of Scientific Technologies Corporation during the data collection phase of the project. Stolpe has also served on the advisory board for Merck. Choudhry has no conflicts of interest to declare.
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Affiliation(s)
| | - Niteesh K. Choudhry
- Harvard Medical School; Harvard T.H. Chan School of Public Health; and Center for Healthcare Delivery Sciences, Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts
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Perceptions of influenza and pneumococcal vaccine uptake by older persons in Australia. Vaccine 2019; 37:4454-4459. [DOI: 10.1016/j.vaccine.2019.06.079] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Revised: 06/24/2019] [Accepted: 06/26/2019] [Indexed: 01/21/2023]
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Pullagura GR, Waite NM, Houle SKD, Violette R, Wong WWL. Cost-utility analysis of offering a novel remunerated community pharmacist consultation service on influenza vaccination for seniors in Ontario, Canada. J Am Pharm Assoc (2003) 2019; 59:489-497.e1. [PMID: 30979576 DOI: 10.1016/j.japh.2019.02.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Revised: 02/01/2019] [Accepted: 02/24/2019] [Indexed: 10/27/2022]
Abstract
BACKGROUND Despite the availability of free and accessible influenza vaccine to all Ontarians, uptake has remained suboptimal. Although reasons to not receive the vaccine vary widely, health care provider recommendations remain the most effective strategy to positively influence vaccination decisions. OBJECTIVES This study aimed to predict the relative quality of life, costs, and cost-effectiveness of introducing a remunerated community pharmacist consultation service on influenza vaccination for Ontarians aged ≥ 65 years. METHODS A cost-utility analysis was performed from a third-party public payer perspective over 1 year. The delivery of consultation services by community pharmacists on influenza vaccination, billable at CAD $15 was compared with current standard practices (absence of remunerated consultations). Model inputs were derived primarily from existing literature. The impact of parameter uncertainties was assessed through deterministic and probabilistic sensitivity analyses. RESULTS The provision of influenza vaccine consultation services was predicted to prevent 2407 cases of mild influenza and 3 influenza-related deaths at an additional cost of CAD $2.03 per person over current practices. The incremental costs per quality-adjusted life-year (QALY) gained for the enhanced care strategy compared with standard care was CAD $2087. The interpretation of the base-case result was found to be robust across all sensitivity analyses. The projected additional costs of implementing pharmacist consultations in Ontario was estimated at CAD $1.15 million per year, and the anticipated benefits included a gain of 507 QALY per year. CONCLUSION Pharmacist-delivered consultation services on influenza vaccination are cost-effective and lead to improved clinical outcomes for Ontario seniors. Introduction of such services offers a promising strategy to address challenges related to poor vaccine uptake in this group.
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The role of provider characteristics on the hepatitis A and B vaccination status of adults in the United States during 2007-2015. Prev Med Rep 2019; 14:100833. [PMID: 30886816 PMCID: PMC6402425 DOI: 10.1016/j.pmedr.2019.100833] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Accepted: 02/16/2019] [Indexed: 01/05/2023] Open
Abstract
Hepatitis A and B vaccine coverage is suboptimal in US adults, even among those at increased risk for infection, morbidity, or mortality. To understand where medical education and resources might enhance vaccine coverage, it is important to first identify providers and places most commonly associated with the administration of hepatitis vaccinations. We conducted a retrospective analysis of commercial and Medicare insurance claims data from 2007 to 2015 to describe provider types and places of vaccination against hepatitis A and B among adults in the US, and estimated the time to initial vaccination from first diagnosis of a condition for which the Advisory Committee on Immunization Practices (ACIP) recommends hepatitis A and/or B vaccination among at-risk adults. We identified 183,326 adults who received hepatitis A vaccine, 148,119 hepatitis B vaccine, and 64,953 a bivalent vaccine. Mean age was 42.1–45.8 years. Family practice and internal medicine physicians were the main vaccine providers: 38.9% and 20.2% for hepatitis A, 43.7% and 21.4% for hepatitis B, 35.3% and 15.9% for bivalent vaccinations, respectively. ≥90% of initial vaccinations occurred in an office practice. In at-risk patients, median time to first-dose received was 11.8, 20.9, and 20.9 months for hepatitis A, hepatitis B, and hepatitis A/B vaccines, respectively. Primary care and office practices were the most common providers and places of vaccination, respectively, for hepatitis A and B vaccine. For at-risk patients, further research is needed to design vaccination strategies to improve the median time from first ACIP-recommended condition diagnosis to initial vaccination against hepatitis A and B. Most frequent provider type for hepatitis vaccination is primary care providers. Physician offices are the most frequent site for hepatitis vaccinations. Time to initial hepatitis vaccination from first at-risk diagnosis needs improvement.
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Heywood AE, López-Vélez R. Reducing infectious disease inequities among migrants. J Travel Med 2019; 26:5198602. [PMID: 30476162 DOI: 10.1093/jtm/tay131] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Revised: 11/13/2018] [Accepted: 11/20/2018] [Indexed: 02/06/2023]
Abstract
BACKGROUND migration has reached unprecedented levels, with 3.6% of the world's population living outside their country of birth. Migrants comprise a substantial proportion of high-income country populations, are at increased risk of a range of infectious diseases, compared to native-born populations and may experience worse health outcomes due to barriers accessing timely diagnoses and treatment. Poor access to essential healthcare services can be attributed to several factors, including language and cultural barriers and lack of specific inclusive health policies. METHODS This review draws on evidence from the immigrant health and travel medicine literature, with a focus on infectious disease risks. It presents strategies to reduce barriers to healthcare access through health promotion and screening programs both at the community and clinic level and the delivery of linguistically and culturally competent care. The Methods: Salud Entre Culturas (SEC) 'Health Between Cultures' project from the Tropical Medicine Unit at the Hospital Ramon y Cajal in Madrid is described as an effective model of care. RESULTS For those providing healthcare to migrant populations, the use of community-consulted approaches are considered best practice in the development of health education, health promotion and the delivery of targeted health services. At the clinic-level, strategies optimizing care for migrants include the use of bilingual healthcare professionals or community-based healthcare workers, cultural competence training of all clinic staff, the appropriate use of trained interpreters and the use of culturally appropriate health promotion materials. CONCLUSIONS Multifaceted strategies are needed to improve access, community knowledge, community engagement and healthcare provider training to provide appropriate care to migrant populations to reduce infectious disease disparities.
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Affiliation(s)
- Anita E Heywood
- Level 3, Samuels Building, School of Public Health and Community Medicine, UNSW Sydney, NSW, Australia
| | - Rogelio López-Vélez
- National Referral Unit for Tropical Diseases, Department of Infectious Diseases, Ramón y Cajal University Hospital, Madrid, Spain
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A systematic review of adult tetanus-diphtheria-acellular (Tdap) coverage among healthcare workers. Vaccine 2019; 37:1030-1037. [PMID: 30630694 DOI: 10.1016/j.vaccine.2018.12.046] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Revised: 11/28/2018] [Accepted: 12/14/2018] [Indexed: 12/12/2022]
Abstract
During the last decades pertussis incidence raised globally. Several vaccination strategies targeting adults to reduce pertussis among young infants have been proposed, including vaccination of healthcare workers (HCWs). The aim of this study was to analyse, by performing a systematic review of literature, published papers that evaluated Tdap coverage among HCWs, variables associated with vaccine uptake and efforts implemented to raise vaccination rates. We searched the MedLine, Embase, SCOPUS, LILACS, Web of Science and Cochrane for full-text studies that evaluated Tdap coverage in HCW. Two independent reviewers screened the articles and extracted the data.Twenty-eight studies published from 2009 to 2018 were reviewed. Most studies were conducted in the USA. Initial Tdap coverage varied from 6.1% to 63.9%. USA and France are the only two countries with studies evaluating Tdap coverage within HCWs using national data. In the USA, Tdap coverage in HCWs raised from 6.1% to 45.1% from 2007 to 2015. In the analysis of French national data, a Tdap coverage of 63.9% was observed. Five studies used interventions to raise Tdap coverage in HCWs. Two intervention studies implemented mandatory vaccination and three used educational strategies. All of them achieved coverages over 86%. Only eleven studies analysed the association of Tdap vaccination with variables of interest. Previous immunization with other vaccines recommended for HCWs (like influenza, hepatitis B and MMR) was positively associated with Tdap uptake in four studies. In conclusion, overall Tdap coverage among HCWs is low, but seems to increase over the years after the vaccine introduction and with implementation of interventions to increase coverage.
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Conceição de Oliveira V, Oliveira de Moraes Tavares L, Tauane Pires Maforte N, Noêmia Leão Ribeiro Silva L, Maria Siqueira Rennó H, Gonçalves Amaral G, Maria da Fonseca Viegas S. A percepção da equipe de enfermagem sobre a segurança do paciente em sala de vacinação. REVISTA CUIDARTE 2018. [DOI: 10.15649/cuidarte.v10i1.590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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