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Gonzalez-Jaramillo N, Abbühl D, Roa-Díaz ZM, Kobler-Betancourt C, Frahsa A. COVID-19 vaccine acceptance in the general population and under-resourced communities from high-income countries: realist review. BMJ Open 2024; 14:e084560. [PMID: 38631831 PMCID: PMC11029206 DOI: 10.1136/bmjopen-2024-084560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Accepted: 03/28/2024] [Indexed: 04/19/2024] Open
Abstract
OBJECTIVE To compare vaccination willingness before rollout and 1 year post-rollout uptake among the general population and under-resourced communities in high-income countries. DESIGN A realist review. DATA SOURCES Embase, PubMed, Dimensions ai and Google Scholar. SETTING High-income countries. DEFINITIONS We defined vaccination willingness as the proportion of participants willing or intending to receive vaccines prior to availability. We defined vaccine uptake as the real proportion of the population with complete vaccination as reported by each country until November 2021. RESULTS We included data from 62 studies and 18 high-income countries. For studies conducted among general populations, the proportion of vaccination willingness was 67% (95% CI 62% to 72%). In real-world settings, the overall proportion of vaccine uptake among those countries was 73% (95% CI 69% to 76%). 17 studies reported pre-rollout willingness for under-resourced communities. The summary proportion of vaccination willingness from studies reporting results among people from under-resourced communities was 52% (95% CI 0.46% to 0.57%). Real-world evidence about vaccine uptake after rollout among under-resourced communities was limited. CONCLUSION Our review emphasises the importance of realist reviews for assessing vaccine acceptance. Limited real-world evidence about vaccine uptake among under-resourced communities in high-income countries is a call to context-specific actions and reporting.
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Affiliation(s)
| | - Dominik Abbühl
- ISPM, University of Bern, Bern, Switzerland
- Faculty of Medicine, University of Bern, Bern, Switzerland
| | - Zayne Milena Roa-Díaz
- ISPM, University of Bern, Bern, Switzerland
- Faculty of Medicine, University of Bern, Bern, Switzerland
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Santos AJ, Kislaya I, Matias-Dias C, Machado A. Health beliefs and attitudes toward Influenza and COVID-19 vaccination in Portugal: a study using a mixed-method approach. Front Public Health 2024; 11:1331136. [PMID: 38312138 PMCID: PMC10834706 DOI: 10.3389/fpubh.2023.1331136] [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: 10/31/2023] [Accepted: 12/21/2023] [Indexed: 02/06/2024] Open
Abstract
Introduction Vaccination is one of the most effective population strategies to prevent infectious diseases and mitigate pandemics, and it is important to understand vaccine uptake determinants since vaccine hesitancy has been increasing for the past few decades. The Health Belief Model (HBM) has been widely used for understanding vaccination behavior. The current study aimed to assess influenza vaccine (IV) non-uptake and attitudes toward COVID-19 vaccination, two important respiratory diseases with similar symptoms, and routes of transmission in the Portuguese population. Methods We conducted a cross-sectional study using a panel sample of randomly chosen Portuguese households. A total of 1,050 individuals aged 18 years and over responded to a telephone or online questionnaire. Through a mixed-method approach, we employed thematic content analysis to describe reasons for not taking the IV, considering the HBM dimensions, and quantitative statistical analysis to estimate IV and COVID-19 vaccine coverage. Results The IV uptake for the overall population was 30.7% (CI 95%: 26.5, 35.2). Susceptibility was found to be a main factor for IV non-uptake, followed by barriers, such as stock availability and fear of adverse effects. The uptake of the COVID-19 vaccine was very high in the study population (83.1%, CI 95%: 13.6%-20.9%). There was a high perception of COVID-19-associated severity and fear of the consequences. Individuals who reported IV uptake seemed to perceive a higher severity of COVID-19 and a higher benefit of taking the COVID-19 vaccine for severe complications. Discussion Thus, the population does not seem to consider influenza to be a health risk, as opposed to COVID-19, which is considered to be a possibly severe disease. The association between IV uptake and COVID-19 perceptions highlights that an overall attitude toward vaccination in general may be an important individual determinant.
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Affiliation(s)
- Ana João Santos
- CINTESIS@RISE, Department of Education and Psychology, University of Aveiro, Aveiro, Portugal
| | - Irina Kislaya
- Department of Infectious Diseases Epidemiology, Bernhard Nocht Institute for Tropical Medicine (BNITM), Hamburg, Germany
- Epidemiology Department, National Institute of Health Doctor Ricardo Jorge, Lisboa, Portugal
- Comprehensive Health Research Center (CHRC), NOVA University of Lisbon, Lisbon, Portugal
| | - Carlos Matias-Dias
- Epidemiology Department, National Institute of Health Doctor Ricardo Jorge, Lisboa, Portugal
- Comprehensive Health Research Center (CHRC), NOVA University of Lisbon, Lisbon, Portugal
- Public Health Research Centre, National School of Public Health, NOVA University of Lisbon, Lisbon, Portugal
| | - Ausenda Machado
- Epidemiology Department, National Institute of Health Doctor Ricardo Jorge, Lisboa, Portugal
- Comprehensive Health Research Center (CHRC), NOVA University of Lisbon, Lisbon, Portugal
- Public Health Research Centre, National School of Public Health, NOVA University of Lisbon, Lisbon, Portugal
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Palache A, Billingsley JK, MacLaren K, Morgan L, Rockman S, Barbosa P. Lessons learned from the COVID-19 pandemic for improved influenza control. Vaccine 2023; 41:5877-5883. [PMID: 37598027 DOI: 10.1016/j.vaccine.2023.08.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 08/10/2023] [Accepted: 08/12/2023] [Indexed: 08/21/2023]
Abstract
The World Health Organization noted that COVID-19 vaccination programmes could be leveraged to deliver influenza vaccination. In 2008, the International Federation of Pharmaceutical Manufacturers and Associations' (IFPMA) Influenza Vaccine Supply International Task Force (IVS) developed a survey method using the number of influenza vaccine doses distributed globally to estimate vaccination coverage rates. Seven hundred and ninety-seven million doses were distributed in 2021, representing a 205% increase over the 262 million doses distributed in 2004, exceeding the number of doses distributed during and after the 2009-2010 influenza pandemic. The most obvious explanation for the global increase is the enabling of critical elements of the vaccine ecosystem by decision-makers during the COVID-19 pandemic to reinforce implementation of influenza vaccination programs. Most of the improvements in performance of influenza programs during the COVID-19 pandemic can be classified in four categories: 1) promoting vaccination using tailored approaches for specific populations; 2) improving convenient access to influenza vaccines in COVID-safe settings; 3) improving reimbursement of seasonal influenza vaccination for priority groups; 4) maintaining the timing of vaccination to the autumn. In spite of the increase in rates of seasonal influenza vaccines distributed during the COVID-19 pandemic, globally, the rate of influenza dose distribution is sub-optimal, and a considerable proportion of the influenza infections remains preventable. To sustain the benefits from increased uptake of influenza vaccines, governments need to sustain the efforts made during the COVID-19 pandemic, and a number of global policy endeavours should be undertaken, including developing a clear global roadmap for achieving influenza control objectives, adopted by a WHA resolution, in line with the strategic objective 3 of the Global Influenza Strategy 2030, embedded in the Immunization Agenda 2030 (IA2030).
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Affiliation(s)
- Abraham Palache
- Consultant at Abbott, C.J. van Houtenlaan 36, 1381 CP Weesp, the Netherlands.
| | | | | | - Lyn Morgan
- Sanofi 14 Espace Henry Vallée, 69007 Lyon, France.
| | - Steven Rockman
- CSL Seqirus Ltd, 63 Poplar Road, Parkville, Victoria 3052, Australia; Department of Immunology and Microbiology, the University of Melbourne, Parkville, Victoria, Australia.
| | - Paula Barbosa
- International Federation of Pharmaceutical Manufacturers and Associations, Ch. des Mines 9, P.O. Box 195, 1211 Geneva 20, Switzerland.
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Garza N, Leibensperger M, Bonnevie E. The Association Between Receiving the Flu and COVID-19 Vaccines and Related Factors, Data from the StopFlu Campaign in Eight States and the District of Columbia, 2022. J Community Health 2023; 48:731-739. [PMID: 37002473 PMCID: PMC10066005 DOI: 10.1007/s10900-023-01213-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/19/2023] [Indexed: 04/03/2023]
Abstract
Given the evolving nature of the COVID-19 pandemic and the importance of vaccines, it is imperative to understand the relationships between receiving the COVID-19 vaccine and other vaccines, such as the flu vaccine. Data were obtained from a survey as part of an evaluation of the StopFlu Kaiser Permanente media campaign, promoting the flu and COVID-19 vaccines in communities of color across eight states and the District of Columbia. The outcome considered was receiving the COVID-19 vaccine. The exposure considered was receiving the flu vaccine. Covariates included demographic factors, and sources of trusted health information. Overall, 4,185 participants had complete data and were included the analysis. Logistic regression was used to assess the relationship between receiving the flu vaccine and COVID-19 vaccine. Among participants, 77.8% reported receiving the COVID-19 vaccine and 55.4% received the flu vaccine. After adjusting for demographics and sources of trusted health information, participants reporting receiving the flu vaccine had 5.18 times the odds of also receiving the COVID-19 vaccine [Adjusted Odds Ratio (AOR): 5.18 95% Confidence Interval (CI): 4.24-6.32]. Trusting advice from a doctor and healthcare organization also had increased odds of receiving the COVID-19 vaccine. (AOR: 1.84 95%CI: 1.45-2.33, AOR: 2.08 95%CI: 1.64-2.63). This study demonstrates that promotion of one vaccine may influence uptake of other vaccines, which is important given the highly politicized nature of the COVID-19 vaccine. Further research could provide more insight into how promotion of a vaccine could impact behavior with regards to another.
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Affiliation(s)
- Nick Garza
- The Public Good Projects, 2308 Mount Vernon Ave, Ste 758, Alexandria, VA, 22301, USA.
| | - Megan Leibensperger
- The Public Good Projects, 2308 Mount Vernon Ave, Ste 758, Alexandria, VA, 22301, USA
| | - Erika Bonnevie
- The Public Good Projects, 2308 Mount Vernon Ave, Ste 758, Alexandria, VA, 22301, USA
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Patel UC, Schultz T, Schmidt J. Veteran influenza vaccination acceptance rates after completion of the COVID-19 vaccination series among historical influenza vaccine refusers. Vaccine 2023:S0264-410X(23)00803-4. [PMID: 37414694 DOI: 10.1016/j.vaccine.2023.06.090] [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: 03/15/2023] [Revised: 06/30/2023] [Accepted: 06/30/2023] [Indexed: 07/08/2023]
Abstract
BACKGROUND Vaccine hesitancy remains an obstacle in disease prevention. The recent COVID-19 pandemic highlighted this issue and may influence acceptance of other recommended immunizations. The objective of this study was to determine the association between receiving the COVID-19 vaccination and the subsequent acceptance of the influenza vaccination in a Veteran population that historically declined influenza vaccination. METHODS Influenza vaccination acceptance rates for the 2021-2022 influenza season were compared in patients who historically declined the influenza vaccine and either received or declined COVID-19 vaccinations. Logistic regression analysis was used to analyze factors associated with receiving influenza vaccination among vaccine hesitant individuals. RESULTS A higher proportion of patients who had received the COVID-19 vaccination(s) subsequently accepted the influenza vaccination compared to the control group (37% vs. 11%, OR = 5.03; CI 3.15-8.26; p = 0.0001). CONCLUSION Among previous influenza vaccine decliners, those who received COVID-19 vaccination had significantly higher odds of receiving subsequent influenza vaccination.
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Affiliation(s)
- Ursula C Patel
- Edward Hines, Jr. VA Hospital, 5000 S. Fifth Ave, Hines, Il 60141, USA.
| | - Thomas Schultz
- Edward Hines, Jr. VA Hospital, 5000 S. Fifth Ave, Hines, Il 60141, USA
| | - Justin Schmidt
- Edward Hines, Jr. VA Hospital, 5000 S. Fifth Ave, Hines, Il 60141, USA
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Lan C, Chen YC, Chang YI, Chuang PC. Impact of COVID-19 Outbreak on Influenza and Pneumococcal Vaccination Uptake: A Multi-Center Retrospective Study. Vaccines (Basel) 2023; 11:986. [PMID: 37243090 PMCID: PMC10223787 DOI: 10.3390/vaccines11050986] [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: 04/20/2023] [Revised: 05/10/2023] [Accepted: 05/11/2023] [Indexed: 05/28/2023] Open
Abstract
During the coronavirus disease 2019 (COVID-19) pandemic, global vaccination efforts declined due to the burden on health systems and community resistance to epidemic control measures. Influenza and pneumococcal vaccines have been recommended for vulnerable populations to prevent severe pneumonia. We investigated community response towards influenza and pneumococcal vaccines (pneumococcal conjugate vaccine and pneumococcal polysaccharide vaccine) after the COVID-19 outbreak in Taiwan. We retrospectively included adults who visited Chang Gung Memorial Hospital (CGMH) institutions for influenza or pneumococcal vaccination from January 2018 to December 2021. The first case of COVID-19 in Taiwan was detected in January 2020; therefore, in this study, hospitalized cases from January 2018 to December 2019 were defined as "before COVID-19 outbreak," and hospitalized cases from January 2020 to December 2021 were defined as "after COVID-19 outbreak". A total of 105,386 adults were enrolled in the study. An increase in influenza vaccination (n = 33,139 vs. n = 62,634) and pneumococcal vaccination (n = 3035 vs. n = 4260) were observed after the COVID-19 outbreak. In addition, there was an increased willingness to receive both influenza and pneumococcal vaccinations among women, adults without underlying disease and younger adults. The COVID-19 pandemic may have increased awareness of the importance of vaccination in Taiwan.
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Affiliation(s)
- Chieh Lan
- Department of Family Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 83301, Taiwan;
| | - Yi-Chun Chen
- Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 83301, Taiwan;
| | - Ye-In Chang
- Department of Computer Science and Engineering, National Sun Yat-sen University, Kaohsiung 80424, Taiwan;
| | - Po-Chun Chuang
- Department of Computer Science and Engineering, National Sun Yat-sen University, Kaohsiung 80424, Taiwan;
- Department of Emergency Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 83301, Taiwan
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