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Zornoza Moreno M, Pérez Martín JJ, Moreno MCG, Abellán MPR. Parental knowledge on the respiratory syncytial virus before the nirsevimab immunization program: Attitudes toward immunization in an autonomous community of Spain. Hum Vaccin Immunother 2024; 20:2357439. [PMID: 38857859 PMCID: PMC11168215 DOI: 10.1080/21645515.2024.2357439] [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: 02/23/2024] [Accepted: 05/16/2024] [Indexed: 06/12/2024] Open
Abstract
Respiratory syncytial virus (RSV) is the leading cause of lower respiratory tract infections in young children and associated with most bronchiolitis- and pneumonia-related hospitalizations. A new preventive monoclonal antibody (MAb), nirsevimab, has been launched in the United States, Luxembourg, and France, and was recently approved to be given in a population-based manner throughout Spain. This study aimed to have a first pre-immunization insight into the Spanish parental knowledge about bronchiolitis, RSV, and nirsevimab immunization. Parents in Murcia with children <2 years of age up to the date of September 1, 2023, were selected to complete a questionnaire. The primary endpoint was the parental knowledge about bronchiolitis, RSV, and nirsevimab. A total of 3,217 responses were analyzed. The majority (95.8%) were aware of bronchiolitis. Meanwhile, 46.6% of the respondents knew about RSV, most of them only after the first child's birth. Information about RSV or bronchiolitis was mainly obtained from family members, with only 4.8% reporting having been informed by Health care Professionals (HCPs). Only 11.2% of respondents were aware of nirsevimab. Nonetheless, these were not entirely satisfied with the information received (score of 3.3 out of 5) and shared that HCPs should be the primary source of information. The present survey then highlights the need for better and more efficient educational strategies directed to all parents/legal guardians. It also sheds some light on the different factors that should be considered to improve awareness of RSV immunization to decrease its burden in Spain and beyond.
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Affiliation(s)
- Matilde Zornoza Moreno
- Prevention and Health Protection Service. Public Health and Addictions Directorate General, Regional Ministry of Health, Murcia, Spain
| | - Jaime Jesús Pérez Martín
- Prevention and Health Protection Service. Public Health and Addictions Directorate General, Regional Ministry of Health, Murcia, Spain
| | - Mª Cruz Gómez Moreno
- Prevention and Health Protection Service. Public Health and Addictions Directorate General, Regional Ministry of Health, Murcia, Spain
| | - Mª Pilar Ros Abellán
- Prevention and Health Protection Service. Public Health and Addictions Directorate General, Regional Ministry of Health, Murcia, Spain
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Butler AM, Newland JG, Sahrmann JM, O'Neil CA, McGrath LJ. Characterizing timeliness of recommended vaccinations among privately-insured children in the United States, 2009-2019. Vaccine 2024; 42:126179. [PMID: 39116485 DOI: 10.1016/j.vaccine.2024.126179] [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: 04/08/2024] [Revised: 07/23/2024] [Accepted: 07/24/2024] [Indexed: 08/10/2024]
Abstract
BACKGROUND The Advisory Committee on Immunization Practices (ACIP) recommends early childhood vaccinations, but knowledge is limited about the magnitude and timing of vaccine delay for each recommended dose on a population level. We sought to characterize longitudinal patient-level patterns of early childhood vaccination schedule adherence. METHODS Using the Merative MarketScan Commercial Database (2009-2019), we identified commercially-insured infants who received at least one timely dose of a 2-month recommended vaccine. We categorized the number of recommended vaccines administered on the same date at 2, 4, 6, and 12-15 months of age (grace period: -7, +21 days). A Sankey diagram illustrated the number of vaccines received concomitantly during each age window and depicted transitions to different states over time (e.g., no vaccine delay to vaccine delay). For each vaccine dose, we estimated the cumulative incidence of receipt. RESULTS Among 1,239,364 eligible children, 28% of infants aged 4 months and 38% of infants aged 6 months did not receive timely, concomitant administration of all recommended vaccines. The number of timely vaccines received concomitantly and age at receipt varied most for doses recommended during the second year of life. Children with a previously delayed (versus timely) dose consistently experienced longer time to subsequent dose. CONCLUSIONS National coverage improved over time for all recommended vaccine doses under study, most notably for measles, mumps, and rubella. However, many children do not receive vaccines on schedule. Interventions to maintain adherence to the recommended schedule are needed early in life.
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Affiliation(s)
- Anne M Butler
- Department of Medicine, Division of Infectious Diseases, Washington University School of Medicine, St. Louis, MO, USA; Department of Surgery, Division of Public Health Sciences, Washington University School of Medicine, St. Louis, MO, USA.
| | - Jason G Newland
- Department of Pediatrics, Division of Infectious Diseases, Washington University School of Medicine, St. Louis, Missouri, USA; NoviSci, Durham, North, Carolina, USA.
| | - John M Sahrmann
- Department of Medicine, Division of Infectious Diseases, Washington University School of Medicine, St. Louis, MO, USA.
| | - Caroline A O'Neil
- Department of Medicine, Division of Infectious Diseases, Washington University School of Medicine, St. Louis, MO, USA.
| | - Leah J McGrath
- Global Medical and Scientific Affairs, Pfizer Inc., New York, NY, United States.
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Melchinger H, Winters M, Christie S, Arias N, Lirman L, Abeyesekera S, Thomson A, Omer SB. Determinants of undervaccination of routine childhood immunization in Argentina: A cross-sectional study. Vaccine 2024; 42:126235. [PMID: 39182313 DOI: 10.1016/j.vaccine.2024.126235] [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: 05/23/2024] [Revised: 07/19/2024] [Accepted: 08/14/2024] [Indexed: 08/27/2024]
Abstract
Routine childhood immunization is one of the most effective methods of preventing infectious diseases in children. In Argentina, there has been a decline in routine immunization coverage since 2015, with very little evidence to date on underlying drivers of this steady decline. We administered an online nationwide behavioral insights survey in Argentina between July 1-25, 2022, targeting parents with at least one child under the age of 12 years. Our survey included 1504 parents, 7% (n = 111) of whom did not or only partially vaccinated their children. We found that, compared to the youngest parents (aged 18-24), older parents were less likely to under-vaccinate their children (e.g., 30-34 year-old parents: adjusted Odds Ratio (aOR): 0.31, 95% Confidence Interval (CI) 0.16-0.57). Parents who undervaccinated their children were more likely to take vaccination advice from parent and wellness social media influencers (parent influencers: aOR 2.51, 95% CI 1.46-4.31), and were less likely to trust the social media accounts of official health organizations (aOR 0.82, 95% CI 0.70-0.96). Furthermore, these parents had heightened concerns about routine immunizations, including the number of vaccines given to children and potential for adverse side effects. When asked whether they knew enough to make a vaccine decision for their children, parents who undervaccinated their children were more likely to report that they did not know enough about vaccines or the vaccination schedule to make a decision. These results offer important insights into parental concerns surrounding routine childhood immunization and suggest potential drivers of - and solutions to - the decline in routine immunization seen in Argentina since 2015.
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Affiliation(s)
- Hannah Melchinger
- Peter O'Donnell Jr. School of Public Health, UT Southwestern Medical Center, Dallas, TX 75390, United States
| | - Maike Winters
- Yale Institute for Global Health, Yale University, New Haven, CT 06511, United States
| | - Sarah Christie
- Yale School of Medicine, Yale University, New Haven, CT 06511, United States
| | | | | | | | | | - Saad B Omer
- Peter O'Donnell Jr. School of Public Health, UT Southwestern Medical Center, Dallas, TX 75390, United States.
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Vashist K, Yankey D, Elam-Evans LD, Mu Y, Valier MR, Pingali C, Hill HA, Santibanez TA, Singleton JA. Changes in vaccine hesitancy among parents of children aged 6 months - 17 Years, National Immunization Surveys, 2019-2022. Vaccine 2024; 42:125989. [PMID: 38806351 DOI: 10.1016/j.vaccine.2024.05.037] [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: 03/20/2024] [Revised: 05/16/2024] [Accepted: 05/16/2024] [Indexed: 05/30/2024]
Abstract
BACKGROUND Vaccine hesitancy (VH) has been a major contributor to large outbreaks of vaccine-preventable diseases globally, including in the United States. METHODS Data from the 2019-2022 National Immunization Surveys were analyzed to assess parental hesitancy toward routine vaccination of their children aged 6 months -17 years. Joinpoint regression was employed to investigate trends in VH from 2019 to 2022 nationally overall and among socio-demographic subgroups. Using logistic regression, the difference between the prevalence of VH before and after the authorization of the COVID-19 vaccine for children aged 6 months-4 years, 5-11 years, and 12-17 years was computed. Both unadjusted and adjusted estimates were reported. VH was also compared within each socio-demographic subgroup with a reference level, at two-time points- before and after the authorization of the COVID-19 vaccine for each age group. RESULTS Overall, VH remained around 19.0 % from Q2 2019 to Q3 2022. Parents of non-Hispanic Black children had the largest average quarterly decrease in VH (β = -0.55; p < 0.05 by test for trend). After the authorization of the COVID-19 vaccine for children aged 6 months to 4 years, the adjusted percentage of children having parents that reported VH decreased by 2.2 (95 % CI: -3.9, -0.6) percentage points (pp) from 21.6 % to 19.4 %. Conversely, for children aged 5-11 years, VH increased by 1.2 (95 % CI: 0.2, 2.3) pp, from 19.8 % to 21.0 %. VH among parents of non-Hispanic Black children decreased after the authorization of the COVID-19 vaccine for adolescents aged 12-17 years but remained significantly higher compared to parents of non-Hispanic White children before and after authorization of the COVID-19 vaccine for all age groups. DISCUSSION About 1 in 5 children had parents reporting VH from 2019 to 2022. Parental VH increased after the authorization of the COVID-19 vaccine for children aged 5-11 years and declined for children aged 6 months-4 years.
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Affiliation(s)
- Kushagra Vashist
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States; Rollins School of Public Health, Emory University, Atlanta, GA, United States.
| | - David Yankey
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Laurie D Elam-Evans
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Yi Mu
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Madeleine R Valier
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Cassandra Pingali
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Holly A Hill
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Tammy A Santibanez
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - James A Singleton
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
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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.
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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.)
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Salmon DA, Chen RT, Black S, Sharfstein J. Lessons learned from COVID-19, H1N1, and routine vaccine pharmacovigilance in the United States: a path to a more robust vaccine safety program. Expert Opin Drug Saf 2024; 23:161-175. [PMID: 38343204 DOI: 10.1080/14740338.2024.2305707] [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: 08/23/2023] [Accepted: 01/11/2024] [Indexed: 02/15/2024]
Abstract
INTRODUCTION Vaccine pharmacovigilance is an essential component of vaccine safety programs. Vaccine pharmacovigilance refers to detecting uncommon adverse events following immunization (AEFI), determining whether they are due to the vaccine or are only a coincidence, and, for those AEFI considered related to vaccination, characterizing them further. When AEFI are due to vaccination, it is important to characterize the attributable risk and ascertain the biological mechanism causing the adverse reaction to inform efforts to prevent or mitigate the risk. A robust post-authorization safety system is necessary for vaccine decision-making, clinical recommendations, vaccine compensation, and vaccine communication and confidence. AREAS COVERED This paper describes the key characteristics of vaccine pharmacovigilance programs, reviews US vaccine pharmacovigilance for routine vaccination programs, COVID-19, and H1N1, and makes recommendations for improving future vaccine safety systems. EXPERT OPINION The key characteristics of vaccine pharmacovigilance programs include passive surveillance, active surveillance, clinical investigation and special studies, and causality assessment. Recent examples illustrate the strengths of US pharmacovigilance systems, including systems for passive and active surveillance, as well as areas for improvement, including study of pathogenesis, consistent funding, and leadership. We make recommendations that would, if implemented, further strengthen the vaccine safety system for future routine and pandemic immunizations.
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Affiliation(s)
- Daniel A Salmon
- Institute for Vaccine Safety, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Robert T Chen
- Brighton Collaboration, A program of the Task Force for Global Health, Decatur, GA, USA
| | - Steve Black
- Global Vaccine Data Network, Auckland, New Zealand
| | - Joshua Sharfstein
- Department of Health, Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Chen C, Yang Q, Tian H, Wu J, Chen L, Ji Z, Zheng D, Chen Y, Li Z, Lu H. Bibliometric and visual analysis of vaccination hesitancy research from 2013 to 2022. Hum Vaccin Immunother 2023; 19:2226584. [PMID: 37387233 PMCID: PMC10332187 DOI: 10.1080/21645515.2023.2226584] [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: 04/01/2023] [Revised: 05/25/2023] [Accepted: 06/14/2023] [Indexed: 07/01/2023] Open
Abstract
Although vaccination is regarded as one of the most significant achievements of public health, there also exists the phenomenon of vaccination hesitancy which refers to delay in acceptance or refusal of vaccination despite availability of vaccination services. In this study, we conducted a bibliometric analysis to provide a comprehensive overview of vaccination hesitancy research from 2013 to 2022. All related publications were retrieved from the Web of Science Core Collection Database. Information on annual publications, countries, organizations, journals, authors, keywords, and documents was analyzed adopting the bibliometix R-package, VOSviewer, and CiteSpace software. A total of 4042 publications were enrolled. The annual publications increased slightly before 2020 but had an extremely dramatic increase from 2020 to 2022. The United States contributed the most articles and had the greatest collaboration with other countries and organizations. The London School of Hygiene & Tropical Medicine was the most active institution. Vaccine was the most cited and influential journal while Vaccines was the most productive journal. It was Dube E who was the most productive authors with the highest h-index. The most frequent keywords were "vaccine hesitancy," "COVID-19," "SARS-CoV2," "immunization," "attitudes," and "willingness." Vaccination hesitancy to some extent hinders the achievement of global public health. The influencing factors vary across time, space, and vaccines. The COVID-19 pandemic and the development of COVID-19 vaccines have made this issue the focus of interest. The complexity and specific contexts of influencing factors of vaccination hesitancy require further study and will potentially be the focus of future research direction.
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Affiliation(s)
- Chaojian Chen
- Department of General Surgery, The Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China
| | - Qiuping Yang
- Department of General Surgery, The Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China
| | - Huiting Tian
- Department of General Surgery, The Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China
| | - Jinyao Wu
- Department of General Surgery, The Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China
| | - Lingzhi Chen
- Department of General Surgery, The Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China
| | - Zeqi Ji
- Department of General Surgery, The Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China
| | - Daitian Zheng
- Department of General Surgery, The Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China
| | - Yexi Chen
- Department of General Surgery, The Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China
| | - Zhiyang Li
- Department of General Surgery, The Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China
| | - Hai Lu
- Department of Breast, The First People’s Hospital of Shao Guan, Shaoguan, Guangdong, China
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Dubé E, Trottier ME, Gagnon D, Bettinger JA, Greyson D, Graham J, MacDonald NE, MacDonald SE, Meyer SB, Witteman HO, Driedger SM. Exploring parents' views of the use of narratives to promote childhood vaccination online. PLoS One 2023; 18:e0284107. [PMID: 37467300 DOI: 10.1371/journal.pone.0284107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 03/23/2023] [Indexed: 07/21/2023] Open
Abstract
BACKGROUND Negative information about vaccines that spreads online may contribute to parents' vaccine hesitancy or refusal. Studies have shown that false claims about vaccines that use emotive personal narratives are more likely to be shared and engaged with on social media than factual evidence-based public health messages. The aim of this study was to explore parents' views regarding the use of positive narratives to promote childhood vaccination. METHODS We identified three ∼4-minute video narratives from social media that counter frequent parental concerns about childhood vaccination: parents and informed decision-making (online misinformation about vaccines); a paediatrician's clinical experience with vaccine-preventable diseases (prevention of still existing diseases); and a mother's experience with vaccine-preventable disease (risks of the disease). Focus group discussions were held with parents of children aged 0 to 5 years to assess their views on these three narratives and their general opinion on the use of narratives as a vaccine promotion intervention. RESULTS Four focus groups discussions were virtually held with 15 parents in December 2021. In general, parents trusted both health care provider's and parent's narratives, but participants identified more with stories having a parent as the main character. Both narratives featuring personal stories with vaccine-preventable diseases were preferred by parents, while the story about informed decision-making was perceived as less influential. Parents expressed the need for reliable and nuanced information about vaccines and diseases and felt that a short video format featuring a story was an efficient vaccine promotion intervention. However, many mentioned that they generally are not watching such videos while navigating the Web. CONCLUSION While vaccine-critical stories are widely shared online, evidence on how best public health could counter these messages remains scarce. The use of narratives to promote vaccination was well-perceived by parents. Future studies are needed to assess reach and impact of such an intervention.
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Affiliation(s)
- Eve Dubé
- Department of Anthropology, Laval University, Quebec, Quebec, Canada
- Department of Biohazard, Quebec National Institute of Public Health, Quebec, Quebec, Canada
| | - Marie-Eve Trottier
- Department of Biohazard, Quebec National Institute of Public Health, Quebec, Quebec, Canada
| | - Dominique Gagnon
- Department of Biohazard, Quebec National Institute of Public Health, Quebec, Quebec, Canada
| | - Julie A Bettinger
- Department of Pediatrics, Vaccine Evaluation Center, BC Children's Hospital Research Institute, University of British Columbia, Vancouver, British Columbia, Canada
| | - Devon Greyson
- Department of Pediatrics, Vaccine Evaluation Center, BC Children's Hospital Research Institute, University of British Columbia, Vancouver, British Columbia, Canada
| | - Janice Graham
- Department of Pediatrics, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Noni E MacDonald
- Department of Pediatrics, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Shannon E MacDonald
- Faculty of Nursing, University, University of Alberta, Edmonton, Alberta, Canada
| | - Samantha B Meyer
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - Holly O Witteman
- Department of Family Medicine, Laval University, Quebec, Quebec, Canada
| | - S Michelle Driedger
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
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Li J, Tang Z, Gong Z. Does the Message Frame Promote People's Willingness to Vaccinate when they Worry about Side Effects from the COVID-19 Vaccine? Evidence from an Online Survey Experiment in China. HEALTH COMMUNICATION 2023; 38:1688-1696. [PMID: 35057686 DOI: 10.1080/10410236.2022.2028469] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Vaccination is an effective strategy for controlling the coronavirus disease 2019 (COVID-19) pandemic. However, worrying about side effects (WSE) from the COVID-19 vaccine is the leading concern making people hesitant to get vaccinated. Regrettably, there are few studies on alleviating the negative impacts of WSE on COVID-19 vaccination. This study aimed to assess whether message framing (gain- and loss-framed) can moderate the impacts of WSE on the willingness to vaccinate. We conducted an online self-administered survey experiment with three groups: control group (non-framed group), gain-framed groups, and loss-framed groups. In total, 981 participants were randomly assigned to one of the three groups, and their willingness to vaccinate themselves, their children, and elderly members was recorded. People with a higher level of WSE exhibited a lower willingness to vaccinate against COVID-19. However, the gain- and loss-framed messages increased people's willingness to vaccinate themselves, their children, and the elderly. Compared to the gain-framed messages, the loss-framed messages had a greater impact on enhancing people's willingness to self-vaccinate, but not on vaccinating their children and the elderly. Although the gain- and loss-framed messages weakened the negative impacts of WSE on the willingness to be vaccinated, their buffer effect was non-significantly different. The findings in this study suggest that a loss-framed messaging strategy could be a valuable tool in disseminating information on vaccination against COVID-19.
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Affiliation(s)
- Jie Li
- School of Public Affairs and Administration, University of Electronic Science and Technology of China
| | - Zhiwei Tang
- School of Public Affairs and Administration, University of Electronic Science and Technology of China
- Shenzhen Institute for Advanced Study, University of Electronic Science and Technology of China
| | - Zepeng Gong
- School of Public Affairs and Administration, University of Electronic Science and Technology of China
- Shenzhen Institute for Advanced Study, University of Electronic Science and Technology of China
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Abdalla SM, Mohamed EY, Elsabagh HM, Ahmad MS, Shaik RA, Mehta V, Mathur A, Ghatge SB. COVID-19 Vaccine Hesitancy among the General Population: A Cross-Sectional Study. Vaccines (Basel) 2023; 11:1125. [PMID: 37376514 DOI: 10.3390/vaccines11061125] [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: 04/06/2023] [Revised: 06/15/2023] [Accepted: 06/16/2023] [Indexed: 06/29/2023] Open
Abstract
Hesitancy about receiving vaccines has been deemed a global danger to public health by WHO. The sociocultural backgrounds of the people have an impact on vaccine acceptance. The purpose of this study was to examine the effect of sociodemographic factors on COVID-19 vaccination hesitancy as well as to identify the factors that contributed to COVID-19 vaccine hesitancy. METHODS A cross-sectional study was carried out to determine the primary variables causing COVID-19 vaccination hesitancy among residents of Pune. The general population was sampled through simple random sampling. The minimum sample size was determined to be 1246. The questionnaire inquired about the individuals' sociodemographic information, vaccination status, and reasons for vaccine hesitancy. RESULTS In total, there were 5381 subjects, 1669 of whom were unvaccinated and 3712 of whom were partially vaccinated. Fear of adverse effects (51.71%), fear of losing a few days of work (43.02%), and inability to secure a vaccine slot online (33.01%) were the most frequently cited reasons. An older population (>60 years, p = 0.004), males (p = 0.032), those who were literate (p = 0.011), those of lower middle socioeconomic status (p = 0.001), and smokers were significantly associated with fear and mistrust of the COVID-19 vaccine, while mistrust of the vaccine was greatest among individuals from the upper and lower middle classes (p = 0.001). CONCLUSION Vaccine hesitancy due to concerns about the side effects and long-term complications was prevalent among the elderly, males, those from the lower middle class, and smokers. This study emphasizes the importance of communicating effectively about the vaccine's efficacy, its distribution, and vaccination sites.
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Affiliation(s)
- Sawsan Mustafa Abdalla
- Department of Family and Community Medicine, College of Medicine, Majmaah University, Al-Majmaah 11952, Saudi Arabia
| | - Elsadig Yousif Mohamed
- Department of Family and Community Medicine, College of Medicine, Majmaah University, Al-Majmaah 11952, Saudi Arabia
| | - Hala Mostafa Elsabagh
- Basic Medical Sciences Department, College of Dentistry, Majmaah University, Al-Majmaah 11952, Saudi Arabia
- Department of Public Health and Community Medicine, Tanta University, Tanta 6632110, Egypt
| | - Mohammad Shakil Ahmad
- Department of Family and Community Medicine, College of Medicine, Majmaah University, Al-Majmaah 11952, Saudi Arabia
| | - Riyaz Ahamed Shaik
- Department of Family and Community Medicine, College of Medicine, Majmaah University, Al-Majmaah 11952, Saudi Arabia
| | - Vini Mehta
- Department of Public Health Dentistry, Dr. D.Y. Patil Dental College and Hospital, Dr. D.Y. Patil Vidyapeeth, Pune 411018, Maharashtra, India
| | - Ankita Mathur
- Department of Periodontology, Dr. D.Y. Patil Dental College and Hospital, Dr. D.Y. Patil Vidyapeeth, Pune 411018, Maharashtra, India
| | - Sharad Balasaheb Ghatge
- Division of Interventional Radiology, Department of Radiology and Imaging, Grant Government Medical College, Sir JJ Group of Hospitals, Mumbai 400008, Maharashtra, India
- Department of Interventional Neuroradiology, Bombay Hospital, Mumbai 400020, Maharashtra, India
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11
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Nikic P, Stankovic B, Santric V, Vukovic I, Babic U, Radovanovic M, Bojanic N, Acimovic M, Kovacevic L, Prijovic N. Role of Healthcare Professionals and Sociodemographic Characteristics in COVID-19 Vaccination Acceptance among Uro-Oncology Patients: A Cross-Sectional Observational Study. Vaccines (Basel) 2023; 11:vaccines11050911. [PMID: 37243015 DOI: 10.3390/vaccines11050911] [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: 04/09/2023] [Revised: 04/26/2023] [Accepted: 04/26/2023] [Indexed: 05/28/2023] Open
Abstract
At the time when mass COVID-19 vaccination began, providing appropriate vaccination advice to uro-oncology patients became a challenge. This was a single-center cross-sectional observational study aimed to investigate the rate of COVID-19 vaccination among uro-oncology patients receiving systemic therapy for metastatic renal cell carcinoma and metastatic castration-resistant prostate cancer. Furthermore, we aimed to assess patients' attitudes and identify factors influencing their decision to vaccinate against COVID-19. Data on patients' sociodemographic characteristics, vaccination status, and awareness and attitudes about COVID-19 vaccination were collected from questionnaires completed by the patients. A total of 173 patients were enrolled in this study, and 124 (71.7%) of them completed the COVID-19 vaccination. Significantly higher vaccination rates were found in male patients, and also in older patients, highly educated patients, and those who lived with one household member. Furthermore, we found significantly higher vaccination rates in patients who had consulted with doctors involved in their treatment, particularly with urologists. A significant association was observed between COVID-19 vaccination and doctor's advice, family member influence, and personal beliefs toward the vaccination. Our study showed multiple associations of patients' sociodemographic characteristics with vaccination rates. Furthermore, consultation with doctors who are particularly involved in oncology treatment and advice received from them were associated with significantly higher vaccination rates among uro-oncology patients.
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Affiliation(s)
- Predrag Nikic
- Clinic of Urology, University Clinical Center of Serbia, 11000 Belgrade, Serbia
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
| | - Branko Stankovic
- Clinic of Urology, University Clinical Center of Serbia, 11000 Belgrade, Serbia
| | - Veljko Santric
- Clinic of Urology, University Clinical Center of Serbia, 11000 Belgrade, Serbia
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
| | - Ivan Vukovic
- Clinic of Urology, University Clinical Center of Serbia, 11000 Belgrade, Serbia
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
| | - Uros Babic
- Clinic of Urology, University Clinical Center of Serbia, 11000 Belgrade, Serbia
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
| | - Milan Radovanovic
- Clinic of Urology, University Clinical Center of Serbia, 11000 Belgrade, Serbia
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
| | - Nebojsa Bojanic
- Clinic of Urology, University Clinical Center of Serbia, 11000 Belgrade, Serbia
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
| | - Miodrag Acimovic
- Clinic of Urology, University Clinical Center of Serbia, 11000 Belgrade, Serbia
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
| | - Luka Kovacevic
- Clinic of Urology, University Clinical Center of Serbia, 11000 Belgrade, Serbia
| | - Nebojsa Prijovic
- Clinic of Urology, University Clinical Center of Serbia, 11000 Belgrade, Serbia
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12
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Opel DJ. Clinician Communication to Address Vaccine Hesitancy. Pediatr Clin North Am 2023; 70:309-319. [PMID: 36841598 DOI: 10.1016/j.pcl.2022.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
Abstract
There are several factors that influence childhood vaccine uptake. Pediatric clinicians play a particularly influential role in parent vaccine decision-making. It is critical therefore that pediatric clinicians have a "communication toolbox"--a set of effective, evidence-based communication strategies to facilitate uptake of childhood vaccines--that they can use in conversations with parents about vaccines. In this article, recent advances in our understanding of what constitutes effective clinician vaccine communication with parents are discussed.
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Affiliation(s)
- Douglas J Opel
- Department of Pediatrics, University of Washington School of Medicine, Center for Clinical and Translational Research, Seattle Children's Research Institute, M/S: JMB-6, 1900 Ninth Avenue, Seattle, WA 98101, USA.
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13
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Gun SY, Moosa AS, Poh CW, Ng SL, Tan NC. A Voice-Annotated Digital Decision Aid to Promote Child Influenza Vaccination: A Feasibility Study. Vaccines (Basel) 2023; 11:vaccines11030565. [PMID: 36992149 DOI: 10.3390/vaccines11030565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 02/25/2023] [Accepted: 02/26/2023] [Indexed: 03/06/2023] Open
Abstract
(1) Background: Child influenza vaccine uptake is suboptimal due partly to vaccine hesitancy. A voice-annotated digital decision aid, Flu Learning Object (FLO), was developed to facilitate parental decision-making. This study assessed parental views on FLO’s usability and utility and determined its preliminary effectiveness in increasing vaccine intention and uptake; (2) Methods: A single-center mixed method study was conducted in a public primary care clinic in Singapore. Parents of children aged 6 months to 5 years who were unvaccinated in the preceding year were recruited. In-depth interviews explored their views of using FLO. Pre- and post-FLO questionnaires assessed their vaccine intention and perceived usability using the System Usability Scale (SUS); (3) Results: 18 parents were recruited. They became more aware of benefits and potential complications, distinguished influenza from the common cold, and recognized recommendations by National Childhood Immunisation Schedule. FLO addressed parents’ concerns and supported their decision-making process. FLO has good usability with a mean SUS score of 79.3, ranked at approximately the 85th percentile. The usage of FLO significantly increased vaccine intention from 55.6% to 94.4% (p = 0.016) with an actual vaccine uptake rate of 50%; (4) Conclusions: Parents generally accepted FLO, which positively influenced their intention to vaccinate their child against influenza.
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Affiliation(s)
- Shih Ying Gun
- SingHealth Polyclinics, Singapore 150167, Singapore
- SingHealth Duke-NUS Family Medicine Academic Clinical Programme, Singapore 150167, Singapore
| | - Aminath Shiwaza Moosa
- SingHealth Polyclinics, Singapore 150167, Singapore
- SingHealth Duke-NUS Family Medicine Academic Clinical Programme, Singapore 150167, Singapore
| | - Chen Wei Poh
- Yong Loo Lin School of Medicine, National University of Singapore (NUS), Singapore 119077, Singapore
| | - Sherryl Lei Ng
- Yong Loo Lin School of Medicine, National University of Singapore (NUS), Singapore 119077, Singapore
| | - Ngiap Chuan Tan
- SingHealth Polyclinics, Singapore 150167, Singapore
- SingHealth Duke-NUS Family Medicine Academic Clinical Programme, Singapore 150167, Singapore
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14
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Comparing the effect of parental education via both lecture and film upon vaccination uptake for children under one year of age: A cluster randomized clinical trial. Vaccine 2023; 41:1067-1073. [PMID: 36599735 DOI: 10.1016/j.vaccine.2022.12.012] [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: 07/05/2022] [Revised: 11/25/2022] [Accepted: 12/01/2022] [Indexed: 01/03/2023]
Abstract
BACKGROUND AND AIM Vaccination is the most cost-effective action in preventing infectious diseases. Despite Iran's success in high vaccination coverage, in some areas there is a delay in vaccination. The aim of this study was to determine and compare the effect of education on immunization via lecture and film upon parental delay in vaccination uptake for children under 12 months of age. METHODS A multicentre cluster-randomized clinical trial with comprehensive urban health centres (CUHCs) in Shooshtar city, Khuzestan province, Iran as the unit of randomization was conducted. Overall, 8 CUHCs were randomized to receive education either via film (n = 165) or lecture (n = 164). In order to assign CUHCs to two groups, a simple random sampling method of coin tossing was used. Parents with children under 12 months and with a history of delayed vaccination were included in the study. Consecutive sampling was performed until the number needed for the cluster was reached. Interventions were delivered in small groups of 5-8 participants. Demographical data and clinical histories were collected from parents directly via a personal characteristic's questionnaire. Clinical data was extracted from vaccination records, the child's vaccine card and the vaccine information registration system. Statistical analyses of intervention effects were performed as per-protocol analysis. RESULTS In terms of individual characteristics and vaccine information significant differences between the two groups were only observed in relation to the parent of the participant, the child's gender, the number of children in the family, and timely injection of the vaccine in the previous child (p < 0.05). The chance of delay in vaccination after the intervention, without and considering the effect of intervening variables was 78 % and 74 % higher in the lecture group than in the film group, respectively (OR = 1.786, CI = 1.152-2.774 vs AOR = 1.743, CI = 1.011-3.007). Overall, 37.6 % of children in the film-based education group and 51.8 % of children in the lecture-based education group received their next vaccine with a delay of more than 7 days. CONCLUSION Education delivered via film can reduce the delay in vaccination more effectively. These findings, along with those of other studies conducted around the world suggest that multimedia education should be considered more widely in the field of education in children's vaccination.
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15
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Vaithilingam S, Hwang LA, Nair M, Ng JWJ, Ahmed P, Musa KI. COVID-19 vaccine hesitancy and its drivers: An empirical study of the vaccine hesitant group in Malaysia. PLoS One 2023; 18:e0282520. [PMID: 36920970 PMCID: PMC10016727 DOI: 10.1371/journal.pone.0282520] [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: 08/12/2022] [Accepted: 02/16/2023] [Indexed: 03/16/2023] Open
Abstract
BACKGROUND Sporadic outbreaks of COVID-19 remain a threat to public healthcare, especially if vaccination levels do not improve. As Malaysia begins its transition into the endemic phase, it is essential to identify the key determinants of COVID-19 vaccination intention amongst the pockets of the population who are still hesitant. Therefore, focusing on a sample of individuals who did not register for the COVID-19 vaccination, the current study integrated two widely used frameworks in the public health domain-the health belief model (HBM) and the theory of reasoned action (TRA)-to examine the inter-relationships of the predictors of vaccination intention amongst these individuals. METHODOLOGY Primary data from 117 respondents who did not register for the COVID-19 vaccination were collected using self-administered questionnaires to capture predictors of vaccination intention amongst individuals in a Malaysian context. The partial least squares structural equation modeling (PLS-SEM) technique was used to analyze the data. RESULTS Subjective norms and attitude play key mediating roles between the HBM factors and vaccination intention amongst the unregistered respondents. In particular, subjective norms mediate the relationship between cues to action and vaccination intention, highlighting the significance of important others to influence unregistered individuals who are already exposed to information from mass media and interpersonal discussions regarding vaccines. Trust, perceived susceptibility, and perceived benefits indirectly influence vaccination intention through attitude, indicating that one's attitude is vital in promoting behavioral change. CONCLUSION This study showed that the behavioral factors could help understand the reasons for vaccine refusal or acceptance, and shape and improve health interventions, particularly among the vaccine-hesitant group in a developing country. Therefore, policymakers and key stakeholders can develop effective strategies or interventions to encourage vaccination amongst the unvaccinated for future health pandemics by targeting subjective norms and attitude.
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Affiliation(s)
- Santha Vaithilingam
- Sunway Institute for Global Strategy and Competitiveness, Sunway University, Selangor, Malaysia
| | - Li-Ann Hwang
- Department of Econometrics and Business Statistics, School of Business, Monash University, Selangor, Malaysia
- * E-mail:
| | - Mahendhiran Nair
- Sunway Institute for Global Strategy and Competitiveness, Sunway University, Selangor, Malaysia
| | - Jason Wei Jian Ng
- Department of Pure and Applied Mathematics, School of Mathematical Sciences, Sunway University, Selangor, Malaysia
| | - Pervaiz Ahmed
- Sunway Institute for Global Strategy and Competitiveness, Sunway University, Selangor, Malaysia
| | - Kamarul Imran Musa
- Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia
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16
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Shaipuzaman NA, Rahman HA. Knowledge and attitude on infant vaccination among university staff in Malaysian public university. Hum Vaccin Immunother 2022; 18:2029258. [PMID: 35239461 PMCID: PMC8993098 DOI: 10.1080/21645515.2022.2029258] [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] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE To determine the knowledge and attitude on infant vaccination among a couple of Universiti Putra Malaysia (UPM) staffs in Serdang, Selangor. METHODS A cross-sectional study was carried out involving 97 respondents. A cluster sampling technique for the categorization of the faculty in UPM to science-based and non-science-based is used. Then, fishbowl technique was adopted in selecting the faculty from the two categorizations, which consists of 1) science-based: Faculty Biotechnology and Science Biomolecule and Faculty of Science; 2) non-science-based: Faculty of Economics and Management and Faculty of Language and Communication. Consequently, a simple random method was used to choose the respondent based on the inclusion and exclusion criteria. Data on socio-demographic characteristic, knowledge and attitude regarding infant vaccination were collected using a modified and pretested questionnaire. The data then were analyzed using SPSS version 22. RESULTS Of 97 respondents, 78 (80.4%) had high knowledge, and 49 (50.5%) have moderate attitude regarding infant vaccination. Overall, science-based faculty and non-science-based faculty prevalence of refuse infant vaccination was 2.1%, 6.5%, respectively. There was a significant association between educational level and the knowledge (p < .05, p = .019). However, there was no significant association between socio-demographic and attitude. Other than that,, there was no association between knowledge and attitude among these two different types of faculty (P > .05, p = .256, p = .597). CONCLUSION Effort are needed for focusing on health education campaign with collaboration between health-care professionals, social media and community to improve their awareness for immunization.
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Affiliation(s)
- Nurulain Atikah Shaipuzaman
- Department of Environmental & Occupational Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Haliza Abdul Rahman
- Institute for Social Sciences Studies, Putra Info Port, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
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17
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Anti-Vaccine Discourse on Social Media: An Exploratory Audit of Negative Tweets about Vaccines and Their Posters. Vaccines (Basel) 2022; 10:vaccines10122067. [PMID: 36560477 PMCID: PMC9782243 DOI: 10.3390/vaccines10122067] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Revised: 11/27/2022] [Accepted: 11/29/2022] [Indexed: 12/03/2022] Open
Abstract
As the anti-vaccination movement is spreading around the world, this paper addresses the ever more urgent need for health professionals, communicators and policy-makers to grasp the nature of vaccine mis/disinformation on social media. A one-by-one coding of 4511 vaccine-related tweets posted from the UK in 2019 resulted in 334 anti-vaccine tweets. Our analysis shows that (a) anti-vaccine tweeters are quite active and widely networked users on their own; (b) anti-vaccine messages tend to focus on the "harmful" nature of vaccination, based mostly on personal experience, values and beliefs rather than hard facts; (c) anonymity does not make a difference to the types of posted anti-vaccine content, but does so in terms of the volume of such content. Communication initiatives against anti-vaccination should (a) work closely with technological platforms to tackle anonymous anti-vaccine tweets; (b) focus efforts on mis/disinformation in three major arears (in order of importance): the medical nature of vaccines, the belief that vaccination is a tool of manipulation and control for money and power, and the "freedom of health choice" discourse against mandatory vaccination; and (c) go beyond common factual measures-such as detecting, labelling or removing fake news-to address emotions induced by personal memories, values and beliefs.
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18
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Evran M, Bekis Bozkurt H. Parents' views and information status on childhood vaccines: which myths play a role. Cent Eur J Public Health 2022; 30:219-224. [PMID: 36718923 DOI: 10.21101/cejph.a6946] [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: 06/03/2021] [Accepted: 11/19/2022] [Indexed: 02/01/2023]
Abstract
OBJECTIVES The participation of families in childhood vaccination decreases slightly every year around the world. Parents arrive at a decision that vaccines are not safe for their children due to many sources of misinformation. The aim of this study was to investigate the relationship between vaccine hesitancy, vaccine knowledge status and socio-demographic characteristics of the children's parents. METHODS In this cross-sectional study, 361 parents of children aged 5 years and under, who were admitted to our paediatric outpatient clinic, were included. The parents received scores between 0-20 points according to the correct answers they gave to the questions asked. RESULTS Although all parents had a positive attitude towards vaccination, some myths, e.g. that vaccination could weaken the child's immune system because it contains heavy metals which could cause infertility and that complementary and alternative medicine could replace vaccination, are thought to be real by 1.7% to 34.6% of the parents. CONCLUSIONS Since the presence of misinformation may lead to vaccine hesitancy and incomplete vaccination, healthcare personnel have important duties and responsibilities for this group.
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Affiliation(s)
| | - Hayrunnisa Bekis Bozkurt
- Department of Paediatric Allergy and Immunology, Goztepe Training and Research Hospital, Faculty of Medicine, Medeniyet University, Istanbul, Turkey
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19
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Dudley MZ, Omer SB, O'Leary ST, Limaye RJ, Ellingson MK, Spina CI, Brewer SE, Bednarczyk RA, Chamberlain AT, Malik F, Frew PM, Church-Balin C, Riley LE, Ault KA, Orenstein WA, Halsey NA, Salmon DA. MomsTalkShots, tailored educational app, improves vaccine attitudes: a randomized controlled trial. BMC Public Health 2022; 22:2134. [PMID: 36411403 PMCID: PMC9676851 DOI: 10.1186/s12889-022-14498-7] [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: 06/23/2022] [Accepted: 10/13/2022] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Many pregnant women and parents have concerns about vaccines. This analysis examined the impact of MomsTalkShots, an individually tailored educational application, on vaccine attitudes of pregnant women and mothers. METHODS MomsTalkShots was the patient-level component of a multi-level intervention to improve maternal and infant vaccine uptake that also included provider- and practice-level interventions. The impact of these interventions was studied using a two-by-two factorial design, randomizing at both the patient- and the practice-level. Study staff recruited pregnant women from a diverse set of prenatal care practices in Colorado and Georgia between June 2017 and July 2018. All participants (n = 2087) received a baseline survey of maternal and infant vaccine intentions and attitudes, and two follow-up surveys at least 1 month and 1 year after their infant's birth, respectively. Half of participants (n = 1041) were randomly assigned to receive educational videos through MomsTalkShots, algorithmically tailored to their vaccine intentions, attitudes, and demographics. Since the practice/provider intervention did not appear impactful, this analysis focused on MomsTalkShots regardless of the practice/provider intervention. RESULTS By 1 month post-birth, MomsTalkShots increased perceived risk of maternal influenza disease (61% among MomsTalkShots recipients vs 55% among controls; Odds Ratio: 1.61, 95% Confidence Interval: 1.23-2.09), confidence in influenza vaccine efficacy (73% vs 63%; OR: 1.97, 95%CI: 1.47-2.65), and perceived vaccine knowledge (55% vs 48%; OR: 1.39, 95%CI: 1.13-1.72). Among those intending not to vaccinate at baseline, MomsTalkShots increased perceived risk of maternal influenza disease (38% vs 32%; OR: 2.07, 95%CI: 1.15-3.71) and confidence in influenza vaccine efficacy (44% vs 28%; OR: 2.62, 95%CI: 1.46-4.69). By 1 year post-birth, MomsTalkShots increased perceived vaccine knowledge (62% vs 50%; OR: 1.74, 95%CI: 1.36-2.24) and trust in vaccine information from obstetricians and pediatricians (64% vs 55%; OR: 1.53, 95%CI: 1.17-2.00). Among those uncertain about vaccinating at baseline, MomsTalkShots increased perceived vaccine knowledge (47% vs 12%; OR: 6.89, 95%CI: 1.52-31.25) and reduced infant vaccine safety concerns (71% vs 91%; OR: 0.24, 95%CI: 0.06-0.98). CONCLUSIONS MomsTalkShots improved pregnant women's and mothers' knowledge and perceptions of maternal and infant vaccines and the diseases they prevent, and offers a scalable tool to address vaccine hesitancy. TRIAL REGISTRATION Registered at Clinicaltrials.gov on 13/09/2016 (registration number: NCT02898688).
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Affiliation(s)
- Matthew Z Dudley
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, 615 N Wolfe St, W5041, Baltimore, MD, 21205, USA.
- Institute for Vaccine Safety, Johns Hopkins University Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA.
| | - Saad B Omer
- Yale Institute for Global Health, Yale School of Medicine, New Haven, USA
- Department of Infectious Diseases, Yale School of Medicine, New Haven, USA
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, USA
- Department of Health Policy and Management, Yale School of Public Health, New Haven, USA
| | - Sean T O'Leary
- Adult and Child Center for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus and Children's Hospital Colorado, 1890 N Revere Ct. Mailstop F443, Aurora, CO, 80045, USA
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, 13123 E 16th Ave, Aurora, CO, 80045, USA
| | - Rupali J Limaye
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, 615 N Wolfe St, W5041, Baltimore, MD, 21205, USA
- Institute for Vaccine Safety, Johns Hopkins University Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA
- International Vaccine Access Center, Johns Hopkins University Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA
- Present address: Merck & Co., Inc., (at Emory University and the University of Nevada - not Merck - when work was performed), NJ, Kenilworth, USA
| | - Mallory K Ellingson
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, USA
| | - Christine I Spina
- Adult and Child Center for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus and Children's Hospital Colorado, 1890 N Revere Ct. Mailstop F443, Aurora, CO, 80045, USA
| | - Sarah E Brewer
- Adult and Child Center for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus and Children's Hospital Colorado, 1890 N Revere Ct. Mailstop F443, Aurora, CO, 80045, USA
- Department of Family Medicine, University of Colorado Anschutz Medical Campus, 13001 E 17th Pl, Aurora, CO, 80045, USA
| | - Robert A Bednarczyk
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, 1518 Clifton Rd. NE, Atlanta, GA, 30322, USA
- Department of Epidemiology, Rollins School of Public Health, Emory University, 1518 Clifton Rd. NE, Atlanta, GA, 30322, USA
- Emory Vaccine Center, Emory University, 201 Dowman Drive, Atlanta, GA, 30322, USA
| | - Allison T Chamberlain
- Department of Epidemiology, Rollins School of Public Health, Emory University, 1518 Clifton Rd. NE, Atlanta, GA, 30322, USA
| | - Fauzia Malik
- Department of Health Policy and Management, Yale School of Public Health, 60 College Street, New Haven, CT, 06520-0834, USA
| | - Paula M Frew
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, 1518 Clifton Rd. NE, Atlanta, GA, 30322, USA
- Division of Infectious Diseases, Department of Medicine, School of Medicine, Emory University, 2015 Uppergate Dr, Atlanta, GA, 30322, USA
- School of Public Health; School of Medicine; Population Health & Health Equity Initiative, Office of Research and Economic Development, University of Nevada, 4505 S. Maryland Pkwy, Las Vegas, NV, 89154, USA
- Present address: Merck & Co., Inc., (at Emory University and the University of Nevada - not Merck - when work was performed), NJ, Kenilworth, USA
| | - Cathy Church-Balin
- Center for Communication Programs, Johns Hopkins University Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA
| | - Laura E Riley
- Department of Obstetrics and Gynecology, Weill Cornell Medicine, 525 East 68th Street, New York, NY, 10065, USA
| | - Kevin A Ault
- Department of Obstetrics and Gynecology, University of Kansas School of Medicine, 3901 Rainbow Boulevard, Kansas City, KS, 66160, USA
| | - Walter A Orenstein
- Emory Vaccine Center, Emory University, 201 Dowman Drive, Atlanta, GA, 30322, USA
- Division of Infectious Diseases, Department of Medicine, School of Medicine, Emory University, 2015 Uppergate Dr, Atlanta, GA, 30322, USA
- Department of Pediatrics, School of Medicine, Emory University, 2015 Uppergate Dr, Atlanta, GA, 30322, USA
| | - Neal A Halsey
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, 615 N Wolfe St, W5041, Baltimore, MD, 21205, USA
- Institute for Vaccine Safety, Johns Hopkins University Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA
| | - Daniel A Salmon
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, 615 N Wolfe St, W5041, Baltimore, MD, 21205, USA
- Institute for Vaccine Safety, Johns Hopkins University Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA
- Department of Health, Behavior and Society, Johns Hopkins University Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA
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Hijazi R, Gesser-Edelsburg A, Feder-Bubis P, Mesch GS. Hesitant and anti-vaccination groups: A qualitative study on their perceptions and attitudes regarding vaccinations and their reluctance to participate in academic research- an example during a measles outbreak among a group of Jewish parents in Israel. Front Public Health 2022; 10:1012822. [PMID: 36438238 PMCID: PMC9682119 DOI: 10.3389/fpubh.2022.1012822] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 10/27/2022] [Indexed: 11/11/2022] Open
Abstract
Background Vaccination is widespread in Western countries and, overall, there is a high vaccination rate. However, immunization is still an enduring challenge. In recent years, the number of parents who choose to delay or refuse vaccines has risen. Objectives (1) to identify the perceptions and attitudes of hesitant and anti-vaccination parents regarding vaccination in general, and vaccinating their children in particular and; (2) to describe the responses of potential participants to the request to participate in academic research regarding their perceptions and attitudes on the subject of vaccines. Methods The research employs the qualitative hermeneutic phenomenological method using two research tools: (1) in-depth interviews with 7 hesitant and 11 anti-vaccination Jewish parents in Israel; and (2) the researchers' field notes from this study process, which describe the responses of 32 potential participants to the request to participate in this academic research. Results The main findings indicate that while most of the interviewees admit to the efficacy of vaccines in preventing diseases, they oppose the way in which vaccines are promoted-based on providing partial information and disregarding parents' concerns and questions. Therefore, they demand transparency about the efficacy and safety of vaccines. The findings also point to a paradoxical finding. On the one hand, these groups claim that health organizations do not understand their position, referring to them as "science-deniers", even though they are not. On the other hand, these parents choose to refrain from participating in scientific studies and voicing their opinions, thereby perpetuating the situation of being misunderstood. Conclusion Hesitant and anti-vaccination groups express mistrust in academic institutions and health organizations. Therefore, an effective dialogue that would include hesitant and anti-vaccination groups, the academy, and health organizations may contribute to a better understanding of the barriers that prevent these groups from getting vaccinated or vaccinating their children and promote public health.
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Affiliation(s)
- Rana Hijazi
- School of Public Health, University of Haifa, Haifa, Israel,*Correspondence: Rana Hijazi
| | - Anat Gesser-Edelsburg
- Head of the Health Promotion Program and Head of the Health and Risk Communication Lab, School of Public Health, University of Haifa, Haifa, Israel
| | - Paula Feder-Bubis
- Department of Health Policy and Management, Faculty of Health Sciences and Guilford Glazer Faculty of Business and Management, Ben-Gurion University of the Negev, Beersheba, Israel
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Li Z, Ji Y, Sun X. The impact of vaccine hesitation on the intentions to get COVID-19 vaccines: The use of the health belief model and the theory of planned behavior model. Front Public Health 2022; 10:882909. [PMID: 36311575 PMCID: PMC9615565 DOI: 10.3389/fpubh.2022.882909] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 09/21/2022] [Indexed: 01/21/2023] Open
Abstract
Object During the later period of the COVID-19 pandemic, the public has been at risk of the evolving COVID-19 variants and hesitated to be vaccinated against COVID-19 to a certain extent. In this context, the health belief model (HBM) and the theory of planned behavior model (TPB) were used to compare and summarize the relationship between vaccine hesitation/non-hesitation and the intentions to get COVID-19 vaccines and its influencing factors. Methods The cross-sectional, population-based online survey was conducted from 14 April to 30 April 2021, and 1757 respondents were recruited to participate in the survey through the Wenjuanxing online survey platform. The HBM and TPB covariate scores were expressed using means and standard deviations and compared between groups using t-tests. Backward multiple linear regression models were used to explore the factors influencing the public's intentions to receive the COVID-19 vaccines. Results This study found that educational background is one of the factors influencing vaccine hesitation. Most people with high education do not hesitate (65.24%), while a more significant proportion of people with low education have vaccine hesitation (66.00%). According to HBM, for the vaccine hesitation group, self-efficacy, family advice, and doctor's advice were the most critical factors affecting the public's future vaccination intentions; for the vaccine non-hesitation group, self-efficacy, doctor's advice, and perceived benefits are the most important influencing factors. According to the TPB, the subjective norm is the most critical factor affecting the future vaccination intention of the vaccine hesitation group, and the attitude toward behavior is the most critical factor affecting the future vaccination intention of the vaccine non-hesitation group. Conclusions In the context of COVID-19, the public's hesitation on the "current" vaccines will still affect future vaccination intentions. Using HBM and TPB would help health policymakers and healthcare providers formulate intervention plans.
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22
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COVID-19 vaccination acceptance and trust among adults in Makkah, Saudi Arabia: a cross-sectional study. J Egypt Public Health Assoc 2022; 97:17. [PMID: 36156163 PMCID: PMC9510074 DOI: 10.1186/s42506-022-00116-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 09/09/2022] [Indexed: 11/17/2022]
Abstract
Background Public acceptance, trust, and actual uptake of COVID-19 vaccines are crucial to stem the pandemic. Although roll out of vaccines was high in KSA, the public response was not sufficiently studied. We aimed to investigate knowledge level, acceptance, and trust in COVID-19 vaccination and related predictors among adults in Makkah, KSA. Methods A web-based cross-sectional survey using a snowballing sample was carried on 507 adult Saudi population living in Makkah city. The survey was developed based on literature search. In the logistic analysis, the dependent variables included acceptance rate and trust in effectiveness and safety of COVID-19 vaccines, while the independent variables (predictors) were sociodemographics and level of knowledge. Results The survey included 507 participants, aged 18–78 years, 55.8% were females, and 36.7% had (or one of their family members) previously been exposed to COVID-19 infection. Their knowledge about COVID-19 vaccination was satisfactory (86.2%) with 71.2% intended to receive COVID-19 vaccination, and 56.4% was confident of the vaccine effectiveness. Vaccine efficacy, duration of protection, schedule of vaccination, and recommendation by authorities may favor their decision to accept or decline COVID-19 vaccines. Good knowledge about vaccines (OR = 2.07; CI: 1.24–3.48 for acceptance and OR = 2.67; CI: 1.58–4.51 for trust), higher educational level (OR = 1.80; CI: 1.07–3.40 for acceptance and OR = 3.59; CI: 2.08–6.21 for trust), previous seasonal flu vaccination (OR = 1.66; CI: 1.09–2.53 for acceptance and OR = 1.91; CI: 1.31–2.79 for trust), female sex (OR = 1.62; CI: 1.1–2.39 for acceptance and OR = 4.15; CI: 2.86–6.04 for trust), and history of COVID-19 infection (OR = 1.57; CI: 1.04–2.37 for acceptance and OR = 1.69; CI: 1.17–2.46 for trust) were among significant predictors for both vaccine acceptance and trust in vaccine effectiveness. Conclusions Adult Saudi population in Makkah city showed satisfactory knowledge about COVID-19 vaccination with moderate rate of vaccine acceptance and a relatively low rate of confidence in vaccine effectiveness. Better understanding of public acceptance and trust in COVID-19 vaccines and addressing barriers to vaccination are recommended to improve vaccine coverage and to reinforce some communication characteristics of the current vaccination campaign.
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Nguyen KH, Srivastav A, Vaish A, Singleton JA. Population Attributable Fraction of Nonvaccination of Child and Adolescent Vaccines Attributed to Parental Vaccine Hesitancy, 2018-2019. Am J Epidemiol 2022; 191:1626-1635. [PMID: 35292806 PMCID: PMC9444805 DOI: 10.1093/aje/kwac049] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 02/17/2022] [Accepted: 03/07/2022] [Indexed: 01/29/2023] Open
Abstract
Understanding the role of vaccine hesitancy in undervaccination or nonvaccination of childhood vaccines is important for increasing vaccine confidence and uptake. We used data from April to June interviews in the 2018 and 2019 National Immunization Survey-Flu (n = 78,725, United States), a nationally representative cross-sectional household cellular telephone survey. We determined the adjusted population attributable fraction (PAF) for each recommended childhood vaccine to assess the contribution of vaccine hesitancy to the observed nonvaccination level. Hesitancy is defined as being somewhat or very hesitant toward childhood vaccines. Furthermore, we assessed the PAF of nonvaccination for influenza according to sociodemographic characteristics, Department of Health and Human Services region, and state. The proportion of nonvaccination attributed to parental vaccine hesitancy was lowest for hepatitis B birth dose vaccine (6.5%) and highest for ≥3-dose diphtheria and tetanus toxoids and acellular pertussis vaccine (31.3%). The PAF of influenza nonvaccination was highest for non-Hispanic Black populations (15.4%), households with high educational (17.7%) and income (16.5%) levels, and urban areas (16.1%). Among states, PAF ranged from 25.4% (New Hampshire) to 7.5% (Louisiana). Implementing strategies to increase vaccination confidence and uptake are important, particularly during the coronavirus disease 2019 pandemic.
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Affiliation(s)
- Kimberly H. Nguyen
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | | | | | - James A. Singleton
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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24
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Hou Z, Guo J, Lai X, Zhang H, Wang J, Hu S, Du F, Francis MR, Fang H. Influenza vaccination hesitancy and its determinants among elderly in China: A national cross-sectional study. Vaccine 2022; 40:4806-4815. [PMID: 35788295 DOI: 10.1016/j.vaccine.2022.06.063] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 06/10/2022] [Accepted: 06/15/2022] [Indexed: 10/17/2022]
Abstract
BACKGROUND The Chinese elderly face a significant threat from seasonal influenza, owing to the consistently low vaccination coverage. This study investigated the prevalence and determinants of influenza vaccination hesitancy among the Chinese elderly. METHODS In 2019, 3849 elderly individuals from 10 provinces in China were recruited in a cross-sectional survey. Multinomial logistic regression was applied to investigate the determinants of influenza vaccination hesitancy. RESULTS Among the elderly respondents, 37.18% expressed some degree of hesitancy towards influenza vaccination: 19.28% were hesitant, and 17.90% refused influenza vaccination, including 19.28% acceptors with doubts and 17.90% refusers. Only 39.10% of the respondents considered themselves as the priority group for influenza vaccination, and 13.93% reported receiving a recommendation for vaccination from healthcare workers. Respondents with higher education levels and from urban areas had significantly higher odds of vaccine hesitancy than their counterparts. Confidence in the safety of vaccines was negatively associated with vaccine hesitancy, but confidence in vaccine efficacy had no such association. Respondents who perceived themselves as highly susceptible to influenza (AOR = 0.85; 95 %CI = 0.77-0.93) and those aware of the elderly as a priority group for influenza vaccination (AOR = 0.51; 95 %CI = 0.41-0.64) had a significantly lower odds of being refusers. CONCLUSION This study found a high prevalence of hesitancy towards influenza vaccination among the Chinese elderly, especially well-educated and urban-dwelling respondents. The government should address vaccine hesitancy through culturally appropriate communication, subsidies for vaccination, and actively promoting vaccines through primary care professionals.
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Affiliation(s)
- Zhiyuan Hou
- School of Public Health, NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China.
| | - Jia Guo
- School of Public Health, Peking University, Beijing 100083, China; China Center for Health Development Studies, Peking University, Beijing 100083, China.
| | - Xiaozhen Lai
- School of Public Health, Peking University, Beijing 100083, China; China Center for Health Development Studies, Peking University, Beijing 100083, China.
| | - Haijun Zhang
- School of Public Health, Peking University, Beijing 100083, China; China Center for Health Development Studies, Peking University, Beijing 100083, China.
| | - Jiahao Wang
- School of Public Health, Peking University, Beijing 100083, China; China Center for Health Development Studies, Peking University, Beijing 100083, China.
| | - Simeng Hu
- School of Public Health, NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China.
| | - Fanxing Du
- School of Public Health, NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China.
| | - Mark R Francis
- Health Sciences Unit, Faculty of Social Sciences, Tampere University, Finland.
| | - Hai Fang
- China Center for Health Development Studies, Peking University, Beijing 100083, China; Peking University Health Science Center-Chinese Center for Disease Control and Prevention Joint Center for Vaccine Economics, Beijing 100083, China; Key Laboratory of Reproductive Health National Health Commission of the People's Republic of China, Beijing 100083, China.
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25
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Al-Naggar RA, Alshaikhli H, Al-Rashidi RR, Murtagh S. COVID-19 vaccine hesitancy in Sana'a, Yemen. INTERNATIONAL JOURNAL OF ONE HEALTH 2022. [DOI: 10.14202/ijoh.2022.58-69] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background and Aim: The development of a coronavirus disease 2019 (COVID-19) vaccine is ongoing. This study aimed to prepare for public acceptance of the vaccine. There is a need to identify the current acceptance and potential barriers to receiving a COVID-19 vaccine in Yemen. Understanding the hesitancy and acceptance of a COVID-19 vaccine are crucial to develop local evidence-based interventions.
Materials and Methods: Twenty students were interviewed in this study. An interview guide was developed and it addressed the willingness to accept a future COVID-19 vaccine. In-depth interviews were conducted, transcribed, and manually analyzed.
Results: The majority of participants agreed that they would take a COVID-19 vaccine for several reasons, including protection for themselves, their families, and others and to stop the spread of COVID-19, for which the vaccine is important, as in other routine vaccinations. However, some participants shared that they would not take the COVID-19 vaccine due to the following reasons: Concerns regarding the safety of the vaccine; feeling fit and healthy, and thus considering themselves to have strong immunity; feeling that the vaccine was manufactured in a rushed manner and thus it would require approval by the World Health Organization; being previously infected with COVID-19 and considering themselves protected, and placing their trust in God and believing no vaccine was needed.
Conclusion: The willingness to receive a future COVID-19 vaccine was high among medical students. However, some students hesitated to take the vaccine. Therefore, mass media interventions are required to maximize vaccine uptake.
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Affiliation(s)
| | - Hisham Alshaikhli
- Department of Anatomy and Physiology, School of Public Health and Interdisciplinary Studies, Faculty of Health and Environmental Sciences, Auckland University of Technology, New Zealand
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Hijazi R, Gesser-Edelsburg A, Feder-Bubis P, Mesch GS. Pro-vaccination Groups Expressing Hesitant Attitudes: A Cross-Sectional Study About the Difference Between Attitudes and Actual Behavior in Israel. Front Public Health 2022; 10:871015. [PMID: 35570981 PMCID: PMC9092369 DOI: 10.3389/fpubh.2022.871015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 04/04/2022] [Indexed: 11/21/2022] Open
Abstract
Background Vaccines have contributed to the decline in mortality, morbidity, and even the eradication of various infectious diseases. Over time, the availability of information to the public and the request for public involvement in the health decision-making process have risen, and the confidence in vaccines has dropped. An increasing number of parents and individuals are choosing to delay or refuse vaccines. Objectives (1) Identifying hesitant attitudes among pro-vaccination parents; (2) testing the difference between the rate of hesitant attitudes and the rate of hesitancy in practice among pro-vaccination parents; and (3) examining the association of sociodemographic characteristics (gender, age, marital status education and religious affiliation) with the difference between hesitant attitudes and hesitancy in practice among pro-vaccination parents. Methods Descriptive cross-sectional survey using an online survey that measured vaccine hesitancy among pro-vaccination parents (n = 558) whose children were in kindergarten (3–5 years), according to a variety of sociodemographic characteristics. Results A significant difference was found between the rate of hesitant attitudes and the rate of hesitation in actual vaccination among pro-vaccination and hesitant parents, where despite that 26% of the parents had hesitant attitudes, only 19% hesitated in practice [P = 0.0003]. There was also a significant difference between the rate of hesitant attitudes and the rate of hesitancy in practice among women [P = 0.0056] and men [P = 0.0158], parents between 30 and 39 years of age [P = 0.0008], traditional parents [P = 0.0093], Non-academic parents [P = 0.0007] and parents with BA degree [P = 0.0474]. Conclusion Pro-vaccination individuals may have hesitant attitudes regarding vaccines. Therefore, it is very important for health authorities to address the public's fears and concerns, including those who are classified as pro-vaccination.
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Affiliation(s)
- Rana Hijazi
- School of Public Health, University of Haifa, Mount Carmel, Haifa, Israel
| | - Anat Gesser-Edelsburg
- Head of the Health Promotion Program and Head of the Health and Risk Communication Lab, School of Public Health, University of Haifa, Mount Carmel, Haifa, Israel
| | - Paula Feder-Bubis
- Department of Health Policy and Management, Faculty of Health Sciences and Guilford Glazer Faculty of Business and Management, Ben-Gurion University of the Negev, Be'er Sheva, Israel
| | - Gustavo S Mesch
- Department of Sociology, University of Haifa, Mount Carmel, Haifa, Israel
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Bankiewicz P, Dworakowska AM, Makarewicz-Wujec M, Kozłowska-Wojciechowska M. Beliefs and sentiments of parents vaccinating their children - small town perspective in Poland: a preliminary study. Cent Eur J Public Health 2022; 30:7-12. [PMID: 35421292 DOI: 10.21101/cejph.a5599] [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: 09/18/2018] [Accepted: 12/03/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Since 2009 the number of unvaccinated children in Poland has been regularly increasing. The purpose of the study was to learn what parents who decide to vaccinate their children feel and believe about their children's vaccines and in particular to find out how these sentiments and beliefs affect their attitude and decision-making with reference to vaccinations. METHODS The interviews were conducted during an immunization visit of parents whose children are covered by immunization schedule; 53 parents aged 23 to 48 years took part in the study. Most study participants were high school or university graduates living in rural areas. Children were 1 week to 5 years old. Thematic analysis was used to analyse interview data. RESULTS Identified factors shaping the parents' positive attitude to vaccination included conviction of necessity of vaccines (effective disease prevention, safety, favourable benefit-to-risk ratio, and concerns about the child). The general anti-vaccination belief was that vaccines are unnecessary. External factors, mainly authority figures and media broadcasts, affect parents' beliefs and decisions. CONCLUSIONS Various factors affect parents' decision concerning immunization of their children. Both compulsory and recommended vaccines should be provided free-of-charge. Choice overload should be reduced. Paediatricians should address parental vaccine hesitancy.
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Affiliation(s)
- Paulina Bankiewicz
- Department of Clinical Pharmacy and Pharmaceutical Care, Medical University of Warsaw, Warsaw, Poland
| | - Anna Maria Dworakowska
- Department of Clinical Pharmacy and Pharmaceutical Care, Medical University of Warsaw, Warsaw, Poland
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Vaccine Hesitancy in Saudi Arabia: A Cross-Sectional Study. Trop Med Infect Dis 2022; 7:tropicalmed7040060. [PMID: 35448835 PMCID: PMC9025486 DOI: 10.3390/tropicalmed7040060] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 03/27/2022] [Accepted: 04/07/2022] [Indexed: 02/01/2023] Open
Abstract
(1) Background: vaccine hesitancy can put the public’s health at risk from vaccine-preventable diseases. This study aimed to address vaccine hesitancy in Saudi Arabia and understand the problem’s magnitude and causes. (2) Methods: this was a descriptive observational study using quantitative and qualitative evaluation methods conducted in Saudi Arabia between December 2020 and February 2021. Public survey forms, exit interviews, and healthcare professional survey forms were used. (3) Results: our study involved 2030 public survey participants, 119 exit interviews of caregivers, and 500 healthcare professionals, demonstrating that vaccine hesitancy was relatively low. Ninety percent of the participants agreed that it was essential for everyone to receive the recommended vaccines with their children (p < 0.001), 92% believed that vaccines are safe for their children (p < 0.001), 91% of the participants agreed to give their new children all the recommended doses (p < 0.001), 86% welcomed mass/school vaccination campaigns (p < 0.001), and 81% were willing to pay for additional vaccines for themselves and their children (p < 0.001). (4) Conclusions: vaccine hesitancy is low in Saudi Arabia, and a positive attitude toward vaccination was detected among most of the participants. Vaccination decision-making is complex and includes emotional, cultural, social, spiritual, and political aspects.
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29
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Nguyen KH, Srivastav A, Lindley MC, Fisher A, Kim D, Greby SM, Lee J, Singleton JA. Parental Vaccine Hesitancy and Association With Childhood Diphtheria, Tetanus Toxoid, and Acellular Pertussis; Measles, Mumps, and Rubella; Rotavirus; and Combined 7-Series Vaccination. Am J Prev Med 2022; 62:367-376. [PMID: 35190101 PMCID: PMC8867922 DOI: 10.1016/j.amepre.2021.08.015] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 08/10/2021] [Accepted: 08/12/2021] [Indexed: 11/01/2022]
Abstract
INTRODUCTION Parental vaccine hesitancy can be a barrier to routine childhood immunization and contribute to greater risk for vaccine-preventable diseases. This study examines the impact of parental vaccine hesitancy on childhood vaccination rates. METHODS This study assessed the association of parental vaccine hesitancy on child vaccination coverage with ≥4 doses of diphtheria, tetanus toxoid, and acellular pertussis vaccine; ≥1 dose of measles, mumps, and rubella vaccine; up-to-date rotavirus vaccine; and combined 7-vaccine series coverage for a sample of children aged 19-35 months using data from the 2018 and 2019 National Immunization Survey-Child (N=7,645). Adjusted differences in multivariable analyses of vaccination coverage were estimated among vaccine hesitant and nonhesitant parents and population attributable risk fraction of hesitancy on undervaccination, defined as not being up to date for each vaccine. RESULTS Almost a quarter of parents reported being vaccine hesitant, with the highest proportion of vaccine hesitancy among parents of children who are non-Hispanic Black (37.0%) or Hispanic (30.1%), mothers with a high school education or less (31.9%), and households living below the poverty level (35.6%). Childhood vaccination coverage for all vaccines was lower for children of hesitant than nonhesitant parents, and the population attributable fraction of hesitancy on undervaccination ranged from 15% to 25%, with the highest percentage for ≥1 dose of measles, mumps, and rubella vaccine. CONCLUSIONS Parental vaccine hesitancy may contribute up to 25% of undervaccination among children aged 19-35 months. Implementation of strategies to address parental vaccine hesitancy is needed to improve vaccination coverage for children and minimize their risk of vaccine-preventable diseases.
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Affiliation(s)
- Kimberly H Nguyen
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia.
| | | | - Megan C Lindley
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Allison Fisher
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - David Kim
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Stacie M Greby
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - James Lee
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - James A Singleton
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
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30
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Ebi SJ, Deml MJ, Jafflin K, Buhl A, Engel R, Picker J, Häusler J, Wingeier B, Krüerke D, Huber BM, Merten S, Tarr PE. Parents' vaccination information seeking, satisfaction with and trust in medical providers in Switzerland: a mixed-methods study. BMJ Open 2022; 12:e053267. [PMID: 35228281 PMCID: PMC8886431 DOI: 10.1136/bmjopen-2021-053267] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES The aim of this study was to better understand parental trust in and satisfaction with information sources and medical providers regarding decision making about childhood vaccines. SETTING The study was part of a Swiss national research programme investigating vaccine hesitancy and underimmunisation. PARTICIPANTS We conducted qualitative interviews with 37 providers and 30 parents, observed 34 vaccination consultations, and then conducted quantitative surveys with 130 providers (both complementary and alternative medicine (CAM) oriented and biomedically oriented) and 1390 parents. MAIN OUTCOME MEASURES Participants' vaccination information sources used in their decision-making process, parents' trust in and satisfaction with these sources and providers. RESULTS Based on the Parent Attitudes about Childhood Vaccines scale, we considered 501 parents as vaccine-hesitant (VH) and 889 parents as non-VH. Whereas both groups mentioned providers as the most trusted source of information, VH-parents were less likely to mention paediatricians (N=358 (71%) vs N=755 (85%)) and public health authorities (N=101 (20%) vs N=333 (37%)) than non-VH-parents. VH-parents were more likely to have consulted another provider (N=196 (39%) vs N=173 (19%)) than non-VH-parents, to express less satisfaction with both their primary (N=342 (82%) vs N=586 (91%)) and other providers (N=82 (42%) vs N=142 (82%)) and less trust in their primary (N=368 (88%) vs N=632 (98%)) and other providers (N=108 (55%) vs N=146 (84%)). VH-parents were less likely to be satisfied with their biomedical primary provider than non-VH-parents (100 (69%) vs 467 (91%)). However, when the primary provider was CAM-oriented, there were similar levels of satisfaction among both groups (237 (89%) VH-parents vs 118 (89%) non-VH-parents). All differences were significant (p<0.05). CONCLUSIONS While the provider remains the main information source, VH parents turn to additional sources and providers, which is likely related to VH parents being rather dissatisfied with and distrusting in obtained information and their provider. ETHICS The local ethics committee (Ethikkommission Nordwest- und Zentralschweiz, EKNZ; project ID number 2017-00725) approved the study.
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Affiliation(s)
- Selina Jana Ebi
- Medizinische Universitätsklinik Kantonsspital Baselland, Bruderholz, Switzerland
- University of Basel, Basel, Switzerland
| | - Michael J Deml
- Department of Sociology, Institute of Sociological Research, University of Geneva, Geneva, Switzerland
- Division of Social and Behavioural Sciences, University of Cape Town School of Public Health and Family Medicine, Observatory, Western Cape, South Africa
| | - Kristen Jafflin
- University of Basel, Basel, Switzerland
- Swiss Tropical and Public Health Institute, Basel, Switzerland
| | - Andrea Buhl
- University of Basel, Basel, Switzerland
- Swiss Tropical and Public Health Institute, Basel, Switzerland
| | - Rebecca Engel
- Medizinische Universitätsklinik Kantonsspital Baselland, Bruderholz, Switzerland
- University of Basel, Basel, Switzerland
| | - Julia Picker
- Medizinische Universitätsklinik Kantonsspital Baselland, Bruderholz, Switzerland
- University of Basel, Basel, Switzerland
| | - Julia Häusler
- Medizinische Universitätsklinik Kantonsspital Baselland, Bruderholz, Switzerland
- University of Basel, Basel, Switzerland
| | | | | | - Benedikt M Huber
- Department of Pediatrics, HFR Fribourg Cantonal Hospital, Fribourg, Switzerland
| | - Sonja Merten
- University of Basel, Basel, Switzerland
- Swiss Tropical and Public Health Institute, Basel, Switzerland
| | - Philip E Tarr
- Medizinische Universitätsklinik Kantonsspital Baselland, Bruderholz, Switzerland
- University of Basel, Basel, Switzerland
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Tandy CB, Odoi A. Geographic disparities and predictors of vaccination exemptions in Florida: a retrospective study. PeerJ 2022; 10:e12973. [PMID: 35223209 PMCID: PMC8877400 DOI: 10.7717/peerj.12973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 01/31/2022] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND In the United States, state-level policies requiring vaccination of school-going children constitute a critical strategy for improving vaccination coverage. However, policies allowing vaccination exemptions have also been implemented and contribute to reductions in vaccination coverage and potential increases in the burden of vaccine-preventable diseases. Understanding the geographic disparities in the distribution of vaccination exemptions and identifying high risk areas is necessary for guiding resource allocation and public health control strategies. This study investigated geographic disparities in vaccination exemptions as well as socioeconomic and demographic predictors of vaccination exemptions in Florida. METHODS Vaccination exemption data were obtained from the Florida Department of Health's Florida HealthCHARTS web interface. Spatial patterns in geographic distribution of total and non-medical vaccination exemptions were assessed using county-level choropleth maps. Negative binomial models were used to identify significant predictors of county-level risks of both total and non-medical vaccination exemptions. RESULTS Total exemptions varied from 0 to 30.2 per 10,000 people. Nine counties had exemption risks in the top two classes (10.4-15.9 and 15.9-30.2 exemptions per 10,000 people). These counties were distributed in five distinct areas: Western Panhandle, central northern area, central, South-eastern coastal area, and the southern coastal border of the state. Non-medical exemptions varied from 0 to 10.4 per 10,000 people. Fifteen counties had exemption risks in the top two classes (3.7-5.6 and 5.6-10.4 exemptions per 10,000 people), and were located in six distinct areas: Western and Central Panhandle, Northeastern, Central-eastern coastal area, Central-western coastal area, and the South-western coastal border of the state. Predictors of high risk of total vaccination exemptions were high density of primary care providers (p < 0.001), high median income (p = 0.001), high percentage of Hispanic population (p = 0.046), and low percentage of population with a college education (p = 0.013). A predictor of high risk of non-medical vaccination exemptions was high percentage of White population (p = 0.045). However, predictors of low risks of non-medical exemptions were high percentages of population: living in rural areas (p = 0.023), with college education (p = 0.013), with high school education (p = 0.009), and with less than high school education (p < 0.001). CONCLUSIONS There is evidence of county-level geographic disparities in both total and non-medical vaccination exemption risks in Florida. These disparities are explained by differences in county-level socioeconomic and demographic factors. Study findings are important in guiding resource allocation for health planning aimed at improving vaccination rates and reducing incidence of vaccine-preventable diseases.
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Motivations for Vaccine Hesitancy Among EMS Providers in the United States who Declined the COVID-19 Vaccine. Prehosp Disaster Med 2022; 37:269-272. [PMID: 35168692 PMCID: PMC8886084 DOI: 10.1017/s1049023x22000309] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Background: Hesitancy towards the coronavirus disease 2019 (COVID-19) vaccine has been a topic of considerable concern in recent months. Studies have reported hesitancy within the general population and specific facets of the health care system. Little evidence has been published about vaccine hesitancy among Emergency Medical Services (EMS) providers despite them having played a frontline role throughout the pandemic. Methods: A 27-question survey examining vaccination decisions and potential influencing factors among EMS providers was created and disseminated. Responses from providers who declined a COVID-19 vaccine were compared with responses from providers who did not decline a COVID-19 vaccine. Results: Across 166 respondents, 16% reported declining a COVID-19 vaccine. Providers who self-identified as men, providers who reported conservative or conservative-leaning beliefs, and providers surrounded by environments where the vaccine was discussed negatively or not encouraged are significantly more likely to decline a vaccine (P <.01). Providers who have declined a vaccine reported significantly greater levels of concern about its safety, effectiveness, and development (P <.01). Conclusion: This study answers key questions about why some EMS providers might be declining COVID-19 vaccinations. Initiatives to improve vaccination among EMS providers should focus on the areas highlighted, and further studies should continue to examine vaccine hesitancy among EMS providers as well as in other populations.
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Rughiniş C, Flaherty MG. The Social Bifurcation of Reality: Symmetrical Construction of Knowledge in Science-Trusting and Science-Distrusting Discourses. FRONTIERS IN SOCIOLOGY 2022; 7:782851. [PMID: 35224088 PMCID: PMC8864180 DOI: 10.3389/fsoc.2022.782851] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 01/11/2022] [Indexed: 06/14/2023]
Abstract
This article proposes a conceptual framework to study the social bifurcation of reality in polarized science-trusting and science-distrusting lay worldviews, by analyzing and integrating five concepts: science work, number work, emotion work, time work, and boundary work. Despite the epistemological asymmetry between accounts relying on mainstream science and science-distrusting or denialist ones, there are symmetrical social processes contributing to the construction of lay discourses. Through conceptual analysis, we synthesize an alternative to the deficit model of contrarian discourses, replacing the model of social actors as "defective scientists" with a focus on their culturally competent agency. The proposed framework is useful for observing the parallel construction of polarized realities in interaction and their ongoing articulation through hinge objects, such as vaccines, seatbelts, guns, or sanitary masks in the Covid-19 context. We illustrate the framework through a comparative approach, presenting arguments and memes from contemporary online media in two controversies: namely, vaccine-trusting versus vaccine-distrusting views and Covid-convinced versus Covid-suspicious discourses.
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Affiliation(s)
- Cosima Rughiniş
- Faculty of Sociology and Social Work, University of Bucharest, Bucharest, Romania
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Pothisa T, Ong-Artborirak P, Seangpraw K, Tonchoy P, Kantow S, Auttama N, Boonyathee S, Choowanthanapakorn M, Bootsikeaw S, Panta P, Dokpuang D. Knowledge of COVID-19 and Its Relationship with Preventive Behaviors and Vaccination among Adults in Northern Thailand's Community. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:1521. [PMID: 35162542 PMCID: PMC8834673 DOI: 10.3390/ijerph19031521] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 01/26/2022] [Accepted: 01/26/2022] [Indexed: 02/01/2023]
Abstract
(1) Background: the 2019 coronavirus disease outbreak (COVID-19) has posed a major threat to public health and had a significant impact on all areas of people's lives. Vaccines against COVID-19 have been developed to control the disease, and an array of personal hygiene measures has been introduced. As a result, information that will support and promote vaccination among populations as well as other health measures against COVID-19 are urgently needed. The goal of this research was to look into the knowledge about COVID-19 and how it relates to preventive behaviors and vaccination among people living in rural areas of northern Thailand. (2) Methods: a cross-sectional study was performed in four upper northern provinces of Thailand. A total of 1524 participants were recruited using the probability sampling technique. Questionnaires were distributed to collect data on general health information, as well as knowledge and preventive behaviors regarding COVID-19. (3) Results: more than half (55.9%) of the participants were female and had not received the COVID-19 vaccine (67.2%). Their mean age was 44.13 years. The majority had moderate COVID-19 knowledge and engaged in preventive behaviors (65.5% and 42.0%, respectively). A linear regression model showed that the COVID-19 knowledge score was related to the COVID-19 preventive behaviors score, with a standardized coefficient of 0.510, after adjusting for age, underlying disease, and body mass index (B = 2.64; 95%CI = 2.42, 2.87). Binary logistic regression revealed that after controlling for age, education, occupation, financial status, and current disease (AOR = 1.87; 95%CI = 1.64-2.13), the score of COVID-19 knowledge was significantly associated with having the COVID-19 vaccine. (4) Discussion: knowledge of COVID-19 is very important for people in rural regions to engage in COVID-19 prevention behaviors and vaccination. Relevant government agencies and health network partners should support proactive education campaigns emphasizing the risk of contracting the disease and its severity in order to promote vaccination against COVID-19 among unvaccinated groups. These campaigns can highlight COVID-19's positive benefit-risk balance in the short and long term and ensure public safety measures against COVID-19.
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Affiliation(s)
- Tharadon Pothisa
- School of Medicine, University of Phayao, Phayao 56000, Thailand; (T.P.); (S.B.)
| | | | - Katekaew Seangpraw
- School of Public Health, University of Phayao, Phayao 56000, Thailand; (P.T.); (S.K.); (N.A.); (M.C.); (S.B.)
| | - Prakasit Tonchoy
- School of Public Health, University of Phayao, Phayao 56000, Thailand; (P.T.); (S.K.); (N.A.); (M.C.); (S.B.)
| | - Supakan Kantow
- School of Public Health, University of Phayao, Phayao 56000, Thailand; (P.T.); (S.K.); (N.A.); (M.C.); (S.B.)
| | - Nisarat Auttama
- School of Public Health, University of Phayao, Phayao 56000, Thailand; (P.T.); (S.K.); (N.A.); (M.C.); (S.B.)
| | - Sorawit Boonyathee
- School of Medicine, University of Phayao, Phayao 56000, Thailand; (T.P.); (S.B.)
| | | | - Sasivimol Bootsikeaw
- School of Public Health, University of Phayao, Phayao 56000, Thailand; (P.T.); (S.K.); (N.A.); (M.C.); (S.B.)
| | - Pitakpong Panta
- School of Nursing, University of Phayao, Phayao 56000, Thailand;
| | - Dech Dokpuang
- School of Allied Health Sciences, University of Phayao, Phayao 56000, Thailand;
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Daniel CL, Williams J, Legg R, McGowen C, Stutzman J. Factors associated with COVID-19 vaccination intentions among adults in the deep South. Vaccine 2022; 40:841-853. [PMID: 35034834 PMCID: PMC8744449 DOI: 10.1016/j.vaccine.2021.12.059] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 12/14/2021] [Accepted: 12/26/2021] [Indexed: 11/30/2022]
Abstract
The recent approval of several COVID-19 vaccines signals progress toward controlling the pandemic. Although social distancing and masking have been effective, vaccines are an important additional measure of protection to reduce COVID-19 spread. Adequate uptake is essential to reach herd immunity, estimated to be approximately 67%. However, vaccine hesitancy, the fast-tracked nature of the COVID-19 vaccines, and misinformation circulating through various forms of media have contributed to lower vaccination intention than desired. The current research study developed an online survey conducted via Facebook to explore the attitudes and perceptions of adult Alabama residents about COVID-19 and the COVID-19 vaccines. Of the 3,781 respondents, only 44.3% reported intent to receive a vaccine, with a large proportion reporting they were unsure (28.1%). Lack of intention to vaccinate was associated with low educational attainment, low COVID-19 knowledge levels, low income, and African American race. The current survey also explored participants’ influenza vaccine behavior as this information can also be used to inform successful COVID-19 vaccine distribution. Of the respondents, 56% report receiving the yearly influenza vaccine and the majority receive it at a pharmacy or healthcare provider office. This informs likely successful locations for COVID-19 vaccine distribution. Appropriate education targeted to populations most likely to refuse COVID-19 vaccination is essential to promote uptake. The information collected from the current study should be utilized to inform effective and efficient vaccine distribution strategies.
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Affiliation(s)
- Casey L Daniel
- University of South Alabama College of Medicine, Mobile, AL 36604, United States; University of South Alabama Mitchell Cancer Institute, Mobile, AL 36604, United States.
| | - Jacob Williams
- University of South Alabama College of Medicine, Mobile, AL 36604, United States
| | - Rachel Legg
- University of South Alabama College of Medicine, Mobile, AL 36604, United States
| | - Chelsea McGowen
- University of South Alabama Mitchell Cancer Institute, Mobile, AL 36604, United States
| | - Jesse Stutzman
- University of South Alabama College of Medicine, Mobile, AL 36604, United States
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Jahanshahi-Amjazi R, Rezaeian M, Abdolkarimi M, Nasirzadeh M. Predictors of the intention to receive the COVID 19 vaccine by Iranians 18-70 year old: Application of health belief model. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2022; 11:175. [PMID: 35847130 PMCID: PMC9277725 DOI: 10.4103/jehp.jehp_647_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Accepted: 09/01/2021] [Indexed: 05/14/2023]
Abstract
BACKGROUND In terms of public health, vaccination is considered as the most effective approach against the infectious diseases. Accepting and receiving the first vaccine produced as an innovation may not be easy. Therefore, the present study was conducted to investigate the predictors of intention to receive COVID-19 vaccine by Iranians aged 18-70 years based on the health belief model in 2021. MATERIALS AND METHODS This descriptive study was performed on 2365 people aged 18-70-year old in Iran by random cluster sampling. Receipt of data was done electronically questionnaire through the Porcelain system. Data were analyzed using SPSS software version 20 using Chi-square, one-way analysis of variance, independent t-test, and multiple regression analysis at a significance level of 0.05. RESULTS The mean score of receiving the Iranian corona vaccine was 3.06 ± 1.30 out of 5 points. About 16.7% reported that they will definitely choose the Iranian vaccine. The highest correlation was between the intention to receive the vaccine with self-efficacy (r = 0.239, P < 0.001) and barriers to receiving the vaccine (r = -0.237, P < 0.001). Self-efficacy (β = 0.114, P < 0.001), perceived barriers (β = -0.126, P < 0.001), and benefits of vaccine (β = 0.061, P = 0.022) were most important predictors the intention to receive the vaccine. CONCLUSION Approximately 38% reported that they would definitely and probably not choose the Iranian corona vaccine. Therefore, it is suggested that more information should be provided about the features and benefits of domestically produced vaccines compared to foreign products.
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Affiliation(s)
- Roya Jahanshahi-Amjazi
- Department of Health Education and Health Promotion, School of Health, Student Research Committee, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Mohsen Rezaeian
- Department of Epidemiology and Biostatistics, School of Medicine, Occupational Environment Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Mehdi Abdolkarimi
- Department of Health Education and Health Promotion, School of Health, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Mostafa Nasirzadeh
- Department of Health Education and Health Promotion, School of Health, Occupational Environment Research Centre, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
- Address for correspondence: Dr. Mostafa Nasirzadeh, Department of Health Education and Health Promotion, School of Health, Occupational Environment Research Centre, Rafsanjan University of Medical Sciences, Rafsanjan, Iran. E-mail:
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Considering a COVID-19 vaccine mandate for pediatric kidney transplant candidates. Pediatr Nephrol 2022; 37:2559-2569. [PMID: 35333972 PMCID: PMC8949834 DOI: 10.1007/s00467-022-05511-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 02/10/2022] [Accepted: 02/11/2022] [Indexed: 12/02/2022]
Abstract
The world continues to face the effects of the SARS-CoV-2 pandemic. COVID-19 vaccines are safe and effective in protecting recipients, decreasing the risk of COVID-19 acquisition, transmission, hospitalization, and death. Transplant recipients may be at greater risk for severe SARS-CoV-2 infection. As a result, transplant programs have begun instituting mandates for COVID-19 vaccine for transplant candidacy. While the question of mandating COVID-19 vaccine for adult transplant candidates has garnered attention in the lay and academic press, these discussions have not explicitly addressed children who may be otherwise eligible for kidney transplants. In this paper we seek to examine the potential ethical justifications of a COVID-19 vaccine mandate for pediatric kidney transplant candidacy through an examination of relevant ethical principles, analogous cases of the use of mandates, differences between adult and pediatric kidney transplant candidates, and the role of gatekeeping in transplant vaccine mandates. At present, it does not appear that pediatric kidney transplant centers are justified to institute a COVID-19 vaccine mandate for candidates. Finally, we will offer suggestions to be considered prior to the implementation of a COVID-19 vaccine mandate.
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Saeed R, Hashmi I. Pakistan Ranks Third Globally With the Most Unvaccinated Children: Is the Impact of Parental Perception and Attitude on Immunization an Essential Contributing Factor to an Unsuccessful Vaccination Coverage? Cureus 2021; 13:e19751. [PMID: 34938628 PMCID: PMC8684801 DOI: 10.7759/cureus.19751] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2019] [Accepted: 11/19/2021] [Indexed: 11/24/2022] Open
Abstract
Introduction Having the third-highest burden of child mortality and ranking third globally for the most under-vaccinated children, Pakistan contains 15% of its population under the age of five, which accounts for 50% of the mortality rate in this country. Every year, almost three million children miss out on an entire course of the most readily available vaccines, leaving them vulnerable to life-threatening diseases. The Expanded Program of Immunization (EPI) was launched in 1978 to protect children from vaccine-preventable childhood diseases. It is the main program through which routine immunization is provided to the public. However, since its inception within Pakistan, it has encountered many problems, including a lack of parental awareness and education. Low literacy rate, socio-economic disparities, cultural and religious beliefs have made parents doubtful about vaccinations. This term is known as vaccine hesitancy. Belief in conspiracy theories has also led to reduced vaccination coverage in Pakistan. Methods A cross-sectional study was conducted on 300 parents with children under five, chosen from Karachi, Pakistan, through a convenience sampling technique. The data was collected via 300 self-administered or researcher administered questionnaires. Associations were evaluated using the chi-square test with the level of significance taken as p < 0.05 and Cramer's V to determine the strength of these associations. Data analysis was done using Statistical Package for the Social Sciences (SPSS) version 20.0. Results Strong associations were found between parental knowledge of immunization, vaccines, and willingness to get their children immunized. Associations were greater and significant in parents with a higher level of education compared to lower. However, lack of knowledge about certain essential vaccines like Pentavalent, Pneumococcal, and IPV was an important aspect to consider. Also, it was noted that their inability to access these free vaccines was due to their own firm beliefs. It was also about the lack of awareness and facilities for a better and beneficial program. 22.3% of parents said that administering multiple vaccines at a time would be harmful to their child, and 21.7% believed it would cause the disease it's supposed to prevent. However, the majority of the parents said they would strongly recommend others to get vaccinated. In this study, religions included and investigated mostly encouraged vaccination to their relatives (p value= 0.079). Occupation and Monthly income had little to no effect on the immunization regime of young children. Conclusion An impact of higher levels of education on the perceptions and attitudes of parents regarding the immunization of children was noted. Consequently, as religion, gender, occupation, and monthly income do not affect parents' perceptions regarding immunizations, the problem lies within their knowledge and understanding of basic medical science and easily communicable diseases. Oblivious to the consequences of contracting a lethal disease, it has developed a laid-back attitude amongst parents. Hence, awareness and education of parents regarding vaccine-preventable diseases by the healthcare system and the governing bodies can lead to a higher successful immunization rate.
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Affiliation(s)
- Rabail Saeed
- Community Health Sciences, Ziauddin University, Karachi, PAK
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Glanz JM, Clarke CL, Daley MF, Shoup JA, Hambidge SJ, Williams JT, Groom HC, Kharbanda EO, Klein NP, Jackson LA, Lewin BJ, McClure DL, Xu S, DeStefano F. The Childhood Vaccination Schedule and the Lack of Association With Type 1 Diabetes. Pediatrics 2021; 148:183391. [PMID: 34851413 PMCID: PMC9258424 DOI: 10.1542/peds.2021-051910] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/15/2021] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES Safety studies assessing the association between the entire recommended childhood immunization schedule and autoimmune diseases, such as type 1 diabetes mellitus (T1DM), are lacking. To examine the association between the recommended immunization schedule and T1DM, we conducted a retrospective cohort study of children born between 2004 and 2014 in 8 US health care organizations that participate in the Vaccine Safety Datalink. METHODS Three measures of the immunization schedule were assessed: average days undervaccinated (ADU), cumulative antigen exposure, and cumulative aluminum exposure. T1DM incidence was identified by International Classification of Disease codes. Cox proportional hazards models were used to analyze associations between the 3 exposure measures and T1DM incidence. Adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) were calculated. Models were adjusted for sex, race and ethnicity, birth year, mother's age, birth weight, gestational age, number of well-child visits, and study site. RESULTS In a cohort of 584 171 children, the mean ADU was 38 days, the mean cumulative antigen exposure was 263 antigens (SD = 54), and the mean cumulative aluminum exposure was 4.11 mg (SD = 0.73). There were 1132 incident cases of T1DM. ADU (aHR = 1.01; 95% CI, 0.99-1.02) and cumulative antigen exposure (aHR = 0.98; 95% CI, 0.97-1.00) were not associated with T1DM. Cumulative aluminum exposure >3.00 mg was inversely associated with T1DM (aHR = 0.77; 95% CI, 0.60-0.99). CONCLUSIONS The recommended schedule is not positively associated with the incidence of T1DM in children. These results support the safety of the recommended childhood immunization schedule.
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Affiliation(s)
- Jason M. Glanz
- Institute for Health Research, Kaiser Permanente Colorado, Denver, Colorado;,Department of Epidemiology, Colorado School of Public Health, University of Colorado, Aurora, Colorado
| | | | - Matthew F. Daley
- Institute for Health Research, Kaiser Permanente Colorado, Denver, Colorado
| | - Jo Ann Shoup
- Institute for Health Research, Kaiser Permanente Colorado, Denver, Colorado
| | | | | | - Holly C. Groom
- Kaiser Permanente Center for Health Research, Northwest Kaiser Permanente, Portland, Oregon
| | | | - Nicola P. Klein
- Kaiser Permanente Division of Research, Kaiser Permanente of Northern California, Oakland, California
| | - Lisa A. Jackson
- Kaiser Permanente Washington Health Research Institute, Kaiser Permanente Washington, Seattle, Washington
| | - Bruno J. Lewin
- Kaiser Permanente Department of Research and Evaluation, Kaiser Permanente of Southern California, Pasadena, California
| | - David L. McClure
- Marshfield Clinic Research Foundation Institute, Marshfield, Wisconsin
| | - Stanley Xu
- Kaiser Permanente Department of Research and Evaluation, Kaiser Permanente of Southern California, Pasadena, California
| | - Frank DeStefano
- Immunization Safety Office, Centers for Disease Control and Prevention, Atlanta, Georgia
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Giannakou K, Kyprianidou M, Hadjikou A, Fakonti G, Photiou G, Tzira E, Heraclides A. Knowledge of mothers regarding children's vaccinations in Greece: an online cross-sectional study. BMC Public Health 2021; 21:2119. [PMID: 34794423 PMCID: PMC8600348 DOI: 10.1186/s12889-021-12179-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 10/29/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND One of the main reasons that influence parental choice to postpone or avoid children's vaccination is insufficient knowledge. Mothers' knowledge can be considered as an important factor when determining childcare, as they are often the primary decision maker for their children's healthcare issues. This study aimed to assess the level of mothers' knowledge and practice on certain aspects of vaccination for their child/children in Greece. METHODS This was an online cross-sectional survey, which collected information about mother's socio-demographic characteristics, vaccination-related information, and vaccine knowledge using a self-administered questionnaire. The survey was conducted between April 2020 and June 2020 and the study population included mothers over 18 years old with at least one child (< 18 years old), living in four broad geographical areas of Greece (Attica, Central Greece, North Greece, and Crete/Aegean Islands). RESULTS A total of 1885 Greek mothers participated in the study. The majority stated that they vaccined their child/children (98%), and the most popular source of information about vaccination was their child's pediatrician (89%). About half of participants (52%) have delayed their child/children vaccination with their pediatrician's suggestion being the main driver. The median knowledge score was 11 which indicates a high knowledge level for childhood vaccination among Greek mothers. Multiple linear regression analysis identified an inverse association between education and knowledge score, characterized by higher knowledge scores among individuals with secondary and even higher among those with higher education. Multiple logistic regression analysis showed that the strict adherence to the prescribed dosage as indicated by the local recommendations for each vaccine, was associated with most of the knowledge items included in the study. CONCLUSIONS Our findings show that the vast majority of mothers in Greece did vaccinate their child/children, while pediatricians appear to have a very influential role in mothers' decision making. High knowledge around vaccination was associated with mothers' educational attainment, being particularly high among those who completed higher education. Considerable attention is required from public health authorities to promote vaccination through educational programs and campaigns, particularly aimed at people with lower educational attainment. Additionally, improving communication between pediatricians and mothers to reach those women who have not decided to vaccinate or delayed vaccination for their children, may prove to be very beneficial.
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Affiliation(s)
- Konstantinos Giannakou
- Department of Health Sciences, School of Sciences, European University Cyprus, 6 Diogenes Str. Engomi, 2404, P.O. Box: 22006, 1516, Nicosia, Cyprus.
| | - Maria Kyprianidou
- Department of Health Sciences, School of Sciences, European University Cyprus, 6 Diogenes Str. Engomi, 2404, P.O. Box: 22006, 1516, Nicosia, Cyprus.,Cyprus International Institute for Environmental and Public Health, Cyprus University of Technology, Limassol, Cyprus
| | - Andria Hadjikou
- Department of Health Sciences, School of Sciences, European University Cyprus, 6 Diogenes Str. Engomi, 2404, P.O. Box: 22006, 1516, Nicosia, Cyprus
| | - Georgia Fakonti
- Department of Health Sciences, School of Sciences, European University Cyprus, 6 Diogenes Str. Engomi, 2404, P.O. Box: 22006, 1516, Nicosia, Cyprus.,Faculty of Medicine, Department of Infectious Diseases, Imperial College London, London, UK
| | - Galatia Photiou
- Cyprus International Institute for Environmental and Public Health, Cyprus University of Technology, Limassol, Cyprus
| | - Eleana Tzira
- Department of Health Sciences, School of Sciences, European University Cyprus, 6 Diogenes Str. Engomi, 2404, P.O. Box: 22006, 1516, Nicosia, Cyprus
| | - Alexandros Heraclides
- Department of Health Sciences, School of Sciences, European University Cyprus, 6 Diogenes Str. Engomi, 2404, P.O. Box: 22006, 1516, Nicosia, Cyprus
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Yoda T, Katsuyama H. Parents' hesitation about getting their children vaccinated against COVID-19 in Japan. Hum Vaccin Immunother 2021; 17:4993-4998. [PMID: 34623937 DOI: 10.1080/21645515.2021.1981087] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Given the urgent global need for vaccinating individuals of all ages against the COVID-19 pandemic, understanding the extent and reasons for parents' willingness to get their children vaccinated is important. This study used an internet-based questionnaire survey to determine parents' willingness to get their children (0 to 15 years) vaccinated in Japan and was conducted in April 2021 before COVID-19 vaccination for children began. Socio-demographic information, information about parents' willingness to get children vaccinated, reasons for their responses, and parents' willingness to get themselves vaccinated were obtained. Descriptive statistics were used to evaluate parents' willingness to get children vaccinated based on the other variables. Logistic regression analyses were conducted to identify the characteristics of parents who indicated willingness to get their children vaccinated and to identify the reasons for vaccine willingness. Of the 1100 respondents, 472 were willing to get children vaccinated, 470 were not sure, and 158 did not want to get children vaccinated. Considerable differences were found in the willingness to get children vaccinated across gender, age groups, occupation, annual income, respondent's academic background, and respondent's willingness to get COVID-19 vaccination for themselves. Reasons for being unsure about the vaccination included the vaccine's potential side effects (84.9%), uncertainty about vaccine safety (54.7%), and not trusting vaccine efficiency (25.7%). Parents' willingness to get the COVID-19 vaccine for themselves was a significant factor for their willingness to get children vaccinated after adjusting all other factors. The study recommends disseminating more and correct information to the public to increase vaccine willingness.
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Affiliation(s)
- Takeshi Yoda
- Department of Public Health, Kawasaki Medical School, Kurashiki, Japan.,Department of Health and Sports Science, Kawasaki University of Medical Welfare, Kurashiki, Japan
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Kyprianidou M, Tzira E, Galanis P, Giannakou K. Knowledge of mothers regarding children's vaccinations in Cyprus: A cross-sectional study. PLoS One 2021; 16:e0257590. [PMID: 34543326 PMCID: PMC8452034 DOI: 10.1371/journal.pone.0257590] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 09/03/2021] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Vaccine hesitancy is identified as one of the top threats to global health. A significant drop of childhood vaccine coverage is reported worldwide. One of the key reasons that influenced mothers' choice to postpone, or avoid children's vaccination, is knowledge. This study aimed to assess the level of Cypriot mothers' knowledge on certain aspects of vaccination of their children, examine the association between vaccination knowledge and selected socio-demographic factors, and lastly assess the association of mothers' knowledge about vaccination with vaccination coverage and delay, compliance to the recommended schedules, vaccination during pregnancy and mother-pediatrician relationship. METHODS An online-based cross-sectional study conducted to collect information about socio-demographic characteristics, child's characteristics, vaccination, and vaccine knowledge, using a self-administered questionnaire. The survey was conducted between April 2020 and June 2020 and the study population included mothers over 18 years old with at least one child (<18 years old) living in Cyprus. RESULTS A total of 703 Cypriot mothers participated in the study. Most of the participants stated that they vaccined their children (97%) and the most popular source of information about vaccination was their pediatrician (90%). More than half of the participants (57%) have delayed their child/children vaccination with their pediatrician's suggestion being the main reason. 36% of mothers had low knowledge while the overall correct rate was 13.6% and the median (IQR) knowledge score was 11 (9-12). Having a medium knowledge about vaccination was associated with having a medium or high income, whilst high knowledge compared to low knowledge was associated with completed a higher education and having a high income. Our analysis showed that the correct knowledge by mothers with regards to vaccination increases the probability of vaccinating their children, following the local recommendations for vaccine dosages, and acquiring and trusting vaccination-related information from their children's pediatrician. CONCLUSION Our findings show that the majority of mothers in Cyprus had positives perceptions regarding childhood vaccination, as reflected with the high vaccination rate, however, some aspects of mothers' knowledge of vaccination need to be improved. Public health strategies to promote vaccination, education programs as well as improved communication tools between pediatricians and mothers need to be considered to achieve favorable vaccination attitudes and practices for all mothers in Cyprus.
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Affiliation(s)
- Maria Kyprianidou
- Department of Health Sciences, School of Sciences, European University Cyprus, Nicosia, Cyprus
- Cyprus International Institute for Environmental and Public Health, Cyprus University of Technology, Limassol, Cyprus
| | - Eleana Tzira
- Department of Health Sciences, School of Sciences, European University Cyprus, Nicosia, Cyprus
| | - Petros Galanis
- Faculty of Nursing, Centre for Health Services Management and Evaluation, National and Kapodistrian University of Athens, Athens, Greece
| | - Konstantinos Giannakou
- Department of Health Sciences, School of Sciences, European University Cyprus, Nicosia, Cyprus
- * E-mail:
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Ştefănuţ AM, Vintilă M, Tomiţă M, Treglia E, Lungu MA, Tomassoni R. The Influence of Health Beliefs, of Resources, of Vaccination History, and of Health Anxiety on Intention to Accept COVID-19 Vaccination. Front Psychol 2021; 12:729803. [PMID: 34594282 PMCID: PMC8477970 DOI: 10.3389/fpsyg.2021.729803] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 08/17/2021] [Indexed: 01/22/2023] Open
Abstract
The aim of this study is to investigate whether Health Belief Model constructs, personal resources, vaccination history and health anxiety exert an influence on vaccination intention. To achieve this end, we carried out a cross-sectional study of 432 people drawn from a convenience sample who answered an online questionnaire. Multiple logistical regressions showed that perception of the severity of the disease, of the benefits of being vaccinated, of barriers, and of cues to action, along with the freeness and accessibility of the vaccine and general vaccination history, are significant predictors regarding vaccination intention.
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Affiliation(s)
- Adelina Mihaela Ştefănuţ
- Department of Psychology, Faculty of Sociology and Psychology, West University of Timişoara, Timişoara, Romania
| | - Mona Vintilă
- Department of Psychology, Faculty of Sociology and Psychology, West University of Timişoara, Timişoara, Romania
| | - Mihaela Tomiţă
- Department of Social Work, Faculty of Sociology and Psychology, West University of Timişoara, Timişoara, Romania
| | - Eugenia Treglia
- Department of Human Sciences, Social and Health, University of Cassino, Cassino, Italy
| | - Monica Alina Lungu
- Department of Human Sciences, Social and Health, University of Cassino, Cassino, Italy
| | - Rosella Tomassoni
- Department of Human Sciences, Social and Health, University of Cassino, Cassino, Italy
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Ugale JL, Spielvogle H, Spina C, Perreira C, Katz B, Pahud B, Dempsey AF, Robinson JD, Garrett K, O'Leary ST, Opel DJ. "It's Like 1998 Again": Why Parents Still Refuse and Delay Vaccines. Glob Pediatr Health 2021; 8:2333794X211042331. [PMID: 34471653 PMCID: PMC8404635 DOI: 10.1177/2333794x211042331] [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: 07/16/2021] [Accepted: 08/09/2021] [Indexed: 11/24/2022] Open
Abstract
We conducted a qualitative study from 2018 to 2019 to update the reasons why US parents’ refuse or delay vaccines. Four focus groups and 4 semi-structured interviews involving 33 primary care pediatric providers were conducted in Washington and Colorado. A thematic analysis was conducted to identify themes related to reasons for parental refusal or delay. Five predominant themes were identified: (1) vaccine safety, (2) relative influence of information sources, decision-makers, and timing, (3) low perceived risk of contracting vaccine-preventable disease, (4) lack of trust, and (5) religious objection. Vaccine safety was the theme mentioned most frequently by providers (N = 45 times by 26 providers) and religious objection to vaccination was referred to the least (N = 6 times by 6 providers). Provider-reported reasons for parental refusal or delay of childhood vaccines in 2018 to 2019 remain similar to those reported in previous studies.
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Affiliation(s)
- Jiana L Ugale
- Seattle Children's Research Institute, Seattle, WA, USA
| | | | - Christine Spina
- University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, CO, USA
| | - Cathryn Perreira
- University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, CO, USA
| | - Ben Katz
- Seattle Children's Research Institute, Seattle, WA, USA
| | - Barbara Pahud
- University of Missouri-Kansas City, Kansas City, MO, USA
| | - Amanda F Dempsey
- University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, CO, USA.,University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | | | - Kathleen Garrett
- University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, CO, USA
| | - Sean T O'Leary
- University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, CO, USA.,University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Douglas J Opel
- Seattle Children's Research Institute, Seattle, WA, USA.,University of Washington School of Medicine, Seattle, WA, USA
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45
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Boz G, Gokce A, Yigit E, Aslan M, Ozer A. Knowledge and behaviors of nurses working at Inonu University Turgut Ozal Medical Center on childhood vaccine refusal. Hum Vaccin Immunother 2021; 17:4512-4517. [PMID: 34473585 DOI: 10.1080/21645515.2021.1963170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
Among 10 global problems of 2019 determined by the World Health Organization, vaccine refusal was one of the problems mentioned. In this context, health services and health personnel whose main objectives are to keep individuals healthy and to prevent diseases have major responsibilities. This study aims to analyze knowledge and behavior of nurses working at Inonu University Turgut Ozal Medical Center on childhood vaccine refusal.This study, conducted between June and July 2019, is a descriptive cross-sectional study. It was conducted in a hospital located in Malatya in eastern Turkey. At the time of the study, 850 nurses work in this hospital. Sample size was calculated to be 263 at a confidence interval of 95% and strength of 80%. Chi-square test and Fisher's exact test were used in statistical analyses.In the present study, 31.7% of the participating nurses stated that they had concerns about childhood vaccines. Two-thirds of nurses stated that their knowledge on vaccines was from their education. The level of hesitance in those agreeing to the fact that vaccines caused autism and infertility, those stating that they did not trust vaccine-producing companies, and those stating that catching the disease was a better immunization method than vaccination was significantly higher than those not agreeing to these and those who were indecisive (p < .05).One-third of nurses was proven to have hesitance on childhood vaccines, and this rate is rather high. Nurses, being both health personnel and the communication channel for guiding parents, should be provided necessary training and practices in order to ease their hesitance on vaccination.
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Affiliation(s)
- Gulseda Boz
- Department of Public Health, Medical Faculty, Inonu University, Malatya, Turkey
| | - Ayse Gokce
- Ministry of Health, Bingol Provincial Health Directorate, Bingol, Turkey
| | - Esra Yigit
- Department of Public Health, Medical Faculty, Inonu University, Malatya, Turkey
| | - Mehmet Aslan
- Department of Pediatrics, Medical Faculty, Inonu University, Malatya, Turkey
| | - Ali Ozer
- Department of Public Health, Medical Faculty, Inonu University, Malatya, Turkey
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Gerber JE, Brewer J, Limaye RJ, Sutherland A, Blunt M, Holroyd TA, Geller G, Carleton B, Kahn J, Salmon DA. Vaccinomics: a cross-sectional survey of public values. Hum Vaccin Immunother 2021; 17:2999-3015. [PMID: 34152932 PMCID: PMC8381829 DOI: 10.1080/21645515.2021.1911217] [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: 01/20/2021] [Accepted: 03/24/2021] [Indexed: 10/21/2022] Open
Abstract
Objective: We characterize public values regarding vaccinomics, which aims to improve vaccine safety and effectiveness using genomics.Methods: Panel survey (2020) of ≥18-year-olds with embedded animation introduced vaccinomics. Sociodemographic, health, and vaccination-related items were adapted from validated scales. Novel items measured trust in public health authorities, vaccinomics-related values, and preferences for federal funding: vaccinomics compared with vaccine issues and chronic diseases. Beginning and end of survey confidence in vaccine safety was measured to assess potential changes. Data were weighted to the U.S. Census. Vaccinomics-related concerns were stratified by sociodemographic characteristics, vaccine hesitancy status (composite outcome), reported serious vaccine reactions, and trust in public health authorities (PHA). Log binomial regression models estimated associations between these variables and agency to make vaccine-related decisions.Results: Most (70.7%, N = 1,925) respondents expected vaccinomics would increase their vaccine confidence compared to now. Agreement was highest among those without serious vaccine reaction experience (unexperienced: 74.2% versus experienced: 62.3%), with high trust in PHA (high: 83.3% versus low: 57.4%), and low vaccine hesitancy among parents of teenagers (low: 78.8% versus high: 62.5%) and adults without minor children (low: 79.8% versus high: 60.6%; all p < .01). Belief that vaccination was an individual's choice was associated with reported serious reactions (adjusted Prevalence Ratio (aPR): 1.16; 95% CI: 1.07, 1.25) and low trust (aPR: 0.91; 0.84, 0.98). Beginning versus end of survey vaccine safety perceptions were similar.Conclusion: Federal funding, communications, and policies should assure the public that vaccinomics will not remove their decision-making power and engender trust in PHA.
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Affiliation(s)
- Jennifer E. Gerber
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Janesse Brewer
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Rupali J. Limaye
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Department of Health Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Institute for Vaccine Safety, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Andrea Sutherland
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Madeleine Blunt
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Taylor A. Holroyd
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Gail Geller
- Department of Health Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Berman Institute of Bioethics, Johns Hopkins University, Baltimore, MD, USA
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Bruce Carleton
- Pharmaceutical Outcomes Programme, BC Children’s Hospital, Vancouver, BC, Canada
- Division of Translational Therapeutics, Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
- British Columbia Children’s Hospital Research Institute, Vancouver, BC, Canada
| | - Jeffery Kahn
- Berman Institute of Bioethics, Johns Hopkins University, Baltimore, MD, USA
| | - Daniel A. Salmon
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Department of Health Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Institute for Vaccine Safety, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Sumengen AA, Ozcevik D, Kursun HY, Ocakci AF. Vaccine-hesitant parents' reasons for choosing alternative protection methods in Turkey. J Res Nurs 2021; 26:540-553. [DOI: 10.1177/1744987120970635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background Parents use alternative protective methods instead of having their children vaccinated because of their various concerns. Aims The aim of this study is to examine the processes by which the parents preferred alternative methods rather than the vaccines to strengthen their child's immune system. Methods Semi-structured, qualitative interviews were conducted with 22 parents who had vaccine hesitancy. The study sample consisted of parents whose children were between the ages of 0 and 18 years and who experienced vaccine hesitancy and lived in Turkey. The interviews with individuals were conducted online and aimed to be representative of the population of Turkey. Results The factors that caused parental vaccine hesitancy were various, such as vaccine contents, distrust of healthcare workers and false information about vaccines. Because of these factors, parents resorted to natural nutrition, vitamin support and some other precautions, such as avoiding takeaway food or preparing homemade food, rather than having their children vaccinated. Conclusions In recent years, it is thought that parents need education about vaccination; outbreaks may be caused by immigrant children who cannot be registered, and therefore cannot be vaccinated, in Turkey, which has received immigration at a high rate.
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Affiliation(s)
- Aylin Akca Sumengen
- Assistant Professor, Department of Nursing, Faculty of Health Sciences, Bahçeşehir University, İstanbul, Turkey
| | - Damla Ozcevik
- PhD student, Graduate School of Health Sciences, Koç University, İstanbul, Turkey
| | - Hulya Yaren Kursun
- School Nurse, Nursing, Graduate School of Health Sciences, Koc University, Istanbul, Turkey
| | - Ayse Ferda Ocakci
- Faculty Member, Nursing, School of Nursing, Child Health and Diseases Nursing, Koc University, Istanbul, Turkey
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Moucheraud C, Guo H, Macinko J. Trust In Governments And Health Workers Low Globally, Influencing Attitudes Toward Health Information, Vaccines. Health Aff (Millwood) 2021; 40:1215-1224. [PMID: 34339250 DOI: 10.1377/hlthaff.2020.02006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Trust, particularly during emergencies, is essential for effective health care delivery and health policy implementation. We used data from the 2018 Wellcome Global Monitor survey (comprising nationally representative samples from 144 countries) to examine levels and correlates of trust in governments and health workers and attitudes toward vaccines. Only one-quarter of respondents globally expressed a lot of trust in their government (trust was more common among people with less schooling, those living in rural areas, those who were financially comfortable, and those who were older), and fewer than half of respondents globally said that they trust doctors and nurses a lot. People's trust in these institutions was correlated with trust in health or medical advice from them, and with more positive attitudes toward vaccines. Vaccine enthusiasm varied substantially across regions, with safety being the most common concern. Policy makers should understand that the public may have varying levels of trust in different institutions and actors. Although much attention is paid to crafting public health messages, it may be equally important, especially during a pandemic, to identify appropriate, trusted messengers to deliver those messages more effectively to different target populations.
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Affiliation(s)
- Corrina Moucheraud
- Corrina Moucheraud is an associate professor in the Department of Health Policy and Management, Jonathan and Karin Fielding School of Public Health, University of California Los Angeles, in Los Angeles, California
| | - Huiying Guo
- Huiying Guo is a PhD student in the Department of Health Policy and Management, Jonathan and Karin Fielding School of Public Health, University of California Los Angeles
| | - James Macinko
- James Macinko is a professor in the Departments of Health Policy and Management and Community Health Sciences, Jonathan and Karin Fielding School of Public Health, University of California Los Angeles
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Catma S, Reindl D. Parents' willingness to pay for a COVID-19 vaccine for themselves and their children in the United States. Hum Vaccin Immunother 2021; 17:2919-2925. [PMID: 33929290 DOI: 10.1080/21645515.2021.1919453] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Differences in obtaining a vaccine vary based on a multitude of factors including perceptions of vaccine safety, efficacy and willingness to pay (WTP). This study focuses on parent perceptions toward a vaccine for COVID-19 including their WTP decisions for their children and themselves. A mixed methods design using a cross-sectional survey was used to assess the perceptions of US parents, with children under 18, in response to the COVID-19 pandemic. The survey was administered online in November 2020 and 584 final responses were collected. The questionnaire consisted of approximately 37 closed and open-ended questions regarding personal background information; awareness, knowledge, and experience of the virus; perception toward vaccines and COVID-19; and the contingent valuation of a hypothetical COVID-19 vaccine. WTP was found to be higher for children and a direct relationship between the number of children and WTP was observed. Parents were willing to pay US$228-$291 for a vaccine for themselves and US$243-US$321 for their children. A positive impact on WTP was found with self-reported parent health status but not children. The findings of this study have important implications for policy programs which require detailed cost-benefit analyses. WTP for a COVID-19 vaccine is crucial to determine the partial benefits of vaccinating to reduce the risk of repetitive widespread outbreaks.
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Affiliation(s)
- Serkan Catma
- Department of Business, University of South Carolina Beaufort, Bluffton, SC, USA
| | - Diana Reindl
- Department of Nursing and Health Professions, University of South Carolina Beaufort, Bluffton, SC, USA
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Talarek E, Chazan M, Winiarska P, Dembiński Ł, Sobierajski T, Banaszkiewicz A. How attitudes towards vaccination change in the face of an outbreak. Hum Vaccin Immunother 2021; 17:805-809. [PMID: 32873126 PMCID: PMC7993138 DOI: 10.1080/21645515.2020.1798152] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 06/26/2020] [Accepted: 07/13/2020] [Indexed: 01/06/2023] Open
Abstract
Outbreaks of infectious diseases cause great fear and a desire to avoid infection. One of the most effective outbreak containment methods is vaccination. However, in order for this strategy to be effective, a majority of the susceptible population should be vaccinated in a short time. This may require changing the practice of immunization execution and changing attitudes toward vaccination. In the survey on the attitudes of Polish parents and guardians toward vaccinations, we asked about the acceptance of vaccination in places other than health-care facilities in both non-epidemic and epidemic conditions. The study was conducted using an anonymous questionnaire in two Warsaw hospitals between August 2018 and February 2019 and was addressed to parents and legal guardians of children. At the time of the survey, "epidemic" was a hypothetical term. Two hundred fifty respondents participated in the study. The pharmacy was the most accepted non-healthcare facility vaccination location, both normally and during an outbreak, with 54.4% (123/226) and 75.2% (170/226) of respondents finding pharmacies an acceptable location, respectively. A gas station had the lowest acceptance: 5.8% (13/226) and 28.8% (65/226), respectively. The only statistically significant demographic factors affecting acceptance of each vaccination location were male sex (p = .001) and higher education level (p = .001). Of those surveyed, 58.5% (131/224) would approve of vaccination in front of a hospital or outpatient clinic during an outbreak; 70.5% (43/61) of men versus 54.0% (88/163) of women, p = .026. In conclusion, during an outbreak, people would be more likely to accept vaccination at locations other than a health-care facility.
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Affiliation(s)
- Ewa Talarek
- Department of Children`s Infectious Diseases, Medical University of Warsaw, Warsaw, Poland
- Regional Hospital of Infectious Diseases in Warsaw, Warsaw, Poland
| | - Magdalena Chazan
- Student Research Association at Department of Pediatric Gastroenterology and Nutrition, Medical University of Warsaw, Warsaw, Poland
| | - Paulina Winiarska
- Student Research Association at Department of Pediatric Gastroenterology and Nutrition, Medical University of Warsaw, Warsaw, Poland
| | - Łukasz Dembiński
- Department of Pediatric Gastroenterology and Nutrition, Medical University of Warsaw, Warsaw, Poland
| | - Tomasz Sobierajski
- Institute of Applied Social Sciences, University of Warsaw, Warsaw, Poland
| | - Aleksandra Banaszkiewicz
- Department of Pediatric Gastroenterology and Nutrition, Medical University of Warsaw, Warsaw, Poland
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