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Chen J, Shantakumar S, Si J, Gowindah R, Parikh R, Chan F, Chan M, Choi WS, Huang E, Huang KC, Huang LM, Kim H, Leong CK, Leong HN, Seo Y, Williams C, Wong ATY. Knowledge, attitude, and practice toward herpes zoster (HZ) and HZ vaccination: Concept elicitation findings from a multi-country study in the Asia Pacific. Hum Vaccin Immunother 2024; 20:2317446. [PMID: 38436584 PMCID: PMC10913700 DOI: 10.1080/21645515.2024.2317446] [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: 11/06/2023] [Accepted: 02/07/2024] [Indexed: 03/05/2024] Open
Abstract
Herpes zoster (HZ) is a prevalent disease characterized by a painful rash. A multi‑country study was conducted to elicit public and physician knowledge, attitude, and practice (KAP) toward HZ disease and vaccination for the assessment of local factors influencing HZ vaccine perceptions in four Asian-Pacific countries/territories One-to-one qualitative interviews were conducted in 2022, among the public (people aged ≥ 50 years, adults with parents aged ≥ 50 years, zoster vaccine live-vaccinated individuals aged ≥ 50 years in Republic of Korea, and HZ patients; n = 78) and physicians (general practitioners and specialists; n = 24). Themes surrounding KAP toward HZ and HZ vaccination were summarized using a thematic analysis. A substantial knowledge gap related to HZ was observed among the public, including its causes, long-term impacts, and the at-risk population. There was a low perceived risk of HZ and low general awareness of HZ vaccine availability, although country/territory-specific differences existed. Fear of HZ-associated pain contributed toward vaccination intent among HZ patients and adults with parents aged ≥ 50 years. HZ-naïve adults who were encouraged to receive the vaccine by others were not motivated to do so due to optimism bias. Physicians were perceived to be a reliable source of information. However, physicians did not always proactively discuss HZ vaccination due to time constraints and a perceived need to prioritize other vaccinations including influenza and pneumococcal vaccines. Initiatives are needed to improve public awareness of HZ and its complications, in terms of overall impact on individuals and society, and highlight the important role of physicians in recommending vaccination.
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Affiliation(s)
- Jing Chen
- Epidemiology and Health Outcomes, GSK, Singapore
| | | | | | | | | | - Felix Chan
- Division of Geriatric Medicine, University Department of Medicine, University of Hong Kong, Pok Fu Lam, Hong Kong
| | | | - Won Suk Choi
- Department of Internal Medicine, Korea University College of Medicine, Korea University Ansan Hospital, Ansan-si, Gyeonggi-do, Republic of Korea
| | | | - Kuo-Chin Huang
- Department of Family Medicine, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu City, Taiwan
| | - Li-Min Huang
- Department of Paediatrics, National Taiwan University Hospital, Taipei City, Taiwan
| | - Hyungwoo Kim
- Early Pipeline Vaccines, GSK, Rockville, MD, USA
| | | | | | - Yubin Seo
- Department of Internal Medicine, Kangnam Sacred Heart Hospital, Hallym University, Seoul, Republic of Korea
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Villanueva P, McDonald E, Croda J, Croda MG, Dalcolmo M, dos Santos G, Jardim B, Lacerda M, Lynn DJ, Marshall H, Oliveira RD, Rocha J, Sawka A, Val F, Pittet LF, Messina NL, Curtis N. Factors influencing adverse events following COVID-19 vaccination. Hum Vaccin Immunother 2024; 20:2323853. [PMID: 38445666 PMCID: PMC10936640 DOI: 10.1080/21645515.2024.2323853] [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: 10/28/2023] [Accepted: 02/23/2024] [Indexed: 03/07/2024] Open
Abstract
Various novel platform technologies have been used for the development of COVID-19 vaccines. In this nested cohort study among healthcare workers in Australia and Brazil who received three different COVID-19-specific vaccines, we (a) evaluated the incidence of adverse events following immunization (AEFI); (b) compared AEFI by vaccine type, dose and country; (c) identified factors influencing the incidence of AEFI; and (d) assessed the association between reactogenicity and vaccine anti-spike IgG antibody responses. Of 1302 participants who received homologous 2-dose regimens of ChAdOx1-S (Oxford-AstraZeneca), BNT162b2 (Pfizer-BioNTech) or CoronaVac (Sinovac), 1219 (94%) completed vaccine reaction questionnaires. Following the first vaccine dose, the incidence of any systemic reaction was higher in ChAdOx1-S recipients (374/806, 46%) compared with BNT162b2 (55/151, 36%; p = 0.02) or CoronaVac (26/262, 10%; p < 0.001) recipients. After the second vaccine dose, the incidence of any systemic reaction was higher in BNT162b2 recipients (66/151, 44%) compared with ChAdOx1-S (164/806, 20%; p < 0.001) or CoronaVac (23/262, 9%; p < 0.001) recipients. AEFI risk was higher in younger participants, females, participants in Australia, and varied by vaccine type and dose. Prior COVID-19 did not impact the risk of AEFI. Participants in Australia compared with Brazil reported a higher incidence of any local reaction (170/231, 74% vs 222/726, 31%, p < 0.001) and any systemic reaction (171/231, 74% vs 328/726, 45%, p < 0.001), regardless of vaccine type. Following a primary course of ChAdOx1-S or CoronaVac vaccination, participants who did not report AEFI seroconverted at a similar rate to those who reported local or systemic reactions. In conclusion, we found that the incidence of AEFI was influenced by participant age and COVID-19 vaccine type, and differed between participants in Australia and Brazil.
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Affiliation(s)
- Paola Villanueva
- Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia
- Infection, Immunity & Global Health, Murdoch Children’s Research Institute, Parkville, VIC, Australia
- Infectious Diseases, Royal Children’s Hospital Melbourne, Parkville, VIC, Australia
- Department of General Medicine, Royal Children’s Hospital Melbourne, Parkville, VIC, Australia
| | - Ellie McDonald
- Infection, Immunity & Global Health, Murdoch Children’s Research Institute, Parkville, VIC, Australia
| | - Julio Croda
- School of Medicine, Federal University of Mato Grosso do Sul, Campo Grande, MS, Brazil
- Fiocruz Mato Grosso do Sul, Fundação Oswaldo Cruz, Campo Grande, Mato Grosso do Sul, Brazil
- Yale School of Public Health, New Haven, CT, USA
| | - Mariana Garcia Croda
- School of Medicine, Federal University of Mato Grosso do Sul, Campo Grande, MS, Brazil
| | - Margareth Dalcolmo
- Helio Fraga Reference Center, Oswaldo Cruz Foundation Ministry of Health, Rio de Janeiro, Brazil
- Pontifical Catholic University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Glauce dos Santos
- Helio Fraga Reference Center, Oswaldo Cruz Foundation Ministry of Health, Rio de Janeiro, Brazil
| | - Bruno Jardim
- Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil
- Carlos Borborema Clinical Research Unit, Manaus, Brazil
| | - Marcus Lacerda
- Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil
| | - David J. Lynn
- Precision Medicine Theme, South Australian Health and Medical Research Institute, Adelaide, SA, Australia
- Flinders Health and Medical Research Institute, Flinders University, Bedford Park, SA, Australia
| | - Helen Marshall
- Robinson Research Institute and Adelaide Medical School, The University of Adelaide and Department of Paediatrics, Adelaide, SA, Australia
| | - Roberto D. Oliveira
- Nursing Course, State University of Mato Grosso do Sul, Dourados, MS, Brazil
- Graduate Program in Health Sciences, Federal University of Grande Dourados, Dourados, MS, Brazil
| | - Jorge Rocha
- Helio Fraga Reference Center, Oswaldo Cruz Foundation Ministry of Health, Rio de Janeiro, Brazil
| | - Alice Sawka
- Department of Thoracic Medicine, Royal Adelaide Hospital, Adelaide, SA, Australia
- University of Adelaide Medical School, Adelaide, SA, Australia
| | - Fernando Val
- Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil
- Carlos Borborema Clinical Research Unit, Manaus, Brazil
| | - Laure F. Pittet
- Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia
- Infection, Immunity & Global Health, Murdoch Children’s Research Institute, Parkville, VIC, Australia
- Infectious Diseases, Royal Children’s Hospital Melbourne, Parkville, VIC, Australia
- Infectious Diseases Unit, Department of Paediatrics, Gynaecology and Obstetrics, Faculty of Medicine, University of Geneva and University Hospitals of Geneva, Geneva, Switzerland
| | - Nicole L. Messina
- Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia
- Infection, Immunity & Global Health, Murdoch Children’s Research Institute, Parkville, VIC, Australia
| | - Nigel Curtis
- Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia
- Infection, Immunity & Global Health, Murdoch Children’s Research Institute, Parkville, VIC, Australia
- Infectious Diseases, Royal Children’s Hospital Melbourne, Parkville, VIC, Australia
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Comparcini D, Tomietto M, Pastore F, Nichol B, Miniscalco D, Flacco ME, Stefanizzi P, Tafuri S, Cicolini G, Simonetti V. Factors Influencing COVID-19 Vaccine Hesitancy in Pregnant and Breastfeeding/Puerperium Women: A Cross-Sectional Study. Vaccines (Basel) 2024; 12:772. [PMID: 39066410 PMCID: PMC11281372 DOI: 10.3390/vaccines12070772] [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: 06/01/2024] [Revised: 07/08/2024] [Accepted: 07/12/2024] [Indexed: 07/28/2024] Open
Abstract
Vaccination among pregnant and breastfeeding women is critical for protecting this vulnerable population and their children. COVID-19 vaccination is recommended both during pregnancy and breastfeeding; however, we still do not fully understand the determinants that influence hesitancy towards COVID-19 vaccination. This study aimed to identify the determinants of vaccine hesitancy in pregnant and breastfeeding, puerperium women. A multicenter, cross-sectional study, involving 435 pregnant and breastfeeding women, was conducted. Vaccination hesitancy was evaluated by administering the Vaccination Attitudes (VAX) Scale and the Zung Anxiety Self-Assessment Scale (SAS) was adopted to measure anxiety levels. Overall, 14% of the participants reported that they did not receive the COVID-19 vaccine, and 78.3% received their first dose during pregnancy or while breastfeeding. The descriptive statistics for the VAX scale showed a total mean score of 3.35 (±1.6), and 75% of participants reported an anxiety index equal to or lower than the threshold. Vaccine hesitancy increased as "adverse events after vaccination" increased (p < 0.01), while SAS levels positively correlated with the participants' mean age (p < 0.05). Investigating the factors influencing vaccine hesitancy enables the development of targeted health policies and SARS-CoV-2 vaccination programs.
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Affiliation(s)
- Dania Comparcini
- Interdisciplinary Department of Medicine, “Aldo Moro”, University of Bari, 70121 Bari, Italy; (P.S.); (S.T.)
| | - Marco Tomietto
- Department of Nursing, Midwifery and Health, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne NE1 8ST, UK;
| | - Francesco Pastore
- Department of Biomedicine and Prevention, TorVergata University, 00133 Roma, Italy;
| | - Bethany Nichol
- Department of Social Work, Education and Community Wellbeing, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne NE1 8ST, UK;
| | | | - Maria Elena Flacco
- Department of Environmental and Prevention Sciences, University of Ferrara, 44121 Ferrara, Italy;
| | - Pasquale Stefanizzi
- Interdisciplinary Department of Medicine, “Aldo Moro”, University of Bari, 70121 Bari, Italy; (P.S.); (S.T.)
| | - Silvio Tafuri
- Interdisciplinary Department of Medicine, “Aldo Moro”, University of Bari, 70121 Bari, Italy; (P.S.); (S.T.)
| | - Giancarlo Cicolini
- Department of Innovative Technologies in Medicine and Dentistry, “Gabriele D’Annunzio” University of Chieti, 66100 Chieti, Italy; (G.C.); (V.S.)
| | - Valentina Simonetti
- Department of Innovative Technologies in Medicine and Dentistry, “Gabriele D’Annunzio” University of Chieti, 66100 Chieti, Italy; (G.C.); (V.S.)
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Yu F, Jiao L, Chen Q, Wang Q, De Allegri M, Cao Z, Chen W, Ma X, Wang C, Wachinger J, Jin Z, Bunker A, Geldsetzer P, Yang J, Xue L, Bärnighausen T, Chen S. Preferences regarding COVID-19 vaccination among 12,000 adults in China: A cross-sectional discrete choice experiment. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0003387. [PMID: 38990924 PMCID: PMC11239003 DOI: 10.1371/journal.pgph.0003387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 05/28/2024] [Indexed: 07/13/2024]
Abstract
Understanding public preferences concerning vaccination is critical to inform pandemic response strategies. To investigate Chinese adults' preferences regarding COVID-19 vaccine attributes, we conducted a cross-sectional online survey in 12,000 Chinese adults in June-July, 2021. Participants were requested to answer a series of discrete choice questions related to hypothetical COVID-19 vaccines. Using mixed logit models, our analysis revealed that participants had a higher preference for COVID-19 vaccines with longer duration of protection (coefficient: 1.272, 95% confidence interval [1.016 to 1.529]) and higher efficacy (coefficient: 1.063, [0.840, 1.287]). Conversely, participants demonstrated a lower preference associated with higher risk of rare but serious side-effects (coefficient: -1.158, [-1.359, -0.958]), oral administration (coefficient: -0.211, [-0.377, -0.046]), more doses (coefficient: -0.148, [-0.296, 0.000]) and imported origin (coefficient: -0.653, [-0.864, -0.443]). Moreover, preferences were heterogeneous by individual factors: highly educated participants were more sensitive to the negative vaccine attributes including price (coefficient -0.312, [-0.370, -0.253]) and imported vaccine (coefficient -0.941, [-1.186, -0.697]); there was also substantial heterogeneity in vaccine preferences with respect to age group, marital status, work status, income, chronic diagnosis history, COVID-19 vaccination history and geographic regions. As the first study of examining the public preferences for COVID-19 vaccine in China with a large nationwide sample of 12,000 adults, our results indicate that future vaccine should pose lower risk, possess longer protection period, have higher efficacy, be domestically produced, and have lower costs to increase the COVID-19 vaccination coverage. Our current study findings from this study provide insights and recommendations for not only COVID-19 vaccine design but also vaccine attribute preferences to increase vaccine uptake in potential future pandemics.
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Affiliation(s)
- Fengyun Yu
- Interdisciplinary Centre for Scientific Computing, University of Heidelberg, Heidelberg, Germany
| | - Lirui Jiao
- Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Qiushi Chen
- The Harold and Inge Marcus Department of Industrial and Manufacturing Engineering, The Pennsylvania State University, University Park, Pennsylvania, United States of America
| | - Qun Wang
- Faculty of Humanities and Social Sciences, Dalian University of Technology, Dalian, China
| | - Manuela De Allegri
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany
| | - Zhong Cao
- State Key Lab of Intelligent Technologies and Systems, Department of Automation, Tsinghua University, Beijing, China
| | - Wenjin Chen
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Xuedi Ma
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Chao Wang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Jonas Wachinger
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany
| | - Zhangfeng Jin
- School of Economics, Zhejiang University of Technology, Hangzhou, China
| | - Aditi Bunker
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany
| | - Pascal Geldsetzer
- Department of Medicine, Division of Primary Care and Population Health, Stanford University School of Medicine, Stanford, California, United States of America
- Chan Zuckerberg Biohub – San Francisco, San Francisco, California, United States of America
| | - Juntao Yang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Lan Xue
- Institute for AI International Governance, Tsinghua University, Beijing, China
- School of Public Policy and Management, Tsinghua University, Beijing, China
| | - Till Bärnighausen
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Simiao Chen
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
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Fitzpatrick T, Yamoah P, Lacuesta G, Sadarangani M, Cook V, Pourshahnazari P, Kalicinsky C, Upton JEM, Cameron SB, Zaborniak K, Kanani A, Lam G, Burton C, Constantinescu C, Pernica JM, Abdurrahman Z, Betschel S, Drolet JP, De Serres G, Quach C, Des Roches A, Chapdelaine H, Salvadori MI, Carignan A, McConnell A, Pham-Huy A, Buchan CA, Cowan J, Hildebrand K, Top KA. Revaccination outcomes among adolescents and adults with suspected hypersensitivity reactions following COVID-19 vaccination: A Canadian immunization research network study. Vaccine 2024:S0264-410X(24)00719-9. [PMID: 38910092 DOI: 10.1016/j.vaccine.2024.06.045] [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: 02/22/2024] [Revised: 06/14/2024] [Accepted: 06/16/2024] [Indexed: 06/25/2024]
Abstract
BACKGROUND COVID-19 vaccination has been associated with anaphylaxis and hypersensitivity reactions. Infectious disease physicians and allergists in the Canadian Special Immunization Clinic (SIC) Network developed guidance for evaluating patients with adverse events following immunization (AEFI) including suspected hypersensitivity. This study evaluated management and adverse event recurrence following subsequent COVID-19 vaccinations. METHODS Individuals aged 12 years and older enrolled at participating SICs before February 28, 2023 who were referred for suspected or diagnosed hypersensitivity reaction following COVID-19 vaccination, or for prevaccination assessment of suspected allergy to a COVID-19 vaccine component were included. De-identified clinical assessments and revaccination data, captured in a centralized database, were analyzed. The Brighton Collaboration case definition (BCCD) for anaphylaxis (2023 version) was applied. RESULTS The analysis included 206 participants from 13 sites: 26 participants referred for pre-vaccination assessment and 180 participants referred for adverse events following COVID-19 vaccination (15/180 [8.3%] with BCCD confirmed anaphylaxis, 84 [46.7%] with immediate hypersensitivity symptoms not meeting BCCD, 33 [18.3%] with other diagnosed hypersensitivity reactions, and 48 [26.7%] participants with a final diagnosis of non-hypersensitivity AEFI). Among participants referred for AEFIs following COVID-19 vaccination, 166/180 (92.2%) were recommended for COVID-19 revaccination after risk assessment, of whom 158/166 (95.2%) were revaccinated (all with a COVID-19 mRNA vaccine). After revaccination, 1/15 (6.7%) participants with prior anaphylaxis, 1/77 (1.3%) with immediate hypersensitivity not meeting criteria for anaphylaxis and 1/24 (4.2%) with other physician diagnosed hypersensitivity developed recurrent AEFI symptoms that met the BCCD for anaphylaxis. All 26 participants referred pre-vaccination, including 9 (34.6%) with history of polyethylene glycol-asparaginase reactions, were vaccinated without occurrence of immediate hypersensitivity symptoms. CONCLUSIONS Most individuals in this national cohort who experienced a hypersensitivity event following COVID-19 vaccination and were referred for specialist review were revaccinated without AEFI recurrence, suggesting that specialist evaluation can facilitate safe revaccination.
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Affiliation(s)
- Tiffany Fitzpatrick
- Canadian Center for Vaccinology, IWK Health and Dalhousie University, Halifax, Nova Scotia, Canada; Public Health Ontario, Toronto, Ontario, Canada
| | - Peter Yamoah
- Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Gina Lacuesta
- Halifax Allergy and Asthma Associates, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Manish Sadarangani
- Division of Infectious Diseases, Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada; Vaccine Evaluation Center, British Columbia Children's Hospital Research Institute, Vancouver, British Columbia, Canada
| | - Victoria Cook
- Division of Immunology, Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Persia Pourshahnazari
- Division of Allergy and Immunology, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Chrystyna Kalicinsky
- Section of Allergy and Clinical Immunology, Department of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Julia E M Upton
- Division of Immunology and Allergy, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Scott B Cameron
- Division of Immunology, Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Karver Zaborniak
- Section of Allergy and Clinical Immunology, Department of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Amin Kanani
- Division of Allergy and Immunology, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Godfrey Lam
- Vancouver Costal Health and Providence Health, Vancouver, British Columbia, Canada
| | - Catherine Burton
- Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Cora Constantinescu
- Alberta Children's Hospital, University of Calgary, Calgary, Alberta, Canada
| | - Jeffrey M Pernica
- Department of Pediatrics, McMaster University and McMaster Children's Hospital, Hamilton, Ontario, Canada
| | - Zainab Abdurrahman
- Department of Pediatrics, McMaster University and McMaster Children's Hospital, Hamilton, Ontario, Canada
| | - Stephen Betschel
- Division of Allergy and Clinical Immunology, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Jean-Philippe Drolet
- Centre Hospitalier Universitaire de Québec-Université Laval, Quebec, Quebec, Canada
| | - Gaston De Serres
- Centre Hospitalier Universitaire de Québec-Université Laval, Quebec, Quebec, Canada
| | - Caroline Quach
- Division of Infectious Diseases, CHU Sainte Justine, Universite de Montreal, Montreal, Quebec, Canada
| | - Anne Des Roches
- Primary Immunodeficiency Clinic, Institut de recherches cliniques de Montréal, Montreal, Quebec, Canada
| | - Hugo Chapdelaine
- Primary Immunodeficiency Clinic, Institut de recherches cliniques de Montréal, Montreal, Quebec, Canada
| | - Marina I Salvadori
- Department of Pediatrics, McGill University, Montreal, Quebec, Canada; Public Health Agency of Canada, Ottawa, Ontario, Canada
| | - Alex Carignan
- Department of Microbiology and Infectious Diseases, Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Athena McConnell
- Pediatric Infectious Diseases, Jim Pattison Children's Hospital, Saskatoon, Saskatchewan, Canada
| | - Anne Pham-Huy
- Division of Infectious Diseases, Immunology and Allergy, CHEO, University of Ottawa, Ottawa, Ontario, Canada
| | - C Arianne Buchan
- Division of Infectious Diseases, Department of Medicine, University of Ottawa, and the Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Juthaporn Cowan
- Division of Infectious Diseases, Department of Medicine, University of Ottawa, and the Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Kyla Hildebrand
- Vaccine Evaluation Center, British Columbia Children's Hospital Research Institute, Vancouver, British Columbia, Canada
| | - Karina A Top
- Canadian Center for Vaccinology, IWK Health and Dalhousie University, Halifax, Nova Scotia, Canada; Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada.
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Yin A, Wang N, Shea PJ, Rosser EN, Kuo H, Shapiro JR, Fenstermacher KZJ, Pekosz A, Rothman RE, Klein SL, Morgan R. Sex and gender differences in adverse events following influenza and COVID-19 vaccination. Biol Sex Differ 2024; 15:50. [PMID: 38890702 PMCID: PMC11184791 DOI: 10.1186/s13293-024-00625-z] [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] [Received: 05/07/2024] [Accepted: 06/06/2024] [Indexed: 06/20/2024] Open
Abstract
INTRODUCTION Active and passive surveillance studies have found that a greater proportion of females report adverse events (AE) following receipt of either the COVID-19 or seasonal influenza vaccine compared to males. In a predominately young adult female population of healthcare workers, we sought to determine the intersection of biological sex and sociocultural gender differences in prospective active reporting of vaccine outcomes, which remains poorly characterized. METHODS This cohort study enrolled Johns Hopkins Health System healthcare workers (HCWs) who were recruited from the mandatory annual fall 2019-2022 influenza vaccine and the fall 2022 COVID-19 bivalent vaccine campaigns. Vaccine recipients were enrolled the day of vaccination and AE surveys were administered two days post-vaccination for bivalent COVID-19 and influenza vaccine recipients. Data were collected regarding the presence of a series of solicited local and systemic AEs. Open-ended answers about participants' experiences with AEs also were collected for the COVID-19 vaccine recipients. RESULTS Females were more likely to report local AEs after either influenza (OR = 2.28, p = 0.001) or COVID-19 (OR = 2.57, p = 0.008) vaccination compared to males, regardless of age or race. Males and females had comparable probabilities of reporting systemic AEs after either influenza (OR = 1.18, p = 0.552) or COVID-19 (OR = 0.96, p = 0.907) vaccination. Hormonal birth control use did not impact the rates of reported AEs following influenza vaccination among reproductive-aged female HCWs. Women reported more interruptions in their daily routine following COVID-19 vaccination than men and were more likely to seek out self-treatment. More women than men scheduled their COVID-19 vaccination before their days off in anticipation of AEs. CONCLUSIONS Our findings highlight the need for sex- and gender-inclusive policies to inform more effective mandatory occupational health vaccination strategies. Further research is needed to evaluate the potential disruption of AEs on occupational responsibilities following mandated vaccination for healthcare workers, a predominately female population, and to more fully characterize the post-vaccination behavioral differences between men and women.
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Affiliation(s)
- Anna Yin
- Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Nadia Wang
- Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Patrick J Shea
- Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Erica N Rosser
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Helen Kuo
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Janna R Shapiro
- Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | - Andrew Pekosz
- Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Department of Emergency Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Richard E Rothman
- Department of Emergency Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Sabra L Klein
- Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
| | - Rosemary Morgan
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
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Zayoud D, Haddad C, Khachman D, Ajrouche R, Lahoud N. Estimating COVID-19 vaccine acceptance in pregnant and lactating women: a cross-sectional study in Lebanon. Arch Public Health 2024; 82:38. [PMID: 38500217 PMCID: PMC10949662 DOI: 10.1186/s13690-024-01267-8] [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: 10/23/2023] [Accepted: 03/08/2024] [Indexed: 03/20/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic highlights vaccination's critical role in reducing morbidity and mortality, depending on public attitude. This study aims to identify the estimates of COVID-19 vaccine acceptance in pregnant and lactating women, as well as associated potential factors. METHODS A cross-sectional study was conducted between August and September 2021, through an online survey and with a paper survey distributed in gynecology and pediatric clinics. Pregnant and breastfeeding women aged 18 years and above were recruited. The attitude scale was created specifically for evaluating attitudes towards the COVID-19 vaccine. RESULTS In total, 207 women participated, with 132 breastfeeding, 74 pregnant and 1 experiencing both conditions. Of these, one hundred and twenty women (58%) considered themselves at risk for COVID-19 infection. In addition, 51.7% (n = 107) of women expressed the intent to receive the vaccine once available. A multivariable linear regression was conducted taking the COVID-19 vaccination attitude scale as a dependent variable. The results revealed an R-squared value of 0.558, indicating that approximately 55.8% of the variance in the attitude scale was accounted for by the included predictors. The results showed that preventive measures (ß=2.25, 95% Confidence Interval (CI) [1.02; 3.48], p < 0.001), preference for vaccines made in Europe and America (ß=1.23; 95% CI [0.69-1.77], p < 0.001), protect yourself for getting sick (ß=4.22, 95% Confidence Interval (CI) [2.83; 5.61], p < 0.001) and belief in the importance of vaccination for themselves and their baby (ß=3.49; 95% CI [2.01; 4.98], p < 0.001) were associated with a positive attitude towards vaccination. Conversely, experiencing a previous bad reaction to a vaccine (ß= -1.35; 95% CI [0.85-1.85], p < 0.001) and concerns regarding COVID-19 vaccine safety (ß= -4.09; 95% CI [-5.98; -2.21], p < 0.001) were associated with a negative attitude towards vaccination. CONCLUSION Our findings reveal that COVID-19 vaccine acceptability among pregnant and breastfeeding women, amidst the pandemic was insufficient to meet community immunity. The identified reasons for vaccine reluctance, notably concerns about safety for both personal health and the health of their pregnancy or newborns, along with insufficient information about the vaccine, underscore the pressing need to address these factors to improve immunization rates.
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Affiliation(s)
- Dana Zayoud
- Clinical and Epidemiological Research Laboratory, Faculty of Pharmacy, Lebanese University, Beirut, Lebanon
| | - Chadia Haddad
- Institut National de Santé Publique, d'Épidémiologie Clinique et de Toxicologie-Liban (INSPECT-LB), Beirut, Lebanon.
- Faculty of Public Health, Lebanese University, Fanar, Lebanon.
- School of Medicine, Lebanese American University, Byblos, Lebanon.
- Research Department, Psychiatric Hospital of the Cross, P.O. Box 60096, Jal Eddib, Lebanon.
| | - Dalia Khachman
- Clinical and Epidemiological Research Laboratory, Faculty of Pharmacy, Lebanese University, Beirut, Lebanon
| | - Roula Ajrouche
- Clinical and Epidemiological Research Laboratory, Faculty of Pharmacy, Lebanese University, Beirut, Lebanon
- Institut National de Santé Publique, d'Épidémiologie Clinique et de Toxicologie-Liban (INSPECT-LB), Beirut, Lebanon
- Department of Health Sciences, University of Sciences and Arts in Lebanon, Beirut, Lebanon
| | - Nathalie Lahoud
- Clinical and Epidemiological Research Laboratory, Faculty of Pharmacy, Lebanese University, Beirut, Lebanon
- Institut National de Santé Publique, d'Épidémiologie Clinique et de Toxicologie-Liban (INSPECT-LB), Beirut, Lebanon
- Faculty of Public Health, Lebanese University, Fanar, Lebanon
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8
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Levi Y, Brandeau ML, Shmueli E, Yamin D. Prediction and detection of side effects severity following COVID-19 and influenza vaccinations: utilizing smartwatches and smartphones. Sci Rep 2024; 14:6012. [PMID: 38472345 DOI: 10.1038/s41598-024-56561-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 03/07/2024] [Indexed: 03/14/2024] Open
Abstract
Vaccines stand out as one of the most effective tools in our arsenal for reducing morbidity and mortality. Nonetheless, public hesitancy towards vaccination often stems from concerns about potential side effects, which can vary from person to person. As of now, there are no automated systems available to proactively warn against potential side effects or gauge their severity following vaccination. We have developed machine learning (ML) models designed to predict and detect the severity of post-vaccination side effects. Our study involved 2111 participants who had received at least one dose of either a COVID-19 or influenza vaccine. Each participant was equipped with a Garmin Vivosmart 4 smartwatch and was required to complete a daily self-reported questionnaire regarding local and systemic reactions through a dedicated mobile application. Our XGBoost models yielded an area under the receiver operating characteristic curve (AUROC) of 0.69 and 0.74 in predicting and detecting moderate to severe side effects, respectively. These predictions were primarily based on variables such as vaccine type (influenza vs. COVID-19), the individual's history of side effects from previous vaccines, and specific data collected from the smartwatches prior to vaccine administration, including resting heart rate, heart rate, and heart rate variability. In conclusion, our findings suggest that wearable devices can provide an objective and continuous method for predicting and monitoring moderate to severe vaccine side effects. This technology has the potential to improve clinical trials by automating the classification of vaccine severity.
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Affiliation(s)
- Yosi Levi
- Department of Industrial Engineering, Tel-Aviv University, Tel-Aviv, Israel
| | - Margaret L Brandeau
- Department of Management Science and Engineering, Stanford University, Stanford, CA, USA
| | - Erez Shmueli
- Department of Industrial Engineering, Tel-Aviv University, Tel-Aviv, Israel
- MIT Media Lab, Cambridge, MA, USA
| | - Dan Yamin
- Department of Industrial Engineering, Tel-Aviv University, Tel-Aviv, Israel.
- Department of Management Science and Engineering, Stanford University, Stanford, CA, USA.
- Center for Combatting Pandemics, Tel-Aviv University, Tel-Aviv, Israel.
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9
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Hussain A, Augustine SW, Pyakurel S, Vempalli H, Dabbara R, O'dare RA, Ayush, Varghese JJ, Inban P, Jayan M, Osigwe EC, Sunkara SM, Khan A. Acute Pancreatitis Induced by COVID-19 Vaccine: A Systematic Review. Cureus 2024; 16:e55426. [PMID: 38571842 PMCID: PMC10990070 DOI: 10.7759/cureus.55426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/03/2024] [Indexed: 04/05/2024] Open
Abstract
Acute pancreatitis, marked by sudden inflammation of the pancreas, presents a complex spectrum of causative factors including gallstone obstruction, alcohol abuse, and viral infections. Recent studies have illuminated the emergence of vaccine-induced acute pancreatitis, notably associated with COVID-19 vaccinations, presenting diverse mechanisms ranging from direct viral-mediated injury to autoimmune reactions. Understanding this link is pivotal for public health, yet challenges persist in identifying and managing cases post-vaccination. Comprehensive literature reviews employing the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement outline the potential pathways and mechanisms leading to vaccine-induced pancreatitis, emphasizing the need for deeper investigations into underlying health conditions and modifications to vaccine components. Notably, the rare occurrences of vaccine-induced pancreatitis extend beyond COVID-19 vaccines, with reports also documenting associations with measles, mumps, and rubella (MMR), human papillomavirus (HPV), and other viral vaccinations. Mechanistically, hypotheses such as molecular mimicry and immunologic injury have been proposed, necessitating ongoing vigilance and exploration. Regulatory agencies play a crucial role in monitoring and communicating vaccine safety concerns, emphasizing transparency to address potential risks and maintain public trust. Understanding and communicating these rare adverse events with transparency remain integral for informed vaccination policies and to allay concerns surrounding vaccine safety.
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Affiliation(s)
- Akbar Hussain
- Internal Medicine, Appalachian Regional Health, Harlan, USA
| | - Sana W Augustine
- Internal Medicine, Liaquat University of Medical and Health Sciences, Hyderabad, PAK
| | - Sandhya Pyakurel
- Internal Medicine, University of Science and Technology Chittagong, Chittagong, BGD
| | | | - Rishika Dabbara
- Internal Medicine, Kamineni Institute of Medical Sciences, Hyderabad, IND
| | - Rachel A O'dare
- Nursing, South University, Savannah, USA
- General Medicine, Medical University of Graz, Graz, AUT
| | - Ayush
- Internal Medicine, National Capital Region Institute of Medical Sciences, Meerut, IND
| | | | - Pugazhendi Inban
- General Medicine, Government Medical College, Omandurar Government Estate, Chennai, IND
| | - Malavika Jayan
- Internal Medicine, Bangalore Medical College and Research Institute, Bangalore, IND
| | | | | | - Aadil Khan
- Trauma Surgery, OSF Healthcare Hospital, University of Illinois College of Medicine, Peoria, USA
- Internal Medicine, Lala Lajpat Rai (LLR) Hospital, Kanpur, IND
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10
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Yin A, Wang N, Shea PJ, Rosser EN, Kuo H, Shapiro JR, Fenstermacher KZJ, Pekosz A, Rothman RE, Klein SL, Morgan R. Sex and gender differences in adverse events following receipt of influenza and COVID-19 vaccination among healthcare workers. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.01.17.24301440. [PMID: 38318206 PMCID: PMC10843156 DOI: 10.1101/2024.01.17.24301440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2024]
Abstract
Introduction Active and passive surveillance studies have found that a greater proportion of females report adverse events (AE) following receipt of either the COVID-19 or seasonal influenza vaccine compared to males. We sought to determine the intersection of biological sex and sociocultural gender differences in prospective active reporting of vaccine outcomes, which remains poorly characterized. Methods This cohort study enrolled Johns Hopkins Health System healthcare workers (HCWs) who were recruited from the annual fall 2019-2022 influenza vaccine and the fall 2022 COVID-19 bivalent vaccine campaigns. Vaccine recipients were enrolled the day of vaccination and AE surveys were administered two days post-vaccination (DPV) for bivalent COVID-19 and Influenza vaccine recipients. Data were collected regarding the presence of a series of solicited local and systemic AEs. Open-ended answers about participants' experiences with AEs also were collected for the COVID-19 vaccine recipients. Results Females were more likely to report local AEs after influenza (OR=2.28, p=0.001) or COVID-19 (OR=2.57, p=0.008) vaccination compared to males, regardless of age or race. Males and females had comparable probabilities of reporting systemic AEs after influenza (OR=1.18, p=0.552) or COVID-19 (OR=0.96, p=0.907) vaccination. Exogenous hormones from birth control use did not impact the rates of reported AEs following COVID-19 vaccination among reproductive-aged female HCWs. Women reported more interruptions in their daily routine following COVID-19 vaccination than men and were more likely to seek out self-treatment. More women than men scheduled their COVID-19 vaccination before their days off in anticipation of AEs. Conclusions Our findings highlight the need for sex- and gender-inclusive policies to inform more effective occupational health vaccination strategies. Further research is needed to evaluate the potential disruption of AEs on occupational responsibilities following mandated vaccination for healthcare workers and to more fully characterize the post-vaccination behavioral differences between men and women. KEY MESSAGE What is already known on this topic: ⇒ Among diversely aged adults 18-64 years, females report more AEs to vaccines, including the influenza and COVID-19 vaccines, than males.⇒ Vaccine AEs play a role in shaping vaccine hesitancy and uptake.⇒ Vaccine uptake related to influenza and COVID-19 are higher among men than women.⇒ Research that addresses both the sex and gender disparities of vaccine outcomes and behaviors is lacking.What this study adds: ⇒ This prospective active reporting study uses both quantitative and qualitative survey data to examine sex and gender differences in AEs following influenza or COVID-19 vaccination among a cohort of reproductive-aged healthcare workers.How this study might affect research, practice, or policy: ⇒ Sex and gender differences in AEs and perceptions relating to vaccination should drive the development of more equitable and effective vaccine strategies and policies in occupational health settings.
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11
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Sans-Fuentes M, Sierra LA, Cruz NS, Rubio V, Lutrick K, Hamm K, Connick E, Shroff P, Billheimer D, Sorensen R, Dinsmore A, Wolfersteig W, Ayers S, Nikolich-Zugich J, Doubeni C, Tilburt J, Rosales C, Moreno F, Derksen D, Oesterle S, Sabo S, Parthasarathy S. Temporal Changes in Vaccine-Specific Willingness Across Race/Ethnicity Following Serious Adverse Event Reports. Am J Public Health 2024; 114:S37-S40. [PMID: 37944076 PMCID: PMC10785178 DOI: 10.2105/ajph.2023.307484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/29/2023] [Indexed: 11/12/2023]
Affiliation(s)
- Maria Sans-Fuentes
- Maria Sans-Fuentes, Elizabeth Connick, and Dean Billheimer are with BIO5 Institute, University of Arizona, Tucson. Lidia Azurdia Sierra, Nina Santa Cruz, Victoria Rubio, Puneet Shroff, and Sairam Parthasarathy are with the Department of Medicine, College of Medicine-Tucson, University of Arizona, Tucson. Karen Lutrick and Cecilia Rosales are with the Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson. Kathryn Hamm, Wendy Wolfersteig, Stephanie Ayers, and Sabrina Oesterle are with the Southwest Interdisciplinary Research Center, Arizona State University, Phoenix. Ronald Sorensen and Alicia Dinsmore are with the Department of Family and Community Medicine, University of Arizona, Tucson. Janko Nikolich-Zugich is with the Department of Immunobiology, University of Arizona, Tucson. Chyke Doubeni and Jon Tilburt are with the Department of Family and Community Medicine, Mayo Clinic, Scottsdale, AZ. Francisco Moreno and Daniel Derksen are with the University of Arizona Health Sciences, Tucson. Samantha Sabo is with the Center for Health Equity Research, Northern Arizona University, Flagstaff
| | - Lidia Azurdia Sierra
- Maria Sans-Fuentes, Elizabeth Connick, and Dean Billheimer are with BIO5 Institute, University of Arizona, Tucson. Lidia Azurdia Sierra, Nina Santa Cruz, Victoria Rubio, Puneet Shroff, and Sairam Parthasarathy are with the Department of Medicine, College of Medicine-Tucson, University of Arizona, Tucson. Karen Lutrick and Cecilia Rosales are with the Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson. Kathryn Hamm, Wendy Wolfersteig, Stephanie Ayers, and Sabrina Oesterle are with the Southwest Interdisciplinary Research Center, Arizona State University, Phoenix. Ronald Sorensen and Alicia Dinsmore are with the Department of Family and Community Medicine, University of Arizona, Tucson. Janko Nikolich-Zugich is with the Department of Immunobiology, University of Arizona, Tucson. Chyke Doubeni and Jon Tilburt are with the Department of Family and Community Medicine, Mayo Clinic, Scottsdale, AZ. Francisco Moreno and Daniel Derksen are with the University of Arizona Health Sciences, Tucson. Samantha Sabo is with the Center for Health Equity Research, Northern Arizona University, Flagstaff
| | - Nina Santa Cruz
- Maria Sans-Fuentes, Elizabeth Connick, and Dean Billheimer are with BIO5 Institute, University of Arizona, Tucson. Lidia Azurdia Sierra, Nina Santa Cruz, Victoria Rubio, Puneet Shroff, and Sairam Parthasarathy are with the Department of Medicine, College of Medicine-Tucson, University of Arizona, Tucson. Karen Lutrick and Cecilia Rosales are with the Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson. Kathryn Hamm, Wendy Wolfersteig, Stephanie Ayers, and Sabrina Oesterle are with the Southwest Interdisciplinary Research Center, Arizona State University, Phoenix. Ronald Sorensen and Alicia Dinsmore are with the Department of Family and Community Medicine, University of Arizona, Tucson. Janko Nikolich-Zugich is with the Department of Immunobiology, University of Arizona, Tucson. Chyke Doubeni and Jon Tilburt are with the Department of Family and Community Medicine, Mayo Clinic, Scottsdale, AZ. Francisco Moreno and Daniel Derksen are with the University of Arizona Health Sciences, Tucson. Samantha Sabo is with the Center for Health Equity Research, Northern Arizona University, Flagstaff
| | - Victoria Rubio
- Maria Sans-Fuentes, Elizabeth Connick, and Dean Billheimer are with BIO5 Institute, University of Arizona, Tucson. Lidia Azurdia Sierra, Nina Santa Cruz, Victoria Rubio, Puneet Shroff, and Sairam Parthasarathy are with the Department of Medicine, College of Medicine-Tucson, University of Arizona, Tucson. Karen Lutrick and Cecilia Rosales are with the Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson. Kathryn Hamm, Wendy Wolfersteig, Stephanie Ayers, and Sabrina Oesterle are with the Southwest Interdisciplinary Research Center, Arizona State University, Phoenix. Ronald Sorensen and Alicia Dinsmore are with the Department of Family and Community Medicine, University of Arizona, Tucson. Janko Nikolich-Zugich is with the Department of Immunobiology, University of Arizona, Tucson. Chyke Doubeni and Jon Tilburt are with the Department of Family and Community Medicine, Mayo Clinic, Scottsdale, AZ. Francisco Moreno and Daniel Derksen are with the University of Arizona Health Sciences, Tucson. Samantha Sabo is with the Center for Health Equity Research, Northern Arizona University, Flagstaff
| | - Karen Lutrick
- Maria Sans-Fuentes, Elizabeth Connick, and Dean Billheimer are with BIO5 Institute, University of Arizona, Tucson. Lidia Azurdia Sierra, Nina Santa Cruz, Victoria Rubio, Puneet Shroff, and Sairam Parthasarathy are with the Department of Medicine, College of Medicine-Tucson, University of Arizona, Tucson. Karen Lutrick and Cecilia Rosales are with the Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson. Kathryn Hamm, Wendy Wolfersteig, Stephanie Ayers, and Sabrina Oesterle are with the Southwest Interdisciplinary Research Center, Arizona State University, Phoenix. Ronald Sorensen and Alicia Dinsmore are with the Department of Family and Community Medicine, University of Arizona, Tucson. Janko Nikolich-Zugich is with the Department of Immunobiology, University of Arizona, Tucson. Chyke Doubeni and Jon Tilburt are with the Department of Family and Community Medicine, Mayo Clinic, Scottsdale, AZ. Francisco Moreno and Daniel Derksen are with the University of Arizona Health Sciences, Tucson. Samantha Sabo is with the Center for Health Equity Research, Northern Arizona University, Flagstaff
| | - Kathryn Hamm
- Maria Sans-Fuentes, Elizabeth Connick, and Dean Billheimer are with BIO5 Institute, University of Arizona, Tucson. Lidia Azurdia Sierra, Nina Santa Cruz, Victoria Rubio, Puneet Shroff, and Sairam Parthasarathy are with the Department of Medicine, College of Medicine-Tucson, University of Arizona, Tucson. Karen Lutrick and Cecilia Rosales are with the Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson. Kathryn Hamm, Wendy Wolfersteig, Stephanie Ayers, and Sabrina Oesterle are with the Southwest Interdisciplinary Research Center, Arizona State University, Phoenix. Ronald Sorensen and Alicia Dinsmore are with the Department of Family and Community Medicine, University of Arizona, Tucson. Janko Nikolich-Zugich is with the Department of Immunobiology, University of Arizona, Tucson. Chyke Doubeni and Jon Tilburt are with the Department of Family and Community Medicine, Mayo Clinic, Scottsdale, AZ. Francisco Moreno and Daniel Derksen are with the University of Arizona Health Sciences, Tucson. Samantha Sabo is with the Center for Health Equity Research, Northern Arizona University, Flagstaff
| | - Elizabeth Connick
- Maria Sans-Fuentes, Elizabeth Connick, and Dean Billheimer are with BIO5 Institute, University of Arizona, Tucson. Lidia Azurdia Sierra, Nina Santa Cruz, Victoria Rubio, Puneet Shroff, and Sairam Parthasarathy are with the Department of Medicine, College of Medicine-Tucson, University of Arizona, Tucson. Karen Lutrick and Cecilia Rosales are with the Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson. Kathryn Hamm, Wendy Wolfersteig, Stephanie Ayers, and Sabrina Oesterle are with the Southwest Interdisciplinary Research Center, Arizona State University, Phoenix. Ronald Sorensen and Alicia Dinsmore are with the Department of Family and Community Medicine, University of Arizona, Tucson. Janko Nikolich-Zugich is with the Department of Immunobiology, University of Arizona, Tucson. Chyke Doubeni and Jon Tilburt are with the Department of Family and Community Medicine, Mayo Clinic, Scottsdale, AZ. Francisco Moreno and Daniel Derksen are with the University of Arizona Health Sciences, Tucson. Samantha Sabo is with the Center for Health Equity Research, Northern Arizona University, Flagstaff
| | - Puneet Shroff
- Maria Sans-Fuentes, Elizabeth Connick, and Dean Billheimer are with BIO5 Institute, University of Arizona, Tucson. Lidia Azurdia Sierra, Nina Santa Cruz, Victoria Rubio, Puneet Shroff, and Sairam Parthasarathy are with the Department of Medicine, College of Medicine-Tucson, University of Arizona, Tucson. Karen Lutrick and Cecilia Rosales are with the Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson. Kathryn Hamm, Wendy Wolfersteig, Stephanie Ayers, and Sabrina Oesterle are with the Southwest Interdisciplinary Research Center, Arizona State University, Phoenix. Ronald Sorensen and Alicia Dinsmore are with the Department of Family and Community Medicine, University of Arizona, Tucson. Janko Nikolich-Zugich is with the Department of Immunobiology, University of Arizona, Tucson. Chyke Doubeni and Jon Tilburt are with the Department of Family and Community Medicine, Mayo Clinic, Scottsdale, AZ. Francisco Moreno and Daniel Derksen are with the University of Arizona Health Sciences, Tucson. Samantha Sabo is with the Center for Health Equity Research, Northern Arizona University, Flagstaff
| | - Dean Billheimer
- Maria Sans-Fuentes, Elizabeth Connick, and Dean Billheimer are with BIO5 Institute, University of Arizona, Tucson. Lidia Azurdia Sierra, Nina Santa Cruz, Victoria Rubio, Puneet Shroff, and Sairam Parthasarathy are with the Department of Medicine, College of Medicine-Tucson, University of Arizona, Tucson. Karen Lutrick and Cecilia Rosales are with the Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson. Kathryn Hamm, Wendy Wolfersteig, Stephanie Ayers, and Sabrina Oesterle are with the Southwest Interdisciplinary Research Center, Arizona State University, Phoenix. Ronald Sorensen and Alicia Dinsmore are with the Department of Family and Community Medicine, University of Arizona, Tucson. Janko Nikolich-Zugich is with the Department of Immunobiology, University of Arizona, Tucson. Chyke Doubeni and Jon Tilburt are with the Department of Family and Community Medicine, Mayo Clinic, Scottsdale, AZ. Francisco Moreno and Daniel Derksen are with the University of Arizona Health Sciences, Tucson. Samantha Sabo is with the Center for Health Equity Research, Northern Arizona University, Flagstaff
| | - Ronald Sorensen
- Maria Sans-Fuentes, Elizabeth Connick, and Dean Billheimer are with BIO5 Institute, University of Arizona, Tucson. Lidia Azurdia Sierra, Nina Santa Cruz, Victoria Rubio, Puneet Shroff, and Sairam Parthasarathy are with the Department of Medicine, College of Medicine-Tucson, University of Arizona, Tucson. Karen Lutrick and Cecilia Rosales are with the Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson. Kathryn Hamm, Wendy Wolfersteig, Stephanie Ayers, and Sabrina Oesterle are with the Southwest Interdisciplinary Research Center, Arizona State University, Phoenix. Ronald Sorensen and Alicia Dinsmore are with the Department of Family and Community Medicine, University of Arizona, Tucson. Janko Nikolich-Zugich is with the Department of Immunobiology, University of Arizona, Tucson. Chyke Doubeni and Jon Tilburt are with the Department of Family and Community Medicine, Mayo Clinic, Scottsdale, AZ. Francisco Moreno and Daniel Derksen are with the University of Arizona Health Sciences, Tucson. Samantha Sabo is with the Center for Health Equity Research, Northern Arizona University, Flagstaff
| | - Alicia Dinsmore
- Maria Sans-Fuentes, Elizabeth Connick, and Dean Billheimer are with BIO5 Institute, University of Arizona, Tucson. Lidia Azurdia Sierra, Nina Santa Cruz, Victoria Rubio, Puneet Shroff, and Sairam Parthasarathy are with the Department of Medicine, College of Medicine-Tucson, University of Arizona, Tucson. Karen Lutrick and Cecilia Rosales are with the Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson. Kathryn Hamm, Wendy Wolfersteig, Stephanie Ayers, and Sabrina Oesterle are with the Southwest Interdisciplinary Research Center, Arizona State University, Phoenix. Ronald Sorensen and Alicia Dinsmore are with the Department of Family and Community Medicine, University of Arizona, Tucson. Janko Nikolich-Zugich is with the Department of Immunobiology, University of Arizona, Tucson. Chyke Doubeni and Jon Tilburt are with the Department of Family and Community Medicine, Mayo Clinic, Scottsdale, AZ. Francisco Moreno and Daniel Derksen are with the University of Arizona Health Sciences, Tucson. Samantha Sabo is with the Center for Health Equity Research, Northern Arizona University, Flagstaff
| | - Wendy Wolfersteig
- Maria Sans-Fuentes, Elizabeth Connick, and Dean Billheimer are with BIO5 Institute, University of Arizona, Tucson. Lidia Azurdia Sierra, Nina Santa Cruz, Victoria Rubio, Puneet Shroff, and Sairam Parthasarathy are with the Department of Medicine, College of Medicine-Tucson, University of Arizona, Tucson. Karen Lutrick and Cecilia Rosales are with the Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson. Kathryn Hamm, Wendy Wolfersteig, Stephanie Ayers, and Sabrina Oesterle are with the Southwest Interdisciplinary Research Center, Arizona State University, Phoenix. Ronald Sorensen and Alicia Dinsmore are with the Department of Family and Community Medicine, University of Arizona, Tucson. Janko Nikolich-Zugich is with the Department of Immunobiology, University of Arizona, Tucson. Chyke Doubeni and Jon Tilburt are with the Department of Family and Community Medicine, Mayo Clinic, Scottsdale, AZ. Francisco Moreno and Daniel Derksen are with the University of Arizona Health Sciences, Tucson. Samantha Sabo is with the Center for Health Equity Research, Northern Arizona University, Flagstaff
| | - Stephanie Ayers
- Maria Sans-Fuentes, Elizabeth Connick, and Dean Billheimer are with BIO5 Institute, University of Arizona, Tucson. Lidia Azurdia Sierra, Nina Santa Cruz, Victoria Rubio, Puneet Shroff, and Sairam Parthasarathy are with the Department of Medicine, College of Medicine-Tucson, University of Arizona, Tucson. Karen Lutrick and Cecilia Rosales are with the Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson. Kathryn Hamm, Wendy Wolfersteig, Stephanie Ayers, and Sabrina Oesterle are with the Southwest Interdisciplinary Research Center, Arizona State University, Phoenix. Ronald Sorensen and Alicia Dinsmore are with the Department of Family and Community Medicine, University of Arizona, Tucson. Janko Nikolich-Zugich is with the Department of Immunobiology, University of Arizona, Tucson. Chyke Doubeni and Jon Tilburt are with the Department of Family and Community Medicine, Mayo Clinic, Scottsdale, AZ. Francisco Moreno and Daniel Derksen are with the University of Arizona Health Sciences, Tucson. Samantha Sabo is with the Center for Health Equity Research, Northern Arizona University, Flagstaff
| | - Janko Nikolich-Zugich
- Maria Sans-Fuentes, Elizabeth Connick, and Dean Billheimer are with BIO5 Institute, University of Arizona, Tucson. Lidia Azurdia Sierra, Nina Santa Cruz, Victoria Rubio, Puneet Shroff, and Sairam Parthasarathy are with the Department of Medicine, College of Medicine-Tucson, University of Arizona, Tucson. Karen Lutrick and Cecilia Rosales are with the Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson. Kathryn Hamm, Wendy Wolfersteig, Stephanie Ayers, and Sabrina Oesterle are with the Southwest Interdisciplinary Research Center, Arizona State University, Phoenix. Ronald Sorensen and Alicia Dinsmore are with the Department of Family and Community Medicine, University of Arizona, Tucson. Janko Nikolich-Zugich is with the Department of Immunobiology, University of Arizona, Tucson. Chyke Doubeni and Jon Tilburt are with the Department of Family and Community Medicine, Mayo Clinic, Scottsdale, AZ. Francisco Moreno and Daniel Derksen are with the University of Arizona Health Sciences, Tucson. Samantha Sabo is with the Center for Health Equity Research, Northern Arizona University, Flagstaff
| | - Chyke Doubeni
- Maria Sans-Fuentes, Elizabeth Connick, and Dean Billheimer are with BIO5 Institute, University of Arizona, Tucson. Lidia Azurdia Sierra, Nina Santa Cruz, Victoria Rubio, Puneet Shroff, and Sairam Parthasarathy are with the Department of Medicine, College of Medicine-Tucson, University of Arizona, Tucson. Karen Lutrick and Cecilia Rosales are with the Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson. Kathryn Hamm, Wendy Wolfersteig, Stephanie Ayers, and Sabrina Oesterle are with the Southwest Interdisciplinary Research Center, Arizona State University, Phoenix. Ronald Sorensen and Alicia Dinsmore are with the Department of Family and Community Medicine, University of Arizona, Tucson. Janko Nikolich-Zugich is with the Department of Immunobiology, University of Arizona, Tucson. Chyke Doubeni and Jon Tilburt are with the Department of Family and Community Medicine, Mayo Clinic, Scottsdale, AZ. Francisco Moreno and Daniel Derksen are with the University of Arizona Health Sciences, Tucson. Samantha Sabo is with the Center for Health Equity Research, Northern Arizona University, Flagstaff
| | - Jon Tilburt
- Maria Sans-Fuentes, Elizabeth Connick, and Dean Billheimer are with BIO5 Institute, University of Arizona, Tucson. Lidia Azurdia Sierra, Nina Santa Cruz, Victoria Rubio, Puneet Shroff, and Sairam Parthasarathy are with the Department of Medicine, College of Medicine-Tucson, University of Arizona, Tucson. Karen Lutrick and Cecilia Rosales are with the Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson. Kathryn Hamm, Wendy Wolfersteig, Stephanie Ayers, and Sabrina Oesterle are with the Southwest Interdisciplinary Research Center, Arizona State University, Phoenix. Ronald Sorensen and Alicia Dinsmore are with the Department of Family and Community Medicine, University of Arizona, Tucson. Janko Nikolich-Zugich is with the Department of Immunobiology, University of Arizona, Tucson. Chyke Doubeni and Jon Tilburt are with the Department of Family and Community Medicine, Mayo Clinic, Scottsdale, AZ. Francisco Moreno and Daniel Derksen are with the University of Arizona Health Sciences, Tucson. Samantha Sabo is with the Center for Health Equity Research, Northern Arizona University, Flagstaff
| | - Cecilia Rosales
- Maria Sans-Fuentes, Elizabeth Connick, and Dean Billheimer are with BIO5 Institute, University of Arizona, Tucson. Lidia Azurdia Sierra, Nina Santa Cruz, Victoria Rubio, Puneet Shroff, and Sairam Parthasarathy are with the Department of Medicine, College of Medicine-Tucson, University of Arizona, Tucson. Karen Lutrick and Cecilia Rosales are with the Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson. Kathryn Hamm, Wendy Wolfersteig, Stephanie Ayers, and Sabrina Oesterle are with the Southwest Interdisciplinary Research Center, Arizona State University, Phoenix. Ronald Sorensen and Alicia Dinsmore are with the Department of Family and Community Medicine, University of Arizona, Tucson. Janko Nikolich-Zugich is with the Department of Immunobiology, University of Arizona, Tucson. Chyke Doubeni and Jon Tilburt are with the Department of Family and Community Medicine, Mayo Clinic, Scottsdale, AZ. Francisco Moreno and Daniel Derksen are with the University of Arizona Health Sciences, Tucson. Samantha Sabo is with the Center for Health Equity Research, Northern Arizona University, Flagstaff
| | - Francisco Moreno
- Maria Sans-Fuentes, Elizabeth Connick, and Dean Billheimer are with BIO5 Institute, University of Arizona, Tucson. Lidia Azurdia Sierra, Nina Santa Cruz, Victoria Rubio, Puneet Shroff, and Sairam Parthasarathy are with the Department of Medicine, College of Medicine-Tucson, University of Arizona, Tucson. Karen Lutrick and Cecilia Rosales are with the Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson. Kathryn Hamm, Wendy Wolfersteig, Stephanie Ayers, and Sabrina Oesterle are with the Southwest Interdisciplinary Research Center, Arizona State University, Phoenix. Ronald Sorensen and Alicia Dinsmore are with the Department of Family and Community Medicine, University of Arizona, Tucson. Janko Nikolich-Zugich is with the Department of Immunobiology, University of Arizona, Tucson. Chyke Doubeni and Jon Tilburt are with the Department of Family and Community Medicine, Mayo Clinic, Scottsdale, AZ. Francisco Moreno and Daniel Derksen are with the University of Arizona Health Sciences, Tucson. Samantha Sabo is with the Center for Health Equity Research, Northern Arizona University, Flagstaff
| | - Daniel Derksen
- Maria Sans-Fuentes, Elizabeth Connick, and Dean Billheimer are with BIO5 Institute, University of Arizona, Tucson. Lidia Azurdia Sierra, Nina Santa Cruz, Victoria Rubio, Puneet Shroff, and Sairam Parthasarathy are with the Department of Medicine, College of Medicine-Tucson, University of Arizona, Tucson. Karen Lutrick and Cecilia Rosales are with the Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson. Kathryn Hamm, Wendy Wolfersteig, Stephanie Ayers, and Sabrina Oesterle are with the Southwest Interdisciplinary Research Center, Arizona State University, Phoenix. Ronald Sorensen and Alicia Dinsmore are with the Department of Family and Community Medicine, University of Arizona, Tucson. Janko Nikolich-Zugich is with the Department of Immunobiology, University of Arizona, Tucson. Chyke Doubeni and Jon Tilburt are with the Department of Family and Community Medicine, Mayo Clinic, Scottsdale, AZ. Francisco Moreno and Daniel Derksen are with the University of Arizona Health Sciences, Tucson. Samantha Sabo is with the Center for Health Equity Research, Northern Arizona University, Flagstaff
| | - Sabrina Oesterle
- Maria Sans-Fuentes, Elizabeth Connick, and Dean Billheimer are with BIO5 Institute, University of Arizona, Tucson. Lidia Azurdia Sierra, Nina Santa Cruz, Victoria Rubio, Puneet Shroff, and Sairam Parthasarathy are with the Department of Medicine, College of Medicine-Tucson, University of Arizona, Tucson. Karen Lutrick and Cecilia Rosales are with the Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson. Kathryn Hamm, Wendy Wolfersteig, Stephanie Ayers, and Sabrina Oesterle are with the Southwest Interdisciplinary Research Center, Arizona State University, Phoenix. Ronald Sorensen and Alicia Dinsmore are with the Department of Family and Community Medicine, University of Arizona, Tucson. Janko Nikolich-Zugich is with the Department of Immunobiology, University of Arizona, Tucson. Chyke Doubeni and Jon Tilburt are with the Department of Family and Community Medicine, Mayo Clinic, Scottsdale, AZ. Francisco Moreno and Daniel Derksen are with the University of Arizona Health Sciences, Tucson. Samantha Sabo is with the Center for Health Equity Research, Northern Arizona University, Flagstaff
| | - Samantha Sabo
- Maria Sans-Fuentes, Elizabeth Connick, and Dean Billheimer are with BIO5 Institute, University of Arizona, Tucson. Lidia Azurdia Sierra, Nina Santa Cruz, Victoria Rubio, Puneet Shroff, and Sairam Parthasarathy are with the Department of Medicine, College of Medicine-Tucson, University of Arizona, Tucson. Karen Lutrick and Cecilia Rosales are with the Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson. Kathryn Hamm, Wendy Wolfersteig, Stephanie Ayers, and Sabrina Oesterle are with the Southwest Interdisciplinary Research Center, Arizona State University, Phoenix. Ronald Sorensen and Alicia Dinsmore are with the Department of Family and Community Medicine, University of Arizona, Tucson. Janko Nikolich-Zugich is with the Department of Immunobiology, University of Arizona, Tucson. Chyke Doubeni and Jon Tilburt are with the Department of Family and Community Medicine, Mayo Clinic, Scottsdale, AZ. Francisco Moreno and Daniel Derksen are with the University of Arizona Health Sciences, Tucson. Samantha Sabo is with the Center for Health Equity Research, Northern Arizona University, Flagstaff
| | - Sairam Parthasarathy
- Maria Sans-Fuentes, Elizabeth Connick, and Dean Billheimer are with BIO5 Institute, University of Arizona, Tucson. Lidia Azurdia Sierra, Nina Santa Cruz, Victoria Rubio, Puneet Shroff, and Sairam Parthasarathy are with the Department of Medicine, College of Medicine-Tucson, University of Arizona, Tucson. Karen Lutrick and Cecilia Rosales are with the Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson. Kathryn Hamm, Wendy Wolfersteig, Stephanie Ayers, and Sabrina Oesterle are with the Southwest Interdisciplinary Research Center, Arizona State University, Phoenix. Ronald Sorensen and Alicia Dinsmore are with the Department of Family and Community Medicine, University of Arizona, Tucson. Janko Nikolich-Zugich is with the Department of Immunobiology, University of Arizona, Tucson. Chyke Doubeni and Jon Tilburt are with the Department of Family and Community Medicine, Mayo Clinic, Scottsdale, AZ. Francisco Moreno and Daniel Derksen are with the University of Arizona Health Sciences, Tucson. Samantha Sabo is with the Center for Health Equity Research, Northern Arizona University, Flagstaff
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12
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Arzilli G, Stacchini L, Casigliani V, Mazzilli S, Aquino F, Oradini-Alacreu A, Bruni B, Quattrone F, Papini F, Sironi D, Porretta AD, Privitera GP, Rizzo C, Tavoschi L, Lopalco PL. Assessing vaccine hesitancy and health literacy using a new Italian vaccine confidence index and a modified Italian medical term recognition test: A cross-sectional survey on Italian parents. Hum Vaccin Immunother 2023; 19:2271765. [PMID: 37906161 PMCID: PMC10760377 DOI: 10.1080/21645515.2023.2271765] [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: 07/04/2023] [Accepted: 10/13/2023] [Indexed: 11/02/2023] Open
Abstract
The decline in children's vaccination coverage and the resurgence of preventable infectious diseases draw attention to parents' vaccine hesitancy. Our study introduces two validated tools to independently assess vaccine hesitancy and health literacy among parents with school-age children. We developed a Vaccine Confidence Index (VCI) from 10 Likert items, exploring their relationships through exploratory and confirmatory factor analyses. We modified the IMETER (Italian medical term recognition test) to measure health literacy. We assessed the internal consistency of the modified IMETER and the 10 Likert items using Cronbach's alpha test (α) and McDonald's omega total coefficient (ω) with good results (ω = 0.92, α = 0.90; ω = 0.87, α = 0.82 respectively). We used these tools within a questionnaire conducted on 743 parents recruited from pediatric clinic waiting rooms in Italy, collecting demographic data, information sources on vaccines and vaccine-preventable diseases knowledge. The VCI resulting from factor analyses consisted of six items on a ten-point Likert scale, reflecting the ratio of positive to negative items. The survey revealed significant variations in the VCI according to individual features such as education, use of social networks, or Health institutions as sources of information. Multivariate logistic regression identified an association between vaccine intention and the VCI. Health literacy was functional for 91.2% of participants, but knowledge about vaccine-preventable diseases was generally low. The VCI showed no significant association with health literacy and vaccine-preventable diseases knowledge. The VCI and the modified IMETER effectively assess vaccination attitude and health literacy, offering valuable public health tools for tailoring vaccination campaigns to hesitant population subgroups.
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Affiliation(s)
- Guglielmo Arzilli
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Lorenzo Stacchini
- Department of Health Science, University of Florence, Florence, Italy
| | - Virginia Casigliani
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | | | - Francesco Aquino
- Department of Public Health and Hygiene, Azienda USL Toscana Nord Ovest, Versilia, Italy
| | - Aurea Oradini-Alacreu
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Beatrice Bruni
- Department of Public Health and Hygiene, Azienda USL Toscana Nord Ovest, Versilia, Italy
| | - Filippo Quattrone
- Management and Healthcare Laboratory, Institute of Management and Department EMbeDS, Scuola Superiore Sant’Anna, Pisa, Italy
| | - Francesca Papini
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Daniele Sironi
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Andrea Davide Porretta
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
- University Hospital of Pisa, Pisa, Italy
| | - Gaetano Pierpaolo Privitera
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Caterina Rizzo
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
- University Hospital of Pisa, Pisa, Italy
| | - Lara Tavoschi
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Pier Luigi Lopalco
- Department of Biological and Environmental Sciences and Technology, University of Salento, Lecce, Italy
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13
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Raj A, Singh AK, Wagner AL, Boulton ML. Mapping the Cognitive Biases Related to Vaccination: A Scoping Review of the Literature. Vaccines (Basel) 2023; 11:1837. [PMID: 38140241 PMCID: PMC10747196 DOI: 10.3390/vaccines11121837] [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: 10/25/2023] [Revised: 12/05/2023] [Accepted: 12/06/2023] [Indexed: 12/24/2023] Open
Abstract
INTRODUCTION Human behavior and understanding of the vaccine ecosystem play a critical role in the vaccination decision-making process. The objective of this study was to understand different cognitive biases that may lead to vaccine acceptance or hesitancy. METHODS The eligibility criteria for this scoping review was vaccination-related cognitive bias studies published in the English language from inception to April 2022 and available on PubMed, Embase, and Google Scholar. It included all geographical locations and individuals of all age groups and excluded studies focusing on (i) clinical trials of vaccines, (ii) vaccine research conduct bias, (iii) cognitive delay, or (iv) statistical biases. The search method also included reviewing references in the retrieved articles. RESULTS Overall, 58 articles were identified, and after screening, 19 were included in this study. Twenty-one cognitive biases with the potential to affect vaccination decision-making were observed. These biases were further grouped into three broad categories: cognitive biases seen while processing vaccine-related information, during vaccination-related decision-making, and due to prior beliefs regarding vaccination. CONCLUSIONS This review identified critical cognitive biases affecting the entire process of vaccination that can influence research and public health efforts both positively and negatively. Recognizing and mitigating these cognitive biases is crucial for maintaining the population's level of trust in vaccination programs around the world.
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Affiliation(s)
- Amar Raj
- Tata Memorial Hospital, Mumbai 400012, India;
| | - Awnish Kumar Singh
- Former, National Technical Advisory Group on Immunization (NTAGI) Secretariat, Ministry of Health and Family Welfare, New Delhi 110011, India
- School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA; (A.L.W.); (M.L.B.)
| | - Abram L. Wagner
- School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA; (A.L.W.); (M.L.B.)
| | - Matthew L. Boulton
- School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA; (A.L.W.); (M.L.B.)
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14
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Sallam M, Abbasi H, Obeidat RJ, Badayneh R, Alkhashman F, Obeidat A, Oudeh D, Uqba Z, Mahafzah A. Unraveling the association between vaccine attitude, vaccine conspiracies and self-reported side effects following COVID-19 vaccination among nurses and physicians in Jordan. Vaccine X 2023; 15:100405. [PMID: 38161986 PMCID: PMC10755110 DOI: 10.1016/j.jvacx.2023.100405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 10/25/2023] [Accepted: 11/01/2023] [Indexed: 01/03/2024] Open
Abstract
Background The negative impact of vaccine conspiracies is linked with negative health behavior. The aim of the current study was to examine the association between attitudes toward booster COVID-19, influenza, and monkeypox (mpox) vaccinations with post-COVID-19 vaccine side effects, vaccine conspiracies, and attitude towards mandatory vaccination among nurses and physicians in Jordan. Methods A structured closed-ended questionnaire was used to collect data on demographics, COVID-19 history, COVID-19 vaccine type and doses received, self-reported side effects post-COVID-19 vaccination, acceptance of booster COVID-19, seasonal influenza, and mpox vaccinations, attitudes towards mandatory vaccination, and beliefs in vaccine conspiracies. Results The study sample comprised a total of 341 participants. Acceptance of yearly booster COVID-19 vaccination was expressed by 46.6% of the sample, while 73.3% accepted seasonal influenza vaccination, and only 37.0% accepted mpox vaccination. A higher frequency of self-reported side effects following the first COVID-19 vaccine dose was associated with embrace of vaccine conspiracies and vaccine type. For the second vaccine dose, a higher frequency of self-reported side effects was associated with the embrace of vaccine conspiracies, older age, and affiliation to private sector. In multinomial logistic regression analyses, the lower embrace of vaccine conspiracies was associated with lower odds of reporting side effects post-COVID-19 vaccination. The lower embrace of vaccine conspiracies and favorable attitude towards mandatory vaccination were associated with the willingness to get COVID-19, influenza, and mpox vaccinations. Conclusion The study findings highlighted the negative impact of embracing vaccine conspiracies on health-seeking behavior among nurses and physicians. The findings indicated that the willingness to get vaccinated was associated with lower endorsement of vaccine conspiracies. Additionally, the lower embrace of vaccine conspiracies was associated with a lower frequency of self-reported side effects following COVID-19 vaccination. These results emphasize the importance of addressing vaccine misinformation and promoting accurate information to ensure optimal vaccine uptake and public health outcomes.
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Affiliation(s)
- Malik Sallam
- Department of Pathology, Microbiology and Forensic Medicine, School of Medicine, The University of Jordan, Amman, Jordan
- Department of Clinical Laboratories and Forensic Medicine, Jordan University Hospital, Amman, Jordan
| | - Hiba Abbasi
- Department of Internal Medicine, School of Medicine, The University of Jordan, Amman, Jordan
- Department of Internal Medicine, Jordan University Hospital, Amman, Jordan
| | - Rawan J. Obeidat
- The Office of Infection Prevention and Control, Jordan University Hospital, Amman, Jordan
| | - Reham Badayneh
- School of Medicine, The University of Jordan, Amman 11942, Jordan
| | - Farah Alkhashman
- School of Medicine, The University of Jordan, Amman 11942, Jordan
| | - Aseel Obeidat
- School of Medicine, The University of Jordan, Amman 11942, Jordan
| | - Dana Oudeh
- School of Medicine, The University of Jordan, Amman 11942, Jordan
| | - Zena Uqba
- School of Medicine, The University of Jordan, Amman 11942, Jordan
| | - Azmi Mahafzah
- Department of Pathology, Microbiology and Forensic Medicine, School of Medicine, The University of Jordan, Amman, Jordan
- Department of Clinical Laboratories and Forensic Medicine, Jordan University Hospital, Amman, Jordan
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15
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Sepehrinia M, Nejat P, Baniyaghoub R. Impact of Actor's Initial State of Engagement in a Course of Action on Judgements of Post-decisional Regret and Joy: Revisiting Kahneman and Tversky (1982). THE SPANISH JOURNAL OF PSYCHOLOGY 2023; 26:e27. [PMID: 37955114 DOI: 10.1017/sjp.2023.27] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2023]
Abstract
According to the phenomenon commonly known as action effect and vastly replicated across the judgment and decision-making literature, more regret is associated with decisions resulting from action than inaction. Action vs. inaction, however, might either refer to change vs. no change or doing something vs. not doing something. The purpose of this study was to examine the effect of this variation in operationalization of action-inaction on the strength of action effect, for both positive and negative outcomes, across four different domains of employment, finance, education, and health. This was an experimental scenario-based study (N = 215) with four between-subjects conditions varying in outcome valence and the actor's initial state as either engaged or non-engaged in a particular course of action. Action effect was found to be stronger with respect to the initially engaged than the initially non-engaged decision-maker (ηp2 = .04), indicating that action as change results in a stronger action effect than action as doing something. The effect of the initial state was also moderated by domain. In addition, we both replicated and went beyond prior empirical literature regarding the effect of outcome valence and domain on action effect, with our findings being mostly consistent across joy and regret. Findings are discussed in light of the norm theory and its key concept of normality and contribute to the literature on moderators of action effect.
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16
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Omoleke SA, Bamidele M, de Kiev LC. Barriers to optimal AEFI surveillance and documentation in Nigeria: Findings from a qualitative survey. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0001658. [PMID: 37682847 PMCID: PMC10490937 DOI: 10.1371/journal.pgph.0001658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 03/16/2023] [Indexed: 09/10/2023]
Abstract
Effective spontaneous AEFI reporting is the first step to ensuring vaccine safety. Half of the global population lives in countries with weak vaccine safety monitoring systems, especially in the African, Eastern Mediterranean, and Western Pacific regions. Further, Immunisation services have been upscaled without commensurate effective AEFI surveillance systems. Hence, this study aims to comprehensively investigate the impediments to an effective AEFI surveillance system. Given the programmatic and regulatory implications, understanding these impediments would facilitate the development and implementation of policies and strategies to strengthen the AEFI surveillance system in Nigeria. A qualitative research design (using a grounded theory approach) was employed by conducting ten key informant interviews and two Focus Group Discussion sessions among the study population to identify the barriers impeding optimal AEFI surveillance and documentation in Nigeria. This study found that the AEFI surveillance system is in place in Nigeria. However, its functionality is sub-optimal, and the potential capacity is yet to be fully harnessed due to health systems and socio-ecological impediments. The identified impediments are human-resource-related issues- knowledge gaps; limited training; lack of designated officers for AEFI; excessive workload; poor supportive supervision and attitudinal issues; caregiver's factor; governance and leadership- moribund AEFI committee; lack of quality supervisory visit and oversight and weak implementation of AEFI policy guidance. Others include funding and logistics issues- no dedicated budget provision and weak referral mechanism; insecurity; socio-economic and infrastructural deficits- poverty, geographical barriers, limited ICT skills, and infrastructure; and poor feedback and weak community engagement by the health workers. Findings from this study provide empirical evidence and serve as an advocacy tool for vaccine pharmacovigilance strengthening in Nigeria. Addressing the impediments requires health system strengthening and a whole-of-the-society approach to improve vaccine safety surveillance, restore public confidence and promote vaccine demand, strengthen PHC services, and contribute to attaining UHC and SDGs.
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Affiliation(s)
| | - Moyosola Bamidele
- School of Global Health and Bioethics, Euclid University, Bangui, Central African Republic
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17
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De Luca JF, Awad A, Vogrin S, Waldron JL, McInnes K, Gibney G, Hall R, Douglas AP, Chua KYL, Holmes NE, Trubiano JA. Delayed cutaneous hypersensitivities to COVID-19 vaccination: Phenotypic distribution and tolerability of vaccine rechallenge. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2023; 11:2605-2607.e2. [PMID: 37178767 PMCID: PMC10174467 DOI: 10.1016/j.jaip.2023.04.045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 04/11/2023] [Accepted: 04/23/2023] [Indexed: 05/15/2023]
Affiliation(s)
- Joseph F De Luca
- Department of Infectious Diseases, Austin Health, Heidelberg, Victoria, Australia; Department of Infectious Diseases, University of Melbourne, Peter Doherty Institute for Infection and Immunity, Victoria, Melbourne, Australia.
| | - Andrew Awad
- Department of Infectious Diseases, Austin Health, Heidelberg, Victoria, Australia
| | - Sara Vogrin
- Department of Infectious Diseases, Austin Health, Heidelberg, Victoria, Australia; Department of Infectious Diseases, University of Melbourne, Peter Doherty Institute for Infection and Immunity, Victoria, Melbourne, Australia
| | - Jamie L Waldron
- Department of Infectious Diseases, Austin Health, Heidelberg, Victoria, Australia
| | - Kerryn McInnes
- Department of Infectious Diseases, Austin Health, Heidelberg, Victoria, Australia
| | - Grace Gibney
- Department of Infectious Diseases, Austin Health, Heidelberg, Victoria, Australia
| | - Rebecca Hall
- Department of Infectious Diseases, Austin Health, Heidelberg, Victoria, Australia
| | - Abby P Douglas
- Department of Infectious Diseases, Austin Health, Heidelberg, Victoria, Australia
| | - Kyra Y L Chua
- Department of Infectious Diseases, Austin Health, Heidelberg, Victoria, Australia
| | - Natasha E Holmes
- Department of Infectious Diseases, Austin Health, Heidelberg, Victoria, Australia; Department of Infectious Diseases, University of Melbourne, Peter Doherty Institute for Infection and Immunity, Victoria, Melbourne, Australia
| | - Jason A Trubiano
- Department of Infectious Diseases, Austin Health, Heidelberg, Victoria, Australia; Department of Infectious Diseases, University of Melbourne, Peter Doherty Institute for Infection and Immunity, Victoria, Melbourne, Australia
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18
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Michels SY, Niccolai LM, Hadler JL, Freeman RE, Albers AN, Glanz JM, Daley MF, Newcomer SR. Failure to Complete Multidose Vaccine Series in Early Childhood. Pediatrics 2023; 152:e2022059844. [PMID: 37489285 PMCID: PMC10389773 DOI: 10.1542/peds.2022-059844] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/09/2023] [Indexed: 07/26/2023] Open
Abstract
BACKGROUND Most early childhood immunizations require 3 to 4 doses to achieve optimal protection. Our objective was to identify factors associated with starting but not completing multidose vaccine series. METHODS Using 2019 National Immunization Survey-Child data, US children ages 19 to 35 months were classified in 1 of 3 vaccination patterns: (1) completed the combined 7-vaccine series, (2) did not initiate ≥1 of the 7 vaccine series, or (3) initiated all series, but did not complete ≥1 multidose series. Associations between sociodemographic factors and vaccination pattern were evaluated using multivariable log-linked binomial regression. Analyses accounted for the survey's stratified design and complex weighting. RESULTS Among 16 365 children, 72.9% completed the combined 7-vaccine series, 9.9% did not initiate ≥1 series, and 17.2% initiated, but did not complete ≥1 multidose series. Approximately 8.4% of children needed only 1 additional vaccine dose from 1 of the 5 multidose series to complete the combined 7-vaccine series. The strongest associations with starting but not completing multidose vaccine series were moving across state lines (adjusted prevalence ratio [aPR] = 1.45, 95% confidence interval [CI]: 1.18-1.79), number of children in the household (2 to 3: aPR = 1.29, 95% CI: 1.05-1.58; 4 or more: aPR = 1.68, 95% CI: 1.30-2.18), and lack of insurance coverage (aPR = 2.03, 95% CI: 1.42-2.91). CONCLUSIONS More than 1 in 6 US children initiated but did not complete all doses in multidose vaccine series, suggesting children experienced structural barriers to vaccination. Increased focus on strategies to encourage multidose series completion is needed to optimize protection from preventable diseases and achieve vaccination coverage goals.
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Affiliation(s)
- Sarah Y. Michels
- Yale School of Public Health, New Haven, Connecticut
- Center for Population Health Research, University of Montana, Missoula, Montana
| | | | | | - Rain E. Freeman
- Center for Population Health Research, University of Montana, Missoula, Montana
| | - Alexandria N. Albers
- Center for Population Health Research, University of Montana, Missoula, Montana
- School of Public and Community Health Sciences, University of Montana, Missoula, Montana
| | - Jason M. Glanz
- Institute for Health Research, Kaiser Permanente Colorado, Aurora, Colorado
- Department of Epidemiology, University of Colorado School of Public Health, Aurora, Colorado
| | - Matthew F. Daley
- Institute for Health Research, Kaiser Permanente Colorado, Aurora, Colorado
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado
| | - Sophia R. Newcomer
- Center for Population Health Research, University of Montana, Missoula, Montana
- School of Public and Community Health Sciences, University of Montana, Missoula, Montana
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19
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Berendes S, Mounier-Jack S, Ojo-Aromokudu O, Ivory A, Tucker JD, Larson HJ, Free C. "Figuring stuff out myself" - a qualitative study on maternal vaccination in socially and ethnically diverse areas in England. BMC Public Health 2023; 23:1408. [PMID: 37480010 PMCID: PMC10362695 DOI: 10.1186/s12889-023-16317-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 07/15/2023] [Indexed: 07/23/2023] Open
Abstract
BACKGROUND Maternal vaccinations against Influenza, Pertussis, and Covid-19 are recommended in the UK, and vaccines against further infections may become available soon. However, many pregnant women, especially in socially and ethnically diverse areas, have low vaccine uptake. Qualitative studies on the reasons and possible solutions are needed that are inclusive of disadvantaged and minority ethnic groups. We therefore aimed to understand the complex interplay between structural and behavioural factors contributing to the low maternal vaccine uptake in socially and ethnically diverse areas in London in the Covid-19 context. METHODS In 2022, we conducted semi-structured interviews and a focus group discussion among a purposive sample of 38 pregnant/recently pregnant women and 20 health service providers, including 12 midwives. Participants were recruited in ethnically diverse London boroughs. We followed a critical realist paradigm and used a thematic analysis approach. RESULTS The sample included participants who took all, some or none of the maternal vaccines, with some participants unsure whether they had taken or been offered the vaccines. Decision-making was passive or active, with the expectation for pregnant women to do their 'own research'. Participants described various individual, social and contextual influences on their decision-making as they navigated the antenatal care system. Missing or conflicting information from providers meant knowledge gaps were sometimes filled with misinformation from unreliable sources that increased uncertainties and mistrust. Both pregnant women and providers described structural and organisational factors that hindered access to information and vaccinations, including lack of training, time and resources, and shortcomings of health information systems and apps. Some participants described factors that facilitated vaccination uptake and many made recommendations for improvements. CONCLUSIONS Our study showed how structural and organisational factors can compound uncertainties around maternal vaccination among socially and ethnically diverse populations. Results highlight the need for more reliable resources, streamlined workflows, improved electronic information systems and training in their use. Roles and responsibilities should be clarified with potential greater involvement of nurses and pharmacists in vaccine provision. Education and communication should consider individual (language/digital) skills and needs for information and reassurance. Further research is needed to co-produce solutions with service users and providers.
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Affiliation(s)
- Sima Berendes
- Department of Population Health, London School of Hygiene and Tropical Medicine, London, UK.
| | - Sandra Mounier-Jack
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK
| | - Oyinkansola Ojo-Aromokudu
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK
| | - Alice Ivory
- Department of Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Joseph D Tucker
- Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, UK
- Department of Medicine, University of North Carolina, Chapel Hill, NC, USA
| | - Heidi J Larson
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
- Department of Health Metrics Sciences, University of Washington, Seattle, WA, USA
| | - Caroline Free
- Department of Population Health, London School of Hygiene and Tropical Medicine, London, UK
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20
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Peters JA, Farhadloo M. The Effects of Non-Pharmaceutical Interventions on COVID-19 Cases, Hospitalizations, and Mortality: A Systematic Literature Review and Meta-Analysis. AJPM FOCUS 2023; 2:100125. [PMID: 37362389 PMCID: PMC10265928 DOI: 10.1016/j.focus.2023.100125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/28/2023]
Abstract
Introduction To assess the effects of various non-pharmaceutical interventions (NPI) on cases, hospitalizations, and mortality during the first wave of the COVID-19 pandemic. Methods To empirically investigate the impacts of different NPIs on COVID-19-related health outcomes, a systematic literature review was conducted. We studied the effects of 10 NPIs on cases, hospitalizations, and mortality across three periodic lags (2, 3, and 4 weeks-or-more following implementation). Articles measuring the impact of NPIs were sourced from three databases by May 10, 2022, and risk of bias was assessed using the Newcastle-Ottawa scale. Results Across the 44 papers, we found that mask wearing corresponded to decreased per capita cases across all lags (up to -2.71 per 100,000). All NPIs studied except business and bar/restaurant closures corresponded to reduced case growth rates in the two weeks following implementation, while policy stringency and travelling restrictions were most effective after four. While we did not find evidence of reduced deaths in our per capita estimates, policy stringency, masks, SIPOs, limited gatherings, school and business closures were associated with decreased mortality growth rates. Moreover, the two NPIs studied in hospitalizations (SIPOs and mask wearing) showed negative estimates. Conclusions When assessing the impact of NPIs, considering the duration of effectiveness following implementation has paramount significance. While some NPIs may reduce the COVID-19 impact, others can disrupt the mitigative progression of containing the virus. Policymakers should be aware of both the scale of their effectiveness and duration of impact when adopting these measures for future COVID-19 waves.
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Affiliation(s)
- James A. Peters
- Department of Supply Chain & Business Technology Management, John Molson School of Business, Concordia University, Montreal, Quebec, Canada
| | - Mohsen Farhadloo
- Department of Supply Chain & Business Technology Management, John Molson School of Business, Concordia University, Montreal, Quebec, Canada
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21
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Kovačić B, Pavičić M, Skvrce NM, Tomić S. The readiness of the spontaneous reporting system for COVID-19 vaccines safety monitoring in Croatia. ACTA PHARMACEUTICA (ZAGREB, CROATIA) 2023; 73:293-310. [PMID: 37307371 DOI: 10.2478/acph-2023-0029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/15/2023] [Indexed: 06/14/2023]
Abstract
We aimed to identify whether a spontaneous reporting system (SRS) in Croatia could timely identify and confirm signals for COVID-19 vaccines. Post-marketing spontaneous reports of adverse drug reactions (ADRs) following COVID-19 immunisation reported to the Agency for Medicinal Products and Medical Devices of Croatia (HALMED) were extracted and analysed. 6624 cases reporting 30 655 ADRs following COVID-19 immunisation were received from 27th December 2020 to 31st December 2021. Available data in those cases were compared with data available to the EU network at the time when signals were confirmed and minimisation measures were implemented. 5032 cases, reporting 22 524 ADRs, were assessed as non-serious, and 1,592 cases, reporting 8,131 ADRs as serious. The most reported serious ADRs, which were listed in the MedDRA Important medical events terms list, were syncope (n = 58), arrhythmia (n = 48), pulmonary embolism (n = 45), loss of consciousness (n = 43), and deep vein thrombosis (n = 36). The highest reporting rate had Vaxzevria (0.003), followed by Spikevax and Jcovden (0.002), and Comirnaty (0.001). Potential signals were identified, however, they couldn't be timely confirmed solely on cases retrieved by SRS. In order to overcome the limitations of SRS, active surveillance and post-authorisation safety studies of vaccines should be implemented in Croatia.
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Affiliation(s)
- Barbara Kovačić
- 1Department of Pharmacovigilance and Rational Pharmacotherapy Agency for Medicinal Products and Medical Devices of Croatia 10000 Zagreb, Croatia
| | - Morana Pavičić
- 1Department of Pharmacovigilance and Rational Pharmacotherapy Agency for Medicinal Products and Medical Devices of Croatia 10000 Zagreb, Croatia
| | - Nikica Mirošević Skvrce
- 1Department of Pharmacovigilance and Rational Pharmacotherapy Agency for Medicinal Products and Medical Devices of Croatia 10000 Zagreb, Croatia
- 2Centre for Applied Pharmacy, Faculty of Pharmacy and Biochemistry University of Zagreb, 10 000 Zagreb Croatia
| | - Siniša Tomić
- 3Directorate, Agency for Medicinal Products and Medical Devices of Croatia 10000 Zagreb, Croatia
- 4Department of Basic and Clinical Pharmacology with Toxicology, Faculty of Medicine, University of Rijeka 51000 Rijeka, Croatia
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22
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Hasanzad M, Namazi H, Larijani B. COVID-19 anti-vaccine attitude and hesitancy. J Diabetes Metab Disord 2023; 22:1-4. [PMID: 36373157 PMCID: PMC9638374 DOI: 10.1007/s40200-022-01018-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 02/13/2022] [Accepted: 02/28/2022] [Indexed: 11/08/2022]
Abstract
High vaccination rates are required around the world to create herd immunity and terminate the current COVID-19 pandemic growth. With the steady rise in COVID-19 vaccine supplies, hesitancy and rejection to be vaccinated has become a problem worldwide for large vaccine coverage. Understanding the causes of vaccine avoidance or hesitancy can help to increase vaccination intentions in the general population. A number of factors contributed to increasing hesitancy. Some causes of COVID-19 vaccine hesitancy include anti-vaccine myths and confusing messages about some severe side effects of few vaccines, confusion over protection levels, poor health literacy (lack of accurate knowledge about vaccines and virus), deficient legal liability from the vaccine manufacturers, political and economic intentions, mistrust and suspicion of medical companies, concern of efficacy against to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) variants, safety concerns (elderly, people with preexisting comorbidities) and some socio-demographic factors. Urgent interventions and policies targeting the corresponding factors are needed. Recognizing obstacles to vaccine uptake helps in the development of effective solutions to solve them. Evidence-based and behaviorally guided approaches should be used to achieve high acceptance and uptake. Supplementary Information The online version contains supplementary material available at 10.1007/s40200-022-01018-y.
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Affiliation(s)
- Mandana Hasanzad
- Medical Genomics Research Center, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
- Personalized Medicine Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamidreza Namazi
- Medical Ethics and History of Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Bagher Larijani
- Personalized Medicine Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
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23
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Zengeni M, Briggs NN. The Prevalence of COVID-19 Vaccine Hesitancy Among the Black Asian Ethnic Minority in New South Wales, Australia. Cureus 2023; 15:e40626. [PMID: 37350977 PMCID: PMC10284598 DOI: 10.7759/cureus.40626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/18/2023] [Indexed: 06/24/2023] Open
Abstract
INTRODUCTION Vaccination provides a cost-effective approach to controlling the COVID-19 pandemic. The success of vaccination depends on global preparedness and acceptance of the new vaccines, and this is threatened by vaccine hesitancy worldwide. This study aimed to measure the prevalence of COVID-19 vaccine hesitancy, attitudes, and contributing factors in the Black Asian Ethnic Minority (BAME) of New South Wales (NSW), Australia. Aim: This study aimed to measure the prevalence of COVID-19 vaccine hesitancy and identify contributing factors leading to vaccine hesitancy in the Black Asian and Ethnic Minority (BAME) in NSW. METHOD A cross-sectional study was conducted among the BAME community in NSW; over 12 weeks, from January 3rd, 2022, to March 28th, 2022. The study used the pre-existing previously known 5Cs model (confidence, constraints, complacency, calculation, and collective responsibility) to assess reasons for hesitancy. The questionnaire was distributed in English using social media platforms: Facebook and WhatsApp. RESULTS The study received 101 respondents over 18 years from all states in Australia from BAME communities, males and females, with different educational levels, employment sectors, marital statuses, co-existing chronic medical conditions, previous COVID-19 infection status, and COVID-19 vaccine received. Of these, 56 respondents were from NSW. Our findings revealed a high prevalence of COVID-19 vaccine hesitancy among the BAME community in NSW, with 72.8% of respondents demonstrating hesitancy/reluctance due to various attitudes identified by the 5Cs model. Despite this high hesitancy, 98.2% of the participants had received at least one to three vaccine doses. CONCLUSION Even in populations with high vaccine uptake, it is still essential to address vaccine hesitancy and provide ongoing education about the importance of vaccination, particularly as new variants of COVID-19 continue to emerge and the need for booster shots may arise. This can help ensure continued protection against the virus and prevent future outbreaks.
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Affiliation(s)
- Mercy Zengeni
- Medicine, Oceania University of Medicine, Brisbane, AUS
| | - Naomi N Briggs
- Emergency Medicine, Sunshine Coast University Hospital, Sunshine Coast, AUS
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24
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Jin SW, Lattimore DC, Harlin E, Davis L, Erholtz V, Brandt HM. Medical and public health professionals' perceived facilitators and barriers of human papillomavirus (HPV) vaccination among African American adolescents in Shelby County, Tennessee. BMC Health Serv Res 2023; 23:469. [PMID: 37165427 PMCID: PMC10173571 DOI: 10.1186/s12913-023-09415-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 04/18/2023] [Indexed: 05/12/2023] Open
Abstract
Human papillomavirus (HPV) infects nearly 85% of sexually active Americans during their lifetime, causing most cervical and five other cancers. Routine HPV vaccination is recommended for adolescents to prevent HPV-attributable cancers, but HPV vaccination coverage remains low, especially in Tennessee. In 2021, 54.6% of the population in Shelby County, Tennessee was Black or African American, reporting higher rates of new cervical cancer cases than other counties in Tennessee. While medical and public health professionals (HPs) play a critical role in promoting vaccination coverage, little is known about the factors HPs perceive to influence HPV vaccination for this population. This study sought to explore HPs' perceived facilitators and barriers of HPV vaccination among African American adolescents. Qualitative individual interviews with 26 HPs in Shelby County were conducted between October 2019 and February 2020. Interpretive content analysis of the interview data guided by the socio-ecological model revealed several important themes regarding the facilitators and barriers across the individual, interpersonal, and community levels. At the individual level, parental vaccine hesitancy emerged as a leading barrier to HPV vaccination, while appropriate education facilitated the vaccination. At the interpersonal level, a lack of strong provider recommendations impeded HPV vaccination, whereas improved communication skills with patients facilitated the vaccination. Finally, the community-level barriers included a lack of education and social/religious norms; the community-level facilitators included community outreach efforts. HPs should consider development of comprehensive community-based approaches that leverage the facilitators and barriers at multiple levels to increase HPV vaccination among African American adolescents in this region.
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Affiliation(s)
- Seok Won Jin
- School of Social Work, The University of Memphis, 119 McCord Hall, Memphis, TN, 38152, USA.
- Department of Medical Humanities and Social Science, College of Medicine, Yonsei University, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea.
- Institute of Media Arts , Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea.
| | | | - Eric Harlin
- School of Social Work, The University of Memphis, 119 McCord Hall, Memphis, TN, 38152, USA
| | - Levonna Davis
- School of Social Work, The University of Memphis, 119 McCord Hall, Memphis, TN, 38152, USA
| | - Virginia Erholtz
- The University of Memphis, 226 McCord Hall, Memphis, TN, 38152, USA
| | - Heather M Brandt
- HPV Cancer Prevention Program, St. Jude Children's Research Hospital, 262 Danny Thomas Place, Memphis, TN, 38105, USA
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25
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Riad A, Schulz-Weidner N, Dziedzic A, Howaldt HP, Attia S. Oral side effects of COVID-19 vaccines in 32 European countries: Analysis of EudraVigilance reports. J Med Virol 2023; 95:e28771. [PMID: 37212314 DOI: 10.1002/jmv.28771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 01/27/2023] [Accepted: 04/20/2023] [Indexed: 05/23/2023]
Abstract
The recent reports of oral side effects (SEs) following COVID-19 vaccination warrant further investigation into their prevalence, severity, and aetiology. This study was conducted to synthesize the first-ever population-level evidence about oral SEs of COVID-19 vaccines in Europe. The European Union Drug Regulating Authorities Pharmacovigilance (EudraVigilance) database was accessed in August 2022 to extract summary data of all potential oral SEs reported after COVID-19 vaccination. The data were reported descriptively and cross-tabulated to facilitate sub-group analysis per vaccine type, sex, and age group. Dysgeusia was the most commonly reported oral SE (0.381 case per each 100 received reports), followed by oral paraesthesia (0.315%), ageusia (0.296%), lip swelling (0.243%), dry mouth (0.215%), oral hypoaesthesia (0.210%), swollen tongue (0.207%), and taste disorder (0.173%). Females had significantly (Sig. < 0.001) a higher prevalence of all most common (top 20) oral SEs, except for salivary hypersecretion, which was equally prevalent among females and males. The present study revealed a low prevalence of oral SEs, with taste-related, other sensory and anaphylactic SEs being the most common SEs in Europe, similar to what was found earlier among the US population. Future studies should explore the potential risk factors of oral sensory and anaphylactic SEs to verify whether they are causally linked to COVID-19 vaccines.
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Affiliation(s)
- Abanoub Riad
- Department of Public Health, Faculty of Medicine, Masaryk University, Brno, Czech Republic
- Department of Oral and Maxillofacial Surgery, Justus-Liebig-University, Giessen, Germany
| | | | - Arkadiusz Dziedzic
- Department of Restorative Dentistry with Endodontics, Medical University of Silesia, Katowice, Poland
| | - Hans-Peter Howaldt
- Department of Oral and Maxillofacial Surgery, Justus-Liebig-University, Giessen, Germany
| | - Sameh Attia
- Department of Oral and Maxillofacial Surgery, Justus-Liebig-University, Giessen, Germany
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26
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Grignolio Corsini A, Zagarella RM, Adamo M, Caporale C. From COVID-19 vaccine candidates to compulsory vaccination: The attitudes of Italian citizens in the key 7-month of vaccination campaign. Vaccine 2023; 41:2582-2588. [PMID: 36925424 PMCID: PMC9981525 DOI: 10.1016/j.vaccine.2023.02.081] [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: 10/12/2022] [Accepted: 02/26/2023] [Indexed: 03/06/2023]
Abstract
INTRODUCTION The aim of the study is to understand the evolution of COVID-19 vaccine acceptance over the key 7-month vaccine campaign in Italy, a period in which the country moved from candidate vaccines to products administered to the public. The research focus points to evaluate COVID-19 vaccine attitudes in adults and their children, propension towards compulsory vaccination, past and present adherence to anti-flu and anti-pneumococcal vaccines, and the reasons for trust/mistrust of vaccines. METHODS Italian residents aged 16->65 years were invited to complete an online survey from September 2020 to April 2021. The survey contained 13 questions: 3 on demographic data; 8 on vaccine attitudes; and 2 open-ended questions about the reasons of vaccine confidence/refusal. A preliminary word frequency analysis has been conducted, as well as a statistical bivariate analysis. RESULTS Of 21.537 participants, the confidence of those in favor of the COVID-19 vaccine increases of 50 % and the number of people who wanted more information decreases by two-third. Willingness to vaccinate their children against COVID-19 also increased from 51 % to 66.5 %. Only one-third of the strong vaccine-hesitant participants, i.e. 10 %, remained hostile. Compulsory vaccination showed a large and increasing favor by participants up to 78 %, in a way similar to their propensity for children's mandatory vaccination (70.6 %). Respondents' past and present adherence to anti-flu and anti-pneumococcal vaccines does not predict their intentions to vaccinate against COVID-19. Finally, a semantic analysis of the reasons of acceptance/refusal of COVID-19 vaccination suggests a complex decision-making process revealed by the participants' use of common words in pro-and-cons arguments. CONCLUSION The heterogeneity in the COVID-19 vaccine hesitancy, determinants and opinions detected at different ages, genders and pandemic phases suggests that health authorities should avoid one-size-fits-all vaccination campaigns. The results emphasize the long-term importance of reinforcing vaccine information, communication and education needs.
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Affiliation(s)
- Andrea Grignolio Corsini
- Interdepartmental Center for Research Ethics and Integrity, National Research Council, Rome, Italy; Faculty of Medicine & Surgery, Vita-Salute San Raffaele University, Milan, Italy.
| | | | - Massimiliano Adamo
- Institute for applied mathematics "Mauro Picone" (IAC), National Research Council, Rome, Italy.
| | - Cinzia Caporale
- Interdepartmental Center for Research Ethics and Integrity, National Research Council, Rome, Italy.
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27
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Graves C, Wright WL, Wolynn TH. Using Behavioural Science to Help Understand Vaccine Hesitancy. EMJ MICROBIOLOGY & INFECTIOUS DISEASES 2023. [DOI: 10.33590/emjmicrobiolinfectdis/10305093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
This article is based on a Learning Lounge educational session that took place on 22nd October 2022, as part of Infectious Diseases Society of America (IDSA) IDWeek™ 2022 held in Washington, D.C., USA. The objectives of the Learning Lounge were to enhance understanding of the principal reasons for patients’ vaccine hesitancy based on key sociocultural, behavioural, and psychological factors; identify the general communication ‘cues’ and specific psychosocial objections that signal a patient’s inclination to vaccine bias; and help healthcare professionals (HCP) learn how to address vaccine hesitancy based on patients’ cognitive and behavioural biases. The knowledge shared in this Learning Lounge can help guide and assist HCPs in recognising and addressing vaccine hesitancy, thereby supporting effective conversations with patients and/or their caregivers, and drive more personalised solutions to improve acceptance of vaccinations. The Learning Lounge was hosted by Christopher Graves, Founder and President of the Ogilvy Centre for Behavioral Science, New York, New York, USA., who is an expert on vaccine hesitancy and guiding HCPs on recognising and addressing this phenomenon. Graves was joined by Wendy Wright, Partners in Healthcare Education, LLC, Bedford, New Hampshire, USA, and Todd Wolynn, Kids Plus Pediatrics, Pittsburgh, Pennsylvania, USA, in a roleplay discussion to highlight cognitive biases that are relevant to vaccine hesitancy, and how these might be addressed in clinical practice.
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Affiliation(s)
| | - Wendy L. Wright
- Partners in Healthcare Education, LLC, Bedford, New Hampshire, USA
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28
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Hromatko I, Mikac U, Tadinac M. Intention to Vaccinate against COVID-19 among Young Adults: The Role of Conspiratorial Thinking. Vaccines (Basel) 2023; 11:vaccines11020321. [PMID: 36851199 PMCID: PMC9965982 DOI: 10.3390/vaccines11020321] [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: 12/21/2022] [Revised: 01/23/2023] [Accepted: 01/30/2023] [Indexed: 02/04/2023] Open
Abstract
The anti-scientific and anti-vaccine movements gained momentum amidst the health and socio-economic crisis brought about by the COVID-19 pandemic. These widespread pseudoscientific beliefs and the endorsement of conspiracy theories likely contributed to the COVID-19 vaccine hesitancy. The aim of this study was to explore which variables best differentiated between groups of vaccinated (n = 289), vaccine-hesitant (n = 106), and vaccine-refusing (n = 146) young adults. The study was conducted online at the beginning of the mass vaccination campaign in Croatia when the vaccine just became available for younger and non-vulnerable members of the general population. The demographic variables, COVID-19 anxiety, and conspiratorial thinking regarding COVID-19 were entered into the discriminant analysis. The function explaining 89.2% of the group differences, mostly between the vaccinated and vaccine-refusing, was largely defined by conspiratorial thinking regarding COVID-19 (0.852), followed by variables with substantially less discriminative power, including COVID-19 anxiety (0.423; lower in the vaccine-refusing group), political orientation (0.486; vaccine-refusing leaning less to the left), financial and educational status (0.435 and 0.304, respectively; both lower in the vaccine-refusing group), and religiosity (0.301; higher in the vaccine-refusing group). These results confirm that among young adults, the decision to vaccinate against COVID-19 might be heavily influenced by one's proclivity to engage in conspiratorial thinking.
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29
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Bai Y, Liu D, He Q, Liu J, Mao Q, Liang Z. Research progress on circular RNA vaccines. Front Immunol 2023; 13:1091797. [PMID: 36713460 PMCID: PMC9878156 DOI: 10.3389/fimmu.2022.1091797] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 12/27/2022] [Indexed: 01/13/2023] Open
Abstract
Owing to the success of linear mRNA coronavirus disease 2019 (COVID-19) vaccines, biopharmaceutical companies and research teams worldwide have attempted to develop more stable circular RNA (circRNA) vaccines and have achieved some preliminary results. This review aims to summarize key findings and important progress made in circRNA research, the in vivo metabolism and biological functions of circRNAs, and research progress and production process of circRNA vaccines. Further, considerations regarding the quality control of circRNA vaccines are highlighted herein, and the main challenges and problem-solving strategies in circRNA vaccine development and quality control are outlined to provide a reference for circRNA vaccine-related research.
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Affiliation(s)
- Yu Bai
- Division of Hepatitis and Enterovirus Vaccines, National Institutes for Food and Drug Control, Beijing, China,NHC Key Laboratory of Research on Quality and Standardization of Biotech Products, National Institutes for Food and Drug Control, Beijing, China,NMPA Key Laboratory for Quality Research and Evaluation of Biological Products, Institute of Biological Products, National Institutes for Food and Drug Control, Beijing, China
| | - Dong Liu
- Division of Hepatitis and Enterovirus Vaccines, National Institutes for Food and Drug Control, Beijing, China,NHC Key Laboratory of Research on Quality and Standardization of Biotech Products, National Institutes for Food and Drug Control, Beijing, China,NMPA Key Laboratory for Quality Research and Evaluation of Biological Products, Institute of Biological Products, National Institutes for Food and Drug Control, Beijing, China
| | - Qian He
- Division of Hepatitis and Enterovirus Vaccines, National Institutes for Food and Drug Control, Beijing, China,NHC Key Laboratory of Research on Quality and Standardization of Biotech Products, National Institutes for Food and Drug Control, Beijing, China,NMPA Key Laboratory for Quality Research and Evaluation of Biological Products, Institute of Biological Products, National Institutes for Food and Drug Control, Beijing, China
| | - Jianyang Liu
- Division of Hepatitis and Enterovirus Vaccines, National Institutes for Food and Drug Control, Beijing, China,NHC Key Laboratory of Research on Quality and Standardization of Biotech Products, National Institutes for Food and Drug Control, Beijing, China,NMPA Key Laboratory for Quality Research and Evaluation of Biological Products, Institute of Biological Products, National Institutes for Food and Drug Control, Beijing, China
| | - Qunying Mao
- Division of Hepatitis and Enterovirus Vaccines, National Institutes for Food and Drug Control, Beijing, China,NHC Key Laboratory of Research on Quality and Standardization of Biotech Products, National Institutes for Food and Drug Control, Beijing, China,NMPA Key Laboratory for Quality Research and Evaluation of Biological Products, Institute of Biological Products, National Institutes for Food and Drug Control, Beijing, China,*Correspondence: Zhenglun Liang, ; Qunying Mao,
| | - Zhenglun Liang
- Division of Hepatitis and Enterovirus Vaccines, National Institutes for Food and Drug Control, Beijing, China,NHC Key Laboratory of Research on Quality and Standardization of Biotech Products, National Institutes for Food and Drug Control, Beijing, China,NMPA Key Laboratory for Quality Research and Evaluation of Biological Products, Institute of Biological Products, National Institutes for Food and Drug Control, Beijing, China,*Correspondence: Zhenglun Liang, ; Qunying Mao,
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30
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Christou-Ergos M, Wiley KE, Leask J. Willingness to receive a vaccine is influenced by adverse events following immunisation experienced by others. Vaccine 2023; 41:246-250. [PMID: 36446655 DOI: 10.1016/j.vaccine.2022.11.034] [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: 08/15/2022] [Revised: 11/02/2022] [Accepted: 11/16/2022] [Indexed: 11/28/2022]
Abstract
An adverse event following immunization (AEFI) can have consequences for an individual's future decision making and may contribute to vaccine hesitancy. AEFIs vary in severity and can be experienced directly (by an individual themselves) or indirectly (through witnessed or recounted events). We sought to measure the prevalence of specific AEFIs and understand which AEFIs have the greatest associations with reduced willingness to receive a vaccine and how injection anxiety may moderate the relationship. We conducted a cross-sectional online survey with both qualitative and quantitative elements in a sample of adults aged 18 years and over in Australia. Nineteen percent of the 1050 respondents reported experiencing an AEFI that they found stressful. Those who experienced an AEFI reported significantly higher levels of injection anxiety than those who did not. Within the group who reported experiencing an AEFI, respondents were significantly less likely to be willing to receive a COVID-19 vaccine if they reported: indirect exposure to an uncommon/rare AEFI compared with other AEFIs (aOR:0.39; 95% CI: 0.18-0.87); indirect exposure to a scientifically unsupported AEFI compared with other AEFIs (aOR:0.18; 95% CI: 0.05-0.57). Direct exposure to an AEFI was not associated with willingness to receive a COVID-19 vaccine. For those who reported experiencing an AEFI, the odds of willingness to receive a COVID-19 vaccine decreased significantly with an increase in injection anxiety (aOR:0.94; 95% CI: 0.9-0.98). Our results suggest that more is needed to mitigate the consequences of AEFIs on vaccine willingness. Empathically acknowledging at a community level, the experience of both real and perceived AEFIs and incorporating accounts of positive vaccination experiences in vaccine hesitancy interventions may be useful.
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Affiliation(s)
- Maria Christou-Ergos
- University of Sydney, Faculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, Sydney, NSW, Australia.
| | - Kerrie E Wiley
- University of Sydney, Faculty of Medicine and Health, School of Public Health, Sydney, NSW, Australia; Sydney Infectious Diseases Institute, Westmead Hospital, Westmead, NSW, Australia
| | - Julie Leask
- University of Sydney, Faculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, Sydney, NSW, Australia; Sydney Infectious Diseases Institute, Westmead Hospital, Westmead, NSW, Australia
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31
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Searles M, Jose Ronquillo Mora Y, Carlo L, Heydari N, Takyiwaa Y, Borbor-Cordova MJ, Campagna CD. Zika virus knowledge and vaccine acceptance among undergraduate students in Guayaquil, Ecuador. Vaccine X 2022; 13:100258. [PMID: 36686399 PMCID: PMC9850025 DOI: 10.1016/j.jvacx.2022.100258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 11/17/2022] [Accepted: 12/27/2022] [Indexed: 12/29/2022] Open
Abstract
Purpose Zika virus (ZIKV) was declared a Public Health Emergency of International Concern (PHEIC) in 2016. Concerns surrounding the effects of ZIKV persist today and several vaccine candidates are currently in various stages of development worldwide. There is limited research on ZIKV vaccine acceptability worldwide, and little research specific to Latin American countries. This research aims to identify the general beliefs and acceptance of a potential ZIKV vaccine in the undergraduate population at Escuela Superior Politécnica del Litoral (ESPOL) in Guayaquil, Ecuador. Methods Between January and November 2019, 429 undergraduate students at ESPOL responded anonymously to a ZIKV vaccine survey. Frequencies, percentages, simple correspondence analysis, and bivariate inferential analyses were conducted using Kendall's tau-b test. Tests explored associations between likelihood of receiving a ZIKV vaccine and demographic, ZIKV information seeking, ZIKV psychosocial variables, and ZIKV information source variables. Results Among the eligible participants, 241 (56.2%) were willing to receive a ZIKV vaccine if one was made commercially available. Most students were male (61.5%), age 20-25 (63.3%), and of mixed (Mestizo) race (95.3%). Results provided insight into student's knowledge on ZIKV, revealed television as the most common information source, and found most students were willing to receive a ZIKV vaccine were one to become available. Bivariate results revealed most respondents reported feeling neutral or likely to receive a ZIKV vaccine regardless of their agreeability with ZIKV information seeking behavior and psychosocial variables. Conclusions This study provides insight into ZIKV knowledge among ESPOL university students and reveals most respondents obtained ZIKV related information from television. The most common reason for not wanting to receive a hypothetical ZIKV vaccine was vaccine hesitancy. Likelihood of receiving a ZIKV vaccine was associated with several information seeking behavior and psychosocial variables. Public health campaigns should focus on comprehensive ZIKV education efforts in this population.
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Affiliation(s)
- Madison Searles
- Institute for Global Health and Translational Science, State University of New York Upstate Medical University, 505 Irving Avenue Suite 4200, Syracuse, NY, 13210, USA
| | - Ysai Jose Ronquillo Mora
- Facultad de Ingeniería Marítima y Ciencias del Mar, Escuela Superior Politécnica del Litoral, Guayaquil, Ecuador
| | - Lorena Carlo
- Department of Health Informatics, School of Health Professions, Rutgers University, Piscataway, NJ, 08854, USA,Facultad de Ingeniería Electricidad y Computación, Escuela Superior Politécnica del Litoral, Guayaquil, Ecuador
| | - Naveed Heydari
- Institute for Global Health and Translational Science, State University of New York Upstate Medical University, 505 Irving Avenue Suite 4200, Syracuse, NY, 13210, USA
| | - Yaa Takyiwaa
- Institute for Global Health and Translational Science, State University of New York Upstate Medical University, 505 Irving Avenue Suite 4200, Syracuse, NY, 13210, USA,College of Medicine, State University of New York Upstate Medical University, 750 East Adams Street, Syracuse, NY, 13210, USA
| | - Mercy J Borbor-Cordova
- Facultad de Ingeniería Marítima y Ciencias del Mar, Escuela Superior Politécnica del Litoral, Guayaquil, Ecuador,Pacific International Center for Disaster Risk Reduction (-RRD), ESPOL, Campus Gustavo Galindo Km. 30.5 Vía Perimetral, Guayaquil, Ecuador
| | - Christina D Campagna
- Institute for Global Health and Translational Science, State University of New York Upstate Medical University, 505 Irving Avenue Suite 4200, Syracuse, NY, 13210, USA,Department of Public Health and Preventive Medicine, State University of New York Upstate Medical University, 750 East Adams Street, Syracuse, NY, 13210, USA,Corresponding author.
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Joyce MC, Mountjoy NJ, Johnson JA, Newman JT, Bandy DL, Atalla NA, Singh A, McElroy D. From trial to practice: incidence and severity of COVID-19 vaccine side effects in a medically at-risk and vaccine-hesitant community. BMC Public Health 2022; 22:2351. [DOI: 10.1186/s12889-022-14824-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 12/06/2022] [Indexed: 12/15/2022] Open
Abstract
Abstract
Background
The rapid authorization and widespread rollout of COVID-19 vaccines in the United States demonstrated a need for additional data on vaccine side effects, both to provide insight into the range and severity of side effects that might be expected in medically-diverse populations as well as to inform decision-making and combat vaccine hesitancy going forward. Here we report the results of a survey of 4825 individuals from southcentral Kentucky who received two doses of either the Pfizer-BioNTech (BNT162b2) or Moderna (mRNA-1273) vaccine between December 14, 2020 and May 1, 2021. As new versions of the vaccine are rolled-out, local initiatives such as this may offer a means to combat vaccine hesitancy in reference to COVID-19, but are also important as we face new viral threats that will necessitate a rapid vaccine rollout, and to combat a growing public distrust of vaccines in general.
Methods
Individuals that received two doses of either BNT162b2 or mRNA-1273 between December 14, 2020 and May 1, 2021 were sent a survey, created by the research team. Respondents were asked to rate the incidence and severity of 15 potential side effects and two related outcomes following each of their two doses of the vaccine. All statistical analyses were carried out using SYSTAT, version 13. The data were analyzed utilizing a range of statistical tests, including chi-square tests of association, Cohen’s h, Kruskal-Wallis test one-way nonparametric ANOVA, least-squares regression, and Wilcoxon signed-ranks test. Significance was assessed using Bonferroni-adjusted criteria within families of tests.
Results
In general, the pattern and severity in side effects was similar to both clinical trial data as well as other published studies. Responses to the mRNA-1273 vaccine were more severe than to BNT162b2, though all were generally in the mild to moderate category. Individuals who reported having previously tested positive for COVID-19 reported stronger responses following the first dose of either vaccine relative to COVID-naïve individuals. The reported severity to the COVID-19 vaccine was positively correlated with self-reported responses to other vaccines.
Conclusions
Our findings allow broad-scale estimates of the nature and severity of reactions one might expect following vaccination within a clinically-diverse community, and provide a context for addressing vaccine hesitancy in communities such as ours, where locally-generated data and communication may be more influential than national trends and statistics in convincing individuals to become vaccinated. Further, we argue this community-based approach could be important in the future in three key ways: 1) as new boosters and modified vaccines re-volatilize vaccine hesitancy, 2) as new vaccines receive similar testing and rapid authorization, and 3) to combat vaccine hesitancy in other arenas (e.g., annual vaccines, childhood vaccines).
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Zeng H, Liu H, Liu M, Zhou Z, Wang SB, Zhou K, Li W, Dai L, Chen Y, Uy JP, Sun C, Ye Z. Understanding the Attitudes and Willingness of Adult Chinese Patients with Rheumatic Diseases Towards COVID-19 Vaccination. Risk Manag Healthc Policy 2022; 15:2269-2281. [PMID: 36479305 PMCID: PMC9721124 DOI: 10.2147/rmhp.s384337] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Accepted: 11/17/2022] [Indexed: 06/01/2024] Open
Abstract
BACKGROUND The SARS-CoV-2 pandemic has imposed substantial health and economic burdens on the societies. COVID-19 vaccination is the most effective method of controlling the epidemic. This study assessed the attitude, willingness, and related factors of adult patients with rheumatic diseases (RDs) in China towards COVID-19 vaccination and identified their reasons for being vaccinated. METHODS A cross-sectional survey was administered to patients with rheumatic diseases from July 18 to August 18, 2021, using an online questionnaire. Logistic regression analysis was performed to examine the data. RESULTS We analyzed data drawn from 464 participants who provided valid responses. A total of 324 (69.83%) RD patients were not willing to be vaccinated, of which 76.97% believed that COVID-19 vaccination might exacerbate the diseases symptoms. Logistic regression analysis showed that a combination of experiencing systemic damage, being in the acute attack stage of the disease, and fear of the adverse impact of vaccination on rheumatism, etc., were the predominant factors affecting the intentional vaccination rate in adult patients with rheumatic diseases (p < 0.05). CONCLUSION The COVID-19 intentional vaccination rate was relatively low in adult Chinese patients with RD. Public health education and the dissemination of government scientific data for patients with RD should be enhanced to increase COVID-19 vaccination rates.
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Affiliation(s)
- Huiqiong Zeng
- Department of Rheumatology, Shenzhen Futian Hospital for Rheumatic Diseases, Shenzhen, People’s Republic of China
| | - Hanjiang Liu
- Department of Safety Supervision Division, Guangdong Pharmaceutical Association, Guangzhou, People’s Republic of China
| | - Meifen Liu
- Department of Rheumatology, Shenzhen Futian Hospital for Rheumatic Diseases, Shenzhen, People’s Republic of China
| | - Zhen Zhou
- Department of Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Shi-Bin Wang
- Department of Mental Health, Guangdong Mental Health Center, Guangdong Provincial People’s Hospital, Guangzhou, People’s Republic of China
| | - Kaixia Zhou
- Department of Clinical Laboratory, Shanghai Cancer Center, Fudan University, Shanghai, People’s Republic of China
| | - Wengen Li
- Department of Rheumatology and Immunology, Meizhou People’s Hospital (Huangtang Hospital), Meizhou, People’s Republic of China
| | - Liping Dai
- Department of Rheumatology, Shenzhen Futian Hospital for Rheumatic Diseases, Shenzhen, People’s Republic of China
| | - Yashuo Chen
- Department of Rheumatology, Shenzhen Futian Hospital for Rheumatic Diseases, Shenzhen, People’s Republic of China
| | - John Patrick Uy
- Department of Infectious Disease and International Health, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA
| | - Chenyu Sun
- Department of AMITA Health Saint Joseph Hospital Chicago, University of Illinois at Chicago, Chicago, IL, USA
| | - Zhizhong Ye
- Department of Rheumatology, Shenzhen Futian Hospital for Rheumatic Diseases, Shenzhen, People’s Republic of China
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Identifying Modifiable Predictors of COVID-19 Vaccine Side Effects: A Machine Learning Approach. Vaccines (Basel) 2022; 10:vaccines10101747. [PMID: 36298612 PMCID: PMC9608090 DOI: 10.3390/vaccines10101747] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 10/14/2022] [Accepted: 10/15/2022] [Indexed: 02/03/2023] Open
Abstract
Side effects of COVID-19 or other vaccinations may affect an individual's safety, ability to work or care for self or others, and/or willingness to be vaccinated. Identifying modifiable factors that influence these side effects may increase the number of people vaccinated. In this observational study, data were from individuals who received an mRNA COVID-19 vaccine between December 2020 and April 2021 and responded to at least one post-vaccination symptoms survey that was sent daily for three days after each vaccination. We excluded those with a COVID-19 diagnosis or positive SARS-CoV2 test within one week after their vaccination because of the overlap of symptoms. We used machine learning techniques to analyze the data after the first vaccination. Data from 50,484 individuals (73% female, 18 to 95 years old) were included in the primary analysis. Demographics, history of an epinephrine autoinjector prescription, allergy history category (e.g., food, vaccine, medication, insect sting, seasonal), prior COVID-19 diagnosis or positive test, and vaccine manufacturer were identified as factors associated with allergic and non-allergic side effects; vaccination time 6:00-10:59 was associated with more non-allergic side effects. Randomized controlled trials should be conducted to quantify the relative effect of modifiable factors, such as time of vaccination.
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Nuwarda RF, Ramzan I, Weekes L, Kayser V. Vaccine Hesitancy: Contemporary Issues and Historical Background. Vaccines (Basel) 2022; 10:vaccines10101595. [PMID: 36298459 PMCID: PMC9612044 DOI: 10.3390/vaccines10101595] [Citation(s) in RCA: 50] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 09/19/2022] [Accepted: 09/20/2022] [Indexed: 11/16/2022] Open
Abstract
Vaccination, despite being recognized as one of the most effective primary public health measures, is viewed as unsafe and unnecessary by an increasing number of individuals. Anxiety about vaccines and vaccination programs leading to vaccine hesitancy results from a complex mix of social and political influences, cultural and religious beliefs, the availability of and ability to interpret health and scientific information, and personal and population experiences of health systems and government policies. Vaccine hesitancy is becoming a serious threat to vaccination programs, and was identified as one of the World Health Organization’s top ten global health threats in 2019. The negative impact of anti-vaccination movements is frequently cited as one of the major reasons for rising vaccine hesitancy amongst the general public world-wide. This review discusses the various issues surrounding vaccine hesitancy and the anti-vaccine movement, starting with the definitions of vaccine hesitancy and the anti-vaccine movement in their early history and in the modern era, before discussing the key drivers of vaccine hesitancy, particularly across different regions of the world, with a focus on various countries with low-, middle-, or high-income economies with different socio-economic populations. The review concludes with the impact of vaccine hesitancy on herd immunity and social, psychological, and public health measures to counter vaccine hesitancy.
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Le XTT, Hoang QL, Ta NTK, Pham QT, Nguyen TT, Phan HTM, Nguyen TV, Le HTT, Nguyen NT, Hoang LD, Luong PTH, An LH, Nguyen TH, Nguyen TT, Nguyen HT, Le HT, Nguyen DQ, Nguyen PV, Nguyen TX, Do TTT, Nguyen TH. Common adverse events following immunization with the COVID-19 comirnaty vaccine (Pfizer-BioNTech) among adult population in Hanoi, Vietnam, 2021. FRONTIERS IN TROPICAL DISEASES 2022. [DOI: 10.3389/fitd.2022.987698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
RationaleTo prevent and control the COVID-19 pandemic, the biggest immunization campaign in history had been deployed worldwide. Therefore, it is important to inform the adverse events following immunization (AEFI) to populations.ObjectivesTo prevent vaccine hesitancy, this study focused on finding the common AEFI with the COVID-19 Comirnaty vaccine (Pfizer-BioNTech) among participants aged 18 and above and related factors in Hanoi, Vietnam.MethodsA cross-sectional study was carried out to collect participants’ data and AEFI after being vaccinated at Hanoi Medical University, Vietnam, in 2021. Logistic regression was utilized for analyzing the correlated factors of AEFI.ResultsWe recruited a random sample of 820 participants who received both basic doses of Pfizer vaccine in September and October 2021. The proportion of AEFI after the first dose, second dose, and both doses of Pfizer vaccine was 24.4%, 64.2%, and 18.5%, respectively. AEFI mostly appeared within 1 day and lasted for 1 to 2 days. The AEFI were more common in females (OR=1.7; 95%CI=1.25–2.29) and younger age groups (OR=1.9; 95%CI=1.37–2.58). History of allergy, allergic diseases, chronic diseases, and occupations were not statistically significant with AEFI.ConclusionOur findings indicated that the COVID-19 Comirnaty vaccine is safe to be injected. Gender and age group are important factors influencing AEFI.
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Yiannakoulias N, Darlington JC, Slavik CE, Benjamin G. Negative COVID-19 Vaccine Information on Twitter: Content Analysis. JMIR INFODEMIOLOGY 2022; 2:e38485. [PMID: 36348980 PMCID: PMC9632001 DOI: 10.2196/38485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 07/29/2022] [Accepted: 08/18/2022] [Indexed: 11/20/2022]
Abstract
Background Social media platforms, such as Facebook, Instagram, Twitter, and YouTube, have a role in spreading anti-vaccine opinion and misinformation. Vaccines have been an important component of managing the COVID-19 pandemic, so content that discourages vaccination is generally seen as a concern to public health. However, not all negative information about vaccines is explicitly anti-vaccine, and some of it may be an important part of open communication between public health experts and the community. Objective This research aimed to determine the frequency of negative COVID-19 vaccine information on Twitter in the first 4 months of 2021. Methods We manually coded 7306 tweets sampled from a large sampling frame of tweets related to COVID-19 and vaccination collected in early 2021. We also coded the geographic location and mentions of specific vaccine producers. We compared the prevalence of anti-vaccine and negative vaccine information over time by author type, geography (United States, United Kingdom, and Canada), and vaccine developer. Results We found that 1.8% (131/7306) of tweets were anti-vaccine, but 21% (1533/7306) contained negative vaccine information. The media and government were common sources of negative vaccine information but not anti-vaccine content. Twitter users from the United States generated the plurality of negative vaccine information; however, Twitter users in the United Kingdom were more likely to generate negative vaccine information. Negative vaccine information related to the Oxford/AstraZeneca vaccine was the most common, particularly in March and April 2021. Conclusions Overall, the volume of explicit anti-vaccine content on Twitter was small, but negative vaccine information was relatively common and authored by a breadth of Twitter users (including government, medical, and media sources). Negative vaccine information should be distinguished from anti-vaccine content, and its presence on social media could be promoted as evidence of an effective communication system that is honest about the potential negative effects of vaccines while promoting the overall health benefits. However, this content could still contribute to vaccine hesitancy if it is not properly contextualized.
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Affiliation(s)
- Niko Yiannakoulias
- School of Earth, Environment and Society McMaster University Hamilton, ON Canada
| | - J Connor Darlington
- School of Geography and Environmental Management University of Waterloo Waterloo, ON Canada
| | - Catherine E Slavik
- Center for Science Communication Research School of Journalism and Communication University of Oregon Eugene, OR United States
| | - Grant Benjamin
- Department of Economics University of Toronto Toronto, ON Canada
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Application of behavioral economics for understanding health behaviors among adolescents and young adults. Curr Opin Pediatr 2022; 34:326-333. [PMID: 35793607 PMCID: PMC9310431 DOI: 10.1097/mop.0000000000001126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW Behavioral economics (BE) concepts have become well studied tools in addressing patient issues, such as weight loss, smoking cessation, and medication adherence. Although predominantly studied in adult populations, emerging literature has shown BE's utility for adolescent/young adult (AYA) populations, offering a practical framework to safeguard AYA health and influence healthy decision making. RECENT FINDINGS We identified substantive areas in which BE concepts have been applied in AYA populations (e.g., substance use) and outline how these concepts have been used as a tool to identify individuals at risk for poor outcomes and to leverage behavioral insights to improve health behaviors. SUMMARY BE research holds significant promise as a tool for clinicians and researchers to encourage healthy decision making in AYA populations. Yet, there are opportunities for BE research to expand further into current trends impacting adolescent health, such as electronic nicotine delivery systems, social media apps, and coronavirus disease 2019 vaccinations. Furthermore, the full degree of BE utility remains to be explored, as few studies demonstrate the translation of associative findings into direct interventions. Additional work is needed to formalize BE techniques into best practices that clinicians can implement in their daily practice.
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Ichino A. Vaccine hesitancy and the reluctance to “tempt fate”. PHILOSOPHICAL PSYCHOLOGY 2022. [DOI: 10.1080/09515089.2022.2096432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Anna Ichino
- Department of Philosophy, Università degli Studi di Milano, Milan, Italy
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Casigliani V, Menicagli D, Fornili M, Lippi V, Chinelli A, Stacchini L, Arzilli G, Scardina G, Baglietto L, Lopalco P, Tavoschi L. Vaccine Hesitancy and Cognitive Biases: Evidence for tailored communication with parents. Vaccine X 2022; 11:100191. [PMID: 35859887 PMCID: PMC9289735 DOI: 10.1016/j.jvacx.2022.100191] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 06/28/2022] [Indexed: 11/29/2022] Open
Abstract
The model to analyse vaccine hesitancy should include the evaluation of cognitive biases. Communication interventions should be tailored based on the drivers of parents’ choice. Conspiracy mentality and risk propension correlate with the vaccine hesitancy.
Background Vaccine hesitancy (VH) remains worldwide a reason of concern. Most of the vaccination education strategies followed a “fact-based” approach, based on the assumption that decision making is a rational process, without considering the influence of cognitive biases and heuristics. Our study aimed at identifying factors involved in the parents’ vaccination choice to inform and shape communication interventions. Methods We conducted an online national survey among parents between November 2020 and April 2021. The questionnaire consisted of 42 items organised in 4 parts: (1) personal information, (2) cognitive biases and risk propension, (3) Analytic Thinking (Cognitive Reflection Test), (4) conspiracy mentality, health literacy, and VH. Exploratory factor analysis was conducted to identify latent variables underlying the 19 items related to the 6 cognitive biases. Factors were categorised in quintiles and the corresponding pseudo-continuous variables used as predictors of the VH. Logistic regression model was applied to assess the association of the VH with factors, conspiracy mentality and risk propension. We adjusted for age, gender, economic status, and education levels. Results The study included 939 parents, 764 women (81.4%), 69.8% had a degree or higher level of education. Considering cognitive biases, four factors explaining 54% of the total variance were identified and characterised as: fear of the side effects of vaccines (scepticism factor); carelessness of the risk and consequences of infections (denial factor); optimistic attitude (optimistic bias factor); preference for natural products (naturalness bias factor). All factors were positively associated to VH (p < 0.001) as were conspiracy mentality (p = 0.007) and risk propension (p = 0.002). Conclusions This study confirmed the need to amplify the model used to analyse the VH considering cognitive biases as important factor affecting the parents’ decision making. These results may be useful to design personalised communication interventions regarding vaccines and vaccination.
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Chrissian AA, Oyoyo UE, Patel P, Lawrence Beeson W, Loo LK, Tavakoli S, Dubov A. Impact of COVID-19 vaccine-associated side effects on health care worker absenteeism and future booster vaccination. Vaccine 2022; 40:3174-3181. [PMID: 35465979 PMCID: PMC9013647 DOI: 10.1016/j.vaccine.2022.04.046] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 03/24/2022] [Accepted: 04/11/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND Short-term side effects related to mRNA vaccines against SARS-CoV-2 are frequent and bothersome, with the potential to disrupt work duties and impact future vaccine decision-making. OBJECTIVE To identify factors more likely to lead to vaccine-associated work disruption, employee absenteeism, and future vaccine reluctance among healthcare workers (HCWs). HYPOTHESIS Side effects related to COVID vaccination: 1- frequently disrupt HCW duties, 2- result in a significant proportion of HCW absenteeism, 3- contribute to uncertainty about future booster vaccination, 4- vary based on certain demographic, socioeconomic, occupational, and vaccine-related factors. METHODS Using an anonymous, voluntary electronic survey, we obtained responses from a large, heterogeneous sample of COVID-19-vaccinated HCWs in two healthcare systems in Southern California. Descriptive statistics and regression models were utilized to evaluate the research questions. RESULTS Among 2,103 vaccinated HCWs, 579 (27.5%) reported that vaccine-related symptoms disrupted their professional responsibilities, and 380 (18.1%) missed work as a result. Independent predictors for absenteeism included experiencing generalized and work-disruptive symptoms, and receiving the Moderna vaccine [OR = 1.77 (95% CI = 1.33 - 2.36), p < 0.001]. Physicians were less likely to miss work due to side effects (6.7% vs 21.2% for all other HCWs, p < 0.001). Independent predictors of reluctance toward future booster vaccination included lower education level, younger age, having received the Moderna vaccine, and missing work due to vaccine-related symptoms. CONCLUSION Symptoms related to mRNA vaccinations against SARS-CoV-2 may frequently disrupt work duties, lead to absenteeism, and impact future vaccine decision-making. This may be more common in Moderna recipients and less likely among physicians. Accordingly, health employers should schedule future booster vaccination cycles to minimize loss of work productivity.
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Affiliation(s)
- Ara A Chrissian
- Division of Pulmonary, Critical Care, Hyperbaric, Allergy, and Sleep Medicine, Loma Linda University, Loma Linda, CA, USA.
| | | | - Pranjal Patel
- Division of Pulmonary, Critical Care, Hyperbaric, Allergy, and Sleep Medicine, Loma Linda University, Loma Linda, CA, USA
| | - W Lawrence Beeson
- School of Public Health, Epidemiology and Biostatistics, Loma Linda University, Loma Linda, CA, USA
| | - Lawrence K Loo
- Department of Medicine, Loma Linda University, Loma Linda, CA, USA
| | | | - Alex Dubov
- School of Behavioral Health, Loma Linda University, Loma Linda, CA, USA
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Mertens G, Lodder P, Smeets T, Duijndam S. Fear of COVID-19 predicts vaccination willingness 14 months later. J Anxiety Disord 2022; 88:102574. [PMID: 35512598 PMCID: PMC9047433 DOI: 10.1016/j.janxdis.2022.102574] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 04/22/2022] [Accepted: 04/24/2022] [Indexed: 01/25/2023]
Abstract
Vaccines are an important tool for governments and health agencies to contain and curb the Coronavirus Disease-19 (COVID-19) pandemic. However, despite their effectiveness and safeness, a substantial portion of the population worldwide is hesitant to get vaccinated. In the current study, we examined whether fear of COVID-19 predicts vaccination willingness. In a longitudinal study (N = 938), fear for COVID-19 was assessed in April 2020 and vaccination willingness was measured in June 2021. Approximately 11% of our sample indicated that they were not willing to get vaccinated. Results of a logistic regression showed that increased fear of COVID-19 predicts vaccination willingness 14 months later, even when controlling for several anxious personality traits, infection control perceptions, risks for loved ones, self-rated health, previous infection, media use, and demographic variables. These results show that fear of COVID-19 is a relevant construct to consider for predicting and possibly influencing vaccination willingness. Nonetheless, sensitivity and specificity of fear of COVID-19 to predict vaccination willingness were quite low and only became slightly better when fear of COVID-19 was measured concurrently. This indicates that other potential factors, such as perceived risks of the vaccines, probably also play a role in explaining vaccination willingness.
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Affiliation(s)
- Gaëtan Mertens
- Department of Medical and Clinical Psychology, Tilburg University, Tilburg, the Netherlands.
| | - Paul Lodder
- Department of Medical and Clinical Psychology, Tilburg University, Tilburg, the Netherlands,Department of Methods and Statistics, Tilburg University, Tilburg, the Netherlands
| | - Tom Smeets
- Department of Methods and Statistics, Tilburg University, Tilburg, the Netherlands
| | - Stefanie Duijndam
- Department of Methods and Statistics, Tilburg University, Tilburg, the Netherlands
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Abstract
PURPOSE OF REVIEW To offer: (1) Insight into the antivaccine movement's use of social media negatively impacting vaccine hesitancy and disease outbreaks, (2) Examples via case observations, and (3) Selected resources to combat vaccine hesitancy. RECENT FINDINGS For the past 25 years, daily social media usage has risen continually, allowing information to spread widely to a reading/listening/viewing audience via mostly unvetted social media sites. During a pandemic/epidemic (e.g., coronavirus disease 2019 pandemic), an overabundance of information from many sources, including social media, has led to what is now termed as an 'infodemic'. Infodemics arise from overwhelming amounts of both correct and incorrect information from experts and nonexperts alike. Differentiating correct from incorrect information is difficult for social media users who can be swayed by nonscientific 'influencers' or fear-mongering more than by vetted expert scientific information. Consequently, vaccine misinformation is steadily increasing via social media, the use of which is often believed to be associated with vaccine hesitancy. Stopping the spread of misinformation has been a difficult task. SUMMARY Vaccine misinformation on social media has been detrimental to public health. Vaccine advocates must increase the use of social media to the advantage of public health in the persistent struggle against vaccine hesitancy/refusal.
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Affiliation(s)
- Shannon E Clark
- Division of Infectious Diseases, Children's Mercy - Kansas City
| | | | - Christopher J Harrison
- Division of Infectious Diseases, Children's Mercy - Kansas City
- The University of Missouri, Kansas City, Missouri, USA
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Kumar D, Mathur M, Kumar N, Rana RK, Tiwary RC, Raghav PR, Kumar A, Kapoor N, Mathur M, Tanu T, Sethia S, Lahariya C. Understanding the phases of vaccine hesitancy during the COVID-19 pandemic. Isr J Health Policy Res 2022; 11:16. [PMID: 35317859 PMCID: PMC8939479 DOI: 10.1186/s13584-022-00527-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 03/08/2022] [Indexed: 11/13/2022] Open
Abstract
Vaccine hesitancy is an important feature of every vaccination and COVID-19 vaccination is not an exception. During the COVID-19 pandemic, vaccine hesitancy has exhibited different phases and has shown both temporal and spatial variation in these phases. This has likely arisen due to varied socio-behavioural characteristics of humans and their response towards COVID 19 pandemic and its vaccination strategies. This commentary highlights that there are multiple phases of vaccine hesitancy: Vaccine Eagerness, Vaccine Ignorance, Vaccine Resistance, Vaccine Confidence, Vaccine Complacency and Vaccine Apathy. Though the phases seem to be sequential, they may co-exist at the same time in different regions and at different times in the same region. This may be attributed to several factors influencing the phases of vaccine hesitancy. The complexities of the societal reactions need to be understood in full to be addressed better. There is a dire need of different strategies of communication to deal with the various nuances of all of the phases. To address of vaccine hesitancy, an understanding of the societal reactions leading to various phases of vaccine hesitancy is of utmost importance.
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Affiliation(s)
- Dewesh Kumar
- Department of PSM, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, 834001, India.
| | - Mansi Mathur
- Immunization Technical Support Unit, Ministry of Health and Family Welfare, New Delhi, India
| | - Nitesh Kumar
- Department of Community Medicine, Subharti Medical College, Meerut, U.P., India
| | | | | | - Pankaja Ravi Raghav
- Department of Community and Family Medicine, AIIMS, Jodhpur, Rajasthan, India
| | - Amarendra Kumar
- Subregional Team Leader Office, WHO Country Office for India, Ranchi, Jharkhand, India
| | | | - Medha Mathur
- Department of Community Medicine, Geetanjali Medical College and Hospital, Udaipur, Rajasthan, India
| | - Tanya Tanu
- Department of PSM, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, 834001, India
| | - Soumitra Sethia
- Department of Community Medicine, Government Medical College, Khandwa, M.P., India
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Malli F, Lampropoulos IC, Papagiannis D, Papathanasiou IV, Daniil Z, Gourgoulianis KI. Association of SARS-CoV-2 Vaccinations with SARS-CoV-2 Infections, ICU Admissions and Deaths in Greece. Vaccines (Basel) 2022; 10:vaccines10020337. [PMID: 35214795 PMCID: PMC8876225 DOI: 10.3390/vaccines10020337] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 02/14/2022] [Accepted: 02/15/2022] [Indexed: 01/27/2023] Open
Abstract
The available coronavirus disease 2019 (COVID-19) vaccines have shown their effectiveness in clinical trials. We aimed to assess the real-world effects of SARS-CoV-2 vaccinations in Greece. We combined national data on vaccinations, SARS-CoV-2 cases, COVID-19-related ICU admissions and COVID-19-related deaths. We observed 3,367,673 vaccinations (30.68% of the Greek population), 278,821 SARS-CoV-2 infections and 7401 COVID-19-related deaths. The vaccination rate significantly increased from week 2 to week 6 by 85.70%, and from week 7 to 25 by 15.65%. The weekly mean of SARS-CoV-2 cases, COVID-19 ICU patients and COVID-19 deaths markedly declined as vaccination coverage accumulated. The rate of SARS-CoV-2 cases increased significantly from week 2 to week 13 by 16.15%, while from weeks 14–25 the rate decreased significantly by 13.50%. The rate of COVID-19-related ICU admissions decreased significantly by 7.41% from week 2 to week 4, increased significantly by 17.22% from weeks 5–11, then decreased significantly from weeks 17–20, by 11.99%, and from weeks 21–25, by 16.77%. The rate of COVID-19-related deaths increased significantly from week 2 to week 15 by 12.08% and decreased significantly by 16.58% from weeks 16–25. The data from this nationwide observational study underline the beneficial impact of the national vaccination campaign in Greece, which may offer control of the SARS-CoV-2 pandemic.
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Affiliation(s)
- Foteini Malli
- Respiratory Disorders Laboratory, Faculty of Nursing, University of Thessaly, 41500 Larissa, Greece
- Respiratory Medicine Department, Faculty of Medicine, University of Thessaly, 41500 Larissa, Greece; (I.C.L.); (Z.D.); (K.I.G.)
- Correspondence: ; Tel.: +30-2413502896
| | - Ioannis C. Lampropoulos
- Respiratory Medicine Department, Faculty of Medicine, University of Thessaly, 41500 Larissa, Greece; (I.C.L.); (Z.D.); (K.I.G.)
| | - Dimitrios Papagiannis
- Public Health & Vaccines Laboratory, School of Health Sciences, Faculty of Nursing, University of Thessaly, 41110 Larissa, Greece;
| | - Ioanna V. Papathanasiou
- Community Nursing Laboratory, Faculty of Nursing, University of Thessaly, 41500 Larissa, Greece;
| | - Zoe Daniil
- Respiratory Medicine Department, Faculty of Medicine, University of Thessaly, 41500 Larissa, Greece; (I.C.L.); (Z.D.); (K.I.G.)
| | - Konstantinos I. Gourgoulianis
- Respiratory Medicine Department, Faculty of Medicine, University of Thessaly, 41500 Larissa, Greece; (I.C.L.); (Z.D.); (K.I.G.)
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Zhu P, Tatar O, Griffin-Mathieu G, Perez S, Haward B, Zimet G, Tunis M, Dubé È, Rosberger Z. Efficacy of a brief, altruism-eliciting video intervention in enhancing COVID-19 vaccination intentions amongst a population-based sample of younger adults: Randomized controlled trial (Preprint). JMIR Public Health Surveill 2022; 8:e37328. [PMID: 35544437 PMCID: PMC9153910 DOI: 10.2196/37328] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 04/28/2022] [Accepted: 05/07/2022] [Indexed: 11/22/2022] Open
Abstract
Background High COVID-19 vaccine uptake is crucial to containing the pandemic and reducing hospitalizations and deaths. Younger adults (aged 20-39 years) have demonstrated lower levels of vaccine uptake compared to older adults, while being more likely to transmit the virus due to a higher number of social contacts. Consequently, this age group has been identified by public health authorities as a key target for vaccine uptake. Previous research has demonstrated that altruistic messaging and motivation is associated with vaccine acceptance. Objective This study had 2 objectives: (1) to evaluate the within-group efficacy of an altruism-eliciting short, animated video intervention in increasing COVID-19 vaccination intentions amongst unvaccinated Canadian younger adults and (2) to examine the video’s efficacy compared to a text-based intervention focused exclusively on non-vaccine-related COVID-19 preventive health measures. Methods Using a web-based survey in a pre-post randomized control trial (RCT) design, we recruited Canadians aged 20-39 years who were not yet vaccinated against COVID-19 and randomized them in a 1:1 ratio to receive either the video intervention or an active text control. The video intervention was developed by our team in collaboration with a digital media company. The measurement of COVID-19 vaccination intentions before and after completing their assigned intervention was informed by the multistage Precaution Adoption Process Model (PAPM). The McNemar chi-square test was performed to evaluate within-group changes of vaccine intentions. Exact tests of symmetry using pairwise McNemar tests were applied to evaluate changes in multistaged intentions. Between-group vaccine intentions were assessed using the Pearson chi-square test postintervention. Results Analyses were performed on 1373 participants (n=686, 50%, in the video arm, n=687, 50%, in the text arm). Within-group results for the video intervention arm showed that there was a significant change in the intention to receive the vaccine (χ21=20.55, P<.001). The between-group difference in postintervention intentions (χ23=1.70, P=.64) was not significant. When administered the video intervention, we found that participants who had not thought about or were undecided about receiving a COVID-19 vaccine were more amenable to change than participants who had already decided not to vaccinate. Conclusions Although the video intervention was limited in its effect on those who had firmly decided not to vaccinate, our study demonstrates that prosocial and altruistic messages could increase COVID-19 vaccine uptake, especially when targeted to younger adults who are undecided or unengaged regarding vaccination. This might indicate that altruistic messaging provides a “push” for those who are tentative toward, or removed from, the decision to receive the vaccine. The results of our study could also be applied to more current COVID-19 vaccination recommendations (eg, booster shots) and for other vaccine-preventable diseases. Trial Registration ClinicalTrials.gov NCT04960228; https://clinicaltrials.gov/ct2/show/NCT04960228
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Affiliation(s)
- Patricia Zhu
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada
- Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - Ovidiu Tatar
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada
- Research Center, Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada
| | | | - Samara Perez
- Cedars Cancer Center, McGill University Health Center, Montreal, QC, Canada
- Department of Oncology, McGill University, Montreal, QC, Canada
| | - Ben Haward
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada
| | - Gregory Zimet
- Division of Adolescent Medicine, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Matthew Tunis
- National Advisory Committee on Immunization Secretariat, Centre for Immunization Readiness, Public Health Agency of Canada, Ottawa, ON, Canada
| | - Ève Dubé
- Faculty of Social Sciences; Anthropology, University of Laval, Québec, QC, Canada
| | - Zeev Rosberger
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada
- Department of Psychiatry, McGill University, Montreal, QC, Canada
- Department of Oncology, McGill University, Montreal, QC, Canada
- Department of Psychology, McGill University, Montreal, QC, Canada
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Afzal A, Shariff MA, Perez-Gutierrez V, Khalid A, Pili C, Pillai A, Venugopal U, Kasubhai M, Kanna B, Poole BD, Pickett BE, Redd DS, Menon V. Impact of Local and Demographic Factors on Early COVID-19 Vaccine Hesitancy among Health Care Workers in New York City Public Hospitals. Vaccines (Basel) 2022; 10:vaccines10020273. [PMID: 35214729 PMCID: PMC8879070 DOI: 10.3390/vaccines10020273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 02/04/2022] [Accepted: 02/07/2022] [Indexed: 12/04/2022] Open
Abstract
Despite the development of several effective vaccines, SARS-CoV-2 continues to spread, causing serious illness among the unvaccinated. Healthcare professionals are trusted sources of information about vaccination, and therefore understanding the attitudes and beliefs of healthcare professionals regarding the vaccines is of utmost importance. We conducted a survey-based study to understand the factors affecting COVID-19 vaccine attitudes among health care professionals in NYC Health and Hospitals, at a time when the vaccine was new, and received 3759 responses. Machine learning and chi-square analyses were applied to determine the factors most predictive of vaccine hesitancy. Demographic factors, education, role at the hospital, perceptions of the pandemic itself, and location of work and residence were all found to significantly contribute to vaccine attitudes. Location of residence was examined for both borough and neighborhood, and was found to have a significant impact on vaccine receptivity. Interestingly, this borough-level data did not correspond to the number or severity of cases in the respective boroughs, indicating that local social or other influences likely have a substantial impact. Local and demographic factors should be strongly considered when preparing pro-vaccine messages or campaigns.
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Affiliation(s)
- Afsheen Afzal
- Department of Medicine, NYC Health and Hospitals/Lincoln, Bronx, NY 10451, USA; (A.A.); (M.A.S.); (V.P.-G.); (A.K.); (A.P.); (U.V.); (M.K.); (B.K.)
| | - Masood A. Shariff
- Department of Medicine, NYC Health and Hospitals/Lincoln, Bronx, NY 10451, USA; (A.A.); (M.A.S.); (V.P.-G.); (A.K.); (A.P.); (U.V.); (M.K.); (B.K.)
| | - Victor Perez-Gutierrez
- Department of Medicine, NYC Health and Hospitals/Lincoln, Bronx, NY 10451, USA; (A.A.); (M.A.S.); (V.P.-G.); (A.K.); (A.P.); (U.V.); (M.K.); (B.K.)
| | - Amnah Khalid
- Department of Medicine, NYC Health and Hospitals/Lincoln, Bronx, NY 10451, USA; (A.A.); (M.A.S.); (V.P.-G.); (A.K.); (A.P.); (U.V.); (M.K.); (B.K.)
| | - Christina Pili
- Research Administration, NYC Health and Hospitals/Central Office, New York, NY 10013, USA;
| | - Anjana Pillai
- Department of Medicine, NYC Health and Hospitals/Lincoln, Bronx, NY 10451, USA; (A.A.); (M.A.S.); (V.P.-G.); (A.K.); (A.P.); (U.V.); (M.K.); (B.K.)
| | - Usha Venugopal
- Department of Medicine, NYC Health and Hospitals/Lincoln, Bronx, NY 10451, USA; (A.A.); (M.A.S.); (V.P.-G.); (A.K.); (A.P.); (U.V.); (M.K.); (B.K.)
| | - Moiz Kasubhai
- Department of Medicine, NYC Health and Hospitals/Lincoln, Bronx, NY 10451, USA; (A.A.); (M.A.S.); (V.P.-G.); (A.K.); (A.P.); (U.V.); (M.K.); (B.K.)
| | - Balavenkatesh Kanna
- Department of Medicine, NYC Health and Hospitals/Lincoln, Bronx, NY 10451, USA; (A.A.); (M.A.S.); (V.P.-G.); (A.K.); (A.P.); (U.V.); (M.K.); (B.K.)
| | - Brian D. Poole
- Department of Microbiology and Molecular Biology, Brigham Young University, Provo, UT 84602, USA; (B.E.P.); (D.S.R.)
- Correspondence: (B.D.P.); (V.M.); Tel.: +1-801-422-8092 (B.D.P.)
| | - Brett E. Pickett
- Department of Microbiology and Molecular Biology, Brigham Young University, Provo, UT 84602, USA; (B.E.P.); (D.S.R.)
| | - David S. Redd
- Department of Microbiology and Molecular Biology, Brigham Young University, Provo, UT 84602, USA; (B.E.P.); (D.S.R.)
| | - Vidya Menon
- Department of Medicine, NYC Health and Hospitals/Lincoln, Bronx, NY 10451, USA; (A.A.); (M.A.S.); (V.P.-G.); (A.K.); (A.P.); (U.V.); (M.K.); (B.K.)
- Correspondence: (B.D.P.); (V.M.); Tel.: +1-801-422-8092 (B.D.P.)
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Correa-Rodríguez M, Rueda-Medina B, Callejas-Rubio JL, Ríos-Fernández R, de la Hera-Fernández J, Ortego-Centeno N. COVID-19 vaccine literacy in patients with systemic autoimmune diseases. CURRENT PSYCHOLOGY 2022; 42:1-16. [PMID: 35068910 PMCID: PMC8764502 DOI: 10.1007/s12144-022-02713-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/11/2022] [Indexed: 12/22/2022]
Abstract
COVID-19 related infodemic is a threat to the successful COVID-19 vaccination campaigns. This might be especially apparent for patients with autoimmune diseases since there is no data available about the balance between benefits and risks of the newly developed COVID-19 vaccines in this population. We aim (i) to evaluate vaccine literacy skills in a population of patients with systemic autoimmune diseases, (ii) to examine the potential associations between vaccine literacy skills and sociodemographic characteristics and (iii) to analyze the relationships between attitudes, perceptions and beliefs about current vaccinations and vaccine literacy skills and sociodemographic characteristics. A cross-sectional study was conducted among 319 patients with systemic autoimmune diseases (92% females; 49.5% of patients in the 31-50 years age category). The vaccine literacy levels were determined using the Health Literacy about Vaccination in adulthood in Italian (HLVa-IT). Sociodemographic characteristics including gender, age, country and area of residence, civil status, socioeconomic status, educational attainment and occupational status were evaluated. The mean vaccine literacy functional and interactive-critical scores were 2.59 ± 0.74 and 3.07 ± 0.60, respectively. The vaccine literacy interactive-critical score was higher in females than in males (p = 0.048). Interactive-critical scores were associated with the area of residence, civil status and socioeconomic status, with the highest score in urban area of ≥ 100.000 inhabitants (p = 0.045), in widow patients (p = 0.023) and in patients with high socioeconomic status (p = 0.018). Significant differences were observed between the different education levels, for both the functional and the interactive-critical scores (p = 0.002 and p < 0.001, respectively), the highest score was observed in patients who completed a university degree. The level of vaccine literacy for functional and interactive-critical scales were medium. Area of residence, civil status and socioeconomic status represented determinants of vaccine literacy interactive-critical scale. Educational attainment also contributes to vaccine literacy functional scale. Insight into these factors is required to ensure an optimal vaccine literacy level in patients with autoimmune diseases. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1007/s12144-022-02713-y.
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Affiliation(s)
- María Correa-Rodríguez
- Department of Nursing, Faculty of Health Sciences, University of Granada, Granada, Spain
| | - Blanca Rueda-Medina
- Department of Nursing, Faculty of Health Sciences, University of Granada, Granada, Spain
| | - José-Luis Callejas-Rubio
- Systemic Autoimmune Diseases Unit, San Cecilio University Hospital, Granada, Spain
- Present Address: Instituto de Investigación Biosanitaria Ibs.GRANADA, Granada, Spain
| | - Raquel Ríos-Fernández
- Systemic Autoimmune Diseases Unit, San Cecilio University Hospital, Granada, Spain
- Present Address: Instituto de Investigación Biosanitaria Ibs.GRANADA, Granada, Spain
| | - Javier de la Hera-Fernández
- Systemic Autoimmune Diseases Unit, San Cecilio University Hospital, Granada, Spain
- Present Address: Instituto de Investigación Biosanitaria Ibs.GRANADA, Granada, Spain
| | - Norberto Ortego-Centeno
- Present Address: Instituto de Investigación Biosanitaria Ibs.GRANADA, Granada, Spain
- School of Medicine, University of Granada, Granada, Spain
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