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Nasiri A, Farshidi H, Rezaei F, Dehdari T, Kazemi A, Rezapour H, Goshtaei M. Perceived barriers of migrants and refugees to vaccinate their children against Measles and polio: a study in Iran. Int J Equity Health 2023; 22:253. [PMID: 38057773 DOI: 10.1186/s12939-023-02075-2] [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: 09/11/2023] [Accepted: 12/04/2023] [Indexed: 12/08/2023] Open
Abstract
BACKGROUND This study examined the perceived barriers of migrants and refugees to vaccinating their children against measles and polio in Iran. METHODS First, an instrument was developed and validated through several steps. Next, 1,067 parents who had not vaccinated their children against polio and measles or had delayed receiving any dose of these two vaccines until the age of 15 were selected from 16 provinces and completed the instrument. Finally, the data were analyzed. RESULTS The results of the explanatory factor analysis showed that the perceived barriers affecting vaccination against polio and measles vaccines were categorized into five factors: low knowledge, negative attitude, communication challenges, lack of participation in vaccination programs, and problems related to migration and refugees. Additionally, the results indicated a significant difference in the mean score of perceived barriers based on participants' level of education, economic status, and nationality. CONCLUSION The identified barriers may provide a perspective for developing effective efforts in this area. Interventions should focus on parents with low education and poor economic status.
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Affiliation(s)
- Amir Nasiri
- Department of Health Education and Health Promotion, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Hossein Farshidi
- Rajaie Cardiovascular, Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Farshid Rezaei
- Health Education and Promotion Department, Deputy of Public Health, MOHME, Tehran, Iran
| | - Tahereh Dehdari
- Health Promotion Research Center, Iran University of Medical Sciences, Tehran, Iran.
| | - Afrouzeh Kazemi
- Health Education and Promotion Department, Deputy of Public Health, MOHME, Tehran, Iran
| | - Hamid Rezapour
- Health Education and Promotion Department, Deputy of Public Health, MOHME, Tehran, Iran
| | - Massomeh Goshtaei
- Health Education and Promotion Department, Deputy of Public Health, Iran University of Medical Sciences, Tehran, Iran
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Herzig van Wees S, Abunnaja K, Mounier-Jack S. Understanding and explaining the link between anthroposophy and vaccine hesitancy: a systematic review. BMC Public Health 2023; 23:2238. [PMID: 37957574 PMCID: PMC10644591 DOI: 10.1186/s12889-023-17081-w] [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: 10/27/2022] [Accepted: 10/27/2023] [Indexed: 11/15/2023] Open
Abstract
BACKGROUND Due to low vaccination uptake and measles outbreaks across Europe, public health authorities have paid increasing attention to anthroposophic communities. Public media outlets have further described these communities as vaccine refusers or "anti-vaxxers". The aim of this review was to understand the scope of the problem and explore assumptions about vaccination beliefs in anthroposophic communities. For the purpose of this review, we define anthroposophic communities as people following some/certain views more or less loosely connected to the philosophies of anthroposophy. The systematic review addresses three research questions and (1) collates evidence documenting outbreaks linked to anthroposophic communities, (2) literature on vaccination coverage in anthroposophic communities, and (3) lastly describes literature that summarizes theories and factors influencing vaccine decision-making in anthroposophic communities. METHODS This is a systematic review using the following databases: Medline, Web of Science, Psycinfo, and CINAHL. Double-blinded article screening was conducted by two researchers. Data was summarized to address the research questions. For the qualitative research question the data was analysed using thematic analysis with the assistance of Nvivo12.0. RESULTS There were 12 articles documenting 18 measles outbreaks linked to anthroposophic communities between the years 2000 and 2012. Seven articles describe lower vaccination uptake in anthroposophic communities than in other communities, although one article describes that vaccination coverage in low-income communities with a migrant background was lower than in the anthroposophic community they studied. We found eight articles examining factors and theories influencing vaccine decision making in anthroposophic communities. The qualitative analysis revealed four common themes. Firstly, there was a very broad spectrum of vaccine beliefs among the anthroposophic communities. Secondly, there was a consistent narrative about problems or concerns with vaccines, including toxicity and lack of trust in the system. Thirdly, there was a strong notion of the importance of making individual and well-informed choices as opposed to simply following the masses. Lastly, making vaccine choices different from public health guidelines was highly stigmatized by those outside of the anthroposophic community but also those within the community. CONCLUSION Continuing to further knowledge of vaccine beliefs in anthroposophic communities is particularly important in view of increasing measles rates and potential sudden reliance on vaccines for emerging diseases. However, popular assumptions about vaccine beliefs in anthroposophic communities are challenged by the data presented in this systematic review.
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Affiliation(s)
| | - Khadija Abunnaja
- Department of Global Public Health, Karolinska Institute, Stockholm, Sweden
| | - Sandra Mounier-Jack
- Department of Global Health and Development, London School of Hygiene and Tropical, London, UK
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Yeskendir A, Gusmanov A, Zhussupov B. Parental attitudes, beliefs and behaviors toward childhood and COVID-19 vaccines: A countrywide survey conducted in Kazakhstan examining vaccine refusal and hesitancy. Vaccine 2023; 41:6548-6557. [PMID: 37648608 DOI: 10.1016/j.vaccine.2023.08.063] [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: 06/01/2023] [Revised: 08/17/2023] [Accepted: 08/24/2023] [Indexed: 09/01/2023]
Abstract
BACKGROUND Vaccination rates worldwide have declined in recent years. This decrease is primarily driven by vaccine hesitancy, which remains understudied in Central Asia, including Kazakhstan. Furthermore, there is great concern about parental hesitancy toward COVID-19 vaccines, as previous studies have focused on adult vaccine hesitancy. The current study was conducted by UNICEF and funded by USAID to explore the drivers of routine and COVID-19 immunization behaviors among parents and caregivers in Kazakhstan. METHODS Using a cross-sectional methodology, researchers conducted 3081 face-to-face interviews with parents and caregivers of children aged 0-17 years across cities and villages in Kazakhstan. A tablet-based questionnaire (CAPI) was utilized, collecting participants' data on sociodemographic characteristics, childhood and COVID-19 vaccination behaviors, and potential drivers. RESULTS Total of 239 participants (7.8%) were found to previously refuse vaccination due to their own beliefs. Stronger belief that vaccines are efficacious (AdjOR = 0.47), stronger belief that childhood vaccines are safe and danger of vaccine-preventable diseases is high (AdjOR = 0.73), firmer trust in societal factors (AdjOR = 0.77) and positive attitudes of family members toward immunization (AdjOR = 0.6) were significantly associated with parental refusal of childhood vaccines. The large proportion of respondents (N = 2,634, 85.6%) missed the COVID-19 vaccination of their child or were unwilling to get vaccinated. Stronger belief that COVID-19 vaccines are safe and efficacious (AdjsOR = 0.18), lacking important information about COVID-19 vaccines (AdjOR = 1.25) and parents being unvaccinated against COVID-19 (AdjOR = 2.3) were significant predictors of vaccine hesitancy. CONCLUSION This study revealed numerous socio-demographic and behavioral factors significantly associated with parental refusal of childhood vaccines and hesitancy toward COVID-19 vaccines. Many parents not refusing vaccination possessed negative attitudes towards vaccines. Potential changes in their attitudes and beliefs of parents were observed compared to findings from pre-COVID era. Continuous monitoring of parental hesitancy, proper interventions and education of healthcare workers are suggested to reduce parental vaccine hesitancy.
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Affiliation(s)
- Alua Yeskendir
- UNICEF Kazakhstan National Consultant on COVID-19 Vaccine C4D/Demand Generation Activities, Kazakhstan.
| | - Arnur Gusmanov
- Department of Biomedical Sciences, Nazarbayev University School of Medicine, Astana, Kazakhstan.
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Social clustering of unvaccinated children in schools in the Netherlands. Epidemiol Infect 2022; 150:e200. [PMID: 36093608 PMCID: PMC9987017 DOI: 10.1017/s0950268822001455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
For the measles-mumps-rubella (MMR) vaccine, the World Health Organization-recommended coverage for herd protection is 95% for measles and 80% for rubella and mumps. However, a national vaccine coverage does not reflect social clustering of unvaccinated children, e.g. in schools of Orthodox Protestant or Anthroposophic identity in The Netherlands. To fully characterise this clustering, we estimated one-dose MMR vaccination coverages at all schools in the Netherlands. By combining postcode catchment areas of schools and school feeder data, each child in the Netherlands was characterised by residential postcode, primary and secondary school (referred to as school career). Postcode-level vaccination data were used to estimate vaccination coverages per school career. These were translated to coverages per school, stratified by school identity. Most schools had vaccine coverages over 99%, but major exceptions were Orthodox Protestant schools (63% in primary and 58% in secondary schools) and Anthroposophic schools (67% and 78%). School-level vaccine coverage estimates reveal strong clustering of unvaccinated children. The school feeder data reveal strongly connected Orthodox Protestant and Anthroposophic communities, but separated from one another. This suggests that even at a national one-dose MMR coverage of 97.5%, thousands of children per cohort are not protected by herd immunity.
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Skitarelić N, Vidaić M, Skitarelić N. Parents’ versus Grandparents’ Attitudes about Childhood Vaccination. CHILDREN 2022; 9:children9030345. [PMID: 35327717 PMCID: PMC8946897 DOI: 10.3390/children9030345] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 02/01/2022] [Accepted: 02/28/2022] [Indexed: 11/16/2022]
Abstract
Background: We investigated and compared practices and attitudes about childhood vaccination between young parents and their parents and identified influences and sources of information in the County of Zadar, Croatia. Methods: This research was conducted in six general practice and paediatric medical clinics. It included 300 volunteers, including 150 younger parents and 150 older grandparents. Information was collected with a survey questionnaire. The survey data were statistically processed. Results: The 300 participants were divided into 2 groups. Most of the respondents were married, employed, had a high school education, and had a good economic status, often with two children and living in the city. Generally, the attitude towards vaccination was positive. Healthcare workers made the most important influence on the decision for vaccination. The younger age group was significantly affected by social networks and the internet and wanted more information. They were afraid of the adjuvants in vaccines. The older respondents held that vaccination must be legally regulated and did not believe the anti-vaccine media headlines. Conclusions: Our respondents had positive attitudes towards childhood vaccination, noticed the benefits of vaccinating children, and held that untreated children represent a risk for the community. They were well informed and satisfied with the collaboration with medical professionals, although the media and social networks had some impact on attitudes.
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Affiliation(s)
- Nataša Skitarelić
- Department of Health Studies, University of Zadar, 23000 Zadar, Croatia; (M.V.); (N.S.)
- Zadar General Hospital, 23000 Zadar, Croatia
- Correspondence: ; Tel.: +385-23-400414
| | - Marija Vidaić
- Department of Health Studies, University of Zadar, 23000 Zadar, Croatia; (M.V.); (N.S.)
| | - Neven Skitarelić
- Department of Health Studies, University of Zadar, 23000 Zadar, Croatia; (M.V.); (N.S.)
- Zadar General Hospital, 23000 Zadar, Croatia
- Medicine Faculty, University of Rijeka, 51000 Rijeka, Croatia
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6
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Chang WH. A review of vaccine effects on women in light of the COVID-19 pandemic. Taiwan J Obstet Gynecol 2020; 59:812-820. [PMID: 33218394 PMCID: PMC7486065 DOI: 10.1016/j.tjog.2020.09.006] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/28/2020] [Indexed: 11/13/2022] Open
Abstract
The pandemic situation triggered by the spread of COVID-19 has caused great harm worldwide. More than six million people have been infected, and more than 360,000 of them have died. This is the worst catastrophe suffered by mankind in recent history. In the face of this severe disaster, people all over the world are frightened of the prospect of facing an outbreak or an annual recurrence. However, the development of a vaccine will help control the impact of COVID-19. Women in particular have been more seriously affected by the pandemic. Since the pressure and physical load they suffer are often greater than what men endure, women are more threatened by COVID-19. Though women have a poorer quality of life and work and face worse economic conditions, they also tend to have better physiological immunity than men, which can ease the effect of COVID-19. The early development of a vaccine against COVID-19 is an important issue that must take into consideration women's better immune response to the virus along with the technique of hormone regulation. Relevant research has been conducted on female-specific vaccines in the past, and women's issues were considered during those clinical trials to ensure that complications and antibody responses were positive and effective in women. National policies should also propose good strategies for women to be vaccinated. This could improve consciousness, give women a better vaccination experience, enhance their willingness to vaccinate, and protect them from COVID-19 infection.
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Affiliation(s)
- Wen-Han Chang
- Department of Medicine, Mackay Medical College, New Taipei, Taiwan; Department of Emergency Medicine, Mackay Memorial Hospital, Taipei, Taiwan; Mackay Medicine, Nursing and Management College, Taipei, Taiwan; Institute of Mechatronic Engineering, National Taipei University of Technology, Taipei, Taiwan; Graduate Institute of Injury Prevention and Control, College of Public Health and Nutrition, Taipei Medical University, Taipei, Taiwan; Department of Emergency, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
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Hunter PR, Colón-González FJ, Brainard J, Majuru B, Pedrazzoli D, Abubakar I, Dinsa G, Suhrcke M, Stuckler D, Lim TA, Semenza JC. Can economic indicators predict infectious disease spread? A cross-country panel analysis of 13 European countries. Scand J Public Health 2019; 48:351-361. [PMID: 31291826 DOI: 10.1177/1403494819852830] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Aims: It is unclear how economic factors impact on the epidemiology of infectious disease. We evaluated the relationship between incidence of selected infectious diseases and economic factors, including economic downturn, in 13 European countries between 1970 and 2010. Methods: Data were obtained from national communicable disease surveillance centres. Negative binomial forms of the generalised additive model (GAM) and the generalised linear model were tested to see which best reflected transmission dynamics of: diphtheria, pertussis, measles, meningococcal disease, hepatitis B, gonorrhoea, syphilis, hepatitis A and salmonella. Economic indicators were gross domestic product per capita (GDPpc), unemployment rates and (economic) downturn. Results: GAM models produced the best goodness-of-fit results. The relationship between GDPpc and disease incidence was often non-linear. Strength and directions of association between population age, tertiary education levels, GDPpc and unemployment were disease dependent. Overdispersion for almost all diseases validated the assumption of a negative binomial relationship. Downturns were not independently linked to disease incidence. Conclusions: Social and economic factors can be correlated with many infections. However, the trend is not always in the same direction, and these associations are often non-linear. Economic downturn or recessions as indicators of increased disease risk may be better replaced by GDPpc or unemployment measures.
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Affiliation(s)
| | | | | | | | - Debora Pedrazzoli
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, UK
| | | | - Girmaye Dinsa
- T.H. Chan School of Public Health, Harvard University, USA
| | - Marc Suhrcke
- Centre for Health Economics, University of York, UK
| | | | - Tek-Ang Lim
- Science and International Office, French Public Health Agency, France
| | - Jan C Semenza
- European Centre for Disease Prevention and Control (ECDC), Sweden
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Gualano MR, Bert F, Voglino G, Buttinelli E, D'Errico MM, De Waure C, Di Giovanni P, Fantini MP, Giuliani AR, Marranzano M, Masanotti G, Massimi A, Nante N, Pennino F, Squeri R, Stefanati A, Signorelli C, Siliquini R. Attitudes towards compulsory vaccination in Italy: Results from the NAVIDAD multicentre study. Vaccine 2018; 36:3368-3374. [PMID: 29729995 DOI: 10.1016/j.vaccine.2018.04.029] [Citation(s) in RCA: 61] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Revised: 03/26/2018] [Accepted: 04/11/2018] [Indexed: 11/29/2022]
Abstract
BACKGROUND Vaccine hesitancy is a considerable issue in European countries and leads to low coverage rates. After a long debate, Italy has made vaccination mandatory for admission to its schools. METHODS In the NAVIDAD study (a cross-sectional multicentre study), a 63-item questionnaire was administered to 1820 pregnant women from 15 Italian cities. The questionnaire assessed the interviewee's opinion on mandatory vaccines, as well as their socioeconomic status, sources of information about vaccines, confidence in the Italian National Healthcare Service (NHS), and intention to vaccinate their newborn. RESULTS Information sources play a key role in determining the opinion on restoration of mandatory vaccines; in particular, women who obtained information from anti-vaccination movements are less likely to accept the vaccines (OR: 0.35, 95% CI: 0.21-0.58, p < 0.001). Women who had confidence in healthcare professional information agreed more on mandatory vaccination than did the other women (OR: 2.66, 95% CI: 1.62-4.36, p < 0.001); those who perceived that healthcare professionals have economic interest in child immunization and who declared that healthcare providers inform only on vaccinations benefits not on risks were less likely to agree on compulsory vaccination (OR: 0.66, CI 95%: 0.46-0.96, p = 0.03; OR: 0.66, CI 95%: 0.46-0.95, p = 0.03, respectively). CONCLUSION Information sources and confidence towards health professionals are the main determinants of acceptance of mandatory vaccine restoration. To increase the acceptability of the restoration and reduce vaccine hesitancy, these aspects need to be strengthened.
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Affiliation(s)
- M R Gualano
- Department of Public Health, University of Torino, Italy
| | - F Bert
- Department of Public Health, University of Torino, Italy
| | - G Voglino
- Department of Public Health, University of Torino, Italy.
| | - E Buttinelli
- Postgraduate School of Public Health, Department of Biomedical Sciences for Health, University of Milan, Italy
| | - M M D'Errico
- Department of Biomedical Sciences and Public Health, Università Politecnica delle Marche, Ancona, Italy
| | - C De Waure
- Institute of Public Health, Section of Hygiene, Catholic University of the Sacred Heart, Rome, Italy
| | - P Di Giovanni
- Department of Pharmacy, Università degli Studi "G. D'Annunzio" of Chieti-Pescara, Italy
| | - M P Fantini
- Department of Biomedical and Neuromotor Sciences (DIBINEM) University of Bologna, Bologna, Italy
| | - A R Giuliani
- Department of Life, Health and Environmental Sciences, University of L'Aquila, Italy
| | - M Marranzano
- Department of Medical and Surgical Sciences and Advanced Technologies "G.F. Ingrassia", Section of Hygiene and Preventive Medicine, University of Catania, Catania, Italy
| | - G Masanotti
- Public Health Section, Department of Experimental Medicine, University of Perugia, Perugia, Italy
| | - A Massimi
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - N Nante
- Post Graduate School of Public Health, University of Siena, Siena, Italy
| | - F Pennino
- Department of Public Health, University of Naples "Federico II", Italy
| | | | - A Stefanati
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - C Signorelli
- Department of Morphology, Surgery and Experimental Medicine, Section of Obstetrics and Gynecology, University of Ferrara, Ferrara, Italy
| | - R Siliquini
- Department of Public Health, University of Torino, Italy
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Wang X, Zhou X, Leesa L, Mantwill S. The Effect of Vaccine Literacy on Parental Trust and Intention to Vaccinate after a Major Vaccine Scandal. JOURNAL OF HEALTH COMMUNICATION 2018; 23:413-421. [PMID: 29589807 DOI: 10.1080/10810730.2018.1455771] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
Health literacy, and more specifically vaccine literacy, might be an important factor in reducing the negative effects of exposure to misleading reports on vaccination. This study explores the association between vaccine literacy and vaccination-related outcomes after misleading reports on a scandal concerning locally produced childhood vaccines had emerged in 2016 in China. Data for this study came from a cross-sectional survey, which was conducted in April 2016 in Hangzhou, China. Data were collected in kindergartens and community health centers among parents of children up to 6 years of age. Data were analyzed for 1864 participants. Binary logistic regression models showed that, after controlling for socio-demographics and children's age, parents who had better vaccine literacy (<0.05) were more likely to trust and choose domestically produced vaccines, which account for about 95% of the total vaccinations in China. This study provides evidence on a still largely understudied relationship between vaccine literacy and vaccination-related outcomes. Findings might suggest that higher literacy levels could reduce some of the negative effects of being exposed to misleading information on vaccination, eventually leading to less vaccination hesitancy.
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Affiliation(s)
- Xiaomin Wang
- a Institute for Social Medicine , Zhejiang University , Hangzhou , Zhejiang , China
- b Department of Social and Behavioral Sciences , Harvard T.H. Chan School of Public Health , Boston , Massachusetts , USA
- c Center for Community-Based Research , Dana-Farber Cancer Institute , Boston , Massachusetts , USA
| | - Xudong Zhou
- a Institute for Social Medicine , Zhejiang University , Hangzhou , Zhejiang , China
| | - Lin Leesa
- b Department of Social and Behavioral Sciences , Harvard T.H. Chan School of Public Health , Boston , Massachusetts , USA
- c Center for Community-Based Research , Dana-Farber Cancer Institute , Boston , Massachusetts , USA
- d Division of Policy Translation and Leadership Development , Harvard T.H. Chan School of Public Health , Boston , Massachusetts , USA
| | - Sarah Mantwill
- e Department of Health Sciences and Health Policy , University of Lucerne , Lucerne , Switzerland
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Karafillakis E, Larson HJ. The benefit of the doubt or doubts over benefits? A systematic literature review of perceived risks of vaccines in European populations. Vaccine 2017; 35:4840-4850. [PMID: 28760616 DOI: 10.1016/j.vaccine.2017.07.061] [Citation(s) in RCA: 166] [Impact Index Per Article: 23.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Revised: 07/18/2017] [Accepted: 07/19/2017] [Indexed: 01/07/2023]
Abstract
OBJECTIVES The success of vaccination strategies depends in part on population perceptions of benefits and risks of vaccines and related confidence in vaccination. Better knowledge of public concerns about vaccines and what is driving them is needed to inform vaccination strategies and communications. This literature reviewer examined studies on vaccine and vaccination risk perceptions and concerns across European populations. METHODS A systematic literature review was conducted to identify studies published between 2004 and 2014 in Europe. A descriptive analysis was performed. FINDINGS A total of 145 articles were selected, most of which were conducted in the UK, the Netherlands and France and studied seasonal influenza, HPV and pandemic influenza vaccination. Across all countries and vaccines, the primary area of concern was vaccine safety, followed by perceptions of low likelihood of contracting vaccine-preventable diseases (VPDs), perceived low severity of VPDs, beliefs that vaccines do not work, and overall lack of information. Concerns were found to be vaccine-, country- and population-specific. CONCLUSION In addition to identifying concerns about vaccination in Europe, this study confirmed the notion that individuals have many safety concerns about vaccination and often believe that the risks of vaccination outweigh their benefits. More research needs to be conducted to explore the impact of different types of communication strategies, which would frame the benefits of vaccination as well as risks of not vaccinating. Strategies to better inform public perceptions of vaccines should include the provision of unbiased, comprehensive information tailored to population information needs, and delivered using multiple and new communication technologies such as social media.
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Affiliation(s)
- Emilie Karafillakis
- Vaccine Confidence Project, London School of Hygiene & Tropical medicine, London, United Kingdom
| | - Heidi J Larson
- Vaccine Confidence Project, London School of Hygiene & Tropical medicine, London, United Kingdom; Department of Global Health, University of Washington, Seattle, USA.
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Yitshak-Sade M, Davidovitch N, Novack L, Grotto I. Ethnicity and immunization coverage among schools in Israel. ETHNICITY & HEALTH 2016; 21:439-451. [PMID: 26304468 DOI: 10.1080/13557858.2015.1068281] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
OBJECTIVE Recent years have seen a global trend of declining immunization rates of recommended vaccines that is more pronounced among school-age children. Ethnic disparities in child immunization rates have been reported in several countries. We investigated an effect of ethnicity on the vaccination rates of immunizations routinely administered within schools in Israel. DESIGN Data were collected from the Ministry of Health database regarding immunization coverage for all registered Israeli schools (3736) in the years 2009-2011. Negative binomial regression was used to assess the association between school ethnicity and immunization coverage while controlling for school characteristics. RESULTS The lowest immunization coverage was found in Bedouin schools (median values of 75.1%, 81.5% and 0% for the first, second and eighth grades, respectively) in 2011. During this year, vaccination coverage in the first and second grades in Jewish schools was 1.51 and 1.35 times higher, respectively, compared to Bedouin schools. In the years 2009 and 2010, no significant increase in risk for lower vaccination rate was observed in Bedouin schools, and children in Arab and Druze schools were more likely to have been vaccinated. CONCLUSION The lower vaccination refusal rate found in Bedouin schools supports the hypothesis that difficulties related to accessibility constitute the main problem rather than noncompliance with the recommended vaccination protocol for school-age children, featuring higher socio-economic status groups. Our study emphasizes the importance of identifying, beyond the national-level data, subpopulation groups at risk for non-vaccination. This knowledge is essential to administrative-level policy-makers for the allocation of resources and the planning of intervention programs.
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Affiliation(s)
- Maayan Yitshak-Sade
- a Faculty of Health Sciences , Ben-Gurion University of the Negev , Beer-Sheva , Israel
- b Clinical Research Center , Soroka University Medical Center , Beer-Sheva , Israel
| | - Nadav Davidovitch
- c Department of Health Systems Management , Faculty of Health Sciences, Ben-Gurion University of the Negev , Beer-Sheva , Israel
| | - Lena Novack
- d Department of Public Health , Faculty of Health Sciences, Ben-Gurion University of the Negev , Beer-Sheva , Israel
| | - Itamar Grotto
- d Department of Public Health , Faculty of Health Sciences, Ben-Gurion University of the Negev , Beer-Sheva , Israel
- e Ministry of Health , Jerusalem , Israel
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Tashani M, Alfelali M, Azeem MI, Fatema FN, Barasheed O, Alqahtani AS, Tekin H, Rashid H, Booy R. Barriers of vaccinations against serious bacterial infections among Australian Hajj pilgrims. Postgrad Med 2016; 128:541-7. [PMID: 27233684 DOI: 10.1080/00325481.2016.1191956] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
OBJECTIVES Vaccination against serious bacterial infections is recommended for Hajj pilgrims. Although the uptake of mandatory vaccines among Hajj pilgrims is acceptable, the uptake of other recommended vaccines remains suboptimal. In this study, we have explored the barriers to vaccination against serious bacterial infections among Australian Hajj pilgrims. METHODS Travellers aged 18 years and older planning to attend Hajj in the years 2014 and 2015 were surveyed at the immunization clinic of the Children's Hospital at Westmead, Sydney, Australia. A questionnaire-based survey was conducted to explore pilgrims' vaccination histories for their previous visits to Mecca, the reasons for non-receipt of vaccination, and to assess knowledge about the transmission of infections. RESULTS A total of 300 participants aged 18-76 (median 41) years completed the survey. Most (233 [77.7%]) were born outside Australia. Overall, 113 (37.7%) had performed pilgrimage in the past; 19 (16.8%) of them reported receiving pneumococcal vaccine and 16 (14.1%) diphtheria, tetanus and pertussis (DTP) vaccine. Lack of awareness about the availability of the vaccines was the main reason for non-receipt of pneumococcal and DTP vaccines (respectively 41.1% and 44.7%). Most pilgrims (266 [88.7%]) believed that travel vaccines are necessary before embarking on a journey; however, some expressed concerns about adverse reactions (156 [52.0%]), cost (114 [38.0%]), and permissibility of the vaccine according to their religion (6 [2.0%]). Respectively, 187 (62.3%), 145 (48.3%) and 86 (28.7%) respondents did not correctly know how meningococcal and pneumococcal diseases and pertussis transmit. Nevertheless, most (256 [85.3%]) indicated that they trust their family doctor for medical information and most (203 [67.7%]) preferred to receive the medical information in English. CONCLUSION The uptake of recommended vaccines against serious bacterial infections among Australian Hajj pilgrims is low. Lack of awareness about the availability of vaccines, misperceptions surrounding the safety of vaccines and high cost are key barriers of uptake.
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Affiliation(s)
- Mohamed Tashani
- a National Centre for Immunisation Research and Surveillance (NCIRS) , The Children's Hospital at Westmead , Sydney , Australia.,b Discipline of Paediatrics and Child Health, Sydney Medical School , University of Sydney , Sydney , Australia
| | - Mohammad Alfelali
- a National Centre for Immunisation Research and Surveillance (NCIRS) , The Children's Hospital at Westmead , Sydney , Australia.,b Discipline of Paediatrics and Child Health, Sydney Medical School , University of Sydney , Sydney , Australia.,c Department of Family and Community Medicine, Faculty of Medicine in Rabigh , King Abdulaziz University , Jeddah , Saudi Arabia
| | - Mohammad Irfan Azeem
- a National Centre for Immunisation Research and Surveillance (NCIRS) , The Children's Hospital at Westmead , Sydney , Australia.,b Discipline of Paediatrics and Child Health, Sydney Medical School , University of Sydney , Sydney , Australia
| | - Fayeza Nusrat Fatema
- a National Centre for Immunisation Research and Surveillance (NCIRS) , The Children's Hospital at Westmead , Sydney , Australia
| | - Osamah Barasheed
- a National Centre for Immunisation Research and Surveillance (NCIRS) , The Children's Hospital at Westmead , Sydney , Australia.,b Discipline of Paediatrics and Child Health, Sydney Medical School , University of Sydney , Sydney , Australia.,d The Executive Administration of Research , King Abdullah Medical City (KAMC) , Makkah , Saudi Arabia
| | - Amani Salem Alqahtani
- a National Centre for Immunisation Research and Surveillance (NCIRS) , The Children's Hospital at Westmead , Sydney , Australia.,e School of Public Health , The University of Sydney , Sydney , Australia
| | - Hatice Tekin
- a National Centre for Immunisation Research and Surveillance (NCIRS) , The Children's Hospital at Westmead , Sydney , Australia
| | - Harunor Rashid
- a National Centre for Immunisation Research and Surveillance (NCIRS) , The Children's Hospital at Westmead , Sydney , Australia.,b Discipline of Paediatrics and Child Health, Sydney Medical School , University of Sydney , Sydney , Australia.,f Marie Bashir Institute for Infectious Diseases and Biosecurity, School of Biological Sciences and Sydney Medical School , University of Sydney , Sydney , Australia
| | - Robert Booy
- a National Centre for Immunisation Research and Surveillance (NCIRS) , The Children's Hospital at Westmead , Sydney , Australia.,b Discipline of Paediatrics and Child Health, Sydney Medical School , University of Sydney , Sydney , Australia.,f Marie Bashir Institute for Infectious Diseases and Biosecurity, School of Biological Sciences and Sydney Medical School , University of Sydney , Sydney , Australia.,g WHO Collaborating Centre for Mass Gatherings and High Consequence/High Visibility Events , Flinders University , Adelaide , Australia
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13
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Tabacchi G, Costantino C, Napoli G, Marchese V, Cracchiolo M, Casuccio A, Vitale F. Determinants of European parents' decision on the vaccination of their children against measles, mumps and rubella: A systematic review and meta-analysis. Hum Vaccin Immunother 2016; 12:1909-23. [PMID: 27163657 PMCID: PMC4964810 DOI: 10.1080/21645515.2016.1151990] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Low measles, mumps and rubella (MMR) immunization levels in European children highlight the importance of identifying determinants of parental vaccine uptake to implement policies for increasing vaccine compliance. The aim of this paper is to identify the main factors associated with partial and full MMR vaccination uptake in European parents, and combine the different studies to obtain overall quantitative measures. This activity is included within the ESCULAPIO project, funded by the Italian Ministry of Health. ORs and CIs were extracted, sources of heterogeneity explored and publication bias assessed. Forty-five papers were retrieved for the qualitative study, 26 of which were included in the meta-analysis. The following factors were associated with lower MMR vaccine uptake: misleading knowledge, beliefs and perceptions on vaccines (OR 0.57, CI 0.37-0.87); negative attitudes and behaviors toward vaccination (OR 0.71, CI 0.52-0.98); demographic characteristics, such as different ethnicity in Southern populations (OR 0.44, CI 0.31-0.61), higher child's age (OR 0.80, CI 0.76-0.85); low socio-economic status (OR 0.64, CI 0.51-0.80), especially low income (OR 0.39, CI 0.25-0.60) and education (OR 0.64, CI 0.48-0.84), high number of children (OR 0.54, CI 0.42-0.69), irregular marital status (OR 0.80, CI 0.66-0.96). The factors explaining heterogeneity were country location, administration modality, collection setting and responses reported on MMR alone or in combination. Findings from this study suggest policy makers to focus communication strategies on providing better knowledge, correct beliefs and perceptions on vaccines, and improving attitudes and behaviors in parents; and to target policies to people of ethnic minority from Southern Europe, low educated and deprived, with higher number of children and non-married marital status.
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Affiliation(s)
- Garden Tabacchi
- a Department of Sciences for Health Promotion and Mother-Child Care "G.D'Alessandro ", University of Palermo , Palermo , Italy
| | - Claudio Costantino
- a Department of Sciences for Health Promotion and Mother-Child Care "G.D'Alessandro ", University of Palermo , Palermo , Italy
| | - Giuseppe Napoli
- a Department of Sciences for Health Promotion and Mother-Child Care "G.D'Alessandro ", University of Palermo , Palermo , Italy
| | - Valentina Marchese
- a Department of Sciences for Health Promotion and Mother-Child Care "G.D'Alessandro ", University of Palermo , Palermo , Italy
| | - Manuela Cracchiolo
- a Department of Sciences for Health Promotion and Mother-Child Care "G.D'Alessandro ", University of Palermo , Palermo , Italy
| | - Alessandra Casuccio
- a Department of Sciences for Health Promotion and Mother-Child Care "G.D'Alessandro ", University of Palermo , Palermo , Italy
| | - Francesco Vitale
- a Department of Sciences for Health Promotion and Mother-Child Care "G.D'Alessandro ", University of Palermo , Palermo , Italy
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14
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van Lier A, Tostmann A, Harmsen IA, de Melker HE, Hautvast JLA, Ruijs WLM. Negative attitude and low intention to vaccinate universally against varicella among public health professionals and parents in the Netherlands: two internet surveys. BMC Infect Dis 2016; 16:127. [PMID: 26979822 PMCID: PMC4793755 DOI: 10.1186/s12879-016-1442-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2015] [Accepted: 02/22/2016] [Indexed: 11/10/2022] Open
Abstract
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.
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Affiliation(s)
- Alies van Lier
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), P.O. Box 1 (internal P.O. Box 75), 3720 BA, Bilthoven, The Netherlands.
| | - Alma Tostmann
- Academic Collaborative Centre AMPHI, Department of Primary and Community Care, Radboud university medical center, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands
| | - Irene A Harmsen
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), P.O. Box 1 (internal P.O. Box 75), 3720 BA, Bilthoven, The Netherlands.,Department of Work & Social Psychology, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands
| | - Hester E de Melker
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), P.O. Box 1 (internal P.O. Box 75), 3720 BA, Bilthoven, The Netherlands
| | - Jeannine L A Hautvast
- Regional Public Health Service 'GGD Gelderland-Zuid', P.O. Box 1120, 6501 BC, Nijmegen, The Netherlands.,Academic Collaborative Centre AMPHI, Department of Primary and Community Care, Radboud university medical center, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands
| | - Wilhelmina L M Ruijs
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), P.O. Box 1 (internal P.O. Box 75), 3720 BA, Bilthoven, The Netherlands.,Regional Public Health Service 'GGD Gelderland-Zuid', P.O. Box 1120, 6501 BC, Nijmegen, The Netherlands
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15
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Veldwijk J, van der Heide I, Rademakers J, Schuit AJ, de Wit GA, Uiters E, Lambooij MS. Preferences for Vaccination. Med Decis Making 2015; 35:948-58. [DOI: 10.1177/0272989x15597225] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2014] [Accepted: 06/05/2015] [Indexed: 11/17/2022]
Abstract
Purpose. The purpose of this study is to examine to what extent health literacy is associated with parental preferences concerning childhood vaccination. Methods. A cross-sectional study was conducted among 467 Dutch parents of newborns aged 6 weeks (response rate of 37%). A self-reported questionnaire was used to measure health literacy by means of Chew’s Set of Brief Screening Questions, as well as parental preferences for rotavirus vaccination by means of a discrete choice experiment. Five rotavirus-related characteristics were included (i.e., vaccine effectiveness, frequency of severe side effects, location of vaccination, protection duration, and out-of-pocket costs). Panel latent class models were conducted, and health literacy and educational level were added to the class probability model to determine the association between health literacy and study outcomes. Results. Lower educated and lower health literate respondents considered protection duration to be more important and vaccine effectiveness and frequency of severe side effects to be less important compared with higher educated and higher health literate respondents. While all respondents were willing to vaccinate against rotavirus when the vaccine was offered as part of the National Immunization Program, only lower educated and lower health literate parents were willing to vaccinate when the vaccine was offered on the free market. Conclusion: Health literacy is associated with parents’ preferences for rotavirus vaccination. Whether differences in vaccination decisions are actually due to varying preferences or might be better explained by varying levels of understanding should be further investigated. To contribute to more accurate interpretation of study results, it may be advisable that researchers measure and report health literacy when they study vaccination decision behavior.
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Affiliation(s)
- Jorien Veldwijk
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, the Netherlands (JV, IH, AJS, GAW, EU, MSL)
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands (JV, GAW)
- NIVEL, Netherlands Institute for Health Services Research, Utrecht, the Netherlands (IH, JR)
- Department of Health Sciences and EMGO Institute for Health and Care Research, VU University Amsterdam, Amsterdam, the Netherlands (AJS)
| | - Iris van der Heide
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, the Netherlands (JV, IH, AJS, GAW, EU, MSL)
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands (JV, GAW)
- NIVEL, Netherlands Institute for Health Services Research, Utrecht, the Netherlands (IH, JR)
- Department of Health Sciences and EMGO Institute for Health and Care Research, VU University Amsterdam, Amsterdam, the Netherlands (AJS)
| | - Jany Rademakers
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, the Netherlands (JV, IH, AJS, GAW, EU, MSL)
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands (JV, GAW)
- NIVEL, Netherlands Institute for Health Services Research, Utrecht, the Netherlands (IH, JR)
- Department of Health Sciences and EMGO Institute for Health and Care Research, VU University Amsterdam, Amsterdam, the Netherlands (AJS)
| | - A. Jantine Schuit
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, the Netherlands (JV, IH, AJS, GAW, EU, MSL)
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands (JV, GAW)
- NIVEL, Netherlands Institute for Health Services Research, Utrecht, the Netherlands (IH, JR)
- Department of Health Sciences and EMGO Institute for Health and Care Research, VU University Amsterdam, Amsterdam, the Netherlands (AJS)
| | - G. Ardine de Wit
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, the Netherlands (JV, IH, AJS, GAW, EU, MSL)
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands (JV, GAW)
- NIVEL, Netherlands Institute for Health Services Research, Utrecht, the Netherlands (IH, JR)
- Department of Health Sciences and EMGO Institute for Health and Care Research, VU University Amsterdam, Amsterdam, the Netherlands (AJS)
| | - Ellen Uiters
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, the Netherlands (JV, IH, AJS, GAW, EU, MSL)
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands (JV, GAW)
- NIVEL, Netherlands Institute for Health Services Research, Utrecht, the Netherlands (IH, JR)
- Department of Health Sciences and EMGO Institute for Health and Care Research, VU University Amsterdam, Amsterdam, the Netherlands (AJS)
| | - Mattijs S. Lambooij
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, the Netherlands (JV, IH, AJS, GAW, EU, MSL)
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands (JV, GAW)
- NIVEL, Netherlands Institute for Health Services Research, Utrecht, the Netherlands (IH, JR)
- Department of Health Sciences and EMGO Institute for Health and Care Research, VU University Amsterdam, Amsterdam, the Netherlands (AJS)
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16
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Kaaijk P, Kleijne DE, Knol MJ, Harmsen IA, Ophorst OJAE, Rots NY. Parents' attitude toward multiple vaccinations at a single visit with alternative delivery methods. Hum Vaccin Immunother 2015; 10:2483-9. [PMID: 25424960 PMCID: PMC4896758 DOI: 10.4161/hv.29361] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Last decades, the number of routine childhood vaccinations has increased considerably, which consequently has led to multiple vaccine injections per consultation. Implementation of additional vaccines will probably lead to more than 2 vaccine injections per consult, which might be a barrier for parents to vaccinate their child. A decrease in vaccination coverage, however, increases the risk of disease outbreaks. Less stressful alternative methods for vaccine delivery might lead to an increased acceptance of multiple childhood vaccinations by parents. The present questionnaire study was set up to explore the maximum number of vaccine injections per visit that is acceptable for parents, as well as to gauge parents’ attitude toward alternative needle-free methods for vaccine delivery. For this purpose, the parents’ opinion toward a jet injector, a patch, a microneedle system, and nasal spray device as methods for vaccine delivery was assessed. The majority of the 1154 participating parents indicated that 3 vaccine injections per visit was perceived as too much. Most participants had a positive attitude with respect to the jet injector and the patch as alternative vaccine delivery method, whereas the microneedle device and an intranasal spray device were not perceived as better than the conventional syringe by the parents. Parents indicated that both the jet injector and the patch might increase their acceptance of giving their children more than 2 vaccinations at the same time. This should encourage vaccine developers and manufacturers to put efforts in developing these delivery methods for their vaccines.
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Affiliation(s)
- Patricia Kaaijk
- a Netherlands Centre for Infectious Disease Control; National institute for Public Health and the Environment; Bilthoven, The Netherlands
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17
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Byström E, Lindstrand A, Likhite N, Butler R, Emmelin M. Parental attitudes and decision-making regarding MMR vaccination in an anthroposophic community in Sweden – A qualitative study. Vaccine 2014; 32:6752-7. [DOI: 10.1016/j.vaccine.2014.10.011] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2014] [Revised: 10/07/2014] [Accepted: 10/08/2014] [Indexed: 11/16/2022]
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18
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Immunization knowledge and practice among Malaysian parents: a questionnaire development and pilot-testing. BMC Public Health 2014; 14:1107. [PMID: 25346471 PMCID: PMC4226879 DOI: 10.1186/1471-2458-14-1107] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2014] [Accepted: 10/21/2014] [Indexed: 12/01/2022] Open
Abstract
Background Parents are the main decision makers for their children vaccinations. This fact makes parents’ immunization knowledge and practices as predictor factors for immunization uptake and timeliness. The aim of this pilot study was to develop a reliable and valid instrument in Malaysian language to measure immunization knowledge and practice (KP) of Malaysian parents. Methods A cross-sectional prospective pilot survey was conducted among 88 Malaysian parents who attended public health facilities that provide vaccinations. Translated immunization KP questionnaires (Bahasa Melayu version) were used. Descriptive statistics were applied, face and content validity were assessed, and internal consistency, test-retest reliability, and construct validity were determined. Results The mean ± standard deviation (SD) of the knowledge scores was 7.36 ± 2.29 and for practice scores was 7.13 ± 2.20. Good internal consistency was found for knowledge and practice items (Cronbach’s alpha = 0.757 and 0.743 respectively); the test-retest reliability value was 0.740 (p = 0.014). A panel of three specialist pharmacists who are experts in this field judged the face and content validity of the final questionnaire. Parents with up-to-date immunized children had significantly better knowledge and practice scores than parents who did not (p < 0.001 and p = 0.001 respectively), suggesting a good construct validity. A significant difference was found in knowledge and practice scores among parents’ age (p = 0.006 and p = 0.029 respectively) and place of living (p = 0.037 and p = 0.043). The parents’ knowledge level was positively associated with their practice toward immunization (Spearman’s rank correlation coefficient 0.310, p = 0.003). Conclusions The pilot study concluded that the Bahasa Melayu version of the immunization KP questionnaire has good reliability and validity for measuring the knowledge and practices of Malaysian parents and therefore this version can be used in future research.
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19
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van der Maas NA, Mollema L, Berbers GA, van Rooijen DM, van der Avoort HG, Conyn-Van Spaendonck MAE, de Melker HE, van der Klis FR. Immunity against poliomyelitis in the Netherlands, assessed in 2006 to 2007: the importance of completing a vaccination series. Euro Surveill 2014; 19:20705. [DOI: 10.2807/1560-7917.es2014.19.7.20705] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Binary file ES_Abstracts_Final_ECDC.txt matches
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Affiliation(s)
- N A van der Maas
- Epidemiology and Surveillance, Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - L Mollema
- Epidemiology and Surveillance, Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - G A Berbers
- Immunology of Infectious Diseases and Vaccines, Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - D M van Rooijen
- Immunology of Infectious Diseases and Vaccines, Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - H G van der Avoort
- Infectious Disease Research, Diagnostics and Screening, Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - M A E Conyn-Van Spaendonck
- Policy and advice, Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - H E de Melker
- Epidemiology and Surveillance, Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - F R van der Klis
- Immunology of Infectious Diseases and Vaccines, Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
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20
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Luyten J, Desmet P, Dorgali V, Hens N, Beutels P. Kicking against the pricks: vaccine sceptics have a different social orientation. Eur J Public Health 2013; 24:310-4. [PMID: 23813706 DOI: 10.1093/eurpub/ckt080] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND In any country, part of the population is sceptical about the utility of vaccination. To develop successful vaccination programmes, it is important to study and understand the defining characteristics of vaccine sceptics. Research till now mainly focused either on the underlying motives of vaccine refusal, or on socio-demographic differences between vaccine sceptics and non-sceptics. It remained till now unexplored whether both groups differ in terms of basic psychological dispositions. METHODS We held a population survey in a representative sample of the population in Flanders, Belgium (N = 1050), in which we investigated whether respondents' attitude to vaccination was associated with their basic disposition toward other community members or society in general, as measured by the Triandis and Gelfand social orientation scale. RESULTS We found that sceptics and non-sceptics have a different social orientation, even when several variables are controlled for. More specifically, vaccine sceptics scored significantly lower on both horizontal individualism and horizontal collectivism, indicating a lower disposition to see others as equals. CONCLUSION These findings need confirmation in the context of different countries. Such insights can be valuable to optimize the design of effective communication strategies on vaccination programmes.
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Affiliation(s)
- Jeroen Luyten
- 1 Centre for Health Economics Research and Modelling Infectious Diseases, Vaccine and Infectious Disease Institute, University of Antwerp, 2610 Wilrijk, Belgium
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21
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Steens A, Wielders CCH, Bogaards JA, Boshuizen HC, de Greeff SC, de Melker HE. Association between human papillomavirus vaccine uptake and cervical cancer screening in the Netherlands: implications for future impact on prevention. Int J Cancer 2012; 132:932-43. [PMID: 22689326 DOI: 10.1002/ijc.27671] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2011] [Accepted: 05/03/2012] [Indexed: 11/10/2022]
Abstract
Several countries recently added human papillomavirus (HPV) vaccination to cervical cancer screening in the effort to prevent cervical cancer. They include the Netherlands, where both programs are free. To estimate their combined future impact on cancer prevention, information is needed on the association between participation in vaccination now and in screening in the future and on what groups are at risk for nonparticipation. We studied the association between participation in screening by mothers and in vaccination by their daughters. Girls' vaccination status was matched by house-address with their mothers' screening participation. We estimated the effect on cancer incidence by means of computer simulation. We investigated risk groups for nonparticipation using multivariable multilevel logistic regression and calculated population-attributable fractions. Our results, based on 89% of girls invited for vaccination in 2009 (n = 337,368), show that vaccination status was significantly associated with mothers' screening participation (odds ratio: 1.54 [95% confidence interval: 1.51-1.57]). If a mother's screening is taken as proxy of a girl's future screening, only 13% of the girls will not participate in either program compared to 23% if screening alone is available. The positive association between vaccination and screening resulted in slightly lower model estimates of the impact of vaccination on cancer incidence, compared to estimates assuming no association. Girls with nonwestern ethnicities, with young mothers, who live in urban areas with low socioeconomic status, are at risk for nonparticipation. A significant part of potential nonscreeners may be reached through HPV vaccination. Estimates made before vaccination was introduced only slightly overestimated its impact on cervical cancer incidence.
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Affiliation(s)
- Anneke Steens
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
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