Association between risk perception and influenza vaccine hesitancy for children among reproductive women in China during the COVID-19 pandemic: a national online survey

A qualitative assessment of influenza vaccine uptake among children in Kenya

Background

Influenza is a significant contributor to acute respiratory infections (ARI), and children < 5 years are at increased risk of severe influenza disease. In Kenya the influenza vaccine is not included in the Kenya Expanded Programme on Immunization (KEPI). To inform roll-out of a national influenza vaccination program, we implemented an influenza vaccine demonstration project in Nakuru and Mombasa counties in Kenya from 2019 to 2021 and set out to establish factors driving influenza vaccine acceptance and hesitancy among caregivers of children aged 6-23 months.

Methods

Using semi-structured questionnaires, we conducted eight focus group discussions among community members and twelve key informant interviews among healthcare workers to elicit both lay and expert opinions. Thematic analysis of the interviews was conducted using the World Health Organization's "3 Cs" model of vaccine hesitancy to determine reasons for acceptance or hesitancy of the influenza vaccine.

Results

The influenza vaccine was well received among community members and healthcare workers though concerns were raised. Vaccine hesitancy was fuelled by misconceptions about reasons for introducing the vaccine (confidence), perceptions that influenza was not a serious disease (complacency) and administrative fees required at some facilities (convenience). Despite the use of various advocacy, communication and social mobilisation strategies targeted at educating the community on the influenza disease and importance of vaccination, there remained a perception of inadequate reach of the sensitization among some community members. Contextual factors such as the COVID-19 pandemic affected uptake, and parents expressed concern over the growing number of vaccines recommended for children.

Conclusion

Despite lingering concerns, caregivers had their children vaccinated indicating that vaccine hesitancy exists, even among those who accepted the vaccine for their children. Efforts targeted at increasing confidence in and reducing misconceptions towards vaccines through effective communication strategies, are likely to lead to increased vaccine uptake.

Highly Educated Mother's Perception of Childhood Vaccination Hesitancy in Kazakhstan: A Thematic Analysis

Background

Vaccine hesitancy among parents directly affects the child's vaccination status since they are the legal decision-makers regarding vaccinating their children. The study aimed to describe the perceptions of highly educated Kazakhstani mothers about childhood vaccination hesitancy.

Methods

The study utilized a thematic analysis to explore the mothers' perceptions. A sample of 95 participants comprehensively answered the free-text questions in an online questionnaire from January to February 2023. The analysis of the free-text responses followed a semantic thematic analysis approach. The data were coded manually.

Results

From the in-depth analysis of the data, 285 initial codes were extracted. The combination of similar meanings and concept codes led to 14 sub-themes and finally yielded four significant themes: misconceptions about childhood vaccination, fear of the effect of vaccine on children, distrust of the healthcare system, and social learning factors.

Conclusion

The perceptions of Kazakh mothers about childhood vaccination hesitancy may lead to behaviors of delaying and refusing some or all childhood vaccines. Therefore, motivational and educational strategies can be used by healthcare providers to instill trust in parents about childhood vaccines and their safety and effectiveness.

Smartphone usage behaviors and their association with De Quervain's Tenosynovitis (DQT)among college students: a cross-sectional study in Guangxi, China

BACKGROUND

The growing prevalence of smartphone use among college students in China has led to health concerns, including De Quervain's Tenosynovitis (DQT). However, the specific smartphone usage behaviors contributing to DQT remain poorly understood. This study aimed to explore the relationship between smartphone usage behaviors and DQT in college students.

METHODS

A cross-sectional study was conducted with 937 students from various majors in Guangxi between September 2021 and April 2022. Participants completed an online questionnaire assessing smartphone usage behaviors and their association with DQT. The Finkelstein test was employed to diagnose DQT.

RESULTS

Over half of the college students (52%) tested positive for DQT via Finkelstein's test. Higher levels of smartphone usage time (6-8 h/day: OR = 4.454, 95%CI:1.662-12.229; ≥8 h/day: OR = 4.521, 95%CI:1.596-12.811), phone games (OR = 1.997, 95%CI:1.312-3.040), social media (OR = 2.263, 95%CI:1.795-3.833), and leisure activities (OR = 1.679, 95%CI:1.140-2.475) were significantly associated with an increased risk of DQT. Two specific gestures (Bilateral thumbs, BT: OR = 1.900, 95%CI:1.281-2.817; Bilateral thumbs-horizontal screen, BT-HS: OR = 1.872, 95%CI:1.244-2.818) and two screen sizes (5.0-5.5inch: OR = 2.064, 95%CI:1.108-3.846; 6.0-6.5inch: OR = 2.413, 95%CI:1.125-4.083) also exhibited a higher risk of DQT. Bilateral DQT was observed, with Gesture-BT identified as the primary risk factor.

CONCLUSION

Our findings suggest that increased smartphone usage time, phone games, social media, and leisure activities elevate the risk of DQT among college students. Furthermore, two specific gestures and two screen sizes were also linked to a heightened DQT risk. To mitigate DQT development, college students should reduce smartphone usage time and adopt appropriate gestures.

Social Media Overload as a Predictor of Depressive Symptoms Under the COVID-19 Infodemic: A Cross-Sectional Survey From Chinese University Students

Objectives: People's mental health and digital usage have attracted widespread attention during the COVID-19 pandemic. This study aimed to investigate how social media overload influenced depressive symptoms under the COVID-19 infodemic and the role of risk perception and social media fatigue. Methods: A questionnaire survey was conducted on 644 college students during the COVID-19 lockdown in Shanghai, and data analysis was conducted using the PROCESS4.0 tool. Results: The findings showed that in the COVID-19 information epidemic: 1) both information overload and communication overload were significantly and positively associated with depressive symptoms; 2) risk perception of COVID-19, and social media fatigue mediated this association separately; 3) and there was a chain mediating relationship between communication overload and depressive symptoms. Conclusion: Social media overload was positively associated with depressive symptoms among college students under the COVID-19 infodemic by increasing risk perception and social media fatigue. The findings sparked further thinking on how the public should correctly use social media for risk communication during public health emergencies.

Covid-19 vaccination during pregnancy: A mixed-methods study of attitudes in a sample of Italian women and the role of health professionals' communication

OBJECTIVES

We examined Italian pregnant women's attitudes about the diphtheria, tetanus, and pertussis (DTP) vaccine, seasonal influenza, and Covid-19 vaccines, healthcare professionals' (HP) communication, reasons and potential predictors for non-adherence.

METHODS

From August 2021 to January 2022, we carried out a cross-sectional study in Italy using an online self-administered questionnaire addressed to women of age and pregnant, designed using LimeSurvey and disseminated through social media. Questions explored vaccination attitude/perceptions, satisfaction, and trust in HPs' information. Thematic analysis of free-text responses was performed using MaxQDA 2022. Statistical analyses were performed using STATA.

RESULTS

1594 responses were obtained. 52% of women hesitated to be vaccinated against Covid-19 while pregnant. Information received by HPs was deemed incomplete by 56% of participants, unclear by 52%, and untrustworthy by 46%; 49% felt unsupported in their decision-making process. This variable was one predictor of vaccine hesitancy together with concern about vaccine safety in the multivariate model. The analysis of open-ended questions revealed a pervasive feeling of dissatisfaction.

CONCLUSION

The perceived lack of adequate communication and support by HPs affected pregnant women's decision-making process on Covid-19 vaccination.

PRACTICE IMPLICATIONS

HPs need to understand and communicate the importance of vaccination during pregnancy, learning to better tailor their messages.

Parental intention to vaccinate children against seasonal influenza in the Eastern Mediterranean region: A cross-sectional study using the health belief model

Seasonal influenza vaccine is the most effective strategy for reducing influenza incidence and severity. Parental decision-making regarding childhood vaccination is influenced by one's vaccine-related beliefs. A cross-sectional study was conducted to determine the role of the Health Belief Model (HBM) in predicting parental intention to vaccinate their children against influenza in the Eastern Mediterranean Region (EMR). An anonymous online survey was distributed to parents of children aged 6 months to 18 years in 14 EMR countries. Out of the 5964 participants, 28.2% intended to vaccinate their children against influenza. Urban residents (OR = 0.55, 95%CI: 0.35-0.85), decision-making regarding child's health by the father alone (OR = 0.43, 95%CI: 0.34-0.55) or the mother alone (OR = 0.78, 95%CI: 0.65-0.93), having a child with a chronic illness (OR = 0.45, 95%CI: 0.38-0.53), reporting high perceived severity, susceptibility, and benefits (OR = 0.35, 95%CI: 0.30-0.40), and cues to action (OR = 0.45, 95%CI: 0.39-0.51) were inversely associated with parental unwillingness to vaccinate their children against influenza. While parents with a higher number of children in the household (OR = 1.08, 95%CI:1.03-1.12) and higher perceived barriers (OR = 2.92, 95%CI: 2.56-3.34) showed an increased likelihood of unwillingness to vaccinate their children. Interventions targeting parental beliefs and perceptions are necessary to improve influenza vaccination acceptance and coverage among children.

Social Media Overload and Anxiety Among University Students During the COVID-19 Omicron Wave Lockdown: A Cross-Sectional Study in Shanghai, China, 2022

Objectives: The increase in the intensity of social media use during the COVID-19 lockdown has affected mental health. Therefore, it is of practical implications to explore the association between social media overload and anxiety and the underlying mechanisms. Methods: Using data from 644 university students during the COVID-19 blockade in Shanghai from March to April 2022, the chain mediation model of information strain and risk perception of omicron between social media overload and anxiety was then tested using the macro PROCESS4.0 tool. Results: The findings showed that social media overload (including information overload and social overload) was positively associated with anxiety. This relationship was mediated by information strain and risk perception of Omicron. A chain mediating role of information strain and risk perception of Omicron has also been proved in this study. Conclusion: Social media overload has a positive effect on anxiety by increasing information strain and risk perception of Omicron. This study provides some implications for future interventions on how to use social media properly for mental health during the pandemic and health management of urban governance.

Parental Willingness and Associated Factors of Pediatric Vaccination in the Era of COVID-19 Pandemic: A Systematic Review and Meta-Analysis

A significant decline in pediatric vaccination uptake due to the COVID-19 pandemic has been documented. Little is known about the parental willingness and associated factors of pediatric vaccination during the COVID-19 pandemic. An extensive literature search in the databases of PubMed, Scopus, Web of Science, and EBSCOhost were conducted. A total of 20 eligible studies published from 2020–2022 were included for systematic summary by a thematic analysis, among which 12 studies were included in a meta-analysis conducted with R-4.2.1. The prevalence of parental willingness to childhood/routine vaccination and seasonal influenza vaccination was 58.6% (95%CI 2.8–98.6%) and 47.3% (95%CI 25.3–70.5%). Moreover, there is no sufficient evidence of significant change in parental willingness to childhood/routine vaccination, human papillomavirus vaccination, or pneumococcal conjugate vaccination during the pandemic. However, a significant increase in parental willingness to vaccinate their children against seasonal influenza was found. In addition to the factors of parental vaccination willingness/hesitancy that are well-studied in literature, children/parents’ history of COVID-19 and children’s perceived vulnerability to COVID-19 were associated with parental willingness. Developing synergetic strategies to promote COVID-19 vaccination together with other pediatric vaccination is warranted during the pandemic. This may help to improve and/or catch up the vaccine uptake of children during and/or after the COVID-19 pandemic.