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Song MY, Blake-Hepburn D, Karbasi A, Fadel SA, Allin S, Ataullahjan A, Ruggiero ED. Public health partnerships with faith-based organizations to support vaccination uptake among minoritized communities: A scoping review. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0002765. [PMID: 38837963 DOI: 10.1371/journal.pgph.0002765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 04/22/2024] [Indexed: 06/07/2024]
Abstract
Faith-based vaccine initiatives are of growing interest to public health agencies who are looking to increase vaccine confidence among ethnoracially minoritized populations. Despite evidence that support faith-based organizations' (FBOs) partnerships with public health agencies (PHAs) to increase vaccine confidence, reviews on the scope and efforts to ensure equitable vaccination delivery for ethnoracially minoritized populations are scarce. We aimed to understand how public health agencies collaborate with FBOs or faith communities to improve vaccine confidence among minoritized communities in high-, low- and middle- income countries. We conducted a scoping review by searching OVID MEDLINE, Cochrane Library, Cumulative Index to Nursing and Allied Health Literature (CINAHL), SCOPUS, and PROQUEST from 2011 to 2023. We included case studies, news reports, observational studies, experimental, and quasi-experimental studies and multimedia content that describes PHA-FBO partnerships that created vaccine initiatives for marginalized and minoritized communities. The data was extracted, summarized, and results were described narratively. We included 167 initiatives reported in 160 publications; 83.8% of the included articles were published between 2019 to 2023. The interventions carried out by PHA-FBO partnerships attempted to increase vaccine uptake using any or all the following methods. First, the initiatives provided digital and in-person platforms for interfaith learning and established training programs to empower faith leaders to become vaccine ambassadors. Second, the initiatives designed and disseminated education and awareness materials that aimed to be sensitive to religious and gender norms. Third, PHA-FBO partnered to apply equity and faith-based frameworks and provided wrap-around support to enable equitable vaccine access. Majority of the initiatives reported that PHA-FBO partnerships improved vaccine confidence and uptake (71.3%). About 22.2% of the initiatives reported quantitative outcomes post-intervention. PHA-FBO initiatives over the past decade increased vaccine uptake and acceptance among diverse ethnoracially minoritized populations. Reporting of faith-based initiatives are subject to publication bias and can be strengthened by examining more evaluation studies and establishment of key outcome indicators to critically appraise intervention outcomes.
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Affiliation(s)
- Melodie Yunju Song
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | | | - Anna Karbasi
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Shaza A Fadel
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- Clinical Public Health Division, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Sara Allin
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- Institute of Health Policy, Management, and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Anushka Ataullahjan
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- School of Health Studies, Faculty of Health Sciences, Western University, London, Canada
| | - Erica Di Ruggiero
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- Social and Behavioural Health Sciences Division, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
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Soofi SB, Vadsaria K, Mannan S, Habib MA, Tabassum F, Hussain I, Muhammad S, Feroz K, Ahmed I, Islam M, Bhutta ZA. Factors Associated with Vaccine Refusal (Polio and Routine Immunization) in High-Risk Areas of Pakistan: A Matched Case-Control Study. Vaccines (Basel) 2023; 11:vaccines11050947. [PMID: 37243051 DOI: 10.3390/vaccines11050947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 04/19/2023] [Accepted: 04/26/2023] [Indexed: 05/28/2023] Open
Abstract
BACKGROUND Pakistan has subpar childhood immunization rates and immunization activities have faced several challenges over the past years. We evaluated the social-behavioral and cultural barriers and risk factors for refusal of polio, Routine Immunization (RI), or both in high-risk areas of poliovirus circulation. METHODS A matched case-control study was conducted from April to July 2017 in eight super high-risk Union Councils of five towns in Karachi, Pakistan. A total of 3 groups, each with 250 cases, including refusals for the Oral Polio Vaccine (OPV) in campaigns (national immunization days and supplementary immunization activities), RI, and both, were matched with 500 controls and identified using surveillance records. Sociodemographic characteristics, household information, and immunization history were assessed. Study outcomes included social-behavioral and cultural barriers and reasons for vaccine refusal. Data were analyzed in STATA using conditional logistic regression. RESULTS RI refusal was associated with illiteracy and fear of the vaccine's adverse effects, while OPV refusals were linked to the mother's decision authority and the assumption that the OPV caused infertility. Conversely, higher socioeconomic status (SES) and knowledge of and willingness to vaccinate with Inactivated Polio Vaccine (IPV) were inversely associated with RI; and lower SES, walking to the vaccination point, knowledge of IPV, and an understanding of contracting polio were inversely associated with OPV refusals, with the latter two also inversely associated with complete vaccine refusal. CONCLUSION Education, knowledge and understanding of vaccines, and socioeconomic determinants influenced OPV and RI refusals among children. Effective interventions are needed to address knowledge gaps and misconceptions among parents.
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Affiliation(s)
- Sajid Bashir Soofi
- Centre of Excellence in Women and Child Health, Aga Khan University, Karachi 74800, Pakistan
| | - Khadija Vadsaria
- Centre of Excellence in Women and Child Health, Aga Khan University, Karachi 74800, Pakistan
| | - Sara Mannan
- Centre of Excellence in Women and Child Health, Aga Khan University, Karachi 74800, Pakistan
| | - Muhammad Atif Habib
- Centre of Excellence in Women and Child Health, Aga Khan University, Karachi 74800, Pakistan
| | - Farhana Tabassum
- Institute for Global Health and Development, Aga Khan University, Karachi 74800, Pakistan
| | - Imtiaz Hussain
- Centre of Excellence in Women and Child Health, Aga Khan University, Karachi 74800, Pakistan
| | - Sajid Muhammad
- Centre of Excellence in Women and Child Health, Aga Khan University, Karachi 74800, Pakistan
| | - Khalid Feroz
- Centre of Excellence in Women and Child Health, Aga Khan University, Karachi 74800, Pakistan
| | - Imran Ahmed
- Centre of Excellence in Women and Child Health, Aga Khan University, Karachi 74800, Pakistan
| | - Muhammad Islam
- Centre for Global Child Health, The Hospital for Sick Children, 686 Bay Street, Toronto, ON M5G 0A4, Canada
| | - Zulfiqar A Bhutta
- Centre of Excellence in Women and Child Health, Aga Khan University, Karachi 74800, Pakistan
- Institute for Global Health and Development, Aga Khan University, Karachi 74800, Pakistan
- Centre for Global Child Health, The Hospital for Sick Children, 686 Bay Street, Toronto, ON M5G 0A4, Canada
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Abd Manaf NH, Omar MA, Suib FH. Vaccine hesitancy and implications on childhood immunisation in Malaysia. INTERNATIONAL JOURNAL OF HEALTH GOVERNANCE 2021. [DOI: 10.1108/ijhg-05-2021-0055] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposeThe World Health Organization identified vaccine hesitancy as one of the ten threats to global health in 2019. The purpose of this paper is to evaluate the implications and factors affecting parental decision on childhood immunisation in Malaysia.Design/methodology/approachThis paper reviews literature on vaccine hesitancy and evaluation of factors affecting parental decision on childhood immunisation in Malaysia.FindingsVaccine hesitancy is a growing public health concern in Malaysia with factors such as influence of Internet and social media, personal choice and individual right, conspiracy theory, religious reasons and alternative medicine as among the influencing dynamics. An urban, educated demography operating within a postmodern medical paradigm compounds the diminishing value of vaccines.Originality/valueThis paper provides a comprehensive examination of vaccine hesitancy in Malaysia. Critical appraisal on personal choice over societal responsibility within an Asian/Muslim collectivist society has not been discussed in previous studies. The acceptance of homeopathy as an Islamic medicine alternative is peculiar to multi-ethnic, multi-cultural Malaysia.
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Unvaccinated children as community parasites in National Qualitative Study from Turkey. BMC Public Health 2020; 20:1087. [PMID: 32652961 PMCID: PMC7353754 DOI: 10.1186/s12889-020-09184-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Accepted: 06/30/2020] [Indexed: 12/31/2022] Open
Abstract
Background This national qualitative study explores (1) the experiences, observations, and opinions of health care workers (HCWs) about beliefs, socioeconomic, cultural, and environmental characteristics of parents refusing vaccination and (2) regional differences in the identified risk factors; (3) recommended solutions to improve vaccine acceptance in each of 12 regions in Turkey. Methods In total, we carried out 14 individual semi-structured in-depth interviews and 10 focus group discussions with 163 HCWs from 36 provinces. A thematic analysis was performed to explore HCWs’ observations about the parents’ decisions to reject vaccination and possible solutions for vaccine advocacy. Results Within the analyzed data framework, vaccine refusal statements could be defined as vaccine safety, the necessity of vaccines, assumptions of freedom of choice, health workers’ vaccine hesitancy, lack of information about national vaccination schedule and components, not trusting the health system, anti-vaccine publications in social media and newspapers, and refugees. Suggestions based on the HCWs suggestions can be summarized as interventions including (1) creating visual cards with scientific data on vaccine content and disease prevention and using them in counseling patients, (2) writing the vaccine components in a way understandable to ordinary people, (3) highlighting the national quality control and production in the vaccine box and labels, (4) conducting interviews with community opinion leaders, (5) training anti-vaccine HCWs with insufficient scientific knowledge and (6) reducing the tax of parents whose children are fully and punctually vaccinated. Conclusions The solution to vaccine rejection begins with the right approaches to vaccination during pregnancy. Prepared written and visual information notes should present the information as “vaccination acceptance” rather than “vaccination refusal”. Further studies on vaccine refusal rates should be carried out in various regions of the world so that region-specific actions are implemented to decrease the anti-vaxxer movement and to prevent an outbreak of infectious diseases.
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Khoo YSK, Ghani AA, Navamukundan AA, Jahis R, Gamil A. Unique product quality considerations in vaccine development, registration and new program implementation in Malaysia. Hum Vaccin Immunother 2019; 16:530-538. [PMID: 31652090 PMCID: PMC7227723 DOI: 10.1080/21645515.2019.1667206] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
This review aims to present the unique considerations for manufacturing and the regulation of new vaccines in Muslim-populated countries such as Malaysia. Our specific objectives are to highlight vaccine production and the ingredients of concern, summarize the current mechanism for ruling and recommendations on new vaccines, outline the different steps in decision-making on incorporating a new vaccine into the National Immunization Program, describe its issues and challenges, and explore the commercial viability and challenges of producing local permissible (halal) vaccines. Through this review, we hope readers understand that alternatives are present to replace ingredients of concern in vaccines. Halal certification and introduction of a new vaccine into a program are strictly conducted and health-care providers must be prepared to educate the public on this. At the same time, it is hoped that the production of halal vaccine in Malaysia will promote self-reliance in Muslim-populated countries.
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Affiliation(s)
- Yvonne S K Khoo
- National Pharmaceutical Regulatory Agency, Ministry of Health, Malaysia, Petaling Jaya, Selangor, Malaysia
| | - A Ab Ghani
- National Pharmaceutical Regulatory Agency, Ministry of Health, Malaysia, Petaling Jaya, Selangor, Malaysia
| | | | - R Jahis
- Disease Control Division, Ministry of Health, Malaysia, Putrajaya, Malaysia
| | - A Gamil
- Pfizer Inc, Emerging Markets Vaccines Medical and Scientific Affairs, Dubai, United Arab Emirates
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