Opinions of Quebec parents and vaccinators on the usefulness of chickenpox vaccine

Knowledge, attitudes, and behaviors of parents towards varicella and its vaccination

BACKGROUND

The aims of this cross-sectional survey were to examine the knowledge, the attitudes, and the behavior regarding the varicella infection and its vaccination and to get insight into their determinants among parents of children in Italy.

METHODS

From May to June 2015 in the geographic area of Naples (Italy) a random sample of 675 parents of children aged 4-7 years received a self-administered anonymous questionnaire about socio-demographic characteristics, knowledge, attitudes, and behaviors towards varicella and its vaccination.

RESULTS

A total of 414 parents responded to the questionnaire, for a response rate of 61.3%. A history of varicella was reported in 163 children (39.6%). Only 26.6% parents knew that the vaccine was available and the number of doses and this knowledge was significantly higher in those who had a university degree, in those who had received information on the vaccination from a health care provider, and in those who had vaccinated their child. The perceived utility towards vaccination had a mean value of 5.7. The positive attitude towards the utility of the vaccination was higher in parents with a level of education not higher than middle school, in those who had vaccinated their child, in those who considered the varicella a dangerous disease, and in those who had received information from a health care provider. More than one-third had vaccinated their child. Immunization was more frequent in parents who had knowledge about the vaccination, who beliefs that the immunization was useful, who believed that the disease was not dangerous, and who had not a history of varicella among their children.

CONCLUSIONS

Educational programs are needed among parents as support to improve knowledge about vaccination and immunization coverage.

Negative attitude and low intention to vaccinate universally against varicella among public health professionals and parents in the Netherlands: two internet surveys

BACKGROUND

Prior to introduction of universal varicella vaccination, it is crucial to gain insight into the willingness to vaccinate among the population. This is because suboptimal national vaccination coverage might increase the age of infection in children, which will lead to higher complication rates. We studied the attitude and intention to vaccinate against varicella among Dutch public health professionals who execute the National Immunisation Programme (NIP), and parents.

METHODS

Medical doctors and nurses of regional public health services (RPHS) and child health clinics (CHC), and a random sample of parents received an internet survey on varicella vaccination. Separate logistic regression models were used to identify determinants for a positive attitude (professionals) or a positive intention (parents) to vaccinate against varicella within the NIP (free of charge).

RESULTS

The questionnaire was completed by 181 RPHS professionals (67%), 260 CHC professionals (46%), and 491 parents (33%). Of professionals, 21% had a positive attitude towards universal varicella vaccination, while 72% preferred to limit vaccination to high-risk groups only. Of parents, 28% had a positive intention to vaccinate their child against varicella within the NIP. The strongest determinant for a positive attitude or intention to vaccinate against varicella among professionals and parents was the belief that varicella is a disease serious enough to vaccinate against.

CONCLUSIONS

We showed that a majority of the Dutch public health professionals and parents in this study have a negative attitude or low intention to vaccinate universally against varicella, as a result of the perceived low severity of the disease. Most participating professionals support selective vaccination to prevent varicella among high-risk groups.

Knowledge, Attitudes, and Practices regarding Chickenpox Disease and its Prevention in Singapore: Comparison between Parents and Medical Students

Introduction:

The incidence of chickenpox in Singapore is steadily increasing despite the availability of effective preventive measures. To address the need for improvement in public education, a survey was conducted to establish if differences exist amongst parents and medical students with regards to their knowledge, attitudes, and practices regarding chickenpox and its prevention.

Methods:

Over a six-week period in 2010, an online survey involving parents who attended a paediatric clinic, and medical students from the National University of Singapore, was conducted.

Results:

Parents had a significantly greater lack of knowledge compared to medical students ( P <0.001). Family and friends were the main source of information for parents and junior medical students, unlike senior medical students who learnt more from physicians. A large majority of responders (85.2%) favoured vaccination for varying reasons, with parents and junior students being more concerned about the spread of disease and favouring its avoidance, and senior students fearing life-threatening complications. Parents who would not recommend the vaccine considered chickenpox a rite of passage and believed the vaccine lacks long-term benefits, while a perception that the disease is mild was more prevalent among medical students. A better understanding of the disease and vaccine was the most influential factor for changing decisions against vaccination.

Conclusion:

Greater efforts to disseminate information about chickenpox disease and its prevention are needed to address important deficits in public health and medical school education. Being aware that chickenpox can be more than just a mild disease with serious complications may increase the uptake of chickenpox vaccination.

Varicella vaccination for grades 4 and 5 students: from theory to practice

BACKGROUND

In 2002-2003, as part of a pilot project, varicella vaccination was offered to susceptible students in grades 4 and 5 in schools whose health services are provided by a local community services centre in Montréal. This immunization campaign was merged with the hepatitis B immunization programme.

OBJECTIVES

To calculate the proportion of grade 4 and 5 students susceptible to varicella; to calculate the proportion of susceptible students who agree to be vaccinated; to compare the proportion of susceptibles who agree to be vaccinated when varicella vaccination is offered with the first or the second dose of hepatitis B; and to assess whether a catch-up varicella immunization programme would affect the vaccine coverage of a concurrent hepatitis B vaccination programme.

METHODS

The proportions of susceptible students and of parents of susceptibles who consented to vaccination were calculated. The proportions of parents of susceptibles who consented to vaccination were compared for both immunization strategies: varicella vaccination given with the first or second dose of hepatitis B vaccine. Logistic regression was performed to identify possible associations between consent to varicella vaccination and the various variables collected. Rates of vaccine coverage against hepatitis B after two doses were compared for the years 2000-2001 and 2002-2003.

RESULTS

Of 3,856 registered students, 3,486 (90.4%) returned consent forms. Among the 3,272 students for whom information was available, 441 (13.5%) were susceptible, including 394 (89.3%) who consented to vaccination. The rates of vaccine coverage in the schools after two doses of hepatitis B vaccine were exactly the same for the 2000-2001 and 2002-2003 school years.

CONCLUSION

Varicella vaccination of susceptible grade 4 and 5 students associated with a coincident hepatitis B vaccination campaign can be performed without negative impact on the hepatitis B vaccination programme.

Varicella vaccination for grades 4 and 5 students: from theory to practice

BACKGROUND

In 2002-2003, as part of a pilot project, varicella vaccination was offered to susceptible students in grades 4 and 5 in schools whose health services are provided by a local community services centre in Montréal. This immunization campaign was merged with the hepatitis B immunization programme.

OBJECTIVES

To calculate the proportion of grade 4 and 5 students susceptible to varicella; to calculate the proportion of susceptible students who agree to be vaccinated; to compare the proportion of susceptibles who agree to be vaccinated when varicella vaccination is offered with the first or the second dose of hepatitis B; and to assess whether a catch-up varicella immunization programme would affect the vaccine coverage of a concurrent hepatitis B vaccination programme.

METHODS

The proportions of susceptible students and of parents of susceptibles who consented to vaccination were calculated. The proportions of parents of susceptibles who consented to vaccination were compared for both immunization strategies: varicella vaccination given with the first or second dose of hepatitis B vaccine. Logistic regression was performed to identify possible associations between consent to varicella vaccination and the various variables collected. Rates of vaccine coverage against hepatitis B after two doses were compared for the years 2000-2001 and 2002-2003.

RESULTS

Of 3,856 registered students, 3,486 (90.4%) returned consent forms. Among the 3,272 students for whom information was available, 441 (13.5%) were susceptible, including 394 (89.3%) who consented to vaccination. The rates of vaccine coverage in the schools after two doses of hepatitis B vaccine were exactly the same for the 2000-2001 and 2002-2003 school years.

CONCLUSION

Varicella vaccination of susceptible grade 4 and 5 students associated with a coincident hepatitis B vaccination campaign can be performed without negative impact on the hepatitis B vaccination programme.

Varicella vaccine: factors influencing uptake

BACKGROUND

In Canada, varicella vaccine is recommended but its uptake has been low. In contrast to most other recommended paediatric vaccines, this one is not currently provided free of charge in all provinces and territories in Canada.

OBJECTIVE

To evaluate the rate of health care provider offer of varicella vaccine to parents and the most important determinants of parental decision to accept the offer.

METHODS

A structured questionnaire was administered by phone interview to parents of children aged 14 to 17 months in the Quebec City area where the vaccine is not publicly funded.

RESULTS

Among the 477 participants, 37% had been offered the vaccine by their health care provider: 45% when the provider was a paediatrician and 29% for general practitioners or public health clinics. Only 13% of offers included information on the risk of varicella complications, the cost, efficacy and safety of the vaccine. By decreasing order of importance, the factors that positively increased parental decision to use varicella vaccine included: information on vaccine safety, a positive recommendation and a higher family income.

CONCLUSION

Despite a recommendation for universal vaccination, varicella vaccine is not broadly offered and few offers contain all the information both needed to elicit proper consent and correlated with a positive uptake.

Impact of vaccine cost and information about complications of varicella on parental decision regarding varicella vaccine

BACKGROUND

The influence of providing information about complications of disease and vaccine cost on parental decision to vaccinate against varicella was assessed.

METHOD

During telephone interviews of 330 parents of infants aged 9 months, parents were asked if they would agree to have their child vaccinated and were presented information first about varicella complications and then about cost of the vaccine.

RESULTS

When complications were explained but information about cost was not, 94% of parents were favourable toward having their child vaccinated. When complications were not explained but cost was presented, this percentage was only 34%. When both cost and complications were presented, 60% of parents were favourable toward the vaccine.

INTERPRETATION

In improving receptivity towards varicella vaccine, parents should always be presented data regarding varicella complications by their health care provider.

The effect of vaccination on the epidemiology of varicella zoster virus

Varicella zoster virus (VZV) causes chickenpox (varicella) on primary exposure and can reactivate later in life to cause shingles (zoster). As primary infection is more serious in adults than children, and exposure to the virus might boost the immune response to both chickenpox and shingles, there are two main concerns regarding infant VZV vaccination: that it could lead to an increase in adult disease; and/or that it could lead to a temporary increase in the incidence of shingles. This paper reviews the evidence for such outcomes. The consensus view of mathematical modelling studies is that the overall varicella associated burden is likely to decrease in the long term, regardless of the level of vaccine coverage. On the other hand, recent evidence suggests that an increase in zoster incidence appears likely, and the more effective vaccination is at preventing varicella, the larger the increase in zoster incidence. Targeted vaccination of susceptible adolescents and/or the contacts of high-risk individuals can be effective at preventing disease in these individuals with minimal risk to the community. However, targeted strategies would not prevent most disease (including most severe disease), and will not lead to a long-term reduction in the incidence of zoster. Understanding the mechanisms for maintaining immunity against varicella and zoster is critical for predicting the long-term effects of vaccination. Meanwhile sensitive surveillance of both chickenpox and shingles is essential in countries that have implemented, or are about to implement, varicella vaccination.

Impact of vaccine cost and information about complications of varicella on parental decision regarding varicella vaccine

BACKGROUND

The influence of providing information about complications of disease and vaccine cost on parental decision to vaccinate against varicella was assessed.

METHOD

During telephone interviews of 330 parents of infants aged 9 months, parents were asked if they would agree to have their child vaccinated and were presented information first about varicella complications and then about cost of the vaccine.

RESULTS

When complications were explained but information about cost was not, 94% of parents were favourable toward having their child vaccinated. When complications were not explained but cost was presented, this percentage was only 34%. When both cost and complications were presented, 60% of parents were favourable toward the vaccine.

INTERPRETATION

In improving receptivity towards varicella vaccine, parents should always be presented data regarding varicella complications by their health care provider.