1
|
Akinsola KO, Bakare AA, Gobbo E, King C, Hanson C, Falade A, Herzig van Wees S. A systematic review of measures of healthcare workers' vaccine confidence. Hum Vaccin Immunother 2024; 20:2322796. [PMID: 38506574 PMCID: PMC10956625 DOI: 10.1080/21645515.2024.2322796] [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: 12/07/2023] [Accepted: 02/21/2024] [Indexed: 03/21/2024] Open
Abstract
Healthcare workers (HCW) perceptions toward vaccines influence patient and community vaccine decision making. In an era of rising vaccine hesitancy, understanding HCW vaccine confidence is critical. This systematic review aims to review instruments that have been validated to measure HCW vaccine confidence. We conducted a search in five databases in June 2023. Data was descriptively synthesized. Twelve articles describing 10 different tools were included. Most tools included dimensions or items on vaccine knowledge (n = 9), safety (n = 8), vaccine usefulness (n = 8), recommendation behavior (n = 8), and self-vaccination practice (n = 7). All, except one study, were conducted in high-income countries. There was variability in the quality of the validation process. There is limited existing literature on development and validation of tools for HCW vaccine confidence. Based on the tools currently available, the Pro-VC-Be tool is the most well validated. Further research needs to include low- and middle-income contexts.
Collapse
Affiliation(s)
| | - Ayobami A. Bakare
- Department of Community Medicine, University College Hospital, Ibadan, Nigeria
- Global Public Health Department, Karolinska Institutet, Stockholm, Sweden
| | - Elisa Gobbo
- Global Public Health Department, Karolinska Institutet, Stockholm, Sweden
| | - Carina King
- Global Public Health Department, Karolinska Institute, Stockholm, Sweden
| | - Claudia Hanson
- Global Public Health Department, Karolinska Institute, Stockholm, Sweden
- Department of Disease Control, London School of Hygiene & Tropical Medicine, London, UK
- Centre of Excellence for Women and Child Health, Aga Khan University, Nairobi, Kenya
| | - Adegoke Falade
- Department of Pediatrics, University College Hospital, Ibadan, Nigeria
- Pediatrics Department, University of Ibadan, Ibadan, Nigeria
| | | |
Collapse
|
2
|
Mäki KO, Karlsson LC, Kaakinen JK, Schmid P, Lewandowsky S, Antfolk J, Soveri A. COVID-19 and influenza vaccine-hesitancy subgroups. PLoS One 2024; 19:e0308159. [PMID: 39078836 PMCID: PMC11288446 DOI: 10.1371/journal.pone.0308159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2024] [Accepted: 07/16/2024] [Indexed: 08/02/2024] Open
Abstract
Health communicators are faced with the challenge that people can hesitate vaccines for different reasons. Our aim was to identify and describe the qualities of distinct COVID-19 and influenza vaccine-hesitancy subgroups to facilitate the development of tailored vaccine-hesitancy communication. In two studies, we used agglomerative hierarchical cluster analysis to identify COVID-19 (N = 554) and influenza (N = 539) vaccine-hesitancy subgroups in the general population based on nine vaccine hesitancy-related variables (intent to get vaccinated, perceived vaccine safety, perceived vaccine efficacy, perceived disease threat, perceived vaccination responsibility, perceived vaccination convenience, distrust in authorities, conspiracy mentality, and reliance on anecdotal testimonies). We identified and described six distinct COVID-19 vaccine-hesitancy subgroups (the Vaccination Positive, the Ambivalent, the Fearing Skeptic, the Unconvinced, the Constrained Skeptic, and the Vaccination Opponent), and three influenza vaccine-hesitancy subgroups (the Vaccination Positive, the Complacent, and the Vaccination Opponent), with different levels of hesitancy. We discuss the implications of the results for health communicators. Our results shed light on the (dis)similarities between people who hesitate COVID-19 and influenza vaccines and suggest that there is greater variety in hesitancy concerning COVID-19 vaccinations than influenza vaccinations. These findings can be used to design and test tailored vaccination messages.
Collapse
Affiliation(s)
- Karl O. Mäki
- Department of Psychology and Speech-Language Pathology, University of Turku, Turku, Finland
| | - Linda C. Karlsson
- Department of Clinical Medicine, University of Turku, Turku, Finland
- Department of Psychology, Åbo Akademi University, Turku, Finland
| | - Johanna K. Kaakinen
- Department of Psychology and Speech-Language Pathology, University of Turku, Turku, Finland
- INVEST Research Flagship Centre, University of Turku, Turku, Finland
| | - Philipp Schmid
- Centre for Language Studies, Radboud University Nijmegen, Nijmegen, The Netherlands
| | - Stephan Lewandowsky
- School of Psychological Science, University of Bristol, Bristol, United Kingdom
- School of Psychological Science, University of Western Australia, Perth, Australia
- Department of Psychology, University of Potsdam, Potsdam, Germany
| | - Jan Antfolk
- Department of Psychology, Åbo Akademi University, Turku, Finland
| | - Anna Soveri
- Department of Clinical Medicine, University of Turku, Turku, Finland
- Department of Psychology, Åbo Akademi University, Turku, Finland
| |
Collapse
|
3
|
Leshi E, Pagkozidis I, Exidari M, Gioula G, Chatzidimitriou M, Tirodimos I, Dardavesis T, Tsimtsiou Z. Mapping Adult Vaccine Confidence in Future Health Professionals: A Pilot Study among Undergraduate Students at Two Universities in Greece. Vaccines (Basel) 2024; 12:778. [PMID: 39066416 PMCID: PMC11281574 DOI: 10.3390/vaccines12070778] [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: 04/23/2024] [Revised: 07/11/2024] [Accepted: 07/12/2024] [Indexed: 07/28/2024] Open
Abstract
Health professionals' recommendations increase vaccine uptake. We aimed to document stances, practices regarding adult vaccination, and their predictors among undergraduate medical and biomedical science students, as well as their perspectives on increasing vaccine confidence. Among the 430 participants, third-year students from two universities in Greece, only 25.4% were in favor of all vaccines, while no refuters were detected. Predictors of recommending vaccination were the Attitudes Towards Adult Vaccination (ATAVAC) Value (OR 3.26, p < 0.001) and ATAVAC Safety subscales scores (OR 1.36, p < 0.05), being a medical student (OR 2.45, p < 0.05), and having better self-rated health status (OR 2.27, p < 0.05). The importance of getting vaccinated as health professionals was recognized by participants with a higher ATAVAC value (OR 5.39, p < 0.001), ATAVAC Safety scores (OR 1.46, p < 0.05), and increased knowledge regarding the National Immunization Program (OR 1.31, p < 0.05). The God Locus of Health Control (GLHC) was a predictor only in vaccination against COVID-19 (OR 0.91, p < 0.05). Improving community health literacy and health providers' education, boosting trust in authorities, and adopting a person-centered approach emerged as the main themes regarding how to increase vaccine confidence. Mapping health professionals' confidence in vaccines and providing lifelong training support is pivotal in supporting positive attitudes, enhancing their competence, and promoting vaccination in the post-COVID-19 era.
Collapse
Affiliation(s)
- Enada Leshi
- Department of Hygiene, Social-Preventive Medicine and Medical Statistics, School of Medicine, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (E.L.); (I.P.); (I.T.); (T.D.)
- Department of Microbiology, School of Medicine, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (M.E.); (G.G.)
| | - Ilias Pagkozidis
- Department of Hygiene, Social-Preventive Medicine and Medical Statistics, School of Medicine, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (E.L.); (I.P.); (I.T.); (T.D.)
| | - Maria Exidari
- Department of Microbiology, School of Medicine, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (M.E.); (G.G.)
| | - Georgia Gioula
- Department of Microbiology, School of Medicine, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (M.E.); (G.G.)
| | - Maria Chatzidimitriou
- Department of Biomedical Sciences, School of Health Sciences, International Hellenic University, 57400 Thessaloniki, Greece;
| | - Ilias Tirodimos
- Department of Hygiene, Social-Preventive Medicine and Medical Statistics, School of Medicine, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (E.L.); (I.P.); (I.T.); (T.D.)
| | - Theodoros Dardavesis
- Department of Hygiene, Social-Preventive Medicine and Medical Statistics, School of Medicine, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (E.L.); (I.P.); (I.T.); (T.D.)
| | - Zoi Tsimtsiou
- Department of Hygiene, Social-Preventive Medicine and Medical Statistics, School of Medicine, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (E.L.); (I.P.); (I.T.); (T.D.)
| |
Collapse
|
4
|
Zhao T, Cai X, Zhang S, Wang M, Chen L, Wang J, Yu Y, Tao L, Xu X, Luo J, Wang C, Du J, Liu Y, Lu Q, Cui F. Differences in Vaccination Consultation Preferred by Primary Health Care Workers and Residents in Community Settings. Vaccines (Basel) 2024; 12:534. [PMID: 38793785 PMCID: PMC11126119 DOI: 10.3390/vaccines12050534] [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: 04/01/2024] [Revised: 04/24/2024] [Accepted: 04/30/2024] [Indexed: 05/26/2024] Open
Abstract
OBJECTIVE To evaluate the preference of primary HCWs and residents on vaccination consultation in community health services to provide evidence for vaccine hesitancy intervention strategies. METHODS A discrete choice model (DCM) was constructed to evaluate the preference difference between primary HCWs and residents on vaccination consultation in community health services in China during May-July 2022. RESULTS A total of 282 residents and 204 HCWs were enrolled in this study. The residents preferred consulting with an HCW-led approach (β = 2.168), with specialized content (β = 0.954), and accompanied by telephone follow-up (β = 1.552). In contrast, the HCWs preferred face-to-face consultation (β = 0.540) with an HCW-led approach (β = 0.458) and specialized content (β = 0.409), accompanied by telephone follow-up (β = 0.831). College residents and residents with underlying self-reported disease may be near-critically inclined to choose traditional consultation (an offline, face-to-face consultation with standardized content and more prolonged duration) rather than a new-media consulting group (an online consultation with specialized content within 5 min). Urban HCWs preferred long-term consultation groups (the resident-led offline consultation with follow-up lasting more than 5 min). In contrast, rural HCWs preferred efficient consultation (the HCW-led, short-duration, standardized offline consultation mode). CONCLUSION The selection preference for vaccine consultation reveals a gap between providers and demanders, with different groups exhibiting distinct preferences. Identifying these targeted gaps can help design more acceptable and efficient interventions, increasing their likelihood of success and leading to better resource allocation for policymakers to develop targeted vaccination policies.
Collapse
Affiliation(s)
- Tianshuo Zhao
- Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public Health, Peking University, Beijing 100191, China
- Center for Infectious Diseases and Policy Research & Global Health and Infectious Diseases Group, Peking University, Beijing 100191, China
- Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing 100191, China
| | - Xianming Cai
- Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public Health, Peking University, Beijing 100191, China
- Center for Infectious Diseases and Policy Research & Global Health and Infectious Diseases Group, Peking University, Beijing 100191, China
- Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing 100191, China
| | - Sihui Zhang
- Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public Health, Peking University, Beijing 100191, China
- Center for Infectious Diseases and Policy Research & Global Health and Infectious Diseases Group, Peking University, Beijing 100191, China
- Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing 100191, China
| | - Mingting Wang
- Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public Health, Peking University, Beijing 100191, China
- Center for Infectious Diseases and Policy Research & Global Health and Infectious Diseases Group, Peking University, Beijing 100191, China
- Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing 100191, China
| | - Linyi Chen
- Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, PA 15260, USA
| | - Juan Wang
- Jiuzhaigou Center for Disease Control and Prevention, Ngawa 623099, China;
| | - Yajie Yu
- Yilan Center for Disease Control and Prevention, Harbin 154899, China
| | - Liandi Tao
- Longxi Center for Disease Control and Prevention, Longxi 748199, China
| | - Xiaoxia Xu
- Chengguan Center for Disease Control and Prevention, Lanzhou 730030, China;
| | - Jing Luo
- Suzhou Center for Disease Control and Prevention, Suzhou 234099, China
| | - Chao Wang
- Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public Health, Peking University, Beijing 100191, China
- Center for Infectious Diseases and Policy Research & Global Health and Infectious Diseases Group, Peking University, Beijing 100191, China
- Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing 100191, China
| | - Juan Du
- Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public Health, Peking University, Beijing 100191, China
- Center for Infectious Diseases and Policy Research & Global Health and Infectious Diseases Group, Peking University, Beijing 100191, China
- Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing 100191, China
| | - Yaqiong Liu
- Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public Health, Peking University, Beijing 100191, China
- Center for Infectious Diseases and Policy Research & Global Health and Infectious Diseases Group, Peking University, Beijing 100191, China
- Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing 100191, China
| | - Qingbin Lu
- Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public Health, Peking University, Beijing 100191, China
- Center for Infectious Diseases and Policy Research & Global Health and Infectious Diseases Group, Peking University, Beijing 100191, China
- Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing 100191, China
| | - Fuqiang Cui
- Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public Health, Peking University, Beijing 100191, China
- Center for Infectious Diseases and Policy Research & Global Health and Infectious Diseases Group, Peking University, Beijing 100191, China
- Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing 100191, China
| |
Collapse
|
5
|
Vuolanto P, Almeida AN, Anderson A, Auvinen P, Beja A, Bracke P, Cardano M, Ceuterick M, Correia T, De Vito E, Delaruelle K, Delicado A, Esposito M, Ferrara M, Gariglio L, Guerreiro C, Marhánková JH, Hilário AP, Hobson-West P, Iorio J, Järvinen KM, Koivu A, Kotherová Z, Kuusipalo A, Lermytte E, Mendonça J, Morais R, Numerato D, Polak P, Rudek T, Sbaragli S, Scavarda A, Silva K, da Silva PA, Sivelä J, Moura ES, Świątkiewicz-mośny M, Tipaldo G, Wagner A. Trust matters: The Addressing Vaccine Hesitancy in Europe Study. Scand J Public Health 2024; 52:379-390. [PMID: 38346923 PMCID: PMC11067405 DOI: 10.1177/14034948231223791] [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: 02/10/2023] [Revised: 12/07/2023] [Accepted: 12/13/2023] [Indexed: 05/04/2024]
Abstract
This article presents the design of a seven-country study focusing on childhood vaccines, Addressing Vaccine Hesitancy in Europe (VAX-TRUST), developed during the COVID-19 pandemic. The study consists of (a) situation analysis of vaccine hesitancy (examination of individual, socio-demographic and macro-level factors of vaccine hesitancy and analysis of media coverage on vaccines and vaccination and (b) participant observation and in-depth interviews of healthcare professionals and vaccine-hesitant parents. These analyses were used to design interventions aimed at increasing awareness on the complexity of vaccine hesitancy among healthcare professionals involved in discussing childhood vaccines with parents. We present the selection of countries and regions, the conceptual basis of the study, details of the data collection and the process of designing and evaluating the interventions, as well as the potential impact of the study. Laying out our research design serves as an example of how to translate complex public health issues into social scientific study and methods.
Collapse
Affiliation(s)
- Pia Vuolanto
- Tampere University, Faculty of Social Sciences, Research Center for Knowledge, Science, Technology and Innovation Studies, Finland
| | | | | | - Petra Auvinen
- Tampere University, Faculty of Social Sciences, Research Center for Knowledge, Science, Technology and Innovation Studies, Finland
| | - André Beja
- Global Health and Tropical Medicine, GHTM, Associate Laboratory in Translation and Innovation Towards Global Health, LA-REAL, Instituto de Higiene e Medicina Tropical, IHMT, Universidade Nova de Lisboa, UNL, Portugal
| | - Piet Bracke
- Ghent University, Department of Sociology, Health and Demographic Research, Belgium
| | - Mario Cardano
- University of Turin, Department of Cultures, Politics and Society, Italy
| | - Melissa Ceuterick
- Ghent University, Department of Sociology, Health and Demographic Research, Belgium
| | - Tiago Correia
- Global Health and Tropical Medicine, GHTM, Associate Laboratory in Translation and Innovation Towards Global Health, LA-REAL, Instituto de Higiene e Medicina Tropical, IHMT, Universidade Nova de Lisboa, UNL, Portugal
| | - Elisabetta De Vito
- University of Cassino and Southern Lazio, Department of Human, Social and Health Sciences, Italy
| | - Katrijn Delaruelle
- Ghent University, Department of Sociology, Health and Demographic Research, Belgium
| | - Ana Delicado
- Universidade de Lisboa, Instituto de Ciências Sociais, Portugal
| | - Maurizio Esposito
- University of Cassino and Southern Lazio, Department of Human, Social and Health Sciences, Italy
| | - Maria Ferrara
- University of Cassino and Southern Lazio, Department of Human, Social and Health Sciences, Italy
| | - Luigi Gariglio
- University of Turin, Department of Cultures, Politics and Society, Italy
| | - Cátia Guerreiro
- Global Health and Tropical Medicine, GHTM, Associate Laboratory in Translation and Innovation Towards Global Health, LA-REAL, Instituto de Higiene e Medicina Tropical, IHMT, Universidade Nova de Lisboa, UNL, Portugal
| | | | | | - Pru Hobson-West
- University of Nottingham, School of Sociology and Social Policy, UK
| | - Juliana Iorio
- Universidade de Lisboa, Instituto de Ciências Sociais, Portugal
| | - Katri-Maria Järvinen
- Tampere University, Faculty of Social Sciences, Research Center for Knowledge, Science, Technology and Innovation Studies, Finland
| | - Annariina Koivu
- Tampere University, Faculty of Social Sciences, Research Center for Knowledge, Science, Technology and Innovation Studies, Finland
| | - Zuzana Kotherová
- Charles University, Faculty of Social Sciences, the Czech Republic
| | - Aapo Kuusipalo
- Tampere University, Faculty of Social Sciences, Research Center for Knowledge, Science, Technology and Innovation Studies, Finland
| | - Esther Lermytte
- Ghent University, Department of Sociology, Health and Demographic Research, Belgium
| | - Joana Mendonça
- Universidade de Lisboa, Instituto de Ciências Sociais, Portugal
| | - Rita Morais
- Universidade de Lisboa, Instituto de Ciências Sociais, Portugal
| | - Dino Numerato
- Charles University, Faculty of Social Sciences, the Czech Republic
| | - Paulina Polak
- Jagiellonian University, Institute of Sociology, Poland
| | - Tadeusz Rudek
- Jagiellonian University, Institute of Sociology, Poland
| | - Sara Sbaragli
- University of Cassino and Southern Lazio, Department of Human, Social and Health Sciences, Italy
| | - Alice Scavarda
- University of Turin, Department of Cultures, Politics and Society, Italy
| | - Katielle Silva
- Universidade de Lisboa, Instituto de Ciências Sociais, Portugal
| | | | - Jonas Sivelä
- Finnish Institute for Health and Welfare, Cultural, Behavioural and Media Insights Center, Finland
| | - Eva Soares Moura
- Charles University, Faculty of Social Sciences, the Czech Republic
| | | | - Giuseppe Tipaldo
- University of Turin, Department of Cultures, Politics and Society, Italy
| | | |
Collapse
|
6
|
Kainth MK, Sembajwe GN, Ahn H, Qian M, Carrington M, Armellino D, Jan S. Despite mandated primary series, health care personnel still hesitant about COVID-19 vaccine and immunizing children. Vaccine 2024; 42:3122-3133. [PMID: 38604909 PMCID: PMC11268435 DOI: 10.1016/j.vaccine.2024.04.028] [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: 11/08/2023] [Revised: 04/05/2024] [Accepted: 04/06/2024] [Indexed: 04/13/2024]
Abstract
IMPORTANCE Healthcare personnel (HCP) are important messengers for promoting vaccines, for both adults and children. Our investigation describes perceptions of fully vaccinated HCP about COVID-19 vaccine for themselves and primary series for their children. OBJECTIVE To determine associations between sociodemographic, employment characteristics and perceptions of COVID-19 vaccines among HCP overall and the subset of HCP with children, who were all mandated to receive a COVID-19 vaccine, in a large US metropolitan region. DESIGN Cross-sectional survey of fully vaccinated HCP from a large integrated health system. SETTING Participants were electronically enrolled within a multi-site NYS healthcare system from December 21, 2021, to January 21, 2022. PARTICIPANTS Of 78,000 employees, approximately one-third accessed promotional emails; 6,537 employees started surveys and 4165 completed them. Immunocompromised HCP (self-reported) were excluded. EXPOSURE(S) (FOR OBSERVATIONAL STUDIES) We conducted a survey with measures including demographic variables, employment history, booster status, child vaccination status; vaccine recommendation, confidence, and knowledge. MAIN OUTCOME(S) AND MEASURES The primary outcome was COVID-19 vaccine hesitancy for all dose types - primary series or booster doses - among HCP. RESULTS Findings from 4,165 completed surveys indicated that almost 17.2 % of all HCP, including administrative and clinical staff, were hesitant or unsure about receiving a COVID-19 vaccine booster, despite the NYS recommendation to do so. Depending on age group, between 20 % and 40 % of HCP were hesitant about having their children vaccinated for COVID-19, regardless of clinical versus non-clinical duties. In multivariable regression analyses, lack of booster dose, unvaccinated children, females, income less than $50,000, and residence in Manhattan remained significantly associated with vaccine hesitancy. CONCLUSIONS AND RELEVANCE Despite mandated COVID-19 vaccination, a substantial proportion of HCP remained vaccine hesitant towards adult booster doses and pediatric COVID-19 vaccination. While provider recommendation has been the mainstay of combatting COVID-19 vaccine hesitancy, a gap exists between HCP-despite clinical or administrative status-and the ability to communicate the need for vaccination in a healthcare setting. While previous studies describe the HCP vaccine mandate as a positive force to overcome vaccine hesitancy, we have found that despite a mandate, there is still substantial COVID-19 vaccine hesitancy, misinformation, and reluctance to vaccinate children.
Collapse
Affiliation(s)
- Mundeep K Kainth
- Northwell, New Hyde Park, NY, USA; Department of Pediatrics, Cohen Children's Medical Center, New Hyde Park, NY, USA; Department of Molecular Medicine, Feinstein Institutes of Medical Research, Manhasset, NY, USA; Donald and Barbara Zucker School of Medicine at Hofstra/Northwell Health, Hempstead, NY, USA.
| | - Grace N Sembajwe
- Northwell, New Hyde Park, NY, USA; Institute of Health System Science, Feinstein Institutes of Medical Research, Manhasset, NY, USA; Department of Occupational Medicine, Epidemiology, and Prevention, Northwell Health, New York, NY, USA
| | - Heejoon Ahn
- Institute of Health System Science, Feinstein Institutes of Medical Research, Manhasset, NY, USA
| | - Min Qian
- Department of Biostatistics, Mailman School of Public Health, Columbia University Medical Center, New York, NY, USA
| | - Maxine Carrington
- Center for Learning & Innovation, Human Resources, Northwell Health, USA
| | | | - Sophia Jan
- Northwell, New Hyde Park, NY, USA; Department of Pediatrics, Cohen Children's Medical Center, New Hyde Park, NY, USA; Donald and Barbara Zucker School of Medicine at Hofstra/Northwell Health, Hempstead, NY, USA
| |
Collapse
|
7
|
Klüwer B, Gleditsch R, Rydland KM, Mamelund SE, Laake I. Higher educational attainment associated with higher confidence in influenza vaccination in Norway. Vaccine 2024; 42:2837-2847. [PMID: 38519343 DOI: 10.1016/j.vaccine.2024.03.049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 03/07/2024] [Accepted: 03/19/2024] [Indexed: 03/24/2024]
Abstract
AIMS To explore public confidence in influenza vaccination through the use of attitudinal indicators, and study whether educational attainment is related to attitudes towards influenza vaccination. METHODS Confidence in influenza vaccination was measured with three questions adapted from the Vaccine Confidence Project. These questions have been included in four study years of a Norwegian nationally representative telephone survey that cover influenza seasons 2016/17, 2019/20, 2020/21 and 2021/22. Over these four years, a total of 8 436 individuals aged 18-79 years responded to the survey and are included in the analysis. Risk differences (RDs) with 95 % confidence intervals were estimated using multivariable Poisson regression. RESULTS Influenza vaccine confidence increased over time, with approximately 80 % of the general population expressing trust in the vaccine in the 2021/22 season. There was a tendency towards higher confidence in the oldest age group (65-79 years). Moreover, confidence increased with increasing educational attainment. The proportion of participants who agreed that influenza vaccine is compatible with their basic values was close to 20 percentage points lower among those with only compulsory education than among those with higher education at graduate level, RD = -18.4 % (95 % CI -21.4 % to -15.5 %). Educational attainment was consistently associated with influenza vaccine confidence in all seasons, among risk groups 18-64 years, and among health care workers. CONCLUSIONS We observed an increase in confidence in influenza vaccination over the seasons examined in the study. However, the increase has not been equal in all groups and there is a clear educational gradient in influenza vaccine confidence. These findings indicate that despite efforts to increase influenza coverage over several years, the implemented measures have failed to reach all parts of the population.
Collapse
Affiliation(s)
- Birgitte Klüwer
- Division of Infection Control, Norwegian Institute of Public Health, PO Box 222, Skøyen, N-0213 Oslo, Norway.
| | - Rebecca Gleditsch
- Division of Infection Control, Norwegian Institute of Public Health, PO Box 222, Skøyen, N-0213 Oslo, Norway.
| | - Kjersti Margrethe Rydland
- Division of Infection Control, Norwegian Institute of Public Health, PO Box 222, Skøyen, N-0213 Oslo, Norway.
| | - Svenn-Erik Mamelund
- Centre for Research on Pandemics & Society, Oslo Metropolitan University, Senter for velferds- og arbeidslivsforskning, OsloMet - storbyuniversitetet, Postboks 4, St. Olavs plass, 0130 Oslo, Norway.
| | - Ida Laake
- Division of Infection Control, Norwegian Institute of Public Health, PO Box 222, Skøyen, N-0213 Oslo, Norway.
| |
Collapse
|
8
|
Akmatova R, Ebama MS, Temirbekov S, Alymkulova V, Otorbaeva D. A comparative analysis of knowledge, attitude, and practice (KAP) towards influenza and influenza vaccination among healthcare workers in Kyrgyzstan prior to and during the COVID-19 pandemic. Vaccine 2024:S0264-410X(24)00420-1. [PMID: 38594119 DOI: 10.1016/j.vaccine.2024.04.008] [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: 03/12/2024] [Accepted: 04/03/2024] [Indexed: 04/11/2024]
Abstract
INTRODUCTION Influenza, a globally significant respiratory illness with pandemic potential, affects around 1 billion individuals annually, leading to increased risk for severe illness and mortality. Despite recommendations from the WHO Strategic Advisory Group of Experts on Immunization (SAGE) and MoH prioritization, influenza vaccination coverage rate among HCWs in Kyrgyzstan remains low, ranging between 16 % and 46 % over the past five years. Understanding the Knowledge, Attitudes, and Practices (KAP) dynamics of HCWs regarding influenza vaccinations, both before and during the COVID-19 pandemic is crucial for refining national strategies and institutional approaches to enhance vaccination coverage rates in this important risk group. METHOD This study employed cross sectional investigations aimed at assessing KAPs among HCWs regarding influenza disease and vaccination. Conducted prior to and during the initial phase of the COVID-19 pandemic, the project involved 2400 participants from diverse medical disciplines. EPI Info was utilized to run biostatistical analyses, with descriptive and logistic regression models, to elucidate the dynamics of KAP over time. RESULTS The findings indicate that HCWs with over 5 years of experience were more likely to get vaccinated or recommend it to patients (p = 0.000). Low confidence in vaccine effectiveness influenced on recommendations of influenza vaccination in pre-pandemic time, where insufficient (95 %CI 0.08-0.6; p = 0.003) or uncertain assurance in vaccine effectiveness (95 %CI 0.007-0.18; p = 0.000) was a barrier for vaccine promotion during the pandemic. The study underscores to consider mandatory influenza vaccination for HCWs which may impact on likelihood of flu vaccination (p = 0.001). Priority groups for influenza vaccination shifted during the COVID-19 period, emphasizing older adults, individuals with existing conditions, and HCWs, compared to the pre-pandemic focus on HCWs, children, and patients with pre-existing conditions. CONCLUSION Our investigation provides valuable insights into HCWs KAP concerning influenza vaccination in Kyrgyzstan, highlighting the need for targeted interventions addressing factors influencing vaccine acceptance. The study suggests policy implications, advocating for the revision of national strategies to strengthen capacity building for medical staff.
Collapse
Affiliation(s)
- Rakhat Akmatova
- Center for Vaccine Equity, Task Force for Global Health, 330 W. Ponce de Leon Avenue, Decatur, GA 30030, United States.
| | - Malembe S Ebama
- Center for Vaccine Equity, Task Force for Global Health, 330 W. Ponce de Leon Avenue, Decatur, GA 30030, United States.
| | - Sanjar Temirbekov
- Department of Disease Prevention and State Sanitary and Epidemiology Surveillance under the Ministry of Health, 535 Frunze Street, 720033 Bishkek, Kyrgyzstan
| | - Venera Alymkulova
- Department of Disease Prevention and State Sanitary and Epidemiology Surveillance under the Ministry of Health, 535 Frunze Street, 720033 Bishkek, Kyrgyzstan
| | - Dinara Otorbaeva
- Department of Disease Prevention and State Sanitary and Epidemiology Surveillance under the Ministry of Health, 535 Frunze Street, 720033 Bishkek, Kyrgyzstan.
| |
Collapse
|
9
|
De Waele A, Hendrickx G, Valckx S, Domínguez À, Toledo D, Castilla J, Tuells J, Van Damme P. The Vaccine Training Barometer: Assessing healthcare providers' confidence to answer vaccine-related questions and their training needs. Vaccine 2024; 42:2421-2428. [PMID: 38458873 DOI: 10.1016/j.vaccine.2024.02.078] [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: 06/07/2023] [Revised: 01/19/2024] [Accepted: 02/25/2024] [Indexed: 03/10/2024]
Abstract
Healthcare providers (HCP) are seen by the public as the most trustworthy source of information about vaccination. While HCPs could be a valuable partner to increase vaccine confidence in general, it is not clear whether they feel confident themselves to address questions concerning vaccination. In the context of the EU Joint Action on Vaccination (EU-JAV), the Vaccine Training Barometer, an online survey tool, was developed to assess how frequently HCPs receive questions about vaccination, how confident they feel to answer these questions, and to what extent they are willing to follow extra training. After a pilot test in Flanders, Belgium, the Barometer was launched and completed by 833 HCPs in Flanders and 291 HCPs in the Spanish regions of Catalonia, Navarre and Valencian Community from November 2020 until January 2021, during the COVID-19 pandemic, just before and during the start of the first COVID-19 vaccination campaigns. In both countries, HCPs frequently received questions about vaccination (mostly on a daily or weekly basis), and about two thirds of them indicated that the frequency of questions had increased during the three months prior to completing the survey. Most questions were about the side effects and safety of vaccines. In both countries, a considerable proportion of HCPs did not feel confident to answer vaccine-related questions (31.5% felt confident in Flanders, 21.6% in Spain). A large proportion of HCPs received questions in the last three months before the survey that they could not answer (52.4% of respondents in Flemish sample, 41.5% in Spanish sample). Only 11.4% (Flanders) and 11.3% (Spain) of the respondents felt they gained sufficient knowledge through their standard education to be able to answer questions about vaccination. Almost all respondents were willing to follow extra training on vaccination (Flanders: 95.4%, Spain: 96.6%). The Vaccine Training Barometer is thus a useful tool to monitor HCPs' confidence to answer questions about vaccination and to capture their training needs.
Collapse
Affiliation(s)
- Aurélie De Waele
- Centre for Evaluation of Vaccination, University of Antwerp, Drie Eikenstraat 663, 2650 Edegem, Belgium; Departement of Communication Studies, Faculty of Social Sciences, University of Antwerp, Sint-Jacobsstraat 2, 2000 Antwerp, Belgium.
| | - Greet Hendrickx
- Centre for Evaluation of Vaccination, University of Antwerp, Drie Eikenstraat 663, 2650 Edegem, Belgium.
| | - Sara Valckx
- Centre for Evaluation of Vaccination, University of Antwerp, Drie Eikenstraat 663, 2650 Edegem, Belgium.
| | - Àngela Domínguez
- Universitat de Barcelona, Department of Medicine, C/ de Casanova, 143, 08036 Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, C/ Monforte de Lemos 3-5, Pabellón 11, Planta 0, 28029 Madrid, Spain.
| | - Diana Toledo
- Universitat de Barcelona, Department of Medicine, C/ de Casanova, 143, 08036 Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, C/ Monforte de Lemos 3-5, Pabellón 11, Planta 0, 28029 Madrid, Spain.
| | - Jesús Castilla
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, C/ Monforte de Lemos 3-5, Pabellón 11, Planta 0, 28029 Madrid, Spain; Instituto de Salud Pública de Navarra (IdiSNA), C. de Irunlarrea, 3, 31008 Pamplona, Navarra, Spain.
| | - José Tuells
- Edificio Ciencias Sociales, University of Alicante, Carr. de San Vicente del Raspeig, 03690 San Vicente del Raspeig, Alicante, Spain; Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Avda Pintor Baeza, 12, 03010 Alicante, Spain.
| | - Pierre Van Damme
- Centre for Evaluation of Vaccination, University of Antwerp, Drie Eikenstraat 663, 2650 Edegem, Belgium.
| |
Collapse
|
10
|
Bruel S, Rakotomampionona Z, Gignon M, Agrinier N, Ndiaye NC, Lasset C, Giraudeau B, Michel M, Mueller JE, Gauchet A, Banaszuk AS, Thilly N, Gagneux-Brunon A. The intentions of French health university students to recommend and to receive the HPV vaccine are mainly influenced by vaccine knowledge, confidence in vaccines and personal HPV vaccination. Vaccine 2024; 42:1934-1940. [PMID: 38369391 DOI: 10.1016/j.vaccine.2024.02.033] [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: 10/28/2023] [Revised: 02/08/2024] [Accepted: 02/09/2024] [Indexed: 02/20/2024]
Abstract
INTRODUCTION Despite documented effectiveness in preventing several cancers, genital warts and safety of Human Papillomavirus (HPV) vaccine, immunization coverage among French adolescents remains far from the 80 % target. University health students (HS) in France may promote HPV vaccine through a national service (Service Sanitaire des Etudiants en Santé). We aimed to evaluate intentions to recommend the HPV vaccine to friends and relatives, to receive HPV vaccine, and to identify factors associated with these attitudes. METHODS We conducted a cross-sectional survey in five French Universities from October 2019 to February 2020, using a self-administered online questionnaire. We used bivariable and multivariable logistic regression models to identify determinants of behavior around HPV vaccine: (i) individual intention for vaccination, and (ii) vaccine recommendation to friends and relatives. RESULTS Among the 732 respondents (180 men, 552 women), 305 (41.7%) reported previous HPV vaccination (54.5 % among women), 504 (68.9%) would recommend the HPV vaccine to friends and relatives, 532 (72.7%) respondents would be vaccinated today if it was recommended for them. Intentions to recommend or to receive the HPV vaccine were less frequent in nursing students compared to medical and pharmacy students. After adjustment for demographical factors, HPV vaccine knowledge was associated with intention [aOR 1.30 (95%-confidence interval, 1.15-1.47)] and recommendation [1.26 (1.10-1.45)], respectively. Additionally, adjusting for knowledge about HPV infections, and confidence in vaccines in general was associated with vaccine intention [1.55, (1.30-1.84)] and recommendation [1.52 (1.24-1.86)]. HPV-vaccinated HS were more prone to recommend the HPV vaccine to friends and relatives [10.9 (6.6-17.9)]. CONCLUSION A majority of HS would accept and/or recommend HPV vaccines. HS with greater knowledge about the HPV vaccine were more prone to recommend it. Strengthening knowledge about HPV and its vaccination is probably necessary before their Involvement in a HPV immunization program.
Collapse
Affiliation(s)
- Sébastien Bruel
- Department of General Practice, Jacques Lisfranc Faculty of Medicine, Saint-Etienne-Lyon University, Saint-Etienne, France; CIC-Inserm, 1408 CHU de Saint-Etienne, France.
| | - Zohasina Rakotomampionona
- Department of General Practice, Jacques Lisfranc Faculty of Medicine, Saint-Etienne-Lyon University, Saint-Etienne, France
| | - Maxime Gignon
- Preventions, Risks, Medical Information and Epidemiology Department, CHU Amiens-Picardie, Amiens, France; Sorbonne Paris Nord University, Education and Health Promotion Laboratory, UR3412, Sorbonne Paris Cité, France; CRP-CPO, UR UPJV 7273, Université de Picardie Jules Verne, Amiens, France
| | - Nelly Agrinier
- Université de Lorraine, APEMAC, F-54000, Nancy, France; CHRU-Nancy, Inserm, Université de Lorraine, CIC, Epidémiologie Clinique, F-54000 Nancy, France
| | - Ndeye Coumba Ndiaye
- NGERE (Nutrition-Genetics and Exposure to Environmental Risks), INSERM, University of Lorraine, F-54000 Nancy, France
| | - Christine Lasset
- Département Prévention et Santé Publique, Centre Léon Bérard, Lyon, France
| | - Bruno Giraudeau
- Université de Tours, Université de Nantes, INSERM, SPHERE U1246, Tours, France; INSERM CIC 1415, CHRU de Tours, Tours, France
| | - Morgane Michel
- Université Paris Cité, ECEVE, UMR1123, Inserm, Paris, France; Unité d'épidémiologie clinique, hôpital Robert Debré, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Judith E Mueller
- Institut Pasteur, Université Paris Cité, Emerging Disease Epidemiology Unit, F-75015 Paris, France; Université de Rennes, EHESP, CNRS, Inserm, Arènes - UMR 6051, RSMS (Recherche sur les Services et Management en Santé) - U 1309, F-35000 Rennes, France
| | - Aurélie Gauchet
- Université Savoie Mont Blanc, Univ. Grenoble Alpes, LIP/PC2S, 73000 Chambéry, France
| | - Anne-Sophie Banaszuk
- Centre Régional de Coordination des Dépistages des cancers-Pays de la Loire, 5 Rue des Basses Fouassières, Angers 49000, France
| | - Nathalie Thilly
- Université de Lorraine, APEMAC, F-54000 Nancy, France; Université de Lorraine, CHRU-Nancy, Département Méthodologie, Promotion, Investigation, F-54000 Nancy, France
| | - Amandine Gagneux-Brunon
- CIC-Inserm, 1408 CHU de Saint-Etienne, France; Department of Infectious Diseases, CHU de Saint-Etienne, 42055 Saint-Etienne, France; Centre International de Recherche en Infectiologie, Team GIMAP, Université Jean Monnet, Université Claude Bernard Lyon 1, Inserm, U1111, CNRS, UMR530, 42023 Saint-Etienne, France
| |
Collapse
|
11
|
AlShamlan NA, AlOmar RS, AlAbdulKader AM, Shafey MM, AlGhamdi FA, Aldakheel AA, AlShehri SA, Felemban LA, AlShamlan SA, Al Shammari MA. HPV Vaccine Uptake, Willingness to Receive, and Causes of Vaccine Hesitancy: A National Study Conducted in Saudi Arabia Among Female Healthcare Professionals. Int J Womens Health 2024; 16:463-474. [PMID: 38505127 PMCID: PMC10949268 DOI: 10.2147/ijwh.s449979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 03/12/2024] [Indexed: 03/21/2024] Open
Abstract
Background Epidemiological evidence has shown that human papillomavirus (HPV) is the most frequent cause of sexually transmitted infection, and vaccination is an essential measure to prevent associated diseases and complications. This study aimed to assess the HPV vaccine uptake and its associated factors as well as HPV vaccine hesitancy by female healthcare workers (HCWs) in Saudi Arabia. Methods This online, questionnaire-based, cross-sectional study involved female HCWs in Saudi Arabia between July and October 2022. The study tool included questions about sociodemographic, occupational, and reproductive characteristics, uptake of HPV vaccination, and reasons of hesitancy. Chi-squared and t-tests were used for bivariate analyses, and multivariable logistic regression was used to adjust for confounders. Results The total number of participants was 1857. Around 20% of HCWs received at least one dose of the HPV vaccine, and around 45% were willing to take it this year. Lower odds of vaccine uptake were reported among older participants and those with a higher level of education. However, nurses, HCWs with a previous HPV infection, those with a family history of cervical cancer, or those with a previous cervical cancer screening test had higher odds of receiving the vaccine. On the other hand, older participants and diploma degree holders were less willing to take the HPV vaccine. Higher odds of willingness were reported in married HCWs, those with a previous HPV infection, those who received a previous HPV vaccine dose, or those who were screened for cervical cancer. Lack of knowledge and some misconceptions were the most reported reasons for hesitancy. Conclusion Certain factors that affect HCWs personal decisions to take the vaccine were identified. By targeting these issues, epidemiologists, public health officials and women's health care providers can work to increase HPV vaccine uptake and reduce the burden of HPV-related diseases in this population.
Collapse
Affiliation(s)
- Nouf A AlShamlan
- Department of Family and Community Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Reem S AlOmar
- Department of Family and Community Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Assim M AlAbdulKader
- Department of Family and Community Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Marwa Mahmoud Shafey
- Department of Family and Community Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Faisal A AlGhamdi
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Abdullah A Aldakheel
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Saud A AlShehri
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Lyana A Felemban
- College of Medicine, Fakeeh College of Medical Sciences, Jeddah, Saudi Arabia
| | - Shahad A AlShamlan
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Malak A Al Shammari
- Department of Family and Community Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| |
Collapse
|
12
|
Dooley CE, Saif NT, Hodorowicz MT, Doyle ML, Gucer PW, Edwards LA, Cloeren M. Occupational Health Providers' Perceptions of Employee Vaccine Hesitancy. J Occup Environ Med 2024; 66:e42-e47. [PMID: 37871581 DOI: 10.1097/jom.0000000000003006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2023]
Abstract
OBJECTIVE This study examined the perspectives of occupational health providers (OHPs) on the most frequently encountered clinically relevant reasons for employee vaccine hesitancy. METHODS We conducted an anonymous, online, cross-sectional survey of US OHPs ( N = 217). The survey asked OHPs about the major reasons that employees cite for being unwilling to receive the following three categories of vaccines: COVID-19, annual influenza, and others relevant to the workplace. RESULTS Concern about adverse effects was the most frequently reported reason for employee vaccine hesitancy for each vaccine category. Mistrust was reported more frequently for COVID-19 than for the influenza vaccine or other vaccines (χ 2P < 0.05). Targets of employee mistrust included government and researchers or scientists, but mistrust of healthcare providers was uncommon. CONCLUSIONS These results can be used to inform interventions to address vaccine hesitancy in the occupational health setting.
Collapse
Affiliation(s)
- Cara E Dooley
- From the University of Maryland School of Medicine, Baltimore, Maryland (C.D., N.T.S., P.W.G., M.C.); University of Maryland School of Social Work, Baltimore, Maryland (M.T.H.); Johns Hopkins Education and Research Center for Occupational Safety and Health, Baltimore, Maryland (M.L.D.); and University of Maryland School of Nursing, Baltimore, Maryland (L.A.E.)
| | | | | | | | | | | | | |
Collapse
|
13
|
Garrison A, Fressard L, Mitilian E, Gosselin V, Berthiaume P, Casanova L, Gagneur A, Verger P. Motivational interview training improves self-efficacy of GP interns in vaccination consultations: A study using the Pro-VC-Be to measure vaccine confidence determinants. Hum Vaccin Immunother 2023; 19:2163809. [PMID: 36703495 PMCID: PMC10012912 DOI: 10.1080/21645515.2022.2163809] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Immunization-specific motivational interviewing (MI), a patient-centered communication style used to encourage internal motivation for attitudinal and behavioral change, can provide healthcare professionals (HCPs) with the skills and practice required to respond to patients' doubts and concerns related to vaccines. We sought to assess the impact of an MI-training of General Practitioner (GP) interns on the psychosocial determinants of their vaccine confidence and behaviors. French GP interns participated in a virtual three-day MI-workshop in southeastern France. We used the validated Pro-VC-Be questionnaire - before and after the MI-workshop spanning over three months - to measure the evolution of these determinants. Scores before and after workshop trainings were compared in pairs. Participants' scores for commitment to vaccination (+10.5 ± 20.5, P = .001), perceived self-efficacy (+36.0 ± 25.8, P < .0001), openness to patients (+18.7 ± 17.0, P < .0001), and trust in authorities (+9.5 ± 17.2, P = 0.01) significantly increased after the training sessions, but not the score for confidence in vaccines (+1.5 ± 11.9, P = .14). The effect sizes of the four score improvements were moderate to large, with self-efficacy and openness to patients having the largest effect sizes (P = .83 and 0.78, respectively). This study provides evidence that certain determinants of overall vaccine confidence in HCPs, reflected respectively in the openness to patients and self-efficacy scores of the Pro-VC-Be, improve after immunization MI-training workshops. Incorporating immunization-specific MI-training in the curriculum for HCPs could improve several necessary skills to improve HCP-patient relationships and be useful for vaccination and other healthcare services.
Collapse
Affiliation(s)
- Amanda Garrison
- Faculté des Sciences Médicales et Paramédicales, Observatoire Régional de la Santé (ORS) PACA, Marseille, France
| | - Lisa Fressard
- Faculté des Sciences Médicales et Paramédicales, Observatoire Régional de la Santé (ORS) PACA, Marseille, France
| | - Eva Mitilian
- Faculté des Sciences Médicales et Paramédicales, Observatoire Régional de la Santé (ORS) PACA, Marseille, France.,Faculté des Sciences Médicales et Paramédicales, Département Universitaire de Médecine Générale (DUMG), Aix Marseille Université, Marseille, France
| | - Virginie Gosselin
- Centre de Recherche du Centre Hospitalier, Universitaire de Sherbrooke, Sherbrooke, Québec, Canada
| | | | - Ludovic Casanova
- Faculté des Sciences Médicales et Paramédicales, Observatoire Régional de la Santé (ORS) PACA, Marseille, France.,Faculté des Sciences Médicales et Paramédicales, Département Universitaire de Médecine Générale (DUMG), Aix Marseille Université, Marseille, France
| | - Arnaud Gagneur
- Centre de Recherche du Centre Hospitalier, Universitaire de Sherbrooke, Sherbrooke, Québec, Canada.,Department of Pediatrics, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Québec, Canada
| | - Pierre Verger
- Faculté des Sciences Médicales et Paramédicales, Observatoire Régional de la Santé (ORS) PACA, Marseille, France
| |
Collapse
|
14
|
Hurstak E, Farina FR, Paasche-Orlow MK, Hahn EA, Henault LE, Moreno P, Weaver C, Marquez M, Serrano E, Thomas J, Griffith JW. COVID-19 Vaccine Confidence Mediates the Relationship between Health Literacy and Vaccination in a Diverse Sample of Urban Adults. Vaccines (Basel) 2023; 11:1848. [PMID: 38140251 PMCID: PMC10747333 DOI: 10.3390/vaccines11121848] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 12/01/2023] [Accepted: 12/08/2023] [Indexed: 12/24/2023] Open
Abstract
We sought to analyze the relationship between health literacy, confidence in COVID-19 vaccines, and self-reported vaccination. We hypothesized that the relationship between health literacy and vaccination would be mediated by vaccine confidence. We recruited (N = 271) English- and Spanish-speaking adults in Boston and Chicago from September 2018 to September 2021. We performed a probit mediation analysis to determine if confidence in COVID-19 vaccines and health literacy predicted self-reported vaccination. We hypothesized that the relationship between health literacy and vaccination would be mediated by vaccine confidence. Participants were on average 50 years old, 65% female, 40% non-Hispanic Black, 25% Hispanic, and 30% non-Hispanic White; 231 (85%) reported at least one COVID-19 vaccination. A higher mean vaccine confidence score (t = -7.9, p < 0.001) and higher health literacy (t = -2.2, p = 0.03) were associated with vaccination, but only vaccine confidence predicted vaccination in a multivariate model. Vaccine confidence mediated the relationship between health literacy and COVID-19 vaccination (mediated effects: 0.04; 95% CI [0.02, 0.08]). We found that using a simple tool to measure vaccine confidence identified people who declined or delayed COVID-19 vaccination in a diverse sample of adults with varying levels of health literacy. Simple short survey tools can be useful to identify people who may benefit from vaccine promotion efforts and evidence-based communication strategies.
Collapse
Affiliation(s)
- Emily Hurstak
- Section of General Internal Medicine, Boston University Chobanian & Avedisian School of Medicine, Boston, MA 02119, USA;
| | - Francesca R. Farina
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA; (F.R.F.); (E.A.H.); (C.W.); (M.M.); (E.S.); (J.T.); (J.W.G.)
| | - Michael K. Paasche-Orlow
- Department of Medicine, Tufts University School of Medicine, Tufts Medical Center, Boston, MA 02116, USA;
| | - Elizabeth A. Hahn
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA; (F.R.F.); (E.A.H.); (C.W.); (M.M.); (E.S.); (J.T.); (J.W.G.)
| | - Lori E. Henault
- Section of General Internal Medicine, Boston University Chobanian & Avedisian School of Medicine, Boston, MA 02119, USA;
| | - Patricia Moreno
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL 33136, USA;
| | - Claire Weaver
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA; (F.R.F.); (E.A.H.); (C.W.); (M.M.); (E.S.); (J.T.); (J.W.G.)
| | - Melissa Marquez
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA; (F.R.F.); (E.A.H.); (C.W.); (M.M.); (E.S.); (J.T.); (J.W.G.)
| | - Eloisa Serrano
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA; (F.R.F.); (E.A.H.); (C.W.); (M.M.); (E.S.); (J.T.); (J.W.G.)
| | - Jessica Thomas
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA; (F.R.F.); (E.A.H.); (C.W.); (M.M.); (E.S.); (J.T.); (J.W.G.)
| | - James W. Griffith
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA; (F.R.F.); (E.A.H.); (C.W.); (M.M.); (E.S.); (J.T.); (J.W.G.)
| |
Collapse
|
15
|
Gaviola GC, McCarville M, Shendale S, Goodman T, Lomazzi M, Desai S. A review of health worker vaccination programs in low, middle and upper middle-income countries. PUBLIC HEALTH IN PRACTICE 2023; 6:100415. [PMID: 37547811 PMCID: PMC10400463 DOI: 10.1016/j.puhip.2023.100415] [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: 03/20/2023] [Revised: 07/24/2023] [Accepted: 07/25/2023] [Indexed: 08/08/2023] Open
Abstract
Objectives Health workers (HW) are at risk of contracting vaccine preventable diseases when caring for patients and communities. This study aims to evaluate the existing literature on the routine vaccination of health workers against a variety of antigens in low and middle income countries, focusing on facilitators, barriers, and considerations in the implementation of immunization programs and campaigns. Study design A PubMed Literature search. Methods A PubMed search was conducted to find articles that addressed vaccination programs and policies for HW in low-income countries (LIC), lower middle-income countries (LMIC), and upper middle-income countries (UMIC). Original articles, meta-analyses, and reviews published in English between January 2000 and July 2022 were included in the search. Inductive content analysis was used to identify themes that illustrate facilitators, barriers, and considerations in the implementation of immunization programs and campaigns. Results The search identified 4240 studies, 90 were used for analysis as they provided antigen specific details on immunization policies or programs. Hepatitis B was the most frequently discussed antigen, followed by Influenza, then Measles, Rubella and Mumps. With considerable variability by vaccine and country, in most cases the vaccination was not offered free to HW or included in a regular vaccination schedule. Utilizing existing immunization infrastructure such as the Expanded Programme on Immunization (EPI) and having effective management of vaccination programs were found to be key facilitators to vaccinate HW. Conclusions The low vaccination coverage of health workers in LMIC is of concern; attention towards the key considerations, barriers and facilitators of immunization implementation is central to the advancement of health worker vaccination coverage in LMIC's. The COVID-19 pandemic necessitated the swift vaccination of HW. Many LIC countries lacking established HW immunization infrastructure are now administering COVID-19 vaccines. As we move beyond the pandemic's acute phase, there is a chance for those countries to enhance their immunization initiatives and policies for HW concerning other antigens, even if it is not a standard practice currently.
Collapse
Affiliation(s)
- Gabriel C. Gaviola
- Department of Occupational Medicine, Cambridge Health Alliance, Cambridge, MA, USA
- Harvard Medical School, Cambridge, MA, USA
| | - Maddison McCarville
- School of Health and Related Research, University of Sheffield, Sheffield, United Kingdom
- World Federation of Public Health Associations, Geneva, Switzerland
| | - Stephanie Shendale
- Department of Immunization, Vaccines and Biologicals, World Health Organization, Geneva, Switzerland
| | - Tracey Goodman
- Department of Immunization, Vaccines and Biologicals, World Health Organization, Geneva, Switzerland
| | - Marta Lomazzi
- World Federation of Public Health Associations, Geneva, Switzerland
- University of Geneva, Institute of Global Health, Geneva, Switzerland
| | - Shalini Desai
- Department of Immunization, Vaccines and Biologicals, World Health Organization, Geneva, Switzerland
| |
Collapse
|
16
|
Osaigbovo II, Ogboghodo EO, Obarisiagbon OE, Obaseki DE. An assessment of COVID-19 vaccine knowledge and acceptability among healthcare workers in a Nigerian tertiary hospital. Ghana Med J 2023; 57:284-292. [PMID: 38957845 PMCID: PMC11215228 DOI: 10.4314/gmj.v57i4.5] [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] [Indexed: 07/04/2024] Open
Abstract
Objectives To assess the knowledge and acceptability of COVID-19 vaccines among HCWs. Design A descriptive cross-sectional study was conducted in March 2021 among eligible HCWs using a self-administered questionnaire. Setting The study was conducted in a southern Nigerian tertiary hospital. Participants All HCWs not on annual or study leave were eligible to participate. The number of HCWs in each occupational category was determined by proportional allocation. HCWs were selected by stratified sampling technique. Main outcome measures Knowledge of COVID-19 vaccines was assessed using 25 questions. The minimum and maximum scores were 0 and 25, respectively. Scores were converted to percentages. Scores of 50% and above were rated as good knowledge. Participants were also asked if they were willing to receive the vaccine. Results The mean age of 512 participating HCWs was 33.4±7.8 with an M:F ratio of 1:1.1. Overall, 399 (76.6%) had good knowledge. Occupation and exposure to COVID-19 were predictors of knowledge. Three hundred and twenty-eight respondents (63.0%) were willing to take the vaccine. Predictors of willingness to accept vaccination were age, sex, number of years in employment and knowledge about the vaccines (p< 0.05). Conclusions Most HCWs had good knowledge and were disposed to accepting the COVID-19 vaccine. Educational interventions are necessary to improve HCWs knowledge as they may provide vaccine-related information to the general public. Funding None declared.
Collapse
Affiliation(s)
- Iriagbonse I Osaigbovo
- Department of Medical Microbiology, University of Benin Teaching Hospital, PMB 1111, Benin City, Edo State
| | - Esohe O Ogboghodo
- Department of Public Health and Community Medicine, University of Benin Teaching Hospital, PMB 1111, Benin City, Edo State
| | - Otaniyenuwa E Obarisiagbon
- Department of Public Health and Community Medicine, University of Benin Teaching Hospital, PMB 1111, Benin City, Edo State
| | - Darlington E Obaseki
- Office of the Chief Medical Director/ Department of Anatomic Pathology, University of Benin Teaching Hospital, PMB 1111, Benin City, Edo State
| |
Collapse
|
17
|
Kalatzi P, Travlos AK, Geladas N, Iliadou M, Tzavara C, Chryssanthopoulos C, Mihopoulos A, Tziaferi S. Vaccination coverage of primary care providers against seasonal influenza, tetanus, pneumococcal pneumonia and herpes zoster: A cross-sectional study in Greece. AIMS Public Health 2023; 10:952-963. [PMID: 38187900 PMCID: PMC10764975 DOI: 10.3934/publichealth.2023061] [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: 06/10/2023] [Revised: 10/17/2023] [Accepted: 11/14/2023] [Indexed: 01/09/2024] Open
Abstract
Introduction Primary care providers' (PCPs) compliance to self-immunization is important for their protection and the protection of their colleagues and patients and has been associated with the coverage of the general public. In this study, we aim to investigate the vaccination coverage of PCPs. Methods A questionnaire-based cross-sectional survey was conducted among physicians, nurses and pharmacists employed in public or private primary care settings in Greece. Demographic and occupational characteristics as well as vaccination coverage data for influenza, tetanus, pneumococcal pneumonia and herpes zoster were collected. Statistical significance was set at 0.05. Results In total, 748 (61.7% response rate) PCPs participated. Vaccination rates were 66.4% (496/747) for influenza (2019/2020 flu season), 62.9% (469/746) for tetanus (10-year Td or Tdap booster dose), 70% (14/20) for pneumococcal pneumonia (≥ 1 dose of PPSV23 or PCV13) and 12.3% (10/81) for herpes zoster. Multiple logistic regression revealed that nurses had significantly lower probability of being vaccinated against influenza [odds ratio (OR) = 0.25; 95% confidence interval (CI) = 0.14-0.45] and pharmacists had significantly lower probability of being vaccinated against both influenza (OR = 0.44; 95% CI = 0.31-0.62) and influenza & tetanus (OR = 0.52; 95% CI = 0.37-0.73) compared to physicians. Older age (>40 years) was an independent risk factor for not receiving a tetanus vaccine (40-49 vs. 19-39; OR = 0.42; 95% CI = 0.28-0.63, over 50 years old vs. 19-39; OR = 0.54; 95% CI = 0.36-0.79). Conclusions The results revealed suboptimal vaccination rates among health providers who are in the frontline of adult immunization. Individualized and targeted measures to improve their vaccination coverage and indirectly the vaccination coverage of their patients, are therefore required.
Collapse
Affiliation(s)
- Panagiota Kalatzi
- Laboratory of Integrated Health Care, Department of Nursing, University of Peloponnese, Tripoli, Greece
| | - Antonios K. Travlos
- Department of Sports Organization and Management, University of Peloponnese, Sparti, Greece
| | - Nickos Geladas
- Department of Physical Education & Sport Science, National & Kapodistrian University of Athens, Athens, Greece
| | - Maria Iliadou
- Department of Midwifery, University of West Attica, Athens, Greece
| | - Chara Tzavara
- Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Alexandros Mihopoulos
- Laboratory of Integrated Health Care, Department of Nursing, University of Peloponnese, Tripoli, Greece
| | - Styliani Tziaferi
- Laboratory of Integrated Health Care, Department of Nursing, University of Peloponnese, Tripoli, Greece
| |
Collapse
|
18
|
Morgel O, Czock A, Lang P. Peri-Pandemic Acceptance of Influenza and COVID-19 Vaccination by Swiss Healthcare Workers in Primary Care 2020/21: A Cross-Sectional Study. Int J Public Health 2023; 68:1605832. [PMID: 38033764 PMCID: PMC10684700 DOI: 10.3389/ijph.2023.1605832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 10/26/2023] [Indexed: 12/02/2023] Open
Abstract
Objectives: To assess and compare influenza and COVID-19 vaccination uptake of Swiss healthcare workers (HCWs) in primary care 2020/21. Methods: Influenza and COVID-19 vaccination uptake and recommendation behaviours of HCWs in the primary care were assessed using an online semi-structured questionnaire. Associations between vaccination rates and age, language, gender, profession, vaccination history, vaccination training and recommendation behaviours were evaluated using descriptive and multivariable logistic regression analyses. Results: Vaccinated against COVID-19 in 2020/21 were 91.8% of the 1,237 participating HCWs, while 60.1% were vaccinated against influenza. Physicians and pharmacists presented the highest influenza vaccination rates (87.3%, 73.7%, respectively) compared to nurses (45.8%) and medical practice assistants (52.5%) while COVID-19 vaccination rates were high across all professions. Influenza and COVID-19 vaccination rates were significantly associated with age, profession, vaccination history, vaccination training and recommendation behaviours. Conclusion: Acceptance for influenza vaccination has increased during the pandemic but is lower than that for COVID-19 among the HCWs. Demographics, vaccination status and vaccination training impact the vaccination behaviour among HCWs and should be considered in future campaigns to increase vaccination uptake.
Collapse
Affiliation(s)
- Olga Morgel
- Interdisciplinary Emergency Centre Lucerne Cantonal Hospital, Lucerne, Switzerland
| | | | - Phung Lang
- Epidemiology, Biostatistics and Prevention Institute at the University of Zurich, Zurich, Switzerland
| |
Collapse
|
19
|
Tan SH, King TL, Tan SSN, Lai WH, Bujang MA, Voon PJ. Development and validation of Join Clinical Trial Questionnaire (JoinCT). Asia Pac J Clin Oncol 2023. [PMID: 37943536 DOI: 10.1111/ajco.14034] [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: 05/25/2023] [Accepted: 10/30/2023] [Indexed: 11/10/2023]
Abstract
AIM Participant recruitment has always been a major challenge in clinical trials. This study aimed to develop and validate the Join Clinical Trial Questionnaire (JoinCT), exploring the willingness to join a clinical trial and associated factors in patients. METHODS This questionnaire development study involved four phases: (i) exploring and understanding the subject matter, (ii) questionnaire development, (iii) content validity testing, and lastly, (iv) field-testing of the questionnaire. For the field-testing phase, a cross-sectional self-administered survey of JoinCT was conducted among cancer patients with various socio-demographic backgrounds and medical conditions. Besides content validity, Cronbach's alpha was used to evaluate the internal consistency of domains, and confirmatory factor analysis was used to evaluate the model fit of the JoinCT framework. RESULTS A total of 389 respondents participated in the survey. Based on the results obtained from a field data collection phase, JoinCT consisted of four independent variables domains, namely "knowledge", "perception of benefits", "perception of risks", and "confidence". The only dependent variable was the willingness to participate in a clinical trial. The minimum Cronbach's alpha was 0.937, and the model fit for the overall framework of JoinCT is also excellent with Comparative Fit Index (> 0.90), root mean square error approximation (< 0.08), and Standardized Root Mean Square Residual (< 0.08). CONCLUSIONS The Join Clinical Trial Questionnaire (JoinCT) was successfully validated with excellent reliability and validity, and a good model fit. The main factors that contribute to willingness to participate in clinical trials are knowledge, perception of benefits, perception of risks, and confidence.
Collapse
Affiliation(s)
- Shirin Hui Tan
- Clinical Research Centre, Sarawak General Hospital, Ministry of Health, Kuching, Sarawak, Malaysia
| | - Teck Long King
- Clinical Research Centre, Sarawak General Hospital, Ministry of Health, Kuching, Sarawak, Malaysia
| | - Shirley Siang Ning Tan
- Clinical Research Centre, Sarawak General Hospital, Ministry of Health, Kuching, Sarawak, Malaysia
- Department of Pharmacy, Sarawak General Hospital, Ministry of Health, Kuching, Sarawak, Malaysia
| | - Wei Hong Lai
- Clinical Research Centre, Sarawak General Hospital, Ministry of Health, Kuching, Sarawak, Malaysia
| | - Mohamad Adam Bujang
- Clinical Research Centre, Sarawak General Hospital, Ministry of Health, Kuching, Sarawak, Malaysia
| | - Pei Jye Voon
- Department of Radiotherapy and Oncology, Sarawak General Hospital, Ministry of Health, Kuching, Sarawak, Malaysia
| |
Collapse
|
20
|
Kaur M, Coppeta L, Olesen OF. Vaccine Hesitancy among Healthcare Workers in Europe: A Systematic Review. Vaccines (Basel) 2023; 11:1657. [PMID: 38005989 PMCID: PMC10675787 DOI: 10.3390/vaccines11111657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 10/17/2023] [Accepted: 10/25/2023] [Indexed: 11/26/2023] Open
Abstract
This study analyzes vaccine hesitancy (VH) among healthcare workers (HCWs) in 15 European countries. We have undertaken a systematic review by synthesizing data from 46 articles (between 2015 and 2022) encompassing 55,612 subjects. Despite the heterogeneity of the methods in the various studies, we found that physicians had consistently higher vaccination rates than nurses across different countries and different vaccines. Physicians' average vaccination rate was 79% across a selection of vaccines, while that of nurses was 62%. Concerns regarding vaccine safety, information gaps, and the responsibility of healthcare authorities in managing VH are highlighted by qualitative insights. This research contributes to our comprehension of the ways in which VH among HCWs is impacted by healthcare roles, vaccine types, and regional disparities. The insights gleaned from this analysis can serve as a guide for targeted interventions aimed at increasing vaccine acceptance and coverage in Europe, ultimately strengthening public health.
Collapse
Affiliation(s)
- Mandeep Kaur
- European Vaccine Initiative, Universitätsklinikum Heidelberg (Heidelberg University Hospital), Voßstraße 2, 69115 Heidelberg, Germany;
| | - Luca Coppeta
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy;
| | - Ole F. Olesen
- European Vaccine Initiative, Universitätsklinikum Heidelberg (Heidelberg University Hospital), Voßstraße 2, 69115 Heidelberg, Germany;
| |
Collapse
|
21
|
Lyu Y, Lai X, Ma Y, Fang H. Factors associated with recommendation behaviors of four non-National Immunization Program vaccines: a cross-sectional survey among public health workers in China. Infect Dis Poverty 2023; 12:91. [PMID: 37805654 PMCID: PMC10559509 DOI: 10.1186/s40249-023-01142-8] [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: 05/01/2023] [Accepted: 09/25/2023] [Indexed: 10/09/2023] Open
Abstract
BACKGROUND Immunization is a crucial preventive measure to safeguard children under five years old against a range of diseases. In China, the coverage rate of non-National Immunization Program (non-NIP) vaccines can be improved by leveraging the recommendation from public health workers. Hence, understanding the influencing factors of recommendation behaviors assume paramount importance. This study aims to investigate influencing factors of public health workers' recommendation behaviors towards non-NIP vaccines, with a particular emphasis on financial incentives. METHODS A cross-sectional survey was conducted using a multi-stage sampling method in 2019 from August to October. 627 public health workers were recruited from 148 community healthcare centers in ten provincial-level administrative divisions in China. An anonymous questionnaire was used to collect demographic information, attitudes towards vaccination, and recommendation behaviors towards non-NIP vaccines, including Haemophilus influenzae type b (Hib) vaccine, pneumococcal conjugate vaccine, varicella vaccine, and rotavirus vaccine. Descriptive analysis and multivariate logistic regression analysis were adopted in this study. RESULTS Of the 610 public health workers with complete survey data, 53.8%, 57.4%, 84.1%, and 54.1% often recommended Hib vaccine, pneumococcal pneumonia vaccine (PCV), varicella vaccine, and rotavirus vaccine, respectively. Logistic regression revealed that gender (Hib vaccine: OR = 0.4, 95% CI: 0.2-0.8; PCV: OR = 0.4, 95% CI: 0.2-0.8; rotavirus vaccine: OR = 0.3, 95% CI: 0.2-0.6), financial incentives for non-NIP vaccination (Hib vaccine: OR = 1.9, 95% CI: 1.1-3.6; PCV: OR = 2.1, 95% CI: 1.1-3.9; rotavirus vaccine: OR = 2.0, 95% CI: 1.1-3.8) and perception of vaccine safety (Hib vaccine: OR = 2.7, 95% CI: 1.1-7.0; PCV: OR = 3.2, 95% CI: 1.2-8.0; rotavirus vaccine: OR = 3.0, 95% CI: 1.2-7.7) were associated with public health workers' recommendation towards Hib vaccine, PCV and rotavirus vaccine. CONCLUSIONS The findings highlighted public health workers' recommendation behaviors of non-NIP vaccines in China and revealed strong association between vaccine recommendation and financial incentives. This highlights the importance of financial incentives in public health workers' recommendation toward non-NIP vaccines in China. Proper incentives are recommended for public health workers to encourage effective health promotion in immunization practices.
Collapse
Affiliation(s)
- Yun Lyu
- Department of Health Policy and Management, School of Public Health, Peking University, Beijing, China
| | - Xiaozhen Lai
- Department of Health Policy and Management, School of Public Health, Peking University, Beijing, China
- Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Yidi Ma
- Department of Health Policy and Management, School of Public Health, Peking University, Beijing, China
| | - Hai Fang
- China Center for Health Development Studies, Peking University, Beijing, China.
- Peking University Health Science Center-Chinese Center for Disease Control and Prevention Joint Research Center for Vaccine Economics, Peking University, Beijing, China.
- Institute for Global Health and Development, Peking University, Beijing, China.
| |
Collapse
|
22
|
ALI QANBAR MUSTAFA, JASIM ALAAKADHIM, MAHMOOD ABDULKAREEMABDULLAH. Assessment of immunization session practices in primary health care centers in Al-Najaf province. J Public Health Afr 2023; 14:2754. [PMID: 37881728 PMCID: PMC10594596 DOI: 10.4081/jphia.2023.2754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2023] Open
Abstract
Immunization has played a vital role in improving global health by reducing the transmission of infectious diseases. To ensure the successful implementation of immunization programs, it is crucial to thoroughly examine various elements within the Primary Health Care Centers, including immunization session management, cold-chain and logistics management, supervision, and reporting. The study aims to assess the immunization session practices in selected primary healthcare centers in Al-Najaf governorate. A descriptive cross-sectional study was conducted at 26 primary healthcare centers, selected using simple random sampling, across six districts in Najaf governorate. A total of 143 healthcare workers, comprising 122 vaccinators and 21 doctors, were included in the study. questionnaires were utilized to assess immunization session practices. Data collection commenced on December 2, 2022, and concluded on March 2, 2023. Immunization session practices were evaluated as having poor vaccine and diluent management, fair cold chain management, communication with clients and caregivers, vaccine preparation and administration practices, and waste management practices. However, immunization session equipment availability, as well as card review and registration during immunization, received good evaluations. The overall assessment of immunization session practices was determined to be fair. In addition, the study identified significant associations between immunization practices and the number of non-vaccinators working in the immunization unit (P=0.035), and the average number of daily vaccine recipients in primary healthcare centers (P=0.046). The immunization session practices achieved a fair level of assessment, The increased number of daily visitors to the immunization unit and the number of health workers who are non-vaccinator in the unit affected negatively the immunization session practices.
Collapse
Affiliation(s)
- MUSTAFA ALI QANBAR
- Department of Community Health Techniques, College of Health and Medical Technology, Basrah, Southern Technical University
| | - ALAA KADHIM JASIM
- Department of Medical Laboratory Technologies, College of Health and Medical Technology, Basrah, Southern Technical University
| | | |
Collapse
|
23
|
Collini F, Bonaccorsi G, Del Riccio M, Bruschi M, Forni S, Galletti G, Gemmi F, Ierardi F, Lorini C. Does Vaccine Confidence Mediate the Relationship between Vaccine Literacy and Influenza Vaccination? Exploring Determinants of Vaccination among Staff Members of Nursing Homes in Tuscany, Italy, during the COVID-19 Pandemic. Vaccines (Basel) 2023; 11:1375. [PMID: 37631943 PMCID: PMC10458978 DOI: 10.3390/vaccines11081375] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 08/11/2023] [Accepted: 08/16/2023] [Indexed: 08/29/2023] Open
Abstract
BACKGROUND Low coverage of influenza vaccination in nursing home (NH) staff may be attributed to factors such as vaccine confidence (VC) and vaccine literacy (VL). Our study aimed to evaluate the role of VL and VC in predicting the intention to get the influenza vaccine in a sample of employees of NHs in Tuscany, Italy. METHODS Data from staff members in Tuscany were collected using an online questionnaire that examined influenza vaccination history, intentions, demographic information, health status, and VL. Statistical analyses explored the relationships between VC, VL, and vaccination intentions. RESULTS The study included 1794 respondents, (86.3%) and assistants/aides (58.1%), with a median age of 46 years. The intention to get vaccinated was significantly higher among those with health risk conditions, and there was a positive association between VC and VL, specifically its interactive/critical component. The mediation analysis showed that VC completely mediated the relationship between VL and the intention to get vaccinated, with significant effects observed in different subgroups. CONCLUSIONS VC is a key factor that mediates the effect of VL on vaccine intention. These results suggest that interventions aimed at improving VL alone may not be sufficient to increase vaccine uptake unless VC is also addressed.
Collapse
Affiliation(s)
- Francesca Collini
- Quality and Equity Unit, Regional Health Agency of Tuscany, 50141 Florence, Italy
| | | | - Marco Del Riccio
- Department of Health Sciences, University of Florence, 50134 Florence, Italy
| | - Mario Bruschi
- Department of Health Sciences, University of Florence, 50134 Florence, Italy
| | - Silvia Forni
- Quality and Equity Unit, Regional Health Agency of Tuscany, 50141 Florence, Italy
| | - Giacomo Galletti
- Quality and Equity Unit, Regional Health Agency of Tuscany, 50141 Florence, Italy
| | - Fabrizio Gemmi
- Quality and Equity Unit, Regional Health Agency of Tuscany, 50141 Florence, Italy
| | - Francesca Ierardi
- Quality and Equity Unit, Regional Health Agency of Tuscany, 50141 Florence, Italy
| | - Chiara Lorini
- Department of Health Sciences, University of Florence, 50134 Florence, Italy
| |
Collapse
|
24
|
Mudenda S, Daka V, Matafwali SK, Skosana P, Chabalenge B, Mukosha M, Fadare JO, Mfune RL, Witika BA, Alumeta MG, Mufwambi W, Godman B, Meyer JC, Bwalya AG. COVID-19 Vaccine Acceptance and Hesitancy among Healthcare Workers in Lusaka, Zambia; Findings and Implications for the Future. Vaccines (Basel) 2023; 11:1350. [PMID: 37631918 PMCID: PMC10459437 DOI: 10.3390/vaccines11081350] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 08/05/2023] [Accepted: 08/07/2023] [Indexed: 08/29/2023] Open
Abstract
The uptake of COVID-19 vaccines is critical to address the severe consequences of the disease. Previous studies have suggested that many healthcare workers (HCWs) are hesitant to receive the COVID-19 vaccine, further enhancing hesitancy rates within countries. COVID-19 vaccine acceptance and hesitancy levels are currently unknown among HCWs in Zambia, which is a concern given the burden of infectious diseases in the country. Consequently, this study assessed COVID-19 vaccine acceptance and hesitancy among HCWs in Lusaka, Zambia. A cross-sectional study was conducted among 240 HCWs between August and September 2022, using a semi-structured questionnaire. Multivariable analysis was used to determine the key factors associated with vaccine hesitancy among HCWs. Of the 240 HCWs who participated, 54.2% were females. A total of 72.1% of the HCWs would accept being vaccinated, while 27.9% were hesitant. Moreover, 93.3% of HCWs had positive attitudes towards COVID-19 vaccines, with medical doctors having the highest mean attitude score (82%). Encouragingly, HCWs with positive attitudes towards COVID-19 vaccines had reduced odds of being hesitant (AOR = 0.02, 95% CI: 0.01-0.11, p < 0.001). Overall, acceptance of the COVID-19 vaccine among HCWs in Lusaka, Zambia, was high, especially by those with positive attitudes. However, the current hesitancy among some HCWs is a concern. Consequently, there is a need to address this and encourage HCWs to fully promote vaccination programs going forward.
Collapse
Affiliation(s)
- Steward Mudenda
- Department of Pharmacy, School of Health Sciences, University of Zambia, Lusaka 10101, Zambia; (M.M.); (M.G.A.); (W.M.); (A.G.B.)
| | - Victor Daka
- Department of Public Health, Michael Chilufya Sata School of Medicine, Copperbelt University, Ndola 21692, Zambia; (V.D.); (R.L.M.)
| | - Scott K. Matafwali
- Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, UK;
| | - Phumzile Skosana
- Department of Clinical Pharmacy, School of Pharmacy, Sefako Makgatho Health Sciences University, Pretoria 0208, South Africa;
| | - Billy Chabalenge
- Department of Medicines Control, Zambia Medicines Regulatory Authority, Lusaka 31890, Zambia;
| | - Moses Mukosha
- Department of Pharmacy, School of Health Sciences, University of Zambia, Lusaka 10101, Zambia; (M.M.); (M.G.A.); (W.M.); (A.G.B.)
| | - Joseph O. Fadare
- Department of Pharmacology and Therapeutics, Ekiti State University College of Medicine, Ado-Ekiti 362103, Nigeria;
- Department of Medicine, Ekiti State University Teaching Hospital, Ado-Ekiti 362103, Nigeria
| | - Ruth L. Mfune
- Department of Public Health, Michael Chilufya Sata School of Medicine, Copperbelt University, Ndola 21692, Zambia; (V.D.); (R.L.M.)
| | - Bwalya A. Witika
- Department of Pharmaceutical Sciences, School of Pharmacy, Sefako Makgatho Health Sciences University, Pretoria 0208, South Africa;
| | - Mirriam G. Alumeta
- Department of Pharmacy, School of Health Sciences, University of Zambia, Lusaka 10101, Zambia; (M.M.); (M.G.A.); (W.M.); (A.G.B.)
| | - Webrod Mufwambi
- Department of Pharmacy, School of Health Sciences, University of Zambia, Lusaka 10101, Zambia; (M.M.); (M.G.A.); (W.M.); (A.G.B.)
| | - Brian Godman
- Department of Public Health Pharmacy and Management, School of Pharmacy, Sefako Makgatho Health Sciences University, Pretoria 0208, South Africa;
- Department of Pharmacoepidemiology, Strathclyde Institute of Pharmacy and Biomedical Science, University of Strathclyde, Glasgow G4 0RE, UK
| | - Johanna C. Meyer
- Department of Public Health Pharmacy and Management, School of Pharmacy, Sefako Makgatho Health Sciences University, Pretoria 0208, South Africa;
- South African Vaccination and Immunisation Centre, Sefako Makgatho Health Sciences University, Molotlegi Street, Garankuwa, Pretoria 0208, South Africa
| | - Angela G. Bwalya
- Department of Pharmacy, School of Health Sciences, University of Zambia, Lusaka 10101, Zambia; (M.M.); (M.G.A.); (W.M.); (A.G.B.)
| |
Collapse
|
25
|
AlShamlan NA, AlOmar RS, AlAbdulKader AM, AlGhamdi FA, Aldakheel AA, Al Shehri SA, Felemban LA, Shafey MM, Al Shammari MA. Beliefs and Utilization of Cervical Cancer Screening by Female Health Care Workers in Saudi Arabia Using the Health Belief Model: A Nationwide Study. Int J Womens Health 2023; 15:1245-1259. [PMID: 37576181 PMCID: PMC10417788 DOI: 10.2147/ijwh.s415924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 07/29/2023] [Indexed: 08/15/2023] Open
Abstract
Purpose Epidemiologically, cervical cancer is the fourth most commonly diagnosed cancer among females globally and the third most commonly diagnosed gynecological cancer in Saudi Arabia. Screening is an important measure to prevent it. The current study aimed to assess, epidemiologically, female healthcare workers' (HCWs) utilization of cervical cancer screening services and its association with their beliefs about cervical cancer and the screening test, as well as their personal characteristics. Methods This cross-sectional study included female HCWs in Saudi Arabia. A predesigned, self-administered survey was used to collect data, and it included questions about sociodemographic and reproductive characteristics, self-utilization of cervical cancer screening services, and the Health Belief Model (HBM) scale. Regression analyses were conducted to identify predictors of cervical cancer screening service utilization. Results A total of 1857 females participated. The cervical cancer screening test uptake was 24.6% of ever-married females. However, 45% of the participants were willing to have the test. The odds of utilizing a screening were significantly higher among older participants, those with a higher level of education, and those with a higher number of pregnancies. Furthermore, HCWs with a history of HPV infection, cervical cancer in the family, hormonal contraception, or immunocompromised diseases were more likely to have the screening. An increase in the mean scores of the perceived benefits and motives subscales of HBM was associated with an increase in the uptake of screening. However, an increase in perceived barrier scores was significantly associated with a lower likelihood of cervical cancer screening uptake. Conclusion Low cervical screening uptake and slightly higher intentions to have the test exist among HCWs. Certain personal factors and health beliefs significantly affect the utilization of the screening test. Approaches that target perceived benefits, health motivation, and perceived barriers to improve the screening rates of cervical cancer among HCWs are recommended.
Collapse
Affiliation(s)
- Nouf A AlShamlan
- Department of Family and Community Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Reem S AlOmar
- Department of Family and Community Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Assim M AlAbdulKader
- Department of Family and Community Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Faisal A AlGhamdi
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Abdullah A Aldakheel
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Saud A Al Shehri
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Lyana Atif Felemban
- College of Medicine, Fakeeh College of Medical Sciences, Jeddah, Saudi Arabia
| | - Marwa Mahmoud Shafey
- Department of Family and Community Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Malak A Al Shammari
- Department of Family and Community Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| |
Collapse
|
26
|
Choi J, Ryu JG. COVID-19 vaccination intention among nursing, medical, and dental students: A systematic review and meta-regression analysis. Hum Vaccin Immunother 2023; 19:2253600. [PMID: 37732552 PMCID: PMC10515672 DOI: 10.1080/21645515.2023.2253600] [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: 06/08/2023] [Accepted: 08/28/2023] [Indexed: 09/22/2023] Open
Abstract
The introduction of the COVID-19 vaccine amidst the pandemic has heralded a paradigm shift. Healthcare students in nursing, medicine, and dentistry must have positive attitudes owing to their future role in vaccine recommendations to the public and patients. This meta-regression analysis assessed the differences in COVID-19 vaccination intention (VI) of nursing, medical, and dental students. Medline/PubMed, EMBASE, CINAHL, Cochrane Library, and Korean MBASE were searched for eligible studies. Quality was assessed by the Joanna Briggs Institute's quality appraisal. Forty-one studies were included in the final analysis, and the estimation of pooled prevalence (68%) and relevant factors were assessed. Dental students were found to have the lowest VI (57%), which significantly (p = .018) differed from that of nursing students (64%). Countries in South-East Asia and those with high income levels were found to have high VI. Therefore, global vaccine programs for healthcare students should be prepared considering their geographical and economic status.
Collapse
Affiliation(s)
- Jongrim Choi
- College of Nursing, Keimyung University, Daegu, Republic of Korea
| | - Jae Geum Ryu
- College of Nursing, Chodang University, Muan, Republic of Korea
| |
Collapse
|
27
|
Xie Z, Qalati SA, Limón MLS, Sulaiman MABA, Qureshi NA. Understanding factors influencing healthcare workers' intention towards the COVID-19 vaccine. PLoS One 2023; 18:e0286794. [PMID: 37498835 PMCID: PMC10374054 DOI: 10.1371/journal.pone.0286794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 05/23/2023] [Indexed: 07/29/2023] Open
Abstract
Globally, healthcare workers (HCWs) are at high risk of acquiring Coronavirus infection. In addition, they are role models for the general public concerning attitudes towards the COVID-19 vaccine. In addition, they play a critical role in successfully promoting practices aiming to reduce the transmission of COVID-19 infection. Therefore, this study broadly based on the theory of planned behavior (TPB) explores the factors influencing HCWs' intention to be vaccinated. An online survey was administered using Google Form to collect data from HCWs working in the public health sector of Pakistan. The sample included 813 participants, two-thirds were female, and one-third were male. In addition, 41.5% of them were aged between 26-35 years, 32.6% had master's level education, 25% were nurses, and 57.7% of them were living in urban areas. Data analysis was run using Partial Least Squares Structural Equation Modeling (PLS-SEM). The research findings reveal the positive and significant effect of the TPB factors (attitude, subjective norms, and perceived behavioral control) and the extended factor of vaccine confidence on HCWs' intention to be vaccinated. This study's model explains 66.4% of variations in HCWs' intention to be vaccinated.
Collapse
Affiliation(s)
- Zhuyun Xie
- School of Finance and Economics, Jiangsu University, Zhenjiang, China
| | | | | | | | | |
Collapse
|
28
|
Li M, Luo Y, Watson R, Zheng Y, Ren J, Tang J, Chen Y. Healthcare workers' (HCWs) attitudes and related factors towards COVID-19 vaccination: a rapid systematic review. Postgrad Med J 2023; 99:520-528. [PMID: 37319159 DOI: 10.1136/postgradmedj-2021-140195] [Citation(s) in RCA: 122] [Impact Index Per Article: 122.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 05/29/2021] [Indexed: 01/24/2023]
Abstract
Herd immunity through vaccination is a key measure to control COVID-19 pandemic. However, vaccine hesitancy remains a public health threat, which is still common among healthcare workers (HCWs). This systematic review aimed to synthesise evidence on HCWs' attitudes towards COVID-19 vaccination and analyse associated factors to provide information for vaccine policy development and practice. We searched PubMed, Embase, ScienceDirect, Web of Science and three Chinese databases for literature published on 12 February 2021. Two researchers screened the literature independently, and 13 studies were included in the systematic review. Vaccine acceptance varied widely and ranged from 27.7% to 77.3%. HCWs had positive attitudes towards future COVID-19 vaccines, while vaccine hesitancy was still common. Demographic variables such as men, older age and physicians were positive predictive factors. Women and nurses had more vaccine hesitancy. Previous influenza vaccination and self-perceived risk were facilitators. Concerns for safety, efficacy and effectiveness and distrust of the government were barriers. Influences of direct (COVID-19) patient care towards vaccination intention were less conclusive. Tailored communication strategies were needed to increase the uptake rate of COVID-19 vaccines among HCWs. More importantly, more data and information on the safety and efficacy of vaccines should be provided with transparency.
Collapse
Affiliation(s)
- Mei Li
- School of Nursing, Southwest Medical University, Luzhou, Sichuan, China
| | - Yue Luo
- School of Nursing, Southwest Medical University, Luzhou, Sichuan, China
| | - Roger Watson
- Health and Social Care Faculty, University of Hull, Hull, UK
| | - Yu Zheng
- Department of Rheumatism and Immunology, the Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
| | - Jianlan Ren
- Department of Anesthesiology, the Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Jian Tang
- Department of Central Sterile Supply, the Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
| | - Yanhua Chen
- Department of Nursing, the Affiliated Hospital of Southwest Medical University, Luzhou, China
| |
Collapse
|
29
|
Ishak AR, Hsieh YC, Srinivasan H, See KC. Review of Vaccination Recommendations in Guidelines for Non-Communicable Diseases with Highest Global Disease Burden among Adults 75 Years Old and Above. Vaccines (Basel) 2023; 11:1076. [PMID: 37376465 DOI: 10.3390/vaccines11061076] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 05/31/2023] [Accepted: 06/06/2023] [Indexed: 06/29/2023] Open
Abstract
This scientific review paper explores international and country-specific healthcare guidelines for non-communicable diseases with the highest burden among individuals aged 75 years and above. The study aims to identify the best vaccination practices and standardize healthcare practices to improve vaccination adherence in this vulnerable population. Given that older people are more prone to infectious illnesses and have higher rates of morbidity and mortality, vaccinations are essential for disease prevention. Despite the proven efficacy of vaccinations, adherence has plateaued in recent years, partly due to a lack of accessibility, public education, and variability in disease-specific guidelines. This paper highlights the need for a more robust and standardized international vaccination model to improve quality of life and reduce disability-adjusted life years among the elderly. The findings of this study call for further research to review the guidelines as more implementations are put in place, including non-English guidelines.
Collapse
Affiliation(s)
- Abdul Rahman Ishak
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore
| | - Yu Chun Hsieh
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore
| | - Harshitha Srinivasan
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore
| | - Kay Choong See
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore
| |
Collapse
|
30
|
Determination of factors influencing young adults' intention to have COVID-19 vaccine in the Philippines: An integration of Health Belief Model and the Theory of Planned Behavior. PUBLIC HEALTH IN PRACTICE 2023; 5:100359. [PMID: 36818574 PMCID: PMC9916191 DOI: 10.1016/j.puhip.2023.100359] [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] [Received: 04/26/2022] [Revised: 12/26/2022] [Accepted: 01/18/2023] [Indexed: 02/12/2023] Open
Abstract
Objectives The COVID-19 pandemic continues to increase around the world and businesses and markets across the world significantly decreased. The purpose of this study was to determine the factors that affect the intention to be vaccinated for the COVID-19 vaccine among young Filipino adults by integrating the Health Belief Model and Extended Theory of Planned Behavior. Study design A cross-sectional study design was utilized. Methods Factors such as understanding of the COVID-19 vaccine, self-efficacy, cues to action, perceived barriers, perceived benefits, perceived side effects, perceived behavioral control, attitude, subjective norm, and intention to be vaccinated were analyzed by utilizing Structural Equation Modeling (SEM). Results With 865 young Filipino adults who answered a self-administered survey, it was seen that Understanding of the COVID-19 vaccine has the highest direct significant effect on cues to action, followed by perceived barriers, and perceived benefits. Interestingly, the primary factor was Understanding COVID-19 vaccines which had an indirect significant effect on the intention to get vaccinated. This is because knowing what the vaccine is for, its effects, and the application would lead to the acceptance of the COVID-19 vaccine. Moreover, the impact of being known to have the COVID-19 vaccine would lead to the intention to get vaccinated. Conclusions The findings of this study can be utilized especially by the government in developing strategies for encouraging people to take the COVID-19 vaccine. Finally, the model construct of the study can be applied to explore more factors that can affect the intention to be vaccinated with the COVID-19 vaccine and other vaccines people worldwide.
Collapse
|
31
|
Malo B, Labbé F, Meyer SB, Filice E, Graham JE, MacDonald NE, Bettinger JA, Greyson D, MacDonald SE, Driedger SM, Kawchuk G, Dubé E. "I Want People to Be Able to Make an Informed Choice": How Quebec naturopaths discuss vaccination in their practice. Vaccine 2023:S0264-410X(23)00553-4. [PMID: 37210310 DOI: 10.1016/j.vaccine.2023.05.026] [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: 11/25/2022] [Revised: 03/22/2023] [Accepted: 05/09/2023] [Indexed: 05/22/2023]
Abstract
Health care providers' recommendations can play an important role in individuals' vaccination decisions. Despite being one of the most popular complementary and alternative medicine (CAM), naturopathy is understudied in relation to vaccination decisions. We sought to address this gap through this study of vaccination perspectives of naturopathy practitioners in the province of Quebec, Canada. We conducted in-depth interviews with 30 naturopaths. Thematic analysis was conducted. Main themes were developed deductively (i.e., based on prior literature) and expanded through inductive coding of the data. Participants noted that they discuss vaccination in their practice, but only when clients asked questions or wanted advice. Naturopaths described refraining from explicitly recommending for or against vaccination. Instead, they focus on empowering their clients to make their own informed decision regarding vaccination. Most participants noted that they direct clients towards sources of information so that clients could decide for themselves, but some mentioned they discussed with clients what they considered to be risks associated with vaccination, as well as its benefits. These discussions were framed through a personalized and individual approach with clients.
Collapse
Affiliation(s)
- Benjamin Malo
- Axe Maladies infectieuses et immunitaires, Centre de recherche du CHU de Québec-Université Laval, Québec, Canada; Département d'anthropologie, Université Laval, Québec, Canada
| | - Fabienne Labbé
- Axe Santé des populations et pratiques optimales en santé, Centre de recherche du CHU de Québec-Université Laval, Québec, Canada
| | - Samantha B Meyer
- School of Public Health Sciences, University of Waterloo, Waterloo, Canada
| | - Eric Filice
- School of Public Health Sciences, University of Waterloo, Waterloo, Canada
| | - Janice E Graham
- Department of Pediatrics, Dalhousie University, Halifax, Canada
| | | | - Julie A Bettinger
- Vaccine Evaluation Center, BC Children's Hospital Research Institute, University of British Columbia, Vancouver, Canada
| | - Devon Greyson
- Vaccine Evaluation Center, BC Children's Hospital Research Institute, University of British Columbia, Vancouver, Canada
| | | | - S Michelle Driedger
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Gregory Kawchuk
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada
| | - Eve Dubé
- Axe Maladies infectieuses et immunitaires, Centre de recherche du CHU de Québec-Université Laval, Québec, Canada; Département d'anthropologie, Université Laval, Québec, Canada; Direction des risques biologiques et de la santé au travail, Institut national de santé publique du Québec, Québec, Canada.
| |
Collapse
|
32
|
Moghaddam HR, Khan FR, Bazyar H, Aghamohammadi V. Reasons for not getting COVID-19 vaccine in Ardabil, a Northwestern province in Iran: Based on an ecological approach. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2023; 12:111. [PMID: 37397122 PMCID: PMC10312419 DOI: 10.4103/jehp.jehp_1074_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 09/24/2022] [Indexed: 07/04/2023]
Abstract
BACKGROUND Understanding the reasons for not getting the COVID-19 vaccine can help to increase acceptability and tackle vaccine hesitancy and consequently reach high coverage for this new vaccine. Using an ecological approach, the reasons for not getting the vaccine in the Iranian population was investigated. METHODS AND MATERIAL This study was conducted from October to December 2021 on 426 participants who had not received the COVID-19 vaccine. The following subsets of questions were included in the questionnaire: intrapersonal level factors, interpersonal level factors, group and organization, and society and policy-making. Multivariable logistic regression was used, and the odds ratio (OR) and 95% confidence intervals (CIs) were estimated for vaccine hesitancy (dependent variable) according to the reasons for not getting COVID vaccine scores (independent variable) using multivariable logistic regression in 3 different models, including Model 0: unadjusted, Model 1: adjusted for age, gender, and underlying disease, and Model 2: adjustment for age, gender, underlying disease, education, place of living, income, marital status, and employment. RESULTS A significant difference was found regarding gender between likely and not likely groups (P = 0.016). A significant association was observed between the vaccine hesitancy and interpersonal (unadjusted model: OR = 0.833 (CI: 0.738-0.942), P for trend = 0.003; model 1: OR = 0.820 (CI: 0.724-0.930), P for trend = 0.002; model 2: OR = 0.799 (CI: 0.703-0.909), P for trend = 0.001) and group and organization (unadjusted model: OR = 0.861 (CI: 0.783-0.948), P for trend = 0.002; model 1: OR = 0.864 (CI: 0.784-0.952, P for trend = 0.003; model 2:OR = 0.862 (CI: 0.781-0.951, P for trend = 0.003). There was no significant association between vaccine hesitancy and intrapersonal and society and policy-making (P > 0.05). CONCLUSIONS We found that a high score of "interpersonal" and "group and organization" factors were associated with lower intention to COVID vaccine. Moreover, women had higher vaccination intentions than men.
Collapse
Affiliation(s)
| | - Fatemeh R. Khan
- Faculty of Health, Education and Life Sciences, Birmingham City University (BCU), UK
| | - Hadi Bazyar
- Sirjan School of Medical Sciences, Sirjan, Iran
| | - Vahideh Aghamohammadi
- Department of Nutrition, Khalkhal University of Medical Sciences, Khalkhal, Iran
- Student Research Committee, Khalkhal Faculty of Medical Sciences, Khalkhal, Iran
| |
Collapse
|
33
|
Vaux S, Fonteneau L, Péfau M, Venier AG, Gautier A, Altrach SS, Parneix P, Levy-Bruhl D. Acceptability of mandatory vaccination against influenza, measles, pertussis and varicella by workers in healthcare facilities: a national cross-sectional study, France, 2019. Arch Public Health 2023; 81:51. [PMID: 37020228 PMCID: PMC10076374 DOI: 10.1186/s13690-023-01069-4] [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: 11/22/2022] [Accepted: 03/23/2023] [Indexed: 04/07/2023] Open
Abstract
BACKGROUND Vaccination of healthcare workers (HCW) aims to protect them and to reduce transmission to susceptible patients. Influenza, measles, pertussis, and varicella vaccinations are recommended but not mandatory for HCW in France. Insufficient vaccine coverage for these diseases in HCW has raised the question of introducing mandatory vaccination. We conducted a survey to estimate acceptability of mandatory vaccination for these four vaccines by HCW working in healthcare facilities (HCF) in France, and to identify associated determinants. METHODS In 2019, we performed a cross-sectional survey of physicians, nurses, midwives and nursing assistants working in HCF in France using a randomised stratified three-stage sampling design (HCF type, ward category, HCW category). Data were collected in face-to-face interviews using a tablet computer. We investigated the possible determinants of acceptability of mandatory vaccination using univariate and multivariate Poisson regressions, and estimated prevalence ratios (PR). RESULTS A total of 8594 HCW in 167 HCF were included. For measles, pertussis, and varicella, self-reported acceptability of mandatory vaccination (very or quite favourable) was 73.1% [CI95%: 70.9-75.1], 72.1% [69.8-74.3], and 57.5% [54.5-57.7], respectively. Acceptability varied according to i) HCW and ward category for these three vaccinations, ii) age group for measles and pertussis, and iii) sex for varicella. For mandatory influenza vaccination, acceptability was lower (42.7% [40.6-44.9]), and varied greatly between HCW categories (from 77.2% for physicians to 32.0% for nursing assistants). CONCLUSION HCW acceptability of mandatory vaccination was high for measles, pertussis and varicella but not as high for influenza. Vaccination for COVID-19 is mandatory for HCW in France. Replication of this study after the end of the COVID-19 crisis would help assess whether the pandemic had an impact on their acceptability of mandatory vaccination, in particular for influenza.
Collapse
Affiliation(s)
- Sophie Vaux
- Santé Publique France, Saint-Maurice, France.
| | | | - Muriel Péfau
- Nouvelle Aquitaine Healthcare-Associated Infection Control Centre, Bordeaux University Hospital, Bordeaux, France
| | - Anne-Gaëlle Venier
- Nouvelle Aquitaine Healthcare-Associated Infection Control Centre, Bordeaux University Hospital, Bordeaux, France
| | | | | | - Pierre Parneix
- Nouvelle Aquitaine Healthcare-Associated Infection Control Centre, Bordeaux University Hospital, Bordeaux, France
| | | |
Collapse
|
34
|
Lang P, Wu CTS, Le-Nguyen AF, Czock A. Influenza Vaccination Behaviour of Healthcare Workers in Switzerland: A Cross-Sectional Study. Int J Public Health 2023; 68:1605175. [PMID: 36968266 PMCID: PMC10036349 DOI: 10.3389/ijph.2023.1605175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 02/27/2023] [Indexed: 03/12/2023] Open
Abstract
Objectives: As no data are available regarding the influenza vaccination status of Swiss healthcare workers (HCW) in the ambulatory setting, this study aims to investigate their influenza vaccination behaviours.Methods: We conducted an online survey using a four-item, semi-structured questionnaire to assess HCWs influenza vaccination coverage and behaviour. Associations between influenza vaccination status, age and language as well as recommendation behaviour and reasons for vaccination were assessed using descriptive statistics and logistic regression analyses.Results: Of the 1057 completed questionnaires, 425 (40.2%) HCW were vaccinated and 632 (59.8%) not. 78.1% of the physicians and 47.3% pharmacists were vaccinated, compared to only 29.1% of the nurses, 24.3% pharmacy technicians and 13.0% medical practice assistants (MPA). There was a significant association between influenza vaccination status and HCW profession, age, language and how often an influenza vaccination recommendation was made.Conclusion: Demographic factors seem to influence HCWs’ attitudes towards influenza vaccination, which in turn affects the prospect of them recommending the influenza vaccination. Diverse strategies might be necessary to encourage HCW to get vaccinated and hence, promote influenza vaccination.
Collapse
Affiliation(s)
- Phung Lang
- Department of Epidemiology, Institute of Epidemiology, Biostatistics and Prevention, Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | - Charlotte Tsu-Shin Wu
- Department of Psychology, University of California at Davis, Davis, CA, United States
| | | | - Astrid Czock
- QualiCCare, Baden, Switzerland
- *Correspondence: Astrid Czock,
| |
Collapse
|
35
|
Hwang J, Cooley A, Cooley S, Hinck R. The Effects of the Culturally Tailored Narratives on COVID-19 Vaccine Confidence Among Hispanics: A Randomized Online Experiment. JOURNAL OF HEALTH COMMUNICATION 2023; 28:168-181. [PMID: 37006173 DOI: 10.1080/10810730.2023.2191225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/19/2023]
Abstract
Guided by the health belief model (HBM), cultural sensitivity approach, and the theory of situated cognition, this study compares the effects of culturally tailored narratives and generic narratives on the COVID-19 vaccine confidence among Hispanics. It also examines an array of cognitive responses (perceived susceptibility, perceived severity, perceived benefits, perceived barriers, and perceived side effects) associated with the COVID-19 vaccine confidence, and the interaction of these cognitive responses with the two narrative types of messaging. The findings suggest that Hispanics exposed to culturally tailored narratives are more confident in the COVID-19 vaccine compared to Hispanics exposed to generic narratives. The study provides support for the HBM, as the perceived benefit was positively related to vaccine confidence, and the perceived barrier was negatively associated with vaccine confidence. Finally, vaccine confidence was the strongest among Hispanics who had high perceived susceptibility and were exposed to culturally tailored narratives.
Collapse
Affiliation(s)
- Juwon Hwang
- School of Media and Strategic Communication, Oklahoma State University, Stillwater, Oklahoma, USA
| | - Asya Cooley
- School of Media and Strategic Communication, Oklahoma State University, Stillwater, Oklahoma, USA
| | - Skye Cooley
- School of Media and Strategic Communication, Oklahoma State University, Stillwater, Oklahoma, USA
| | - Robert Hinck
- Air War College, Air University, Montgomery, Alabama, USA
| |
Collapse
|
36
|
Belkebir S, Maraqa B, Nazzal Z, Abdullah A, Yasin F, Al-Shakhrah K, Zink T. Exploring the Perceptions of Nurses on Receiving the SARS CoV-2 Vaccine in Palestine: A Qualitative Study. Can J Nurs Res 2023; 55:34-41. [PMID: 34913746 DOI: 10.1177/08445621211066721] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Uncertainty about vaccination among nurses are major barriers to managing the ongoing COVID-19 pandemic worldwide. PURPOSE To explore nurseś perceptions about receiving the SARS CoV-2 vaccine to inform the upcoming Palestinian Ministry of Health (MOH) vaccination efforts. METHODS Four focus groups were conducted with nurses between January 18 and 30, 2021, before MOH launched vaccinations in Palestine. Participants working in government and private facilities were invited to participate and completed an online or paper form to provide demographics, review the study purpose, and give consent. Meetings were facilitated in Arabic either online via the Zoom platform or face-to-face using the same interview guide. Transcripts were translated into English and coded using a template analysis approach. RESULTS Forty-six nurses, with a median age of 29.5y (range, 22-57) from across Palestine participated. Three major themes emerged: uncertainty, trust, and the knowledge needed to move forward. Uncertainty related to the evolving nature of COVID-19, the rapidity of vaccine development, the types and timing of available vaccines. The need for trusted experts to share scientific information about the vaccines to counteract the misinformation in social media. Moreover, reliable vaccine information may help vaccine-hesitant nurses move to vaccine-acceptors and to convince others, including their patients. CONCLUSION The negative perception of nurses towards vaccines is problematic in Palestine and uncertainty about which vaccine(s) will be available adds to the lack of education and mass-media misinformation. Other countries with vaccination efforts that are not wholly planned or implemented and may be struggling with similar concerns.
Collapse
Affiliation(s)
- Souad Belkebir
- Faculty of Medicine and Health Sciences, 455978An-Najah National University, Nablus, Palestine
| | - Beesan Maraqa
- Family and Public Health Deputy Minster office, 61171Ministry of Health, Palestine
| | - Zaher Nazzal
- Faculty of Medicine and Health Sciences, 455978An-Najah National University, Nablus, Palestine
| | | | - Ferial Yasin
- Family and Public Health Deputy Minster office, 61171Ministry of Health, Palestine
| | - Kamal Al-Shakhrah
- Family and Public Health Deputy Minster office, 61171Ministry of Health, Palestine
| | - Therese Zink
- Department of Family Medicine & School of Public Health, Brown University, United States
| |
Collapse
|
37
|
Loncarevic GS, Jovanovic AL, Kanazir MS, Kisic Tepavcevic DB, Maric GD, Pekmezovic TD. Are pediatricians responsible for maintaining high MMR vaccination coverage? Nationwide survey on parental knowledge and attitudes towards MMR vaccine in Serbia. PLoS One 2023; 18:e0281495. [PMID: 36795643 PMCID: PMC9934397 DOI: 10.1371/journal.pone.0281495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Accepted: 01/24/2023] [Indexed: 02/17/2023] Open
Abstract
AIM To assess parental knowledge and attitudes related to MMR vaccination and to determine factors associated with parental decision whether to vaccinate their child with MMR vaccine in Serbian population. METHODS The selection of participants was performed using multi-phase sampling. Seventeen out of the total 160 public health centers on the territory of Republic of Serbia were randomly selected. All parents of children up to the age of 7 who visited the pediatrician at the public health centers from June to August 2017 were recruited. Parents filled in an anonymous questionnaire regarding their knowledge, attitudes and practices in immunization with MMR vaccine. The relative contribution of different factors was explored by univariable and multivariable logistic regression analysis. RESULTS The majority of parents were female (75.2%), with mean age of 34.3 ± 5.7 years, and the average age of children was 4.7 ± 2.4 years, 53.7% of them were girls. In the multivariable model, getting information on vaccination from a pediatrician was associated with 7.5 fold increased probability to vaccinate child with MMR vaccine (OR = 7.52; 95% CI 2.73-20.74; p<0.001), while previous vaccination of the child increased this chance two times (OR = 2.07; 95% CI 1.01-4.27; p = 0.048), and having two children was associated with 84% increase in chance of vaccinating child with MMR vaccine compared to having one child or three or more children (OR = 1.84; 95% CI 1.03-3.29; p = 0.040). CONCLUSION Our study emphasized the key role of pediatricians in the formation of parental attitude on MMR vaccination of their child.
Collapse
Affiliation(s)
| | - Aleksa Lj Jovanovic
- Institute of Epidemiology, University of Belgrade Faculty of Medicine, Belgrade, Serbia
| | | | | | - Gorica D. Maric
- Institute of Epidemiology, University of Belgrade Faculty of Medicine, Belgrade, Serbia
- * E-mail: (TDP); (GDM)
| | - Tatjana D. Pekmezovic
- Institute of Epidemiology, University of Belgrade Faculty of Medicine, Belgrade, Serbia
- * E-mail: (TDP); (GDM)
| |
Collapse
|
38
|
Langer R, Thanner M. Pharmacists' attitudes toward influenza vaccination: does the COVID-19 pandemic make a difference? EXPLORATORY RESEARCH IN CLINICAL AND SOCIAL PHARMACY 2023; 9:100235. [PMID: 36816546 PMCID: PMC9925413 DOI: 10.1016/j.rcsop.2023.100235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 01/26/2023] [Accepted: 02/10/2023] [Indexed: 02/16/2023] Open
Abstract
Background Influenza vaccine uptake in most European countries remains low, despite the World Health Organization's target of 75%. Community pharmacists play a vital role in promoting vaccination; however, they have been reported to be vaccine-hesitant. This study aimed to investigate changes in pharmacists' attitudes toward influenza vaccination since the onset of the COVID-19 pandemic, as well as their COVID-19 vaccination intentions. Methods In December 2020, all members of the Swiss Association of Pharmacists were invited to participate in an online, cross-sectional survey. This study assessed pharmacists' attitudes toward influenza vaccination by surveying influenza vaccine uptake during the 2019-20 influenza season and possible reasons for their decision(s), in addition to their intention to receive COVID-19 and seasonal influenza vaccination(s) during the 2020-21 influenza season. Descriptive analysis and multinomial logistic regression were used to assess predictors of vaccine uptake and intention. Results Of 5900 Swiss pharmacists, 569 (9.6%) completed the survey. The self-reported influenza vaccination coverage among pharmacists during the 2019-20 season was 48.0%. The primary reason for vaccine uptake was the belief that all healthcare workers should be vaccinated, whereas the main reason for refusal was a lack of concern about contracting influenza. The proportions of participants who intend to accept influenza and COVID-19 vaccinations in the 2020-2021 season, when available, were 63.3% and 66.5%, respectively. The most important predictor of high willingness to be vaccinated against influenza in 2020-21 was vaccination history (OR = 3.73; 95% CI = 1.47-9.50), while the most critical predictor of willingness to be vaccinated against COVID-19 was the intention to be vaccinated against influenza (OR = 3.45; 95% CI = 1.74-6.84). Conclusions Findings indicated that although pharmacists' readiness to accept seasonal influenza vaccination significantly increased during the COVID-19 pandemic, influenza vaccine uptake among them remains suboptimal. This is consistent with what has been reported in the literature.
Collapse
Affiliation(s)
- Roland Langer
- Department of Medical Sciences, Private University in the Principality of Liechtenstein (UFL), Triesen, Principality of Liechtenstein,Corresponding author.
| | - Mirjam Thanner
- Frauenklinik, Kantonsspital St. Gallen, St. Gallen, Switzerland
| |
Collapse
|
39
|
Understanding COVID-19 Vaccine Confidence in People Living with HIV: A pan-Canadian Survey. AIDS Behav 2023:10.1007/s10461-023-03991-8. [PMID: 36738344 PMCID: PMC9898854 DOI: 10.1007/s10461-023-03991-8] [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: 01/10/2023] [Indexed: 02/05/2023]
Abstract
Understanding the roots of Covid-19 vaccine hesitancy in at-risk groups, such as persons living with HIV (PLWH), is of utmost importance. We developed a modified Vaccine Hesitancy Scale (VHS) questionnaire using items from the National Advisory Committee on Immunization Acceptability Matrix. To examine factors associated with receiving COVID-19 vaccine and the link between vaccine attitudes and beliefs with vaccine behavior, PLWH were recruited via social media and community-based organizations (February-May 2022). Descriptive statistics were used to summarize results. Total VHS score was generated by adding Likert scale scores and linear regression models used to compare results between participants who received or did not receive COVID-19 vaccines. Logistic regression models were used to identify factors associated with vaccine uptake. A total of 246 PLWH indicated whether they received a COVID-19 vaccine. 89% received ≥ 1 dose. Mean total VHS(SD) for persons having received ≥ 1 COVID-19 vaccine was 17.8(6.2) vs. 35.4(9.4) for participants not having received any COVID-19 vaccine. Persons who received ≥ 1 dose were significantly older than those who had not received any (48.4 ± 13.8 vs. 34.0 ± 7.7 years, p < 0.0001). The majority of participants considered COVID-19 vaccination important for their health(81.3%) and the health of others(84.4%). Multivariate logistic regression revealed the odds of taking ≥ 1dose were increased 2.4-fold [95% CI 1.6, 3.5] with each increase in age of 10 years (p < 0.0001). Sex and ethnicity were not different between groups. In conclusion, PLWH accept COVID-19 vaccines for both altruistic and individual reasons. With evolving recommendations and increasing numbers of booster vaccines, we must re-examine the needs of PLWH regularly.
Collapse
|
40
|
Social and demographic patterns of influenza vaccination coverage in Norway, influenza seasons 2014/15 to 2020/21. Vaccine 2023; 41:1239-1246. [PMID: 36639272 DOI: 10.1016/j.vaccine.2023.01.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 12/12/2022] [Accepted: 01/05/2023] [Indexed: 01/12/2023]
Abstract
AIMS To examine influenza vaccination coverage among risk groups (RG) and health care workers (HCW), and study social and demographic patterns of vaccination coverage over time. METHODS Vaccination coverage was estimated by self-report in a nationally representative telephone survey among 14919 individuals aged 18-79 years over seven influenza seasons from 2014/15 to 2020/21. We explored whether belonging to an influenza RG (being >=65 years of age and/or having >=1 medical risk factor), being a HCW or educational attainment was associated with vaccination status using logistic regression. RESULTS Vaccination coverage increased from 27 % to 66 % among individuals 65-79 years, from 13 % to 33 % among individuals 18-64 years with >=1 risk factor, and from 9 % to 51 % among HCWs during the study period. Being older, having a risk factor or being a HCW were significantly associated with higher coverage in all multivariable logistic regression analyses. Higher education was also consistently associated with higher coverage, but the difference did not reach significance in all influenza seasons. Educational attainment was not significantly associated with coverage while coverage was at its lowest (2014/15-2017/18), but as coverage increased, so did the differences. Individuals with intermediate or lower education were less likely to report vaccination than those with higher education in season 2018/19, OR = 0.61 (95 % CI 0.46-0.80) and OR = 0.58 (95 % CI 0.41-0.83), respectively, and in season 2019/20, OR = 0.69 (95 % CI 0.55-0.88) and OR = 0.71 (95 % CI 0.53-0.95), respectively. When the vaccine was funded in the COVID-19 pandemic winter of 2020/21, educational differences diminished again and were no longer significant. CONCLUSIONS We observed widening educational differences in influenza vaccination coverage as coverage increased from 2014/15 to 2019/20. When influenza vaccination was funded in 2020/21, differences in coverage by educational attainment diminished. These findings indicate that economic barriers influence influenza vaccination decisions among risk groups in Norway.
Collapse
|
41
|
Tagbor S, Ohene LA, Adjei CA, Kyei J. Perceptions and Cues to Action as Predictors of Nurses' Vaccination Intentions at Two Primary Health Care Facilities in Ghana. Am J Trop Med Hyg 2023; 108:433-440. [PMID: 36535250 PMCID: PMC9896321 DOI: 10.4269/ajtmh.21-1335] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 10/13/2022] [Indexed: 12/23/2022] Open
Abstract
Uptake of hepatitis B vaccination by health care providers remains suboptimal in Ghana, although it is considered an effective strategy against the hepatitis B virus. This study aimed to identify the predictors of nurses' hepatitis B vaccination intentions at two municipal health care facilities in Ghana. A descriptive cross-sectional survey was adopted. A section of the health belief model-based questionnaire was administered to 181 nurses conveniently sampled from the two facilities. Data analysis was done using Statistical Product and Service Solutions software version 23.0. Frequencies and percentages were used to assess the demographic characteristics of participants. Pearson r coefficients were used to assess the intercorrelations between individual perceptions, and the cues to action on vaccination intentions. Simple and multiple regression was used to estimate the prediction of individual perceptions, and the cues to action on hepatitis B vaccination intentions of nurses. The findings showed that nurse-perceived benefits and cues to action were positive and significantly related to hepatitis B vaccination intentions of nurses (r = 0.14, P < 0.05; r = 0.17, P < 0.05). Perceived susceptibility and perceived barrier were negative and significantly related to vaccine intentions (r = -0.13, P < 0.05; r = -0.24, P < 0.01). Notably, perceived barrier predicted hepatitis B vaccination intentions (β = -0.22, t = -2.48, P = 0.01). Nurses' vaccination behavioral intentions were positive. It was recommended that perceived barriers to hepatitis B vaccination such as vaccination ineffectiveness, time constraints, high costs, and side effects should be addressed to increase nurses' vaccination uptake.
Collapse
Affiliation(s)
- Solomon Tagbor
- Department of Nursing, Nursing and Midwifery Training College, Kete-Krachi, Ghana
| | - Lillian Akorfa Ohene
- Department of Community Health Nursing, School of Nursing and Midwifery, University of Ghana, Accra, Ghana
| | - Charles Ampong Adjei
- Department of Community Health Nursing, School of Nursing and Midwifery, University of Ghana, Accra, Ghana
| | - Josephine Kyei
- Department of Community Health Nursing, School of Nursing and Midwifery, University of Ghana, Accra, Ghana
| |
Collapse
|
42
|
Barriers in the School-Based Pan-Gender HPV Vaccination Program in Sweden: Healthcare Providers' Perspective. Vaccines (Basel) 2023; 11:vaccines11020310. [PMID: 36851188 PMCID: PMC9962905 DOI: 10.3390/vaccines11020310] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 01/24/2023] [Accepted: 01/28/2023] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Human papillomavirus (HPV) vaccines effectively prevent, and can even eliminate, HPV-related cancers. Currently, vaccination rates are suboptimal in the national Swedish school-based vaccination program. School nurses play a key role in all aspects of the vaccination process. Therefore, this study aims to explore school nurses' perceived HPV vaccination challenges. METHODS Seven focus group interviews were conducted with school nurses (n = 35) working in nine socio-demographically diverse municipalities in mid-Sweden. Data were analyzed using qualitative content analysis. RESULTS Participants described difficulties in encountering and handling the diversity of reasons for vaccine hesitancy. Parents known to be skeptical of vaccines in general were seen as most difficult to reach. Uncertainty was expressed concerning the extent of professional responsibility for vaccine promotion. The informants expressed a lack of guidelines for vaccine promotion and described challenges in supporting the child's own wishes. Creating a safe space for the individual child was seen as crucial. Other problems described were the challenges of overcoming children's fear of needles, supporting unvaccinated children, and being confronted with the remaining gender inequities of the pan-gender vaccination program. CONCLUSIONS Our results suggest that school nurses, especially those new to their profession, may benefit from training and guidance22 material on how to address vaccine hesitancy.
Collapse
|
43
|
Midwives' Knowledge, Attitudes, and Practice Regarding COVID-19 Vaccination for Pregnant Women: A Nationwide Web-Based Survey in Italy. Vaccines (Basel) 2023; 11:vaccines11020222. [PMID: 36851098 PMCID: PMC9961665 DOI: 10.3390/vaccines11020222] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 01/07/2023] [Accepted: 01/17/2023] [Indexed: 01/20/2023] Open
Abstract
This cross-sectional survey investigated the knowledge, attitudes, and practices concerning the COVID-19 vaccination for pregnant women among midwives in Italy and the associated factors. Midwives with at least five years of midwifery education and who had received information about the COVID-19 vaccination from official government organizations or scientific journals were more likely to know in which trimester this vaccine can be administered. A higher perceived utility of this vaccination was observed among midwives working in the public sector, in those concerned by being infected by SARS-CoV-2, who have received at least one dose of this vaccination, in those who considered COVID-19 a severe disease for pregnant women and their fetus, and who believed that the vaccination is safe. One-third of the midwives routinely provided information and half recommended this vaccination. Midwives with more years of activity, who received information about the vaccination from official government organizations or scientific journals, those who had never assisted patients with SARS-CoV-2, and those who believed in midwives' role in COVID-19 prevention were more likely to routinely provide information. Participants who perceived a higher utility of this vaccination, those who believed in midwives' role in COVID-19 prevention, those who received information from official government organizations or scientific journals were more likely to routinely provide a recommendation for the vaccine. Midwives' knowledge must be improved for ensuring that they communicate and recommend the vaccination to their patients.
Collapse
|
44
|
Gudayu TW, Mengistie HT. COVID-19 vaccine acceptance in sub-Saharan African countries: A systematic review and meta-analysis. Heliyon 2023; 9:e13037. [PMID: 36686610 PMCID: PMC9846884 DOI: 10.1016/j.heliyon.2023.e13037] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 01/12/2023] [Accepted: 01/13/2023] [Indexed: 01/19/2023] Open
Abstract
Vaccination is the most effective intervention for the primary prevention of COVID-19. Several studies have been conducted in sub-Saharan African countries on the acceptance and associated factors of COVID-19 vaccine. This review and meta-analysis aimed to recapitulate the pooled magnitude of vaccine acceptance and its favoring factors in sub-Saharan African countries. PUBMED, MEDLINE, Science Direct, Web of Science, and SCOPUS were the main databases searched from 15 March to 5 June 2022; and all the articles written in the English language were included. Also, some articles were retrieved from biomedical peer-reviewed journal sites and Google scholar. The quality of thirty-five selected articles was evaluated using an adapted scale for evaluating cross-sectional studies based on the Newcastle-Ottawa Scale. The result of the review and meta-analysis revealed that COVID-19 vaccine acceptance rate varied across studies. In a pooled analysis, factors such as; higher-level perception of infection risk (OR (95% CI (2.7 (2.1, 3.4))), perceived vaccine safety (13.9 (9.2, 20.9)), virus-related good knowledge (2.7 (2.3, 3.2)) and appropriate attitude (5.9 (4.4, 7.8)), adherence to safety precautions (5.5 (4.8, 6.2)), and infection experience (4.4 (2.8, 6.9)) were positively affected the COVID-19 vaccine acceptance. Also, vaccine acceptance was found to be high among males and chronically ill individuals. Thus, understanding factors that enhance vaccine acceptance would support planners to augment vaccine uptake in the region.
Collapse
Affiliation(s)
- Temesgen Worku Gudayu
- Department of Clinical Midwifery, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia,Corresponding author.
| | | |
Collapse
|
45
|
Stöcker A, Hoffmann J, Mause L, Neufeind J, Ohnhäuser T, Scholten N. What impact does the attitude toward COVID-19 vaccination have on physicians as vaccine providers? A cross sectional study from the German outpatient sector. Vaccine 2023; 41:263-273. [PMID: 36456389 PMCID: PMC9691451 DOI: 10.1016/j.vaccine.2022.11.054] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 11/17/2022] [Accepted: 11/18/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND COVID-19 vaccination is recognized as a key component in addressing the COVID-19 pandemic. Physicians' attitudes toward vaccination are known to play a defining role in the management and dissemination of medical advice to patients. In Germany, outpatient practitioners are predominantly responsible for the dissemination of vaccines. METHOD Using a cross-sectional online survey, 932 outpatient general practitioners, gynecologists, and pediatricians in Germany were asked in fall, 2021, about their attitude toward COVID-19 vaccination and - among others - their communication in vaccine discussions, their assessment of vaccine safety, and reporting of suspected adverse events. Physicians were divided into two groups along their attitudes toward COVID-19 vaccination. In addition, multivariate linear regression models were constructed to assess differences in communication strategies. RESULTS 92 % of physicians had a positive or very positive attitude toward COVID-19 vaccination. Own vaccination status, practice-based vaccination delivery, and estimated vaccination coverage among patients were significantly associated with the attitude toward vaccination. Confidence in vaccine safety was significantly lower among physicians with negative attitudes. There were no differences between the two groups in self-assessment of the ability to detect suspected adverse events, but there were differences in the observing and reporting of adverse events. For the linear regression models, we found that a more negative attitude toward COVID-19 vaccination was significantly associated with increased acceptance of patient refusal of COVID-19 vaccination and empathic behavior for patient concerns. In contrast, willingness to engage in a detailed persuasion consultation was significantly lower. Pediatricians showed significantly higher empathy for patient-side concerns compared to general practitioners, whereas gynecologists showed less empathy than general practitioners. DISCUSSION The physician's attitude toward COVID-19 vaccination influences the physician's practices as a vaccine provider. However, when providing medical advice and healthcare, the physician should focus on the actual needs of the patient.
Collapse
Affiliation(s)
- Arno Stöcker
- University of Cologne, Faculty of Human Sciences & Faculty of Medicine and University Hospital Cologne, Institute of Medical Sociology, Health Services Research, and Rehabilitation Science, Germany,Corresponding author
| | - Jan Hoffmann
- University of Cologne, Faculty of Human Sciences & Faculty of Medicine and University Hospital Cologne, Institute of Medical Sociology, Health Services Research, and Rehabilitation Science, Germany
| | - Laura Mause
- University of Cologne, Faculty of Human Sciences & Faculty of Medicine and University Hospital Cologne, Institute of Medical Sociology, Health Services Research, and Rehabilitation Science, Germany
| | - Julia Neufeind
- Immunization Unit, Robert Koch-Institute, Berlin, Germany
| | - Tim Ohnhäuser
- University of Cologne, Faculty of Human Sciences & Faculty of Medicine and University Hospital Cologne, Institute of Medical Sociology, Health Services Research, and Rehabilitation Science, Germany
| | - Nadine Scholten
- University of Cologne, Faculty of Human Sciences & Faculty of Medicine and University Hospital Cologne, Institute of Medical Sociology, Health Services Research, and Rehabilitation Science, Germany
| |
Collapse
|
46
|
Garrison A, Karlsson L, Fressard L, Fasce A, Rodrigues F, Schmid P, Taubert F, Holford D, Lewandowsky S, Nynäs P, Anderson EC, Gagneur A, Dubé E, Soveri A, Verger P. International adaptation and validation of the Pro-VC-Be: measuring the psychosocial determinants of vaccine confidence in healthcare professionals in European countries. Expert Rev Vaccines 2023; 22:726-737. [PMID: 37507356 DOI: 10.1080/14760584.2023.2242479] [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: 02/18/2023] [Revised: 06/29/2023] [Accepted: 07/26/2023] [Indexed: 07/30/2023]
Abstract
BACKGROUND Healthcare professionals (HCPs) play an important role in vaccination; those with low confidence in vaccines are less likely to recommend them to their patients and to be vaccinated themselves. The study's purpose was to adapt and validate long- and short-form versions of the International Professionals' Vaccine Confidence and Behaviors (I-Pro-VC-Be) questionnaire to measure psychosocial determinants of HCPs' vaccine confidence and their associations with vaccination behaviors in European countries. RESEARCH DESIGN AND METHODS After the original French-language Pro-VC-Be was culturally adapted and translated, HCPs involved in vaccination (mainly GPs and pediatricians) across Germany, Finland, France, and Portugal completed a cross-sectional online survey in 2022. A 10-factor multigroup confirmatory factor analysis (MG-CFA) of the long-form (10 factors comprising 34 items) tested for measurement invariance across countries. Modified multiple Poisson regressions tested the criterion validity of both versions. RESULTS 2,748 HCPs participated. The 10-factor structure fit was acceptable to good everywhere. The final MG-CFA model confirmed strong factorial invariance and showed very good fit. The long- and short-form I-Pro-VC-Be had good criterion validity with vaccination behaviors. CONCLUSION This study validates the I-Pro-VC-Be among HCPs in four European countries; including long- and short-form tools for use in research and public health.
Collapse
Affiliation(s)
- Amanda Garrison
- Faculté des Sciences Médicales Et Paramédicales, Southeastern Health Regional Observatory (Observatoire Régional de la Santé, ORS) PACA, Marseille, France
| | - Linda Karlsson
- Institute of Clinical Medicine, University of Turku, Turku, Finland
| | - Lisa Fressard
- Faculté des Sciences Médicales Et Paramédicales, Southeastern Health Regional Observatory (Observatoire Régional de la Santé, ORS) PACA, Marseille, France
| | - Angelo Fasce
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | | | - Philipp Schmid
- Institute for Planetary Health Behaviour, University of Erfurt, Erfurt, Germany
- Health Communication, Department of Implementation Research, Bernhard-Nocht-Institute for Tropical Medicine, Hamburg, Germany
| | - Frederike Taubert
- Institute for Planetary Health Behaviour, University of Erfurt, Erfurt, Germany
- Health Communication, Department of Implementation Research, Bernhard-Nocht-Institute for Tropical Medicine, Hamburg, Germany
| | - Dawn Holford
- School of Psychological Science, University of Bristol, Bristol, UK
| | - Stephan Lewandowsky
- School of Psychological Science, University of Bristol, Bristol, UK
- Department of Psychology, University of Potsdam, Potsdam, Germany
- School of Psychological Science, University of Western Australia, Crawley, WA, Australia
| | - Peter Nynäs
- Faculty of Arts, Psychology and Theology, Abo Akademi University, Turku, Finland
| | | | - Arnaud Gagneur
- Department of Pediatrics, University of Sherbrooke, Sherbrooke, Québec, Canada
| | - Eve Dubé
- Département d'anthropologie, Faculté des Sciences Sociales, Université Laval, Laval, Canada
| | - Anna Soveri
- Institute of Clinical Medicine, University of Turku, Turku, Finland
| | - Pierre Verger
- Faculté des Sciences Médicales Et Paramédicales, Southeastern Health Regional Observatory (Observatoire Régional de la Santé, ORS) PACA, Marseille, France
| |
Collapse
|
47
|
Pavlovic D, Sahoo P, Larson HJ, Karafillakis E. Factors influencing healthcare professionals' confidence in vaccination in Europe: a literature review. Hum Vaccin Immunother 2022; 18:2041360. [PMID: 35290160 PMCID: PMC9009961 DOI: 10.1080/21645515.2022.2041360] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Health-care professionals (HCPs) have a fundamental role in vaccination, their own beliefs and attitudes affecting both their uptake and recommendation of vaccines. This literature review (n = 89) summarises evidence on HCPs’ perceptions of the risks and benefits of vaccination, trust, and perceptions of mandatory vaccination in Europe. HCPs across studies believed that vaccination is important to protect themselves and their patients. However, beliefs that some diseases such as influenza are less risky were reported by some HCPs as a reason for not getting vaccinated. Concerns about both short- and long-term side effects were identified among HCPs in most studies, such as those affecting the immune or neurological system. Mistrust toward health authorities and pharmaceutical industry was reported in some studies. The question of mandatory vaccination revealed mixed opinions, with some favoring self-determination and others viewing vaccination as a duty. This review highlights key factors influencing HCPs’ confidence in vaccination in Europe.
Collapse
Affiliation(s)
- D Pavlovic
- School of Medicine, University of Zagreb, Zagreb, Croatia
| | - P Sahoo
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | - H J Larson
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK.,Centre for the Evaluation of Vaccination, Vaccine and Infectious Disease Institute, University of Antwerp, Zagreb, Croatia
| | - E Karafillakis
- Centre for the Evaluation of Vaccination, Vaccine and Infectious Disease Institute, University of Antwerp, Zagreb, Croatia
| |
Collapse
|
48
|
Waheed A, Abu Bakr Elsaid NM, Ghweeba M, Elmaraghy N, Al-Touny SA, Nemr N, Kishk RM, Aly HM. Determinants of coronavirus disease 2019 vaccine acceptance, hesitancy, and barriers among healthcare workers in Ismailia, Egypt: a mixed methods study. J Egypt Public Health Assoc 2022; 97:25. [PMID: 36504012 PMCID: PMC9741945 DOI: 10.1186/s42506-022-00122-4] [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] [Received: 09/30/2021] [Accepted: 10/18/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Coronavirus disease 2019 vaccine acceptance among healthcare workers (HCWs) plays a fundamental role in combating the COVID-19 pandemic. Vaccination acceptance depends on perceptions of competence and motives of the providers, producers, health professionals, and policymakers. This study aimed to identify the frequency and determinants of COVID-19 vaccine uptake acceptance, hesitancy, and barriers among HCWs. METHODS A total of 500 HCWs from 3 different hospital affiliations in Ismailia Governorate, Egypt, were included in this mixed methods study. The study was conducted between March and April 2021 through two phases. Phase 1 included a cross-sectional study using a self-administered questionnaire with inquiries about different determinants of vaccine acceptance, hesitancy, and barriers, which was completed either electronically in a Google form or a hard printed copy. Phase 2 included four focus group discussions to explore the determinants in depth. RESULTS The mean age of participants was 33.9 ± 7.9 years, 70% were females, 51.2% were nurses, and 28.6% were physicians. Of the 500 HCWs, only 27.8% accepted taking the vaccine immediately, 49.2% refused, and 23% were hesitant. Vaccine safety was the highest associated factor with vaccine acceptance (odds ratio (OR) = 6.3, 95% confidence interval (CI) 3.132-12.619), followed by previous uptake of influenza vaccine (OR = 3.3, 95% CI 2.048-5.217) and vaccine effectiveness (OR = 2.6, 95% CI 1.282-5.262). The main barriers to vaccine acceptance were mistrust in governmental policies during the pandemic or in the healthcare facility they work in. Hesitancy was common among females and nurses and was attributed to three prominent factors, including safety concerns, negative stories, and personal knowledge. CONCLUSIONS The vaccine acceptance frequency among HCWs was considered low, as the majority either refused or was hesitant about taking the vaccine. Concerns about vaccine safety and effectiveness were significant determinants of vaccine acceptance. Factors related to trust were the main barriers to vaccine uptake. The health authority should establish a surveillance system for side effects of the COVID-19 vaccine and communicate this information between HCWs to decrease their worries about safety and increase vaccine uptake.
Collapse
Affiliation(s)
- Amani Waheed
- grid.33003.330000 0000 9889 5690Department of Public Health, Community, Occupational and Environmental Medicine, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | - Noha M. Abu Bakr Elsaid
- grid.33003.330000 0000 9889 5690Department of Public Health, Community, Occupational and Environmental Medicine, Faculty of Medicine, Suez Canal University, Ismailia, Egypt ,Department of Basic Medical Sciences, Faculty of Medicine, King Salman International University, South Sinai, Egypt
| | - Mayada Ghweeba
- grid.33003.330000 0000 9889 5690Department of Public Health, Community, Occupational and Environmental Medicine, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | - Nermine Elmaraghy
- grid.33003.330000 0000 9889 5690Department of Medical Microbiology and Immunology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | - Shimaa A. Al-Touny
- grid.33003.330000 0000 9889 5690Department of Anaesthesia and ICU, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | - Nader Nemr
- grid.33003.330000 0000 9889 5690Department of Endemic and Infectious Diseases, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | - Rania M. Kishk
- grid.33003.330000 0000 9889 5690Department of Medical Microbiology and Immunology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | - Hebatalla M. Aly
- grid.33003.330000 0000 9889 5690Department of Public Health, Community, Occupational and Environmental Medicine, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| |
Collapse
|
49
|
Investigate Non-EPI Vaccination Recommendation Practice from a Socio-Ecological Perspective: A Mixed-Methods Study in China. Vaccines (Basel) 2022; 10:vaccines10122105. [PMID: 36560515 PMCID: PMC9788484 DOI: 10.3390/vaccines10122105] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 12/03/2022] [Accepted: 12/06/2022] [Indexed: 12/14/2022] Open
Abstract
The uptake of non-EPI vaccines, such as influenza and pneumonia vaccines, are very low in China compared to other countries. In China, immunization services are provided by dedicated vaccination service providers (VSPs), and their recommendation is the key to improve vaccine uptake. This study explores VSP recommendation practices for non-EPI vaccines from a socio-ecological perspective. A mixed-methods study, combining a questionnaire survey and key informant interviews, was conducted in Anhui, Shaanxi, and Guangdong provinces. 555 VSPs completed the valid questionnaire, and 49 VSPs participated in in-depth interviews. Among the surveyed VSPs, 51.54% stated that they always or often recommended non-EPI vaccines in work, and the remaining half reported that they sometimes or never recommended non-EPI vaccines. Most VSPs interviewed communicated about non-EPI vaccines with the public in an informed style, not a presumptive one, and provided the public with all the decision-making latitude. The infrequent recommendation of non-EPI vaccines was widely prevalent among Chinese VSPs regardless of their individual characteristics, and was mainly driven by the interpersonal relationship, institutional arrangement, and public policy. Firstly, the VSPs were concerned about conflicts arising from the recommendation of self-paid vaccines and the risk of adverse reactions following vaccination. Secondly, high workloads left them insufficient time to communicate about non-EPI vaccines. Thirdly, there was no performance assessment or financial incentive for VSPs to recommend non-EPI vaccination, and their main responsibility was around EPI vaccination. Therefore, multi-level socio-ecological systems around non-EPI vaccination should be improved to optimize the communication between VSPs and the public, which include a better system of legal redress to resolve potential misunderstandings between the VSPs and the public, more effective workload management through whole-process health information system and strengthening public health workforce, and the introduction of performance assessment and appropriate incentives on non-EPI vaccination.
Collapse
|
50
|
Slotte P, Karlsson LC, Soveri A. Attitudes towards mandatory vaccination and sanctions for vaccination refusal. Vaccine 2022; 40:7378-7388. [PMID: 35688728 DOI: 10.1016/j.vaccine.2022.05.069] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 05/14/2022] [Accepted: 05/17/2022] [Indexed: 01/28/2023]
Abstract
AIMS Investigating attitudes towards mandatory vaccination and sanctions for vaccination refusal in an area with insufficient vaccination coverage may help health authorities to assess which strategies for increasing vaccination coverage are appropriate. This study examines attitudes to vaccine mandates and asks questions regarding what kinds of sanctions could legitimately result from vaccination refusal. It seeks to find out if people's attitudes towards mandates and towards sanctions for vaccination refusal are related to their attitudes to vaccines and the degree of trust they feel towards health care professionals and health care authorities. The study also discusses how the observed attitudes towards mandates may be related to perceptions of autonomy, responsibility, and equitability. METHODS Data collection was carried out in Finland through an online survey in a region with suboptimal vaccine uptake. Statistical analysis was conducted on a sample of 1101 respondents, using confirmatory factor analysis and structural regression analysis. RESULTS Persons hold different views on mandates and sanctions. Importantly, the persons who support vaccination mandates and sanctions for vaccination refusal are to a great degree the same people who have positive attitudes to vaccines and high trust in health care professionals and health authorities. CONCLUSION Trust is a key factor which has a bearing on people's attitudes towards mandates and sanctions for noncompliance. A focus on the reasons for lack of trust, and on how to enhance trust, is a more feasible long-term way (than mandates) to promote large- scale compliance with childhood vaccine programmes in the studied country context.
Collapse
Affiliation(s)
- Pamela Slotte
- Faculty of Arts, Psychology and Theology, Åbo Akademi University, Tehtaankatu 2, FI-20500 Turku, Finland; Centre of Excellence in Law, Identity and the European Narratives, Siltavuorenpenger 1A, FI-00014 University of Helsinki, Finland.
| | - Linda C Karlsson
- Department of Clinical Medicine, FI-20014 University of Turku, Turku, Finland.
| | - Anna Soveri
- Department of Clinical Medicine, FI-20014 University of Turku, Turku, Finland.
| |
Collapse
|