1
|
Liu S, Durantini MR, Calabrese C, Sanchez F, Albarracin D. A systematic review and meta-analysis of strategies to promote vaccination uptake. Nat Hum Behav 2024:10.1038/s41562-024-01940-6. [PMID: 39090405 DOI: 10.1038/s41562-024-01940-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 07/01/2024] [Indexed: 08/04/2024]
Abstract
Although immunization can dramatically curb the mortality and morbidity associated with vaccine-preventable diseases, vaccination uptake remains suboptimal in many areas of the world. Here, in this meta-analysis, we analysed the results from 88 eligible randomized controlled trials testing interventions to increase vaccination uptake with 1,628,768 participants from 17 countries with variable development levels (for example, Human Development Index ranging from 0.485 to 0.955). We estimated the efficacy of seven intervention strategies including increasing access to vaccination, sending vaccination reminders, providing incentives, supplying information, correcting misinformation, promoting both active and passive motivation and teaching behavioural skills. We showed that the odds of vaccination were 1.5 (95% confidence interval, 1.27 to 1.77) times higher for intervention than control conditions. Among the intervention strategies, using incentives and increasing access were most promising in improving vaccination uptake, with the access strategy being particularly effective in countries with lower incomes and less access to healthcare.
Collapse
Affiliation(s)
- Sicong Liu
- School of Physical Education and Sports Science, South China Normal University, Guangzhou, China.
- Annenberg Public Policy Center, University of Pennsylvania, Philadelphia, PA, USA.
| | - Marta R Durantini
- Annenberg Public Policy Center, University of Pennsylvania, Philadelphia, PA, USA
| | - Christopher Calabrese
- Annenberg Public Policy Center, University of Pennsylvania, Philadelphia, PA, USA
- College of Behavioral, Social and Health Sciences, Clemson University, Clemson, SC, USA
| | - Flor Sanchez
- Department of Psychology, Universidad Autónoma de Madrid, Madrid, Spain
| | - Dolores Albarracin
- Annenberg Public Policy Center, University of Pennsylvania, Philadelphia, PA, USA.
- Department of Psychology, University of Pennsylvania, Philadelphia, PA, USA.
- Annenberg School for Communication, University of Pennsylvania, Philadelphia, PA, USA.
| |
Collapse
|
2
|
Fallucca A, Priano W, Carubia A, Ferro P, Pisciotta V, Casuccio A, Restivo V. Effectiveness of Catch-Up Vaccination Interventions Versus Standard or Usual Care Procedures in Increasing Adherence to Recommended Vaccinations Among Different Age Groups: Systematic Review and Meta-Analysis of Randomized Controlled Trials and Before-After Studies. JMIR Public Health Surveill 2024; 10:e52926. [PMID: 39042433 PMCID: PMC11303899 DOI: 10.2196/52926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 04/16/2024] [Accepted: 04/30/2024] [Indexed: 07/24/2024] Open
Abstract
BACKGROUND To address the global challenge of vaccine hesitancy, the Strategic Advisory Group of Experts on Immunization strongly promotes vaccination reminder and recall interventions. Coupled with the new opportunities presented by scientific advancements, these measures are crucial for successfully immunizing target population groups. OBJECTIVE This systematic review and meta-analysis aims to assess the effectiveness of various interventions in increasing vaccination coverage compared with standard or usual care. The review will cover all vaccinations recommended for different age groups. METHODS In February 2022, 2 databases were consulted, retrieving 1850 studies. Following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, 79 manuscripts were included after the assessment phase. These comprised 46 trials/randomized controlled trials (RCTs) and 33 before-after studies. A meta-analysis using a random-effects model was performed with STATA software (version 14.1.2). The selected outcome was the risk ratio (RR) of vaccination coverage improvement effectiveness. Additionally, meta-regression analyses were conducted for the included manuscripts. RESULTS The analyses showed an overall efficacy of RR 1.22 (95% CI 1.19-1.26) for RCTs and RR 1.70 (95% CI 1.54-1.87) for before-after studies when considering all interventions cumulatively. Subgroup analyses identified multicomponent interventions (RR 1.58, 95% CI 1.36-1.85) and recall clinical interventions (RR 1.24, 95% CI 1.17-1.32) as the most effective in increasing vaccination coverage for RCTs. By contrast, educational interventions (RR 2.13, 95% CI 1.60-2.83) and multicomponent interventions (RR 1.61, 95% CI 1.43-1.82) achieved the highest increases for before-after studies. Meta-regression analyses indicated that the middle-aged adult population was associated with a higher increase in vaccination coverage (RCT: coefficient 0.54, 95% CI 0.12-0.95; before-after: coefficient 1.27, 95% CI 0.70-1.84). CONCLUSIONS Community, family, and health care-based multidimensional interventions, as well as education-based catch-up strategies, effectively improve vaccination coverage. Therefore, their systematic implementation is highly relevant for targeting undervaccinated population groups. This approach aligns with national vaccination schedules and aims to eliminate or eradicate vaccine-preventable diseases.
Collapse
Affiliation(s)
- Alessandra Fallucca
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialities, University of Palermo, Palermo, Italy
| | - Walter Priano
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialities, University of Palermo, Palermo, Italy
| | - Alessandro Carubia
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialities, University of Palermo, Palermo, Italy
| | - Patrizia Ferro
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialities, University of Palermo, Palermo, Italy
| | - Vincenzo Pisciotta
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialities, University of Palermo, Palermo, Italy
| | - Alessandra Casuccio
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialities, University of Palermo, Palermo, Italy
| | | |
Collapse
|
3
|
Oyo-Ita A, Oduwole O, Arikpo D, Effa EE, Esu EB, Balakrishna Y, Chibuzor MT, Oringanje CM, Nwachukwu CE, Wiysonge CS, Meremikwu MM. Interventions for improving coverage of childhood immunisation in low- and middle-income countries. Cochrane Database Syst Rev 2023; 12:CD008145. [PMID: 38054505 PMCID: PMC10698843 DOI: 10.1002/14651858.cd008145.pub4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/07/2023]
Abstract
BACKGROUND Immunisation plays a major role in reducing childhood morbidity and mortality. Getting children immunised against potentially fatal and debilitating vaccine-preventable diseases remains a challenge despite the availability of efficacious vaccines, particularly in low- and middle-income countries. With the introduction of new vaccines, this becomes increasingly difficult. There is therefore a current need to synthesise the available evidence on the strategies used to bridge this gap. This is a second update of the Cochrane Review first published in 2011 and updated in 2016, and it focuses on interventions for improving childhood immunisation coverage in low- and middle-income countries. OBJECTIVES To evaluate the effectiveness of intervention strategies to boost demand and supply of childhood vaccines, and sustain high childhood immunisation coverage in low- and middle-income countries. SEARCH METHODS We searched CENTRAL, MEDLINE, CINAHL, and Global Index Medicus (11 July 2022). We searched Embase, LILACS, and Sociological Abstracts (2 September 2014). We searched WHO ICTRP and ClinicalTrials.gov (11 July 2022). In addition, we screened reference lists of relevant systematic reviews for potentially eligible studies, and carried out a citation search for 14 of the included studies (19 February 2020). SELECTION CRITERIA Eligible studies were randomised controlled trials (RCTs), non-randomised RCTs (nRCTs), controlled before-after studies, and interrupted time series conducted in low- and middle-income countries involving children that were under five years of age, caregivers, and healthcare providers. DATA COLLECTION AND ANALYSIS We independently screened the search output, reviewed full texts of potentially eligible articles, assessed the risk of bias, and extracted data in duplicate, resolving discrepancies by consensus. We conducted random-effects meta-analyses and used GRADE to assess the certainty of the evidence. MAIN RESULTS Forty-one studies involving 100,747 participants are included in the review. Twenty studies were cluster-randomised and 15 studies were individually randomised controlled trials. Six studies were quasi-randomised. The studies were conducted in four upper-middle-income countries (China, Georgia, Mexico, Guatemala), 11 lower-middle-income countries (Côte d'Ivoire, Ghana, Honduras, India, Indonesia, Kenya, Nigeria, Nepal, Nicaragua, Pakistan, Zimbabwe), and three lower-income countries (Afghanistan, Mali, Rwanda). The interventions evaluated in the studies were health education (seven studies), patient reminders (13 studies), digital register (two studies), household incentives (three studies), regular immunisation outreach sessions (two studies), home visits (one study), supportive supervision (two studies), integration of immunisation services with intermittent preventive treatment of malaria (one study), payment for performance (two studies), engagement of community leaders (one study), training on interpersonal communication skills (one study), and logistic support to health facilities (one study). We judged nine of the included studies to have low risk of bias; the risk of bias in eight studies was unclear and 24 studies had high risk of bias. We found low-certainty evidence that health education (risk ratio (RR) 1.36, 95% confidence interval (CI) 1.15 to 1.62; 6 studies, 4375 participants) and home-based records (RR 1.36, 95% CI 1.06 to 1.75; 3 studies, 4019 participants) may improve coverage with DTP3/Penta 3 vaccine. Phone calls/short messages may have little or no effect on DTP3/Penta 3 vaccine uptake (RR 1.12, 95% CI 1.00 to 1.25; 6 studies, 3869 participants; low-certainty evidence); wearable reminders probably have little or no effect on DTP3/Penta 3 uptake (RR 1.02, 95% CI 0.97 to 1.07; 2 studies, 1567 participants; moderate-certainty evidence). Use of community leaders in combination with provider intervention probably increases the uptake of DTP3/Penta 3 vaccine (RR 1.37, 95% CI 1.11 to 1.69; 1 study, 2020 participants; moderate-certainty evidence). We are uncertain about the effect of immunisation outreach on DTP3/Penta 3 vaccine uptake in children under two years of age (RR 1.32, 95% CI 1.11 to 1.56; 1 study, 541 participants; very low-certainty evidence). We are also uncertain about the following interventions improving full vaccination of children under two years of age: training of health providers on interpersonal communication skills (RR 5.65, 95% CI 3.62 to 8.83; 1 study, 420 participants; very low-certainty evidence), and home visits (RR 1.29, 95% CI 1.15 to 1.45; 1 study, 419 participants; very low-certainty evidence). The same applies to the effect of training of health providers on interpersonal communication skills on the uptake of DTP3/Penta 3 by one year of age (very low-certainty evidence). The integration of immunisation with other services may, however, improve full vaccination (RR 1.29, 95% CI 1.16 to 1.44; 1 study, 1700 participants; low-certainty evidence). AUTHORS' CONCLUSIONS Health education, home-based records, a combination of involvement of community leaders with health provider intervention, and integration of immunisation services may improve vaccine uptake. The certainty of the evidence for the included interventions ranged from moderate to very low. Low certainty of the evidence implies that the true effect of the interventions might be markedly different from the estimated effect. Further, more rigorous RCTs are, therefore, required to generate high-certainty evidence to inform policy and practice.
Collapse
Affiliation(s)
- Angela Oyo-Ita
- Department of Community Health, University of Calabar Teaching Hospital, Calabar, Nigeria
| | - Olabisi Oduwole
- Department of Medical Laboratory Science, Achievers University, Owo, Nigeria
| | - Dachi Arikpo
- Cochrane Nigeria, Institute of Tropical Diseases Research and Prevention, University of Calabar Teaching Hospital, Calabar, Nigeria
| | - Emmanuel E Effa
- Internal Medicine, College of Medical Sciences, University of Calabar, Calabar, Nigeria
| | - Ekpereonne B Esu
- Department of Public Health, College of Medical Sciences, University of Calabar, Calabar, Nigeria
| | - Yusentha Balakrishna
- Biostatistics Unit, South African Medical Research Council, Durban, South Africa
| | - Moriam T Chibuzor
- Cochrane Nigeria, Institute of Tropical Diseases Research and Prevention, University of Calabar Teaching Hospital, Calabar, Nigeria
| | - Chioma M Oringanje
- GIDP Entomology and Insect Science, University of Tucson, Tucson, Arizona, USA
| | | | - Charles S Wiysonge
- Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa
- Vaccine-Preventable Diseases Programme, World Health Organization Regional Office for Africa, Cité du Djoué, Brazzaville, Congo
| | - Martin M Meremikwu
- Department of Paediatrics, University of Calabar Teaching Hospital, Calabar, Nigeria
| |
Collapse
|
4
|
Wang Y, Fekadu G, You JHS. Cost-Effectiveness Analyses of Digital Health Technology for Improving the Uptake of Vaccination Programs: Systematic Review. J Med Internet Res 2023; 25:e45493. [PMID: 37184916 DOI: 10.2196/45493] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 03/21/2023] [Accepted: 04/14/2023] [Indexed: 05/16/2023] Open
Abstract
BACKGROUND Vaccination is the most effective strategy to prevent infectious diseases, yet vaccination coverage has not reached the target level. To promote vaccination uptake, digital health interventions (DHIs) have been used in various vaccination programs. OBJECTIVE This study aimed to perform a systematic review of the cost-effectiveness analyses of DHIs for the improvement of the uptake of vaccination programs. METHODS A literature review was conducted in MEDLINE (Ovid), Embase (Ovid), APA PsycINFO (Ovid), Web of Science, Scopus, CINAHL Ultimate (EBSCOhost), Center for Review and Dissemination, and Institute for IEEE Xplore up to October 2022. Health economic evaluations that met the following inclusion criteria were included: (1) adult or pediatric vaccination programs; (2) interventions delivered through digital technology; (3) full-scale health economic analyses including cost-effectiveness, cost-utility, cost-benefit, or cost-consequence analyses; and (4) evaluations conducted by model-based or trial-based analyses. The quality of each included study was evaluated using the Consolidated Health Economic Evaluation Reporting Standards (CHEERS). RESULTS The systematic review included 7 studies. Four of the cost-effectiveness studies were conducted by model-based analyses, and 3 were trial-based analyses. One study reported the additional cost per quality-adjusted life years (QALYs) gained, whereas 6 studies reported the additional cost per individual vaccinated (or return case). The vaccines targeted the human papillomavirus (HPV) vaccine, influenza vaccination, measles-mumps-rubella (MMR) vaccine, and children immunization at different ages. The DHIs were delivered by television campaign, web-based decision aid, SMS text message, telephone, and computer-generated recall letters. The studies were classified as very good (n=5) and good (n=2) qualities. One study concluded that the DHI was cost-saving, and 6 studies concluded that the DHI was cost-effective. CONCLUSIONS This study is the first systematic review on cost-effectiveness analyses of DHIs to improve vaccination uptake. All included studies have good to very good quality on study assessment and reported the DHIs to be cost-saving or cost-effective in the improvement of vaccination uptake.
Collapse
Affiliation(s)
- Yingcheng Wang
- School of Pharmacy, The Chinese University of Hong Kong, Shatin, China (Hong Kong)
| | - Ginenus Fekadu
- School of Pharmacy, The Chinese University of Hong Kong, Shatin, China (Hong Kong)
| | - Joyce Hoi-Sze You
- School of Pharmacy, The Chinese University of Hong Kong, Shatin, China (Hong Kong)
| |
Collapse
|
5
|
Education increases COVID-19 vaccine uptake among people in Canadian federal prisons in a prospective randomized controlled trial: The EDUCATE study. Vaccine 2023; 41:1419-1425. [PMID: 36697314 PMCID: PMC9868384 DOI: 10.1016/j.vaccine.2023.01.040] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 01/13/2023] [Accepted: 01/17/2023] [Indexed: 01/25/2023]
Abstract
Education is key to behavioural adoption and acceptability of health interventions. We evaluated the impact of an educational intervention administered 1:1 to individuals incarcerated in four Canadian federal prisons on COVID-19 vaccine uptake. Eligible individuals (those who had refused all COVID-19 vaccines) were randomized 2:1 to receive the educational intervention or not (control group); those who received the intervention completed questionnaires assessing COVID-19 vaccine-related knowledge, attitudes, and beliefs pre- and post-educational intervention. The primary and secondary outcome measures were COVID-19 vaccine uptake and vaccine confidence, respectively. Between May 3 and September 9, 2022, 202 participants were randomized to receive the intervention, of whom 127 (63 %) agreed to participate. Participants who were randomized to the intervention had higher COVID-19 vaccine uptake vs. the control group (5 % vs 1 %, p = 0.046). COVID-19 vaccine-related knowledge, attitudes, and beliefs improved post-intervention. Education increases COVID-19 vaccine uptake and confidence among people in Canadian federal correctional facilities.
Collapse
|
6
|
Comparing the effect of parental education via both lecture and film upon vaccination uptake for children under one year of age: A cluster randomized clinical trial. Vaccine 2023; 41:1067-1073. [PMID: 36599735 DOI: 10.1016/j.vaccine.2022.12.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 11/25/2022] [Accepted: 12/01/2022] [Indexed: 01/03/2023]
Abstract
BACKGROUND AND AIM Vaccination is the most cost-effective action in preventing infectious diseases. Despite Iran's success in high vaccination coverage, in some areas there is a delay in vaccination. The aim of this study was to determine and compare the effect of education on immunization via lecture and film upon parental delay in vaccination uptake for children under 12 months of age. METHODS A multicentre cluster-randomized clinical trial with comprehensive urban health centres (CUHCs) in Shooshtar city, Khuzestan province, Iran as the unit of randomization was conducted. Overall, 8 CUHCs were randomized to receive education either via film (n = 165) or lecture (n = 164). In order to assign CUHCs to two groups, a simple random sampling method of coin tossing was used. Parents with children under 12 months and with a history of delayed vaccination were included in the study. Consecutive sampling was performed until the number needed for the cluster was reached. Interventions were delivered in small groups of 5-8 participants. Demographical data and clinical histories were collected from parents directly via a personal characteristic's questionnaire. Clinical data was extracted from vaccination records, the child's vaccine card and the vaccine information registration system. Statistical analyses of intervention effects were performed as per-protocol analysis. RESULTS In terms of individual characteristics and vaccine information significant differences between the two groups were only observed in relation to the parent of the participant, the child's gender, the number of children in the family, and timely injection of the vaccine in the previous child (p < 0.05). The chance of delay in vaccination after the intervention, without and considering the effect of intervening variables was 78 % and 74 % higher in the lecture group than in the film group, respectively (OR = 1.786, CI = 1.152-2.774 vs AOR = 1.743, CI = 1.011-3.007). Overall, 37.6 % of children in the film-based education group and 51.8 % of children in the lecture-based education group received their next vaccine with a delay of more than 7 days. CONCLUSION Education delivered via film can reduce the delay in vaccination more effectively. These findings, along with those of other studies conducted around the world suggest that multimedia education should be considered more widely in the field of education in children's vaccination.
Collapse
|
7
|
Romanchuk K, Linthwaite B, Cox J, Park H, Dussault C, Basta NE, Varsaneux O, Worthington J, Lebouché B, MacDonald SE, Ismail SJ, Kronfli N. Determinants of SARS-CoV-2 vaccine willingness among people incarcerated in 3 Canadian federal prisons: a cross-sectional study. CMAJ Open 2022; 10:E922-E929. [PMID: 36280247 PMCID: PMC9640165 DOI: 10.9778/cmajo.20210248] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Maximizing uptake of SARS-CoV-2 vaccines among people in prison is essential in mitigating future outbreaks. We aimed to determine factors associated with willingness to receive SARS-CoV-2 vaccination before vaccine availability. METHODS We chose 3 Canadian federal prisons based on their low uptake of influenza vaccines in 2019-2020. Participants completed a self-administered questionnaire on knowledge, attitude and beliefs toward vaccines. The primary outcome was participant willingness to receive a SARS-CoV-2 vaccine, measured using a 5-point Likert scale to the question, "If a safe and effective COVID-19 vaccine becomes available in prison, how likely are you to get vaccinated?" We calculated the association of independent variables (age, ethnicity, chronic health conditions, 2019-2020 influenza vaccine uptake and prison security level), identified a priori, with vaccine willingness using logistic regression and crude and adjusted odds ratios (ORs) with 95% confidence intervals (CIs). RESULTS We recruited 240 participants from Mar. 31 to Apr. 19, 2021 (median age 46 years; 19.2% female, 25.8% Indigenous). Of these, 178 (74.2%) were very willing to receive a SARS-CoV-2 vaccine. Participants who received the 2019-2020 influenza vaccine (adjusted OR 5.20, 95% CI 2.43-12.00) had higher odds of vaccine willingness than those who did not; those who self-identified as Indigenous (adjusted OR 0.27, 95% CI 0.11-0.60) and in medium- or maximum-security prisons (adjusted OR 0.36, 95% CI 0.12-0.92) had lower odds of vaccine willingness than those who identified as white or those in minimum-security prisons, respectively. INTERPRETATION Most participants were very willing to receive vaccination against SARS-CoV-2 before vaccine roll-out. Vaccine promotion campaigns should target groups with low vaccine willingness (i.e., those who have declined influenza vaccine, identify as Indigenous or reside in high-security prisons).
Collapse
Affiliation(s)
- Kathryn Romanchuk
- Centre for Outcomes Research and Evaluation (Romanchuk, Linthwaite, Cox, Park, Dussault, Lebouché, Kronfli), Research Institute of the McGill University Health Centre; Department of Epidemiology, Biostatistics and Occupational Health (Cox, Basta, Kronfli), School of Population and Global Health, McGill University; Department of Medicine (Cox, Lebouché, Kronfli), Division of Infectious Diseases and Chronic Viral Illness Service, McGill University Health Centre, Montréal, Que.; Correctional Service Canada (Varsaneux, Worthington), Ottawa, Ont.; Department of Family Medicine (Lebouché), McGill University, Montréal, Que.; Faculty of Nursing (MacDonald), University of Alberta; School of Public Health (MacDonald), University of Alberta, Edmonton, Alta.; Division of Immunization Programs and Pandemic Preparedness (Ismail), Centre for Immunization and Respiratory Infectious Diseases, Public Health Agency of Canada and Metro City Medical Clinic, Ottawa, Ont
| | - Blake Linthwaite
- Centre for Outcomes Research and Evaluation (Romanchuk, Linthwaite, Cox, Park, Dussault, Lebouché, Kronfli), Research Institute of the McGill University Health Centre; Department of Epidemiology, Biostatistics and Occupational Health (Cox, Basta, Kronfli), School of Population and Global Health, McGill University; Department of Medicine (Cox, Lebouché, Kronfli), Division of Infectious Diseases and Chronic Viral Illness Service, McGill University Health Centre, Montréal, Que.; Correctional Service Canada (Varsaneux, Worthington), Ottawa, Ont.; Department of Family Medicine (Lebouché), McGill University, Montréal, Que.; Faculty of Nursing (MacDonald), University of Alberta; School of Public Health (MacDonald), University of Alberta, Edmonton, Alta.; Division of Immunization Programs and Pandemic Preparedness (Ismail), Centre for Immunization and Respiratory Infectious Diseases, Public Health Agency of Canada and Metro City Medical Clinic, Ottawa, Ont
| | - Joseph Cox
- Centre for Outcomes Research and Evaluation (Romanchuk, Linthwaite, Cox, Park, Dussault, Lebouché, Kronfli), Research Institute of the McGill University Health Centre; Department of Epidemiology, Biostatistics and Occupational Health (Cox, Basta, Kronfli), School of Population and Global Health, McGill University; Department of Medicine (Cox, Lebouché, Kronfli), Division of Infectious Diseases and Chronic Viral Illness Service, McGill University Health Centre, Montréal, Que.; Correctional Service Canada (Varsaneux, Worthington), Ottawa, Ont.; Department of Family Medicine (Lebouché), McGill University, Montréal, Que.; Faculty of Nursing (MacDonald), University of Alberta; School of Public Health (MacDonald), University of Alberta, Edmonton, Alta.; Division of Immunization Programs and Pandemic Preparedness (Ismail), Centre for Immunization and Respiratory Infectious Diseases, Public Health Agency of Canada and Metro City Medical Clinic, Ottawa, Ont
| | - Hyejin Park
- Centre for Outcomes Research and Evaluation (Romanchuk, Linthwaite, Cox, Park, Dussault, Lebouché, Kronfli), Research Institute of the McGill University Health Centre; Department of Epidemiology, Biostatistics and Occupational Health (Cox, Basta, Kronfli), School of Population and Global Health, McGill University; Department of Medicine (Cox, Lebouché, Kronfli), Division of Infectious Diseases and Chronic Viral Illness Service, McGill University Health Centre, Montréal, Que.; Correctional Service Canada (Varsaneux, Worthington), Ottawa, Ont.; Department of Family Medicine (Lebouché), McGill University, Montréal, Que.; Faculty of Nursing (MacDonald), University of Alberta; School of Public Health (MacDonald), University of Alberta, Edmonton, Alta.; Division of Immunization Programs and Pandemic Preparedness (Ismail), Centre for Immunization and Respiratory Infectious Diseases, Public Health Agency of Canada and Metro City Medical Clinic, Ottawa, Ont
| | - Camille Dussault
- Centre for Outcomes Research and Evaluation (Romanchuk, Linthwaite, Cox, Park, Dussault, Lebouché, Kronfli), Research Institute of the McGill University Health Centre; Department of Epidemiology, Biostatistics and Occupational Health (Cox, Basta, Kronfli), School of Population and Global Health, McGill University; Department of Medicine (Cox, Lebouché, Kronfli), Division of Infectious Diseases and Chronic Viral Illness Service, McGill University Health Centre, Montréal, Que.; Correctional Service Canada (Varsaneux, Worthington), Ottawa, Ont.; Department of Family Medicine (Lebouché), McGill University, Montréal, Que.; Faculty of Nursing (MacDonald), University of Alberta; School of Public Health (MacDonald), University of Alberta, Edmonton, Alta.; Division of Immunization Programs and Pandemic Preparedness (Ismail), Centre for Immunization and Respiratory Infectious Diseases, Public Health Agency of Canada and Metro City Medical Clinic, Ottawa, Ont
| | - Nicole E Basta
- Centre for Outcomes Research and Evaluation (Romanchuk, Linthwaite, Cox, Park, Dussault, Lebouché, Kronfli), Research Institute of the McGill University Health Centre; Department of Epidemiology, Biostatistics and Occupational Health (Cox, Basta, Kronfli), School of Population and Global Health, McGill University; Department of Medicine (Cox, Lebouché, Kronfli), Division of Infectious Diseases and Chronic Viral Illness Service, McGill University Health Centre, Montréal, Que.; Correctional Service Canada (Varsaneux, Worthington), Ottawa, Ont.; Department of Family Medicine (Lebouché), McGill University, Montréal, Que.; Faculty of Nursing (MacDonald), University of Alberta; School of Public Health (MacDonald), University of Alberta, Edmonton, Alta.; Division of Immunization Programs and Pandemic Preparedness (Ismail), Centre for Immunization and Respiratory Infectious Diseases, Public Health Agency of Canada and Metro City Medical Clinic, Ottawa, Ont
| | - Olivia Varsaneux
- Centre for Outcomes Research and Evaluation (Romanchuk, Linthwaite, Cox, Park, Dussault, Lebouché, Kronfli), Research Institute of the McGill University Health Centre; Department of Epidemiology, Biostatistics and Occupational Health (Cox, Basta, Kronfli), School of Population and Global Health, McGill University; Department of Medicine (Cox, Lebouché, Kronfli), Division of Infectious Diseases and Chronic Viral Illness Service, McGill University Health Centre, Montréal, Que.; Correctional Service Canada (Varsaneux, Worthington), Ottawa, Ont.; Department of Family Medicine (Lebouché), McGill University, Montréal, Que.; Faculty of Nursing (MacDonald), University of Alberta; School of Public Health (MacDonald), University of Alberta, Edmonton, Alta.; Division of Immunization Programs and Pandemic Preparedness (Ismail), Centre for Immunization and Respiratory Infectious Diseases, Public Health Agency of Canada and Metro City Medical Clinic, Ottawa, Ont
| | - James Worthington
- Centre for Outcomes Research and Evaluation (Romanchuk, Linthwaite, Cox, Park, Dussault, Lebouché, Kronfli), Research Institute of the McGill University Health Centre; Department of Epidemiology, Biostatistics and Occupational Health (Cox, Basta, Kronfli), School of Population and Global Health, McGill University; Department of Medicine (Cox, Lebouché, Kronfli), Division of Infectious Diseases and Chronic Viral Illness Service, McGill University Health Centre, Montréal, Que.; Correctional Service Canada (Varsaneux, Worthington), Ottawa, Ont.; Department of Family Medicine (Lebouché), McGill University, Montréal, Que.; Faculty of Nursing (MacDonald), University of Alberta; School of Public Health (MacDonald), University of Alberta, Edmonton, Alta.; Division of Immunization Programs and Pandemic Preparedness (Ismail), Centre for Immunization and Respiratory Infectious Diseases, Public Health Agency of Canada and Metro City Medical Clinic, Ottawa, Ont
| | - Bertrand Lebouché
- Centre for Outcomes Research and Evaluation (Romanchuk, Linthwaite, Cox, Park, Dussault, Lebouché, Kronfli), Research Institute of the McGill University Health Centre; Department of Epidemiology, Biostatistics and Occupational Health (Cox, Basta, Kronfli), School of Population and Global Health, McGill University; Department of Medicine (Cox, Lebouché, Kronfli), Division of Infectious Diseases and Chronic Viral Illness Service, McGill University Health Centre, Montréal, Que.; Correctional Service Canada (Varsaneux, Worthington), Ottawa, Ont.; Department of Family Medicine (Lebouché), McGill University, Montréal, Que.; Faculty of Nursing (MacDonald), University of Alberta; School of Public Health (MacDonald), University of Alberta, Edmonton, Alta.; Division of Immunization Programs and Pandemic Preparedness (Ismail), Centre for Immunization and Respiratory Infectious Diseases, Public Health Agency of Canada and Metro City Medical Clinic, Ottawa, Ont
| | - Shannon E MacDonald
- Centre for Outcomes Research and Evaluation (Romanchuk, Linthwaite, Cox, Park, Dussault, Lebouché, Kronfli), Research Institute of the McGill University Health Centre; Department of Epidemiology, Biostatistics and Occupational Health (Cox, Basta, Kronfli), School of Population and Global Health, McGill University; Department of Medicine (Cox, Lebouché, Kronfli), Division of Infectious Diseases and Chronic Viral Illness Service, McGill University Health Centre, Montréal, Que.; Correctional Service Canada (Varsaneux, Worthington), Ottawa, Ont.; Department of Family Medicine (Lebouché), McGill University, Montréal, Que.; Faculty of Nursing (MacDonald), University of Alberta; School of Public Health (MacDonald), University of Alberta, Edmonton, Alta.; Division of Immunization Programs and Pandemic Preparedness (Ismail), Centre for Immunization and Respiratory Infectious Diseases, Public Health Agency of Canada and Metro City Medical Clinic, Ottawa, Ont
| | - Shainoor J Ismail
- Centre for Outcomes Research and Evaluation (Romanchuk, Linthwaite, Cox, Park, Dussault, Lebouché, Kronfli), Research Institute of the McGill University Health Centre; Department of Epidemiology, Biostatistics and Occupational Health (Cox, Basta, Kronfli), School of Population and Global Health, McGill University; Department of Medicine (Cox, Lebouché, Kronfli), Division of Infectious Diseases and Chronic Viral Illness Service, McGill University Health Centre, Montréal, Que.; Correctional Service Canada (Varsaneux, Worthington), Ottawa, Ont.; Department of Family Medicine (Lebouché), McGill University, Montréal, Que.; Faculty of Nursing (MacDonald), University of Alberta; School of Public Health (MacDonald), University of Alberta, Edmonton, Alta.; Division of Immunization Programs and Pandemic Preparedness (Ismail), Centre for Immunization and Respiratory Infectious Diseases, Public Health Agency of Canada and Metro City Medical Clinic, Ottawa, Ont
| | - Nadine Kronfli
- Centre for Outcomes Research and Evaluation (Romanchuk, Linthwaite, Cox, Park, Dussault, Lebouché, Kronfli), Research Institute of the McGill University Health Centre; Department of Epidemiology, Biostatistics and Occupational Health (Cox, Basta, Kronfli), School of Population and Global Health, McGill University; Department of Medicine (Cox, Lebouché, Kronfli), Division of Infectious Diseases and Chronic Viral Illness Service, McGill University Health Centre, Montréal, Que.; Correctional Service Canada (Varsaneux, Worthington), Ottawa, Ont.; Department of Family Medicine (Lebouché), McGill University, Montréal, Que.; Faculty of Nursing (MacDonald), University of Alberta; School of Public Health (MacDonald), University of Alberta, Edmonton, Alta.; Division of Immunization Programs and Pandemic Preparedness (Ismail), Centre for Immunization and Respiratory Infectious Diseases, Public Health Agency of Canada and Metro City Medical Clinic, Ottawa, Ont.
| |
Collapse
|
8
|
Development of effective messages to promote maternal immunization in Kenya. Vaccine 2022; 40:3761-3770. [DOI: 10.1016/j.vaccine.2022.05.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 04/02/2022] [Accepted: 05/05/2022] [Indexed: 11/20/2022]
|
9
|
Lessard D, Ortiz-Paredes D, Park H, Varsaneux O, Worthington J, Basta NE, MacDonald SE, Lebouché B, Cox J, Ismail SJ, Kronfli N. Barriers and facilitators to COVID-19 vaccine acceptability among people incarcerated in Canadian federal prisons: A qualitative study. Vaccine X 2022; 10:100150. [PMID: 35243324 PMCID: PMC8883835 DOI: 10.1016/j.jvacx.2022.100150] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2021] [Revised: 01/24/2022] [Accepted: 02/16/2022] [Indexed: 12/16/2022] Open
Abstract
INTRODUCTION Canadian correctional institutions have been prioritized for COVID-19 vaccination given the multiple outbreaks that have occurred since the start of the pandemic. Given historically low vaccine uptake, we aimed to explore barriers and facilitators to COVID-19 vaccination acceptability among people incarcerated in federal prisons. METHODS Three federal prisons in Quebec, Ontario, and British Columbia (Canada) were chosen based on previously low influenza vaccine uptake among those incarcerated. Using a qualitative design, semi-structured interviews were conducted with a diverse sample (gender, age, and ethnicity) of incarcerated people. An inductive-deductive analysis of audio-recorded interview transcripts was conducted to identify and categorize barriers and facilitators within the Theoretical Domains Framework (TDF). RESULTS From March 22-29, 2021, a total of 15 participants (n = 5 per site; n = 5 women; median age = 43 years) were interviewed, including five First Nations people and six people from other minority groups. Eleven (73%) expressed a desire to receive a COVID-19 vaccine, including two who previously refused influenza vaccination. We identified five thematic barriers across three TDF domains: social influences (receiving strict recommendations, believing in conspiracies to harm), beliefs about consequences (believing that infection control measures will not be fully lifted, concerns with vaccine-related side effects), and knowledge (lack of vaccine-specific information), and eight thematic facilitators across five TDF domains: environmental context and resources (perceiving correctional employees as sources of outbreaks, perceiving challenges to prevention measures), social influences (receiving recommendations from trusted individuals), beliefs about consequences (seeking individual and collective protection, believing in a collective "return to normal", believing in individual privileges), knowledge (reassurance about vaccine outcomes), and emotions (having experienced COVID-19-related stress). CONCLUSIONS Lack of information and misinformation were important barriers to COVID-19 vaccine acceptability among people incarcerated in Canadian federal prisons. This suggests that educational interventions, delivered by trusted health care providers, may improve COVID-19 vaccine uptake going forward.
Collapse
Affiliation(s)
- David Lessard
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Canada
- Canadian Institutes of Health Research Strategy for Patient-Oriented Research Mentorship Chair in Innovative Clinical Trial in HIV, Research Institute of the McGill University Health Centre, Canada
| | - David Ortiz-Paredes
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Canada
| | - Hyejin Park
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Canada
| | | | | | - Nicole E. Basta
- Department of Epidemiology, Biostatistics and Occupational Health, School of Population and Global Health, McGill University, Canada
| | - Shannon E. MacDonald
- Faculty of Nursing, University of Alberta, Canada
- School of Public Health, University of Alberta, Canada
| | - Bertrand Lebouché
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Canada
- Canadian Institutes of Health Research Strategy for Patient-Oriented Research Mentorship Chair in Innovative Clinical Trial in HIV, Research Institute of the McGill University Health Centre, Canada
- Department of Family Medicine, McGill University, Canada
- Department of Medicine, Division of Infectious Diseases and Chronic Viral Illness Service, McGill University Health Centre, Canada
| | - Joseph Cox
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Canada
- Department of Epidemiology, Biostatistics and Occupational Health, School of Population and Global Health, McGill University, Canada
- Department of Medicine, Division of Infectious Diseases and Chronic Viral Illness Service, McGill University Health Centre, Canada
| | - Shainoor J. Ismail
- Division of Immunization Programs and Pandemic Preparedness, Centre for Immunization and Respiratory Infectious Diseases, Public Health Agency of Canada and Metro City Medical Clinic, Canada
| | - Nadine Kronfli
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Canada
- Department of Epidemiology, Biostatistics and Occupational Health, School of Population and Global Health, McGill University, Canada
- Department of Medicine, Division of Infectious Diseases and Chronic Viral Illness Service, McGill University Health Centre, Canada
| |
Collapse
|
10
|
Ortiz-Paredes D, Varsaneux O, Worthington J, Park H, MacDonald SE, Basta NE, Lebouché B, Cox J, Ismail SJ, Kronfli N. Reasons for COVID-19 vaccine refusal among people incarcerated in Canadian federal prisons. PLoS One 2022; 17:e0264145. [PMID: 35263350 PMCID: PMC8906611 DOI: 10.1371/journal.pone.0264145] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 02/03/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Vaccine uptake rates have been historically low in correctional settings. To better understand vaccine hesitancy in these high-risk settings, we explored reasons for COVID-19 vaccine refusal among people in federal prisons. METHODS Three maximum security all-male federal prisons in British Columbia, Alberta, and Ontario (Canada) were chosen, representing prisons with the highest proportions of COVID-19 vaccine refusal. Using a qualitative descriptive design and purposive sampling, individual semi-structured interviews were conducted with incarcerated people who had previously refused at least one COVID-19 vaccine until data saturation was achieved. An inductive-deductive thematic analysis of audio-recorded interview transcripts was conducted using the Conceptual Model of Vaccine Hesitancy. RESULTS Between May 19-July 8, 2021, 14 participants were interviewed (median age: 30 years; n = 7 Indigenous, n = 4 visible minority, n = 3 White). Individual-, interpersonal-, and system-level factors were identified. Three were particularly relevant to the correctional setting: 1) Risk perception: participants perceived that they were at lower risk of COVID-19 due to restricted visits and interactions; 2) Health care services in prison: participants reported feeling "punished" and stigmatized due to strict COVID-19 restrictions, and failed to identify personal benefits of vaccination due to the lack of incentives; 3) Universal distrust: participants expressed distrust in prison employees, including health care providers. INTERPRETATION Reasons for vaccine refusal among people in prison are multifaceted. Educational interventions could seek to address COVID-19 risk misconceptions in prison settings. However, impact may be limited if trust is not fostered and if incentives are not considered in vaccine promotion.
Collapse
Affiliation(s)
- David Ortiz-Paredes
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
| | | | | | - Hyejin Park
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
| | - Shannon E. MacDonald
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - Nicole E. Basta
- Department of Epidemiology, Biostatistics and Occupational Health, School of Population and Global Health, McGill University, Montreal, Quebec, Canada
| | - Bertrand Lebouché
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
- Department of Family Medicine, Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada
- Division of Infectious Diseases and Chronic Viral Illness Service, Department of Medicine, McGill University Health Centre, Montreal, Quebec, Canada
| | - Joseph Cox
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
- Department of Epidemiology, Biostatistics and Occupational Health, School of Population and Global Health, McGill University, Montreal, Quebec, Canada
- Division of Infectious Diseases and Chronic Viral Illness Service, Department of Medicine, McGill University Health Centre, Montreal, Quebec, Canada
| | - Shainoor J. Ismail
- Division of Immunization Programs and Pandemic Preparedness, Centre for Immunization and Respiratory Infectious Diseases, Public Health Agency of Canada, Ottawa, Ontario, Canada
- Metro City Medical Clinic, Edmonton, Alberta, Canada
| | - Nadine Kronfli
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
- Department of Epidemiology, Biostatistics and Occupational Health, School of Population and Global Health, McGill University, Montreal, Quebec, Canada
- Division of Infectious Diseases and Chronic Viral Illness Service, Department of Medicine, McGill University Health Centre, Montreal, Quebec, Canada
| |
Collapse
|
11
|
Lv K, Zhao J, Zhang P. The effect of community comprehensive nursing using scenario-based health education on the infant and young child immunization rates. Am J Transl Res 2021; 13:9663-9670. [PMID: 34540093 PMCID: PMC8430158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 04/02/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE To investigate the effect of community comprehensive nursing using scenario-based health education on the infant and young child immunization rates. METHODS Ninety-eight infants and young children who were given immunizations in our hospital were divided into two groups, with 49 participants in each group. The control group was administered routine nursing, and the research group underwent community comprehensive nursing using scenario-based health education. The vaccination rates, the mastery of vaccination knowledge before and after the nursing, the adverse effects, the compliance, the satisfaction with the nursing, and the incidence of medical disputes were recorded and analyzed. RESULTS The delayed vaccination rate was significantly lower in the research group than it was in the control group, and the timely vaccination rate in the research group was significantly higher than it was in the control group (P<0.05). There was no statistically significant difference in the incidences of medical disputes between the two groups (P>0.05). The basic and total vaccination awareness rates were significantly higher in the research group compared with the control group (P<0.05). The incidence of adverse effects in the research group was significantly lower than it was in the control group (P<0.05). The full and total compliance rates in the research group were both significantly higher than they were in the control group (P<0.05). The proportions of very satisfied and completely satisfied were both significantly higher in the research group compared to the control group (P<0.05). CONCLUSION In the infant and young child immunization program, community comprehensive nursing using scenario-based health education can effectively increase the vaccination rate, increase the parents' knowledge, enhance their compliance, reduce the adverse effects, and improve the satisfaction with the nursing.
Collapse
Affiliation(s)
- Kuihua Lv
- Daodejie Community Health Service Station, The Fifth People's Hospital of Ji'nan Ji'nan, Shandong Province, China
| | - Jie Zhao
- Daodejie Community Health Service Station, The Fifth People's Hospital of Ji'nan Ji'nan, Shandong Province, China
| | - Panfeng Zhang
- Daodejie Community Health Service Station, The Fifth People's Hospital of Ji'nan Ji'nan, Shandong Province, China
| |
Collapse
|
12
|
Horváth A. Acceptance of varicella vaccination. Hum Vaccin Immunother 2021; 17:1699-1702. [PMID: 33326320 DOI: 10.1080/21645515.2020.1843337] [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: 10/22/2022] Open
Abstract
Varicella is a common vaccine-preventable disease that usually presents in children as a mild infection; however, severe complications also occur. The burden of varicella is significant in the terms of incidence, complication, and hospitalization rate related to varicella and economic disease burden. Despite the evidence of overall positive effects of varicella vaccination, there are great differences in the implementation of varicella vaccination and in the uptake of the vaccine from country to country. Improving acceptance of varicella vaccination on the national and on the individual level would decrease the burden of the disease on the health of children and on health-care resources. In studies determining factors of parental acceptance of varicella vaccination questions specific for varicella vaccination were highlighted. Addressing these issues with open, evidence based communication is important to improve and maintain the trust of the public in varicella vaccination.
Collapse
Affiliation(s)
- Andrea Horváth
- Institute of Medical Microbiology, Semmelweis University, Budapest, Hungary
| |
Collapse
|
13
|
Langford AT. Health Communication and Decision Making about Vaccine Clinical Trials during a Pandemic. JOURNAL OF HEALTH COMMUNICATION 2020; 25:780-789. [PMID: 33719877 PMCID: PMC8765457 DOI: 10.1080/10810730.2020.1864520] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
The COVID-19 pandemic has magnified the importance of clinical trials for finding a safe and effective vaccine to protect against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes COVID-19. Although communication about vaccines and vaccine hesitancy were challenges long before COVID-19, the twin facts of a pandemic and an "infodemic" of health information, misinformation, and disinformation have raised new challenges for vaccine-related communication and decision-making. The goal of this commentary is to highlight strategies to improve communication and decision-making for adults considering participation in COVID-19 vaccine clinical trials. First, I present a general conceptual model for clinical trial participation that can be applied to various vaccine and other clinical trial contexts. Next, I introduce the ASK (Assume, Seek, Know) approach for enhancing clinical trial participation: (1) assume that all patients will want to know their options, (2) seek the counsel of stakeholders, and (3) know your numbers. The ideas presented in this commentary are intended to enhance vaccine-specific clinical trial communication, decision-making, and literacy, while dually offering strategies and resources that may help reduce vaccine hesitancy and increase vaccine uptake over time.
Collapse
Affiliation(s)
- Aisha T Langford
- Department of Population Health, NYU Grossman School of Medicine, New York, NY, USA
| |
Collapse
|
14
|
Hu Y, Chen Y, Liang H, Wang Y. Reliability and validity of a survey to identify vaccine hesitancy among parents in Changxing county, Zhejiang province. Hum Vaccin Immunother 2019; 15:1092-1099. [PMID: 30676850 DOI: 10.1080/21645515.2019.1572409] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
BACKGROUND To evaluate the validity and reliability of a survey to identify vaccine hesitancy among parents. METHODS Cross-sectional survey of parents of 19-35 month old children was conducted in Changxing County, Zhejiang Province, through a questionnaire developed for the survey of the vaccine hesitancy. Construct validity was assessed by linking parental responses to their child's immunization record. The association between mean% of days of under-immunization and the parental socio-demographics and the individual item response was explored via the univariate and multivariate analyses. Factor analysis was applied to confirm survey sub-domains and Cronbach's α to determine the internal consistency reliability of sub-domain scales. RESULTS We approached 336 households while 285 of them agreed to participate in this study. Education level and the parental 'score of vaccination hesitancy' were significantly associated with the mean% of days of under-immunization. Cronbach's coefficients for the 3 sub-domain scales created by re-grouping the questionnaire's items were 0.71, 0.83, and 0.72, respectively. CONCLUSIONS The survey represented a valid and reliable instrument to identify VHPs and it could help to screen parents to receive an intervention aimed at increasing acceptance of vaccinations.
Collapse
Affiliation(s)
- Yu Hu
- a Institute of Immunization and Prevention , Zhejiang Center for Disease Control and Prevention , Hangzhou , China
| | - Yaping Chen
- a Institute of Immunization and Prevention , Zhejiang Center for Disease Control and Prevention , Hangzhou , China
| | - Hui Liang
- a Institute of Immunization and Prevention , Zhejiang Center for Disease Control and Prevention , Hangzhou , China
| | - Ying Wang
- a Institute of Immunization and Prevention , Zhejiang Center for Disease Control and Prevention , Hangzhou , China
| |
Collapse
|