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Sharp M, Lozano P, Southworth A, Peters A, Lam H, Randal FT, Quinn M, Kim KE. Mixed methods approach to understanding COVID-19 vaccine hesitancy among immigrants in the Chicago. Vaccine 2024; 42:125552. [PMID: 38199924 DOI: 10.1016/j.vaccine.2023.12.062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Revised: 11/30/2023] [Accepted: 12/20/2023] [Indexed: 01/12/2024]
Abstract
BACKGROUND COVID-19 vaccine hesitancy has been particularly high among immigrant populations, whose experience is shaped by a history of racism and discriminations, and distrust of the healthcare system. In this study we draw from the Theory of Planned Behavior to examine COVID-19 vaccine hesitancy among immigrants in Chicago. METHODS A mixed-methods approach comprising of both focus groups and a health survey was conducted from February to August 2022. Five focus groups were held (N = 35) among Black, Asian and Arab/Palestine participants to understand attitudes and beliefs around the COVID-19 vaccine. Focus groups were analyzed using a modified template approach to text analysis. Based on these findings and themes, we developed a survey that was conducted among 413 immigrants from the mentioned communities. We used hierarchical ordinal regression analyses to examine the relationship between COVID-19 vaccine hesitancy and vaccination status. RESULTS Qualitative analysis suggest that the major factors influencing COVID-19 vaccine hesitancy included fear of adverse reactions, misinformation around COVID-19 and the vaccine, negative social norms around vaccination, and external pressure to get vaccinated. From our quantitative analysis we found that 24% of participants were unvaccinated, 5% were partially vaccinated, 32.3% were vaccinated but not boosted, and 39% were vaccinated and boosted for COVID-19. Hierarchical regression models suggest that immigrants who hold negative attitudes and social norms around the COVID-19 vaccine are less likely to vaccinate. CONCLUSIONS Understanding vaccine hesitancy among immigrants allows for the creation of culturally and linguistically tailored education that can be utilized to increase vaccine confidence and uptake.
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Affiliation(s)
| | - Paula Lozano
- University of Chicago Center for Asian Health Equity, Chicago, IL, United States
| | | | - Aven Peters
- University of Chicago Center for Asian Health Equity, Chicago, IL, United States
| | - Helen Lam
- University of Chicago Center for Asian Health Equity, Chicago, IL, United States
| | | | - Michael Quinn
- University of Chicago Center for Asian Health Equity, Chicago, IL, United States
| | - Karen E Kim
- University of Chicago Center for Asian Health Equity, Chicago, IL, United States
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2
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Mylan S. Suspicious business: COVID-19 vaccination in Palabek refugee settlement, northern Uganda. Soc Sci Med 2024; 346:116695. [PMID: 38452488 DOI: 10.1016/j.socscimed.2024.116695] [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: 09/22/2023] [Revised: 12/09/2023] [Accepted: 02/12/2024] [Indexed: 03/09/2024]
Abstract
Dichotomised debates in public health discourse regarding COVID-19 vaccine supply and vaccine hesitancy do not capture the realities of vaccine uptake in Palabek refugee settlement, northern Uganda. Issues of supply, which analyse manufacture and distribution, foreground global inequalities and political influences. In contrast, vaccine hesitancy, emphasing rectifying deficiencies in knowledge and trust, leaves little room for the politics that shape vaccine uptake. The 'vaccine anxieties' framework problematises these dichotomised debates and proposes consideration of bodily, social and political dimensions. This article builds on the vaccine anxieties framework in relation to ethnographic research conducted in Palabek. Using the worldview of Acholi refugees from South Sudan, a focus on 'suspicious business' demonstrates that debates surrounding vaccine supply and hesitancy are intertwined, and, additionally, suggests spiritual elements should be paid greater attention. In Palabek, inconsistencies in distribution directly impacted vaccine uptake. Furthermore, vaccine interventions that built on deficiency models did not work. Vaccine uptake was inseparable from its biopolitical context that continued to perpetuate the same unequal dynamics of power and control that kept wealth circulating amongst certain powers, whilst others faced worsening precarity but remained perpetual recipients of humanitarian assistance and global health intervention, with little prospect of meaningful change. Suspicious business captures fluid dynamics that move between spiritual and physical realms, capturing wider geopolitical dynamics as they are revealed in everyday lives. In doing so, this flexible approach reveals the centrality of the politics of COVID-19, whilst constantly incorporating evolving dynamics. This flexibility provides potential for improving vaccine uptake, if wider geopolitical inequalities are addressed.
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Affiliation(s)
- Sophie Mylan
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine (LSHTM) , London, WC1H 9SH, UK.
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3
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Deal A, Crawshaw AF, Carter J, Knights F, Iwami M, Darwish M, Hossain R, Immordino P, Kaojaroen K, Severoni S, Hargreaves S. Defining drivers of under-immunization and vaccine hesitancy in refugee and migrant populations. J Travel Med 2023; 30:taad084. [PMID: 37335192 PMCID: PMC10481413 DOI: 10.1093/jtm/taad084] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 05/15/2023] [Accepted: 05/29/2023] [Indexed: 06/21/2023]
Abstract
BACKGROUND/OBJECTIVE Some refugee and migrant populations globally showed lower uptake of COVID-19 vaccines and are also considered to be an under-immunized group for routine vaccinations. These communities may experience a range of barriers to vaccination systems, yet there is a need to better explore drivers of under-immunization and vaccine hesitancy in these mobile groups. METHODS We did a global rapid review to explore drivers of under-immunization and vaccine hesitancy to define strategies to strengthen both COVID-19 and routine vaccination uptake, searching MEDLINE, Embase, Global Health PsycINFO and grey literature. Qualitative data were analysed thematically to identify drivers of under-immunization and vaccine hesitancy, and then categorized using the 'Increasing Vaccination Model'. RESULTS Sixty-three papers were included, reporting data on diverse population groups, including refugees, asylum seekers, labour migrants and undocumented migrants in 22 countries. Drivers of under-immunization and vaccine hesitancy pertaining to a wide range of vaccines were covered, including COVID-19 (n = 27), human papillomavirus (13), measles or Measles-mumps-rubella (MMR) (3), influenza (3), tetanus (1) and vaccination in general. We found a range of factors driving under-immunization and hesitancy in refugee and migrant groups, including unique awareness and access factors that need to be better considered in policy and service delivery. Acceptability of vaccination was often deeply rooted in social and historical context and influenced by personal risk perception. CONCLUSIONS These findings hold direct relevance to current efforts to ensure high levels of global coverage for a range of vaccines and to ensure that marginalized refugee and migrant populations are included in the national vaccination plans of low-, middle- and high-income countries. We found a stark lack of research from low- and middle-income and humanitarian contexts on vaccination in mobile groups. This needs to be urgently rectified if we are to design and deliver effective programmes that ensure high coverage for COVID-19 and routine vaccinations.
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Affiliation(s)
- Anna Deal
- The Migrant Health Research Group, Institute for Infection and Immunity, St George’s, University of London, London, UK
- Department of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Alison F Crawshaw
- The Migrant Health Research Group, Institute for Infection and Immunity, St George’s, University of London, London, UK
| | - Jessica Carter
- The Migrant Health Research Group, Institute for Infection and Immunity, St George’s, University of London, London, UK
| | - Felicity Knights
- The Migrant Health Research Group, Institute for Infection and Immunity, St George’s, University of London, London, UK
| | - Michiyo Iwami
- The Migrant Health Research Group, Institute for Infection and Immunity, St George’s, University of London, London, UK
| | - Mohammad Darwish
- The Health and Migration Programme, World Health Organization, Geneva, Switzerland
| | - Rifat Hossain
- The Health and Migration Programme, World Health Organization, Geneva, Switzerland
| | - Palmira Immordino
- The Health and Migration Programme, World Health Organization, Geneva, Switzerland
| | - Kanokporn Kaojaroen
- The Health and Migration Programme, World Health Organization, Geneva, Switzerland
| | - Santino Severoni
- The Health and Migration Programme, World Health Organization, Geneva, Switzerland
| | - Sally Hargreaves
- The Migrant Health Research Group, Institute for Infection and Immunity, St George’s, University of London, London, UK
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Youssef NJ, Tfaily NK, Moumneh MBM, Boutros CF, Elharake JA, Malik AA, McFadden SM, Galal B, Yildirim I, Khoshnood K, Omer SB, Memish ZA, Dbaibo GS. COVID-19 Vaccine Acceptance and Hesitancy Among Health Care Workers in Lebanon. J Epidemiol Glob Health 2023; 13:55-66. [PMID: 36735184 PMCID: PMC9896451 DOI: 10.1007/s44197-023-00086-4] [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: 06/23/2022] [Accepted: 01/12/2023] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Lebanon endured its worst economic and financial crisis in 2020-2021. To minimize the impact of COVID-19 pandemic, it is important to improve the overall COVID-19 vaccination rate. Given that vaccine hesitancy among health care workers (HCWs) affects the general population's decision to be vaccinated, our study assessed COVID-19 vaccine acceptance among Lebanon HCWs and identified barriers, demographic differences, and the most trusted sources of COVID-19 information. METHODS A cross-sectional study was conducted between January and May 2021 among HCWs across nine hospitals, the Orders of Physicians, Nurses, and Pharmacists in Lebanon. Descriptive statistics were performed to evaluate the COVID-19 vaccine acceptance, and univariate and multivariable to identify their predictors. RESULTS Among 879 participants, 762 (86.8%) were willing to receive the COVID-19 vaccine, 52 (5.9%) refused, and 64 (7.3%) were undecided. Males (226/254; 88.9%) and those ≥ 55 years (95/100; 95%) had the highest rates of acceptance. Of the 113 who were not willing to receive the vaccine, 54.9% reported that the vaccine was not studied well enough. Participants with a previous SARS-CoV-2 infection and those who did not know if they had a previous infection (p = 0.002) were less likely to accept the vaccine compared to those with no previous infection. The most trusted COVID-19 sources of information were WHO (69.3%) and healthcare providers (68%). CONCLUSION Lebanese HCWs had a relatively high acceptance rate for COVID-19 vaccination compared to other countries. Our findings are important in informing the Lebanese health care authorities to establish programs and interventions to improve vaccine uptake among HCWs and the general population.
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Affiliation(s)
- Nour J. Youssef
- grid.411654.30000 0004 0581 3406Center for Infectious Diseases Research, Division of Pediatric Infectious Diseases, Department of Pediatrics and Adolescent Medicine, American University of Beirut Medical Center, Hamra , 1107 Beirut Lebanon
- grid.411654.30000 0004 0581 3406Division of Pediatric Infectious Diseases, Department of Pediatrics and Adolescent Medicine, American University of Beirut Medical Center, Hamra, 1107 Beirut Lebanon
| | - Nadim K. Tfaily
- grid.411654.30000 0004 0581 3406Center for Infectious Diseases Research, Division of Pediatric Infectious Diseases, Department of Pediatrics and Adolescent Medicine, American University of Beirut Medical Center, Hamra , 1107 Beirut Lebanon
| | - Mohammad Bahij M. Moumneh
- grid.411654.30000 0004 0581 3406Center for Infectious Diseases Research, Division of Pediatric Infectious Diseases, Department of Pediatrics and Adolescent Medicine, American University of Beirut Medical Center, Hamra , 1107 Beirut Lebanon
| | - Celina F. Boutros
- grid.411654.30000 0004 0581 3406Center for Infectious Diseases Research, Division of Pediatric Infectious Diseases, Department of Pediatrics and Adolescent Medicine, American University of Beirut Medical Center, Hamra , 1107 Beirut Lebanon
| | - Jad A. Elharake
- grid.47100.320000000419368710Yale Institute for Global Health, New Haven, CT 06510 USA
- grid.47100.320000000419368710Department of Internal Medicine, Infectious Disease, Yale School of Medicine, New Haven, CT 06510 USA
| | - Amyn A. Malik
- grid.47100.320000000419368710Yale Institute for Global Health, New Haven, CT 06510 USA
- grid.47100.320000000419368710Department of Internal Medicine, Infectious Disease, Yale School of Medicine, New Haven, CT 06510 USA
| | - SarahAnn M. McFadden
- grid.47100.320000000419368710Yale Institute for Global Health, New Haven, CT 06510 USA
- grid.47100.320000000419368710Department of Internal Medicine, Infectious Disease, Yale School of Medicine, New Haven, CT 06510 USA
| | - Bayan Galal
- grid.47100.320000000419368710Yale University, New Haven, CT 06520 USA
| | - Inci Yildirim
- grid.47100.320000000419368710Yale Institute for Global Health, New Haven, CT 06510 USA
- grid.47100.320000000419368710Department of Internal Medicine, Infectious Disease, Yale School of Medicine, New Haven, CT 06510 USA
| | - Kaveh Khoshnood
- grid.47100.320000000419368710Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT 06510 USA
| | - Saad B. Omer
- grid.47100.320000000419368710Yale Institute for Global Health, New Haven, CT 06510 USA
- grid.47100.320000000419368710Department of Internal Medicine, Infectious Disease, Yale School of Medicine, New Haven, CT 06510 USA
- grid.47100.320000000419368710Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT 06510 USA
- grid.47100.320000000419368710Yale School of Nursing, Orange, CT 06477 USA
| | - Ziad A. Memish
- Research and Innovation Center, King Saud Medical City, Ministry of Health, Riyadh, Kingdom of Saudi Arabia
- College of Medicine, Al Faisal University, Riyadh, Kingdom of Saudi Arabia
- grid.189967.80000 0001 0941 6502Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA USA
| | - Ghassan S. Dbaibo
- grid.411654.30000 0004 0581 3406Center for Infectious Diseases Research, Division of Pediatric Infectious Diseases, Department of Pediatrics and Adolescent Medicine, American University of Beirut Medical Center, Hamra , 1107 Beirut Lebanon
- grid.411654.30000 0004 0581 3406Division of Pediatric Infectious Diseases, Department of Pediatrics and Adolescent Medicine, American University of Beirut Medical Center, Hamra, 1107 Beirut Lebanon
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Understanding COVID-19 Vaccine Confidence in People Living with HIV: A pan-Canadian Survey. AIDS Behav 2023:10.1007/s10461-023-03991-8. [PMID: 36738344 PMCID: PMC9898854 DOI: 10.1007/s10461-023-03991-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/10/2023] [Indexed: 02/05/2023]
Abstract
Understanding the roots of Covid-19 vaccine hesitancy in at-risk groups, such as persons living with HIV (PLWH), is of utmost importance. We developed a modified Vaccine Hesitancy Scale (VHS) questionnaire using items from the National Advisory Committee on Immunization Acceptability Matrix. To examine factors associated with receiving COVID-19 vaccine and the link between vaccine attitudes and beliefs with vaccine behavior, PLWH were recruited via social media and community-based organizations (February-May 2022). Descriptive statistics were used to summarize results. Total VHS score was generated by adding Likert scale scores and linear regression models used to compare results between participants who received or did not receive COVID-19 vaccines. Logistic regression models were used to identify factors associated with vaccine uptake. A total of 246 PLWH indicated whether they received a COVID-19 vaccine. 89% received ≥ 1 dose. Mean total VHS(SD) for persons having received ≥ 1 COVID-19 vaccine was 17.8(6.2) vs. 35.4(9.4) for participants not having received any COVID-19 vaccine. Persons who received ≥ 1 dose were significantly older than those who had not received any (48.4 ± 13.8 vs. 34.0 ± 7.7 years, p < 0.0001). The majority of participants considered COVID-19 vaccination important for their health(81.3%) and the health of others(84.4%). Multivariate logistic regression revealed the odds of taking ≥ 1dose were increased 2.4-fold [95% CI 1.6, 3.5] with each increase in age of 10 years (p < 0.0001). Sex and ethnicity were not different between groups. In conclusion, PLWH accept COVID-19 vaccines for both altruistic and individual reasons. With evolving recommendations and increasing numbers of booster vaccines, we must re-examine the needs of PLWH regularly.
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6
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Debela MS, Garrett APN, Charania NA. Vaccine hesitancy and its determinants among refugee parents resettled in Aotearoa New Zealand. Hum Vaccin Immunother 2022; 18:2131336. [PMID: 36315907 PMCID: PMC9746517 DOI: 10.1080/21645515.2022.2131336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 09/09/2022] [Accepted: 09/29/2022] [Indexed: 11/04/2022] Open
Abstract
Vaccine hesitancy is an important factor underpinning suboptimal vaccine uptake and evidence on marginalized subgroups, such as refugees, is limited. This cross-sectional survey was conducted in 2020/21 with former refugee parents who resettled in Aotearoa New Zealand (NZ). The Parent Attitudes about Childhood Vaccines (PACV) was offered in Somali, Oromo, Arabic, and English languages, and the reliability of the four versions were evaluated. The prevalence of parental vaccine hesitancy was explored and the association between vaccine hesitancy and sociodemographic factors was examined using logistic regression. One hundred and seventy-eight responses were included in the analysis. The Cronbach's alpha scores for Somali, Oromo, Arabic, and English PACV were 0.89, 0.64, 0.53, and 0.77, respectively. The rate of parental vaccine hesitancy was 16.3%, 95% CI (10.7, 21.3). Most caregivers were concerned about vaccine side effects (47%), safety (43%), and efficacy (40%). Less than a quarter (21%) of parents had delayed their child receiving a vaccine and 12% had refused to vaccinate their child for reasons other than medical exemptions. After adjusting for covariate/s, parents' primary source of information and education status were significantly associated with vaccine hesitancy. Media as a primary source of vaccine information and low education status were associated with higher vaccine hesitancy. Vaccine hesitancy is relatively low among former refugees and is influenced by modifiable factors, including educational level and primary source of vaccine information. Vaccine information tailored to former refugee parents' concerns are required to reduce vaccine hesitancy and improve vaccine uptake.
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Affiliation(s)
- Mulisa Senbeta Debela
- Department of Public Health, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand
| | - A. P. Nick Garrett
- Department of Biostatistics and Epidemiology, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand
| | - Nadia A. Charania
- Department of Public Health, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand
- Migrant and Refugee Health Research Centre, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand
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7
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Immordino P, Graci D, Casuccio A, Restivo V, Mazzucco W. COVID-19 Vaccination in Migrants and Refugees: Lessons Learnt and Good Practices. Vaccines (Basel) 2022; 10:vaccines10111965. [PMID: 36423059 PMCID: PMC9692740 DOI: 10.3390/vaccines10111965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 10/24/2022] [Accepted: 11/11/2022] [Indexed: 11/22/2022] Open
Abstract
The COVID-19 pandemic has exacerbated inequalities between low- and high-income countries. Within the latter, a greater impact is seen in the poorest and most vulnerable people, including refugees, asylum seekers, and migrants. They all may experience poor access to quality healthcare or have suboptimal health-seeking behavior, distrust of governments, or fear of detention and deportation if seeking healthcare. Some refugees and migrants may face multiple barriers to vaccination and access to health systems that are relevant to the administration of COVID-19 vaccines, despite the growing inclusion of these populations in public health policies. Several good practices have emerged to ensure the inclusion of these populations in vaccination and healthcare for COVID-19 globally. However, inequalities persist between high-income and low-/middle-income populations. The inequalities in COVID-19 vaccination reflect the already existing ones in common health services worldwide. Further efforts are necessary to reduce such disparities, to protect the vulnerable, and, by extension, the general population. The initiatives organized, both at global and local levels, to support vaccination campaigns represent a notable example of how complex multilevel structures, such as health systems, as well as limited resource health services, can successfully face, even during a health emergency, the challenges related to global health issues.
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8
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Tjaden J, Haarmann E, Savaskan N. Experimental evidence on improving COVID-19 vaccine outreach among migrant communities on social media. Sci Rep 2022; 12:16256. [PMID: 36171245 PMCID: PMC9518941 DOI: 10.1038/s41598-022-20340-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 09/12/2022] [Indexed: 12/02/2022] Open
Abstract
Studies from several countries suggest that COVID-19 vaccination rates are lower among migrants compared to the general population. Urgent calls have been made to improve vaccine outreach to migrants, however, there is limited evidence on effective approaches, especially using social media. We assessed a targeted, low-cost, Facebook campaign disseminating COVID-19 vaccine information among Arabic, Turkish and Russian speakers in Germany (N = 888,994). As part of the campaign, we conducted two randomized, online experiments to assess the impact of the advertisement (1) language and (2) depicted messenger (government authority, religious leader, doctor or family). Key outcomes included reach, click-through rates, conversion rates and cost-effectiveness. Within 29 days, the campaign reached 890 thousand Facebook users. On average, 2.3 individuals accessed the advertised COVID-19 vaccination appointment tool for every euro spent on the campaign. Migrants were 2.4 (Arabic), 1.8 (Russian) and 1.2 (Turkish) times more likely to click on advertisements translated to their native language compared to German-language advertisements. Furthermore, findings showed that government representatives can be more successful in engaging migrants online compared to other messengers, despite common claims of lower trust in government institutions among migrants. This study highlights the potential of tailored, and translated, vaccination campaigns on social media for reaching migrants who may be left out by traditional media campaigns.
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Affiliation(s)
- Jasper Tjaden
- Department of Economic and Social Sciences, University of Potsdam, Potsdam, Germany.
| | - Esther Haarmann
- International Organization for Migration, Global Migration Data Analysis Centre, Berlin, Germany
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9
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Tankwanchi ABS, Jaca A, Ndlambe AM, Zantsi ZP, Bowman B, Garrison MM, Larson HJ, Vermund SH, Wiysonge CS. Non-COVID-19 vaccine hesitancy among migrant populations worldwide: a scoping review of the literature, 2000-2020. Expert Rev Vaccines 2022; 21:1269-1287. [DOI: 10.1080/14760584.2022.2084075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
| | - Anelisa Jaca
- Cochrane South Africa, South African Medical Research Council, Cape Town, SA
| | - Asiphe M Ndlambe
- Cochrane South Africa, South African Medical Research Council, Cape Town, SA
| | - Zukiswa P Zantsi
- Cochrane South Africa, South African Medical Research Council, Cape Town, SA
| | - Brett Bowman
- Department of Psychology, School of Human and Community Development, University of the Witwatersrand, Johannesburg, SA
| | - Michelle M Garrison
- Department of Health Systems and Population Health, School of Public Health, University of Washington, Seattle, WA, USA
| | - Heidi J Larson
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
- Institute of Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Sten H Vermund
- Yale School of Public Health, Yale University, New Haven, CT, USA
| | - Charles S Wiysonge
- Cochrane South Africa, South African Medical Research Council, Cape Town, SA
- Department of Global Health, Stellenbosch University, Cape Town, SA
- School of Public Health and Family Medicine, University of Cape Town, Cape Town, SA
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10
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Akintunde TY, Tassang AE, Okeke M, Isangha SO, Musa TH. Perceived Vaccine Efficacy, Willingness to Pay for COVID-19 Vaccine and Associated Determinants among Foreign Migrants in China. ELECTRONIC JOURNAL OF GENERAL MEDICINE 2022. [DOI: 10.29333/ejgm/11920] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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11
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Galal B, Lazieh S, Al-Ali S, Khoshnood K. Assessing vaccine hesitancy in Arab countries in the Middle East and North Africa (MENA) region: a scoping review protocol. BMJ Open 2022; 12:e045348. [PMID: 35149559 PMCID: PMC8844954 DOI: 10.1136/bmjopen-2020-045348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
INTRODUCTION Vaccine-preventable disease outbreaks have increased in past years, and there is great public health interest in monitoring attitudes towards vaccination as well as identifying factors contributing to vaccine hesitancy and refusal. Although the WHO declared vaccine hesitancy as one of the top threats to global health in 2019, studies focused on the determinants and extent of vaccine hesitancy in Arab countries in the Middle East and North Africa (MENA) region are lacking. This scoping review explores the various factors surrounding vaccine hesitancy, including but not limited to geographic, cultural and religious factors, and examines the extent and nature of the existing evidence on this topic. In light of current development of various COVID-19 vaccines, our work seeks to elucidate the barriers to vaccine uptake in specific populations. METHODS AND ANALYSIS This review will be conducted using the Joanna Briggs Institute Manual for Scoping Reviews. It will comply with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines. Studies published in English, Arabic and French between January 1998 and December 2020 will be drawn from PubMed, Embase, Cochrane and Scopus. The search strategy will include terms related to vaccination and vaccine hesitancy in Arab countries in the MENA region. We will also include grey literature on the topic by searching Google and Google Scholar. Studies will be selected according to the Participants-Intervention-Comparators-Outcome model, and all study titles and abstracts will be screened by two reviewers. Disagreements will be resolved with a third reviewer's input. ETHICS AND DISSEMINATION This review is exempted from ethical approval and will be published in a peer-reviewed open-access journal to ensure wide dissemination.
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Affiliation(s)
- Bayan Galal
- Yale University, New Haven, Connecticut, USA
| | - Stefany Lazieh
- Rutgers University School of Arts and Sciences, New Brunswick, New Jersey, USA
| | | | - Kaveh Khoshnood
- Department of Epidemiology of Microbial Diseases, Yale University, New Haven, Connecticut, USA
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12
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Abu-Shamsieh A, Maw S. Pediatric Care for Immigrant, Refugee, and Internationally Adopted Children. Pediatr Clin North Am 2022; 69:153-170. [PMID: 34794672 DOI: 10.1016/j.pcl.2021.09.006] [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] [Indexed: 10/19/2022]
Abstract
Immigrant children are a diverse group and include refugees, asylees, and internationally adopted children. They have various infectious disease risk factors, depending on conditions within their country of origin, journey, and current living conditions. Infectious disease screening should take place within the framework of a comprehensive medical evaluation in the medical home. Some screening is recommended for all immigrant children including hepatitis B, syphilis, HIV, tuberculosis, and intestinal parasites; other diseases can be tested for based on individual risks. Although guidelines and resources are available, there is limited evidence supporting much of the care of immigrant children and youth.
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Affiliation(s)
- Aimee Abu-Shamsieh
- Department of Pediatrics, University of California San Francisco (UCSF) Fresno Medical Education Program, 155 North Fresno Street, Suite 218, Fresno, CA, 93701, USA.
| | - Soe Maw
- Department of Pediatrics, University of California San Francisco (UCSF) Fresno Medical Education Program, 155 North Fresno Street, Suite 218, Fresno, CA, 93701, USA
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13
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Deal A, Halliday R, Crawshaw AF, Hayward SE, Burnard A, Rustage K, Carter J, Mehrotra A, Knights F, Campos-Matos I, Majeed A, Friedland JS, Edelstein M, Mounier-Jack S, Hargreaves S. Migration and outbreaks of vaccine-preventable disease in Europe: a systematic review. THE LANCET. INFECTIOUS DISEASES 2021; 21:e387-e398. [PMID: 34626552 DOI: 10.1016/s1473-3099(21)00193-6] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 03/04/2021] [Accepted: 03/17/2021] [Indexed: 12/25/2022]
Abstract
Migrant populations are one of several underimmunised groups in the EU or European Economic Area (EU/EEA), yet little is known about their involvement in outbreaks of vaccine-preventable diseases. This information is vital to develop targeted strategies to improve the health of diverse migrant communities. We did a systematic review (PROSPERO CRD42019157473; Jan 1, 2000, to May 22, 2020) adhering to PRISMA guidelines, to identify studies on vaccine-preventable disease outbreaks (measles, mumps, rubella, diphtheria, pertussis, polio, hepatitis A, varicella, Neisseria meningitidis, and Haemophilus influenzae) involving migrants residing in the EU/EEA and Switzerland. We identified 45 studies, reporting on 47 distinct vaccine-preventable disease outbreaks across 13 countries. Most reported outbreaks involving migrants were of measles (n=24; 6496 cases), followed by varicella (n=11; 505 cases), hepatitis A (n=7; 1356 cases), rubella (n=3; 487 cases), and mumps (n=2; 293 cases). 19 (40%) outbreaks, predominantly varicella and measles, were reported in temporary refugee camps or shelters. Of 11 varicella outbreaks, nine (82%) were associated with adult migrants. Half of measles outbreaks (n=11) were associated with migrants from eastern European countries. In conclusion, migrants are involved in vaccine-preventable disease outbreaks in Europe, with adult and child refugees residing in shelters or temporary camps at particular risk, alongside specific nationality groups. Vulnerability varies by disease, setting, and demographics, highlighting the importance of tailoring catch-up vaccination interventions to specific groups in order to meet regional and global vaccination targets as recommended by the new Immunisation Agenda 2030 framework for action. A better understanding of vaccine access and intent in migrant groups and a greater focus on co-designing interventions is urgently needed, with direct implications for COVID-19 vaccine delivery.
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Affiliation(s)
- Anna Deal
- The Migrant Health Research Group, Institute for Infection and Immunity, St George's, University of London, London, UK; Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Rae Halliday
- The Migrant Health Research Group, Institute for Infection and Immunity, St George's, University of London, London, UK
| | - Alison F Crawshaw
- The Migrant Health Research Group, Institute for Infection and Immunity, St George's, University of London, London, UK
| | - Sally E Hayward
- The Migrant Health Research Group, Institute for Infection and Immunity, St George's, University of London, London, UK; Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Amelia Burnard
- The Migrant Health Research Group, Institute for Infection and Immunity, St George's, University of London, London, UK
| | - Kieran Rustage
- The Migrant Health Research Group, Institute for Infection and Immunity, St George's, University of London, London, UK
| | - Jessica Carter
- The Migrant Health Research Group, Institute for Infection and Immunity, St George's, University of London, London, UK
| | | | - Felicity Knights
- The Migrant Health Research Group, Institute for Infection and Immunity, St George's, University of London, London, UK
| | - Ines Campos-Matos
- Public Health England, London, UK; UCL Collaborative Centre for Inclusion Health, University College London, London, UK
| | - Azeem Majeed
- Department of Primary Care & Public Health, Imperial College London, London, UK
| | - Jon S Friedland
- The Migrant Health Research Group, Institute for Infection and Immunity, St George's, University of London, London, UK
| | | | - Sandra Mounier-Jack
- Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Sally Hargreaves
- The Migrant Health Research Group, Institute for Infection and Immunity, St George's, University of London, London, UK.
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14
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Dzieciolowska S, Hamel D, Gadio S, Dionne M, Gagnon D, Robitaille L, Cook E, Caron I, Talib A, Parkes L, Dubé È, Longtin Y. Covid-19 vaccine acceptance, hesitancy, and refusal among Canadian healthcare workers: A multicenter survey. Am J Infect Control 2021; 49:1152-1157. [PMID: 33930516 PMCID: PMC8079260 DOI: 10.1016/j.ajic.2021.04.079] [Citation(s) in RCA: 161] [Impact Index Per Article: 53.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Revised: 04/19/2021] [Accepted: 04/21/2021] [Indexed: 01/14/2023]
Abstract
BACKGROUND Determinants of COVID-19 vaccine acceptance among healthcare workers (HCW) remains poorly understood. We assessed HCWs' willingness to be vaccinated and reasons underlying hesitancy. METHODS Cross-sectional survey across 17 healthcare institutions. HCWs eligible for vaccination (Pfizer-BioNTech mRNA) in December 2020 were invited to receive immunization. Multivariate logistic regression was performed to identify predictors of acceptance. Reasons for refusal among those who never intended to be vaccinated (ie, firm refusers) and those who preferred delaying vaccination (ie, vaccine hesitants) were assessed. RESULTS Among 2,761 respondents (72% female, average age, 44), 2,233 (80.9%) accepted the vaccine. Physicians, environmental services workers and healthcare managers were more likely to accept vaccination compared to nurses. Male sex, age over 50, rehabilitation center workers, and occupational COVID-19 exposure were independently associated with vaccine acceptance by multivariate analysis. Factors for refusal included vaccine novelty, wanting others to receive it first, and insufficient time for decision-making. Among those who declined, 74% reported they may accept future vaccination. Vaccine firm refusers were more likely than vaccine hesitants to distrust pharmaceutical companies and to prefer developing a natural immunity by getting COVID-19. CONCLUSIONS Vaccine hesitancy exists among HCWs. Our findings provide useful information to plan future interventions and improve acceptance.
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Affiliation(s)
| | - Denis Hamel
- Institut national de santé publique du Québec, Quebec City, Canada
| | - Souleymane Gadio
- Institut national de santé publique du Québec, Quebec City, Canada
| | - Maude Dionne
- Institut national de santé publique du Québec, Quebec City, Canada
| | - Dominique Gagnon
- Institut national de santé publique du Québec, Quebec City, Canada
| | - Lucie Robitaille
- Institut national de santé publique du Québec, Quebec City, Canada
| | - Erin Cook
- Jewish General Hospital Sir Mortimer B. Davis, Montreal, Canada
| | - Isabelle Caron
- Jewish General Hospital Sir Mortimer B. Davis, Montreal, Canada
| | - Amina Talib
- Jewish General Hospital Sir Mortimer B. Davis, Montreal, Canada
| | - Leighanne Parkes
- McGill University Faculty of Medicine, Montreal, Canada; Jewish General Hospital Sir Mortimer B. Davis, Montreal, Canada
| | - Ève Dubé
- Institut national de santé publique du Québec, Quebec City, Canada; Université Laval, Faculty of Social Sciences, Quebec City, Canada
| | - Yves Longtin
- McGill University Faculty of Medicine, Montreal, Canada; Jewish General Hospital Sir Mortimer B. Davis, Montreal, Canada.
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15
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Tankwanchi AS, Bowman B, Garrison M, Larson H, Wiysonge CS. Vaccine hesitancy in migrant communities: a rapid review of latest evidence. Curr Opin Immunol 2021; 71:62-68. [PMID: 34118728 DOI: 10.1016/j.coi.2021.05.009] [Citation(s) in RCA: 59] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Revised: 05/19/2021] [Accepted: 05/21/2021] [Indexed: 12/30/2022]
Abstract
By refusing or delaying vaccination, vaccine hesitant individuals and communities undermine the prevention, and ultimately, elimination of communicable diseases against which safe and effective vaccines are available. We reviewed recent evidence of vaccine hesitancy within migrant communities in the context of increased human mobility and widespread anti-immigrant sentiment and manifest xenophobia. Among many immigrant parents and families, vaccine hesitancy is largely associated with fears and misinformation about vaccine harms, limited knowledge of both preventable diseases and vaccines, distrust of host countries' health systems and their attendant intentions, language barriers, and perceived incompatibility between vaccine uptake and migrants' religion. Hesitancy toward measles, influenza, and human papillomavirus vaccines are most discernible, and main migrant populations involved include Somalis and Poles.
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Affiliation(s)
| | - Brett Bowman
- Department of Psychology, School of Human and Community Development, University of the Witwatersrand, Johannesburg, South Africa
| | - Michelle Garrison
- Department of Health Services, University of Washington School of Public Health, Seattle, WA, USA; Department of Psychiatry and Behavioral Sciences, Seattle Children's Hospital and University of Washington, Seattle, WA, USA
| | - Heidi Larson
- Department of Health Metrics Sciences, University of Washington School of Medicine, Seattle, WA USA; Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - Charles Shey Wiysonge
- Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa; Department of Global Health, Stellenbosch University, Cape Town, South Africa; School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
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