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Khoury G, Ward JK, Mancini J, Gagneux-Brunon A, Luong Nguyen LB. Health Literacy and Health Care System Confidence as Determinants of Attitudes to Vaccines in France: Representative Cross-Sectional Study. JMIR Public Health Surveill 2024; 10:e45837. [PMID: 38713494 PMCID: PMC11109853 DOI: 10.2196/45837] [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: 01/19/2023] [Revised: 10/05/2023] [Accepted: 01/25/2024] [Indexed: 05/08/2024] Open
Abstract
BACKGROUND Health literacy involves individuals' knowledge, personal skills, and confidence to take action to evaluate and appraise health-related information and improve their health or that of their community. OBJECTIVE This study aimed to analyze the association between health literacy and attitude toward vaccines, adjusted with other factors. METHODS We used the SLAVACO Wave 3, a survey conducted in December 2021 among a sample of 2022 individuals, representative of the French adult population. We investigated factors associated with the attitude toward vaccines using respondents' different sociodemographic data, health literacy levels, and the health care system confidence levels using a multinomial logistic regression analysis. RESULTS Among the participants, 440.4 (21.8%) were classified as "distrustful of vaccines in general," 729.2 (36.1%) were "selectively hesitant," and 852.4 (42.2%) were "nonhesitant." In our model, the level of health literacy was not statistically different between the "distrustful of vaccines in general" and the "selectively hesitant" (P=.48), but it was associated with being a "nonhesitant" (adjusted odds ratio [aOR] 1.86, 95% CI 1.25-2.76). The confidence in the health care system was a strong predictor for a "nonhesitant" attitude toward vaccines (aOR 12.4, 95% CI 7.97-19.2). We found a positive correlation of 0.34 (P<.001) between health literacy and confidence in the health care system, but the interaction term between health literacy and health care system confidence was not significant in our model. CONCLUSIONS Health literacy was associated with a "nonhesitant" attitude toward vaccines. The findings demonstrated that health literacy and confidence in the health care system are modestly correlated. Therefore, to tackle the subject of vaccine hesitancy, the main focus should be on increasing the population's confidence and on increasing their health literacy levels or providing vaccine information addressing the needs of less literate citizens.
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Affiliation(s)
- Georges Khoury
- CIC Cochin Pasteur, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Jeremy K Ward
- Cermes3, CNRS, INSERM, Université Paris Cité, Paris, France
| | - Julien Mancini
- Cancer, Biomedicine & Society Group, APHM, Hop Timone, Public Health Department (BIOSTIC), INSERM, IRD, ISSPAM, SESSTIM, Aix-Marseille University, Marseille, France
| | - Amandine Gagneux-Brunon
- Centre International de Recherche en Infectiologie, Team GIMAP, Inserm, U1111, CNRS, UMR530, CHU de Saint-Etienne, Saint-Etienne, France
| | - Liem Binh Luong Nguyen
- CIC Cochin Pasteur, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, Paris, France
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Chen H, Li Q, Zhang M, Gu Z, Zhou X, Cao H, Wu F, Liang M, Zheng L, Xian J, Chen Q, Lin Q. Factors associated with influenza vaccination coverage and willingness in the elderly with chronic diseases in Shenzhen, China. Hum Vaccin Immunother 2022; 18:2133912. [PMID: 36269145 DOI: 10.1080/21645515.2022.2133912] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Elderly individuals with chronic illnesses are more prone to get influenza. We aimed to investigate the factors associated with influenza coverage and willingness in chronic disease patients aged ≥60 years in Longhua district, Shenzhen City of southern China. Data collected in October 2020 were used in this work. The immunization status of older persons with chronic conditions and their willingness to receive the vaccine were assessed. Multivariable logistic regression was employed to determine the respective independent factors related to vaccination coverage and willingness for influenza. Only 4.8% of 5045 people were immunized against influenza, whereas 92.7% of the individuals agreed to receive the vaccine. Individuals between the ages of 70 and 79 (adjusted OR [aOR] 1.47, P = .012), those with higher education levels (aOR 1.53, P = .005 for high school; aOR 2.44, P < .001 for college or above), those who use of a family doctor (aOR 2.91, P < .001), those who frequently have physical examinations once a year (aOR 2.52, P < .001), and those who have never smoked (aOR 1.62, P = .018) were positively associated with the influenza vaccination. Meanwhile, older age was adversely linked with influenza vaccination willingness (aOR 0.68 for 70-79 years, P = .003; aOR 0.55 for≥80 years, P = .025) in contrast to those aged 60-69. High willingness to get vaccinated was more frequent in people with a high school diploma (aOR 1.33, P = .037). In this work, we observed that the coverage is poor but the immunization desire is high regarding influenza vaccination. Interestingly, older age was associated with higher coverage and lower willingness. These suggest that raising immunization rates among older people with chronic conditions and strengthening health education for caregivers should be the primary concerns.
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Affiliation(s)
- Hongbiao Chen
- Department of Epidemiology and Infectious Disease Control, Longhua Key Discipline of Public Health for the Prevention and Control of Infectious Diseases, Longhua Centre for Disease Control and Prevention, Shenzhen, Guangdong, China
| | - Qiushuang Li
- Department of Epidemiology, School of Public Health, Guangdong Provincial Key Laboratory of Tropical Disease Research, Southern Medical University, Guangzhou, Guangdong, China
| | - Minyi Zhang
- Department of Epidemiology, School of Public Health, Guangdong Provincial Key Laboratory of Tropical Disease Research, Southern Medical University, Guangzhou, Guangdong, China
| | - Zihao Gu
- Department of Epidemiology and Infectious Disease Control, Longhua Key Discipline of Public Health for the Prevention and Control of Infectious Diseases, Longhua Centre for Disease Control and Prevention, Shenzhen, Guangdong, China
| | - Xiaofeng Zhou
- Department of Epidemiology and Infectious Disease Control, Longhua Key Discipline of Public Health for the Prevention and Control of Infectious Diseases, Longhua Centre for Disease Control and Prevention, Shenzhen, Guangdong, China
| | - He Cao
- Department of Epidemiology and Infectious Disease Control, Longhua Key Discipline of Public Health for the Prevention and Control of Infectious Diseases, Longhua Centre for Disease Control and Prevention, Shenzhen, Guangdong, China
| | - Fei Wu
- Department of Epidemiology, School of Public Health, Guangdong Provincial Key Laboratory of Tropical Disease Research, Southern Medical University, Guangzhou, Guangdong, China
| | - Minyi Liang
- Department of Epidemiology, School of Public Health, Guangdong Provincial Key Laboratory of Tropical Disease Research, Southern Medical University, Guangzhou, Guangdong, China
| | - Liting Zheng
- Department of Epidemiology, School of Public Health, Guangdong Provincial Key Laboratory of Tropical Disease Research, Southern Medical University, Guangzhou, Guangdong, China
| | - Juxian Xian
- Department of Epidemiology, School of Public Health, Guangdong Provincial Key Laboratory of Tropical Disease Research, Southern Medical University, Guangzhou, Guangdong, China
| | - Qing Chen
- Department of Epidemiology, School of Public Health, Guangdong Provincial Key Laboratory of Tropical Disease Research, Southern Medical University, Guangzhou, Guangdong, China
| | - Qihui Lin
- Department of Epidemiology and Infectious Disease Control, Longhua Key Discipline of Public Health for the Prevention and Control of Infectious Diseases, Longhua Centre for Disease Control and Prevention, Shenzhen, Guangdong, China
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Kumar S, Shah Z, Garfield S. Causes of Vaccine Hesitancy in Adults for the Influenza and COVID-19 Vaccines: A Systematic Literature Review. Vaccines (Basel) 2022; 10:vaccines10091518. [PMID: 36146596 PMCID: PMC9503596 DOI: 10.3390/vaccines10091518] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 09/07/2022] [Accepted: 09/09/2022] [Indexed: 12/14/2022] Open
Abstract
Background: Vaccine hesitancy was labelled as one of the top ten threats to global health by the World Health Organization in 2019 and is associated with negative health outcomes. Previous reviews on cause of vaccines have not included vaccine hesitancy related to the COVID-19 vaccine. This review aimed to fill this gap by synthesising the findings of studies identifying causes of vaccine hesitancy to the COVID-19 and influenza vaccines. Methods: A systematic literature review was conducted. Searches were carried out in the PubMed, EMBASE and Cochrane databases. Following data extraction, a thematic analysis was conducted of the causes of vaccine hesitancy in adults for the influenza and COVID-19 vaccines. Results: Fourteen papers were included. Four themes were identified as causes of vaccine hesitancy comprising: concerns over safety, lack of trust, lack of need for vaccination and cultural reasons. While concerns over safety were found in all countries, some of these were specific to particular countries and cultures. Our findings suggest that scientific knowledge of vaccines and size of clinical trials during their development reduce vaccine hesitancy. However, pharmaceutical companies were not a trusted source of information. Conclusion: Our findings build on those of previous research to suggest specific information that may be helpful in addressing vaccine hesitancy. Targeted approaches from trusted sources are needed to address specific safety concerns.
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Affiliation(s)
- Simran Kumar
- University College London School of Pharmacy, London WC1N 1AX, UK
| | - Zayna Shah
- University College London School of Pharmacy, London WC1N 1AX, UK
| | - Sara Garfield
- University College London School of Pharmacy, London WC1N 1AX, UK
- Imperial College Healthcare NHS Trust, London W6 8RF, UK
- NIHR Imperial Patient Safety Translational Research Centre, London SW7 2AZ, UK
- Correspondence:
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Toma A, Crişan O. Improving the Pharmacists’ Response to Public Health Emergencies—Documentary Research on Online Resources Provided by National Pharmacists’ Associations. Int J Public Health 2022; 67:1604537. [PMID: 36090828 PMCID: PMC9448858 DOI: 10.3389/ijph.2022.1604537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Accepted: 07/28/2022] [Indexed: 11/25/2022] Open
Abstract
Objectives: Given the expanding role of pharmacists during COVID-19 pandemic, we aimed to investigate the approach of professional associations to supporting their practice and to find ways to improve their response to public health emergencies. Methods: We conducted documentary research on websites of seven national pharmacists’ associations, submitted the findings to a comparative thematic analysis, and made proposals of specific good practices. Results: Many great resources were provided by pharmacists’ associations in Australia, France, Spain, and the US. The similarities include scientific information on COVID-19 tests, treatments and vaccines, legal issues, and wellbeing management. The main differences were in developing medication management programs, supporting hospital pharmacists, helping families, or advocating for an equitable vaccination. In Finland, Hungary and Romania, the focus was on updating emerging information. Considering the need for better managing public health emergencies at organizational level, we suggested good practices regarding training and communication. Conclusion: Professional associations should develop preparedness and response plans for public health emergencies. Practical training and effective communication could improve the resilience of pharmacists and patients during pandemics, which could save lives.
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COVID-19 Disease and Vaccination: Knowledge, Fears, Perceptions and Feelings of Regret for Not Having Been Vaccinated among Hospitalized Greek Patients Suffering SARS-CoV-2 Infection. Infect Dis Rep 2022; 14:587-596. [PMID: 36005265 PMCID: PMC9408697 DOI: 10.3390/idr14040063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 08/04/2022] [Accepted: 08/05/2022] [Indexed: 11/17/2022] Open
Abstract
Background: The development of vaccines against COVID-19 has greatly altered the natural course of this infection, reducing the disease’s severity and patients’ hospitalization. However, hesitancy against vaccination remains an obstacle in the attempt to achieve appropriate herd immunity that could reduce the spread of SARS-CoV-2. The aim of this study was to investigate the perceptions and attitudes of COVID-19 patients hospitalized during the fourth pandemic wave in two Greek hospitals and assess whether their experience had changed their intentions regarding vaccination against COVID-19. Methods: This is a cross-sectional, questionnaire-based survey, conducted from 31 August 2021 to 18 February 2022 in the COVID-19 departments of two tertiary care hospitals. The questionnaire included questions regarding the patients’ educational level, knowledge and beliefs regarding SARS-CoV-2, personal protection measures, beliefs regarding vaccination, vaccination status, reasons for not been vaccinated against SARS-CoV-2, feelings of regret for not been vaccinated, and willingness to be vaccinated in the future. All adult patients with COVID-19 were eligible, regardless of their vaccination status against SARS-CoV-2. Results: In total, 162 patients agreed and participated in the study, with 97% of them suffering severe COVID-19. Their median age was 56 years, and 59.9% (97 patients) were male. Among them, 43.8% had been vaccinated against COVID-19. When unvaccinated patients were asked the reasons for not being vaccinated, the most frequent responses were that they were waiting for more scientific data, due to uncertainty about long-term consequences of the vaccine, and their fear of thrombosis. When at discharge, unvaccinated hospitalized COVID-19 patients were asked whether they would get vaccinated if they could turn time back, and 64.7% of them replied positively. Conclusions: The study reveals several patients’ fears and misconceptions and suggests that there is room for implementing measures that could reduce knowledge gaps allowing for improvement of vaccination rates against COVID-19.
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Goodwin R, Nguyen Luu LA, Wiwattanapantuwong J, Kovács M, Suttiwan P, Levin Y. Two-Tailed Dogs, Social Unrest and COVID-19 Vaccination: Politics, Hesitancy and Vaccine Choice in Hungary and Thailand. Vaccines (Basel) 2022; 10:vaccines10050789. [PMID: 35632545 PMCID: PMC9147869 DOI: 10.3390/vaccines10050789] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 05/10/2022] [Accepted: 05/11/2022] [Indexed: 02/01/2023] Open
Abstract
Background: A long tradition of research has shown an association between political orientation and vaccine uptake. However, we know little about political preferences and the choice of specific vaccines. Methods: We conducted two national surveys, in Hungary (Study 1, online, n = 1130) and Thailand (Study 2, on the street survey: n = 1052), testing associations between political allegiance, trust in government, vaccine willingness, and vaccine choice. Results: In Hungary, those supporting the government or on the political right were more willing to be vaccinated, with this association strongest for government approved vaccines. These respondents were also more likely to accept Chinese and Russian vaccines and reject the Moderna vaccine. In Thailand, vaccinated respondents reported greater trust in the government, with preference for AstraZeneca associated with support for pro-government political parties and preference for Pfizer with anti-government attitudes. Conclusions: Vaccine campaigns need to recognise the role of political loyalties not only in vaccine willingness, but in vaccine choice, especially given the mixing of vaccines across doses.
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Affiliation(s)
- Robin Goodwin
- Faculty of Psychology, University of Warwick, Coventry CV4 7AL, UK;
| | - Lan Anh Nguyen Luu
- Institute of Intercultural Psychology and Education, Eötvös Loránd University, 1075 Budapest, Hungary; (L.A.N.L.); (M.K.)
| | | | - Mónika Kovács
- Institute of Intercultural Psychology and Education, Eötvös Loránd University, 1075 Budapest, Hungary; (L.A.N.L.); (M.K.)
| | - Panrapee Suttiwan
- Faculty of Psychology, Chulalongkorn University, Bangkok 10330, Thailand;
| | - Yafit Levin
- Department of Social Work and Education, Ariel University, Ariel 4076414, Israel;
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Knowledge, Attitudes, Perceptions and Vaccination Acceptance/Hesitancy among the Community Pharmacists of Palermo’s Province, Italy: From Influenza to COVID-19. Vaccines (Basel) 2022; 10:vaccines10030475. [PMID: 35335106 PMCID: PMC8949300 DOI: 10.3390/vaccines10030475] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 03/15/2022] [Accepted: 03/16/2022] [Indexed: 12/04/2022] Open
Abstract
In Italy, following the start of the SARS-CoV-2 vaccination campaign, community pharmacies (CPs) were recruited on a voluntary basis in order to administer COVID-19 vaccines as part of their activities. The aim of the present study was to investigate the knowledge, attitudes, and practices regarding SARS-CoV-2 infection prevention, and vaccine acceptance/hesitancy towards COVID-19 and influenza vaccinations among the community pharmacists operating in the Palermo Province. A cross-sectional study was conducted, with two different questionnaires administered before and after the conduction of the vaccination campaign against SARS-CoV-2 at the COVID-19 vaccination center of the Palermo University Hospital (PUH). The baseline survey showed that 64% of community pharmacists (CPs) declared that they planned to vaccinate against SARS-CoV-2, and 58% were vaccinated against influenza during the 2020/2021 season. Factors significantly associated with willingness to receive the COVID-19 vaccination were confidence in vaccines (adjOR 1.76; CI 1.11–2.80), fear of contracting SARS-CoV-2 infection (adjOR 1.50; CI 1.06–2.11), considering COVID-19 vaccination to be the best strategy to counteract SARS-CoV-2 (adjOR 1.79; CI 1.39–2.29), and adherence to influenza vaccination during the 2020/2021 season (adjOR 3.25; CI 2.23–4.25). The adherence among CPs of the Palermo Province to COVID-19 vaccination was 96.5%. From the post-vaccination survey, the main reasons for changing opinions on vaccination adherence were the introduction of mandatory vaccinations, fear of contracting COVID-19, and limitations on work activities in the case of vaccine refusal. The achievement of very high COVID-19 vaccination coverage rates among healthcare professionals (HCPs) in the present study was mainly due to the mandatory vaccination policies; nevertheless, a willingness for COVID-19 vaccination was relatively high among pharmacists before the beginning of the vaccination campaign. HCPs and CPs should receive training on vaccination, which is recommended in the national immunization plan and is also suggested by the respondents in our study, in order to routinely re-evaluate their own vaccination profiles, as well as those of their patients.
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Psychological factors underpinning vaccine willingness in Israel, Japan and Hungary. Sci Rep 2022; 12:439. [PMID: 35013430 PMCID: PMC8748514 DOI: 10.1038/s41598-021-03986-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 12/08/2021] [Indexed: 02/07/2023] Open
Abstract
The spread of SARS-CoV-2 led to rapid vaccine development. However, there remains considerable vaccine hesitancy in some countries. We investigate vaccine willingness in three nations with very different vaccine histories: Israel, Japan and Hungary. Employing an ecological-systems approach we analyse associations between health status, individual cognitions, norms, trust in government, COVID-19 myths and willingness to be vaccinated, with data from three nationally representative samples (Israel, Jan. 2021, N = 1011; Japan, Feb. 2021, N = 997; Hungary, April 2021, N = 1130). Vaccine willingness was higher in Israel (74%) than Japan (51%) or Hungary (31%). In all three countries vaccine willingness was greatest amongst who would regret not being vaccinated and respondents who trusted their government. Multi-group latent class analysis identified three groups of COVID myths, with particular concern about alteration of DNA (Israel), allergies (Hungary) and infection from the vaccine (Japan). Intervention campaigns should address such cultural myths while emphasising both individual and social benefits of vaccination.
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