1
|
Chen C, Chen T, Huang M, Huang Y, Zhang L, Li P. Factors associated with HPV vaccine hesitancy among college students: A cross-sectional survey based on 3Cs and structural equation model in China. Hum Vaccin Immunother 2024; 20:2309731. [PMID: 38314749 PMCID: PMC10854271 DOI: 10.1080/21645515.2024.2309731] [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: 09/19/2023] [Accepted: 01/22/2024] [Indexed: 02/07/2024] Open
Abstract
Despite the high effectiveness of HPV vaccines in preventing infection, vaccine hesitancy remains a concern, particularly in China. This study aimed to explore college students' attitudes toward HPV vaccination and identify associated factors. Data was collected through a cross-sectional survey using self-administered questionnaires in four cities from May to June 2022. Chi-square tests and logistic regression analyses were conducted to identify factors. Additionally, an integrated structural equation model (SEM) based on the 3Cs (confidence, convenience, complacency) was developed to understand underlying factors contributing to hesitancy. The results from 2261 valid questionnaires were enlightening. A significant 89.47% (59.4% for females) considered HPV vaccination necessary, with 9.82% remaining neutral and only 0.71% deeming it unnecessary. Factors like higher education, being a medical student, residing in urban areas, having medical insurance, more extraordinary living expenses, a family history of tumors, and a solid understanding of HPV played a role in perceiving the vaccine as necessary. Among the 1438 female respondents, 84.36% had no hesitancy toward HPV vaccination, 13.53% expressed hesitancy, and 2.11% refused vaccination. Factors like age, understanding of HPV, medical staff recommendations, living expenses, and family history influenced hesitancy levels. SEM revealed that the 3Cs significantly affected vaccine hesitancy. Factors like price, booking process, vaccination times, trust in vaccines, medical staff recommendations, efficiency, and risk perception collectively influenced hesitancy. In conclusion, this study found high acceptance of HPV vaccination but acknowledged the complexity of hesitancy factors. It recommends medical staff disseminate scientific knowledge, offer recommendations, simplify booking procedures, and expand vaccination sites to address vaccine hesitancy effectively.
Collapse
Affiliation(s)
- Cheng Chen
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ting Chen
- School of Public Health, Wuhan University of Science and Technology, Wuhan, China
| | - Mingzhao Huang
- School of Public Health, Wuhan University of Science and Technology, Wuhan, China
- Hubei Key Laboratory of Occupational Disease Hazard Identification and Control, Wuhan, China
| | - Yan Huang
- Center for Chinese Public Administration Research, School of Government, Sun Yat-sen University, Guangzhou, China
| | - Luying Zhang
- School of Public Health, Fudan University, Shanghai, China
| | - Pindong Li
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Institute of Radiation Oncology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Key Laboratory of Precision Radiation, Wuhan, China
| |
Collapse
|
2
|
Eyawo O, Ugoji UC, Pan S, Oyibo P, Rehman A, Mahboob M, Esimai OA. Predictors of the willingness to accept a free COVID-19 vaccine among households in Nigeria. Vaccine 2024; 42:126225. [PMID: 39216208 DOI: 10.1016/j.vaccine.2024.126225] [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: 01/28/2024] [Revised: 06/19/2024] [Accepted: 08/12/2024] [Indexed: 09/04/2024]
Abstract
BACKGROUND To inform vaccination policy and programmatic strategies to increase COVID-19 vaccine uptake, an understanding of the factors associated with the willingness to vaccinate is needed. METHODS We analyzed data collected from the sixth and tenth round of the Nigerian COVID-19 National Longitudinal Phone Survey conducted by the National Bureau of Statistics and the World Bank in 2020 and 2021, respectively. Exploratory data analysis and feature selection techniques were used to identify important variables. Multivariable logistic regression models were fitted to assess the association between socio-demographic and economic factors and the willingness to receive a free COVID-19 vaccine among Nigerian households at two different time points before vaccines became widely available. RESULTS Data from 1,733 and 1,651 Nigerian households who completed the sixth and tenth round of the survey, respectively, were included. Most respondents (>85% of households) were willing to receive a free COVID-19 vaccine from both survey rounds. The median household size was 6 (IQR: [4, 8]) with females heading about 18% of the households. Approximately 22% of the household heads had not received any formal education. Compared to households whose head had no education, households whose heads had completed tertiary education or higher had significantly lower odds of willingness to be vaccinated (ORround 6: 0.46, 95% CI: [0.31, 0.68], ORround 10: 0.49, 95% CI: [0.34, 0.71]). An increasing proportion of male household members was associated with greater willingness to receive a free COVID-19 vaccine (ORround 6: 1.84, 95% CI: [1.01, 3.33], ORround 10: 5.25, 95% CI: [2.86, 9.65]). Significant associations with vaccine willingness were also observed across geopolitical zones of residence with households in South-East Nigeria (ORround 6: 0.16, 95% CI: [0.10, 0.24]; ORround 10: 0.29, 95% CI: [0.19, 0.43]) and South-South Nigeria (ORround 6: 0.57, 95% CI: [0.36, 0.90], ORround 10: 0.32, 95% CI: [0.22, 0.48]) less likely to be willing to receive a free vaccine compared to households in North-Central Nigeria. CONCLUSION These findings from two different time points before vaccine roll-out suggest that the educational level of household head, proportion of male household members, and the geopolitical zone of residence are important baseline predictors of the willingness to receive a free COVID-19 vaccine in Nigeria. These factors should be carefully considered and specifically targeted when designing public health programs to inform early-stage strategies that address underlying vaccine hesitancy, improve vaccine uptake, promote ongoing COVID-19 vaccination efforts, and potentially enhance other immunization programs in Nigeria.
Collapse
Affiliation(s)
- Oghenowede Eyawo
- School of Global Health, York University, Toronto, ON, Canada; School of Kinesiology and Health Science, York University, Toronto, ON, Canada.
| | | | - Shenyi Pan
- Department of Statistics, University of British Columbia, Vancouver, BC, Canada
| | - Patrick Oyibo
- Department of Health Services Research and Management, School of Health and Psychological Sciences, City University of London, London, United Kingdom; Department of Community Medicine, Faculty of Clinical Medicine, Delta State University, Abraka, Nigeria
| | - Amtull Rehman
- School of Global Health, York University, Toronto, ON, Canada
| | - Mishel Mahboob
- School of Kinesiology and Health Science, York University, Toronto, ON, Canada
| | | |
Collapse
|
3
|
Carter A, Klinner C, Young A, Strnadová I, Wong H, Vujovich-Dunn C, Newman CE, Davies C, Skinner SR, Danchin M, Hynes S, Guy R. "I Thought It Was Better to Be Safe Than Sorry": Factors Influencing Parental Decisions on HPV and Other Adolescent Vaccinations for Students with Intellectual Disability and/or Autism in New South Wales, Australia. Vaccines (Basel) 2024; 12:922. [PMID: 39204045 PMCID: PMC11359071 DOI: 10.3390/vaccines12080922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2024] [Revised: 07/26/2024] [Accepted: 08/10/2024] [Indexed: 09/03/2024] Open
Abstract
The uptake of human papilloma virus (HPV) and other adolescent vaccinations in special schools for young people with disability is significantly lower than in mainstream settings. This study explored the factors believed to influence parental decision making regarding vaccine uptake for students with intellectual disability and/or on the autism spectrum attending special schools in New South Wales, Australia, from the perspective of all stakeholders involved in the program. Focus groups and interviews were conducted with 40 participants, including parents, school staff, and immunisation providers. The thematic analysis identified two themes: (1) appreciating diverse parental attitudes towards vaccination and (2) educating parents and managing vaccination questions and concerns. While most parents were described as pro-vaccination, others were anti-vaccination or vaccination-hesitant, articulating a marked protectiveness regarding their child's health. Reasons for vaccine hesitancy included beliefs that vaccines cause autism, concerns that the vaccination may be traumatic for the child, vaccination fatigue following COVID-19, and assumptions that children with disability will not be sexually active. Special school staff regarded the vaccination information pack as inadequate for families, and nurses described limited educational impact resulting from minimal direct communication with parents. More effective communication strategies are needed to address vaccine hesitancy among parents with children with disability.
Collapse
Affiliation(s)
- Allison Carter
- Kirby Institute, Faculty of Medicine and Health, UNSW Sydney, Sydney, NSW 2052, Australia; (C.K.); (A.Y.); (R.G.)
- Australian Human Rights Institute, UNSW Sydney, Sydney, NSW 2052, Australia
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC V5A 1S6, Canada
| | - Christiane Klinner
- Kirby Institute, Faculty of Medicine and Health, UNSW Sydney, Sydney, NSW 2052, Australia; (C.K.); (A.Y.); (R.G.)
| | - Alexandra Young
- Kirby Institute, Faculty of Medicine and Health, UNSW Sydney, Sydney, NSW 2052, Australia; (C.K.); (A.Y.); (R.G.)
| | - Iva Strnadová
- School of Education, UNSW Sydney, Sydney, NSW 2052, Australia;
- Disability Innovation Institute, UNSW Sydney, Sydney, NSW 2052, Australia
| | - Horas Wong
- Susan Wakil School of Nursing and Midwifery, University of Sydney, Sydney, NSW 2050, Australia;
- Centre for Social Research in Health, UNSW Sydney, Sydney, NSW 2052, Australia;
| | | | - Christy E. Newman
- Centre for Social Research in Health, UNSW Sydney, Sydney, NSW 2052, Australia;
| | - Cristyn Davies
- Specialty of Child and Adolescent Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2050, Australia; (C.D.); (S.R.S.)
- Sydney Infectious Diseases Institute, University of Sydney, Sydney, NSW 2050, Australia
| | - S. Rachel Skinner
- Specialty of Child and Adolescent Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2050, Australia; (C.D.); (S.R.S.)
| | - Margie Danchin
- Murdoch Children’s Research Institute, Melbourne, VIC 3052, Australia;
- Department of Paediatrics, University of Melbourne, Melbourne, VIC 3052, Australia
| | - Sarah Hynes
- Health Protection NSW, Sydney, NSW 2065, Australia;
| | - Rebecca Guy
- Kirby Institute, Faculty of Medicine and Health, UNSW Sydney, Sydney, NSW 2052, Australia; (C.K.); (A.Y.); (R.G.)
| |
Collapse
|
4
|
Manoharan B, Stennett R, de Souza RJ, Bangdiwala SI, Desai D, Kandasamy S, Khan F, Khan Z, Lear SA, Loh L, Nocos R, Schulze KM, Wahi G, Anand SS. Sociodemographic factors associated with vaccine hesitancy in the South Asian community in Canada. CANADIAN JOURNAL OF PUBLIC HEALTH = REVUE CANADIENNE DE SANTE PUBLIQUE 2024:10.17269/s41997-024-00885-7. [PMID: 38713364 DOI: 10.17269/s41997-024-00885-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 03/21/2024] [Indexed: 05/08/2024]
Abstract
OBJECTIVE South Asians represent the largest non-white ethnic group in Canada and were disproportionately impacted by the COVID-19 pandemic. We sought to determine the factors associated with vaccine hesitancy in South Asian Canadians. METHODS We conducted a cross-sectional analysis of vaccine hesitancy using data collected at the baseline assessment of a prospective cohort study, COVID CommUNITY South Asian. Participants (18 + years) were recruited from the Greater Toronto and Hamilton Area in Ontario (ON) and the Greater Vancouver Area in British Columbia (BC) between April and November 2021. Demographic characteristics and vaccine attitudes measured by the Vaccine Attitudes Examination (VAX) scale were collected. Each item is scored on a 6-point Likert scale, and higher scores reflect greater hesitancy. A multivariable linear mixed effects model was used to identify sociodemographic factors associated with vaccine hesitancy, adjusting for multiple covariates. RESULTS A total of 1496 self-identified South Asians (52% female) were analyzed (mean age = 38.5 years; standard deviation (SD): 15.3). The mean VAX score was 3.2, SD: 0.8 [range: 1.0‒6.0]. Factors associated with vaccine hesitancy included: time since immigration (p = 0.04), previous COVID-19 infection (p < 0.001), marital status (p < 0.001), living in a multigenerational household (p = 0.03), age (p = 0.02), education (p < 0.001), and employment status (p = 0.001). CONCLUSION Among South Asians living in ON and BC, time since immigration, prior COVID-19 infection, marital status, living in a multigenerational household, age, education, and employment status were associated with vaccine hesitancy. This information can be used to address vaccine hesitancy in the South Asian population in future COVID-19 waves or pandemics.
Collapse
Affiliation(s)
- Baanu Manoharan
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada
| | - Rosain Stennett
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada
| | - Russell J de Souza
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada
- Population Health Research Institute, Hamilton, ON, Canada
| | - Shrikant I Bangdiwala
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada
- Population Health Research Institute, Hamilton, ON, Canada
| | - Dipika Desai
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada
- Population Health Research Institute, Hamilton, ON, Canada
| | - Sujane Kandasamy
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada
| | - Farah Khan
- Population Health Research Institute, Hamilton, ON, Canada
| | - Zainab Khan
- Population Health Research Institute, Hamilton, ON, Canada
| | - Scott A Lear
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
| | - Lawrence Loh
- Centre for Global Health, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Rochelle Nocos
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
| | - Karleen M Schulze
- Population Health Research Institute, Hamilton, ON, Canada
- Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Gita Wahi
- Department of Pediatrics, McMaster University, Hamilton, ON, Canada
| | - Sonia S Anand
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada.
- Population Health Research Institute, Hamilton, ON, Canada.
- Department of Medicine, McMaster University, Hamilton, ON, Canada.
| |
Collapse
|
5
|
Mahmood B, Adu P, McKee G, Bharmal A, Wilton J, Janjua NZ. Ethnic Disparities in COVID-19 Vaccine Mistrust and Receipt in British Columbia, Canada: Population Survey. JMIR Public Health Surveill 2024; 10:e48466. [PMID: 38363596 PMCID: PMC10896316 DOI: 10.2196/48466] [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: 04/25/2023] [Revised: 09/16/2023] [Accepted: 12/15/2023] [Indexed: 02/17/2024] Open
Abstract
BACKGROUND Racialized populations in the United States, Canada, and the United Kingdom have been disproportionately affected by COVID-19. Higher vaccine hesitancy has been reported among racial and ethnic minorities in some of these countries. In the United Kingdom, for example, higher vaccine hesitancy has been observed among the South Asian population and Black compared with the White population, and this has been attributed to lack of trust in government due to historical and ongoing racism and discrimination. OBJECTIVE This study aimed to assess vaccine receipt by ethnicity and its relationship with mistrust among ethnic groups in British Columbia (BC), Canada. METHODS We included adults ≥18 years of age who participated in the BC COVID-19 Population Mixing Patterns Survey (BC-Mix) from March 8, 2021, to August 8, 2022. The survey included questions about vaccine receipt and beliefs based on a behavioral framework. Multivariable logistic regression was used to assess the association between mistrust in vaccines and vaccine receipt among ethnic groups. RESULTS The analysis included 25,640 adults. Overall, 76.7% (22,010/28,696) of respondents reported having received at least 1 dose of COVID-19 vaccines (Chinese=86.1%, South Asian=79.6%, White=75.5%, and other ethnicity=73.2%). Overall, 13.7% (3513/25,640) of respondents reported mistrust of COVID-19 vaccines (Chinese=7.1%, South Asian=8.2%, White=15.4%, and other ethnicity=15.2%). In the multivariable model (adjusting for age, sex, ethnicity, educational attainment, and household size), mistrust was associated with a 93% reduced odds of vaccine receipt (adjusted odds ratio 0.07, 95% CI 0.06-0.08). In the models stratified by ethnicity, mistrust was associated with 81%, 92%, 94%, and 95% reduced odds of vaccine receipt among South Asian, Chinese, White, and other ethnicities, respectively. Indecision, whether to trust the vaccine or not, was significantly associated with a 70% and 78% reduced odds of vaccine receipt among those who identified as White and of other ethnic groups, respectively. CONCLUSIONS Vaccine receipt among those who identified as South Asian and Chinese in BC was higher than that among the White population. Vaccine mistrust was associated with a lower odds of vaccine receipt in all ethnicities, but it had a lower effect on vaccine receipt among the South Asian and Chinese populations. Future research needs to focus on sources of mistrust to better understand its potential influence on vaccine receipt among visible minorities in Canada.
Collapse
Affiliation(s)
- Bushra Mahmood
- Division of Endocrinology, University of British Columbia, Vancouver, BC, Canada
| | - Prince Adu
- British Columbia Center for Disease Control, Vancouver, BC, Canada
- Department of Social Medicine, Heritage College of Osteopathic Medicine, Ohio University, Dublin, OH, United States
| | - Geoffrey McKee
- British Columbia Center for Disease Control, Vancouver, BC, Canada
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - Aamir Bharmal
- British Columbia Center for Disease Control, Vancouver, BC, Canada
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - James Wilton
- British Columbia Center for Disease Control, Vancouver, BC, Canada
| | - Naveed Zafar Janjua
- British Columbia Center for Disease Control, Vancouver, BC, Canada
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
- Centre for Health Evaluation and Outcome Sciences, St Paul's Hospital, Vancouver, BC, Canada
| |
Collapse
|
6
|
Condran B, Kervin M, Burton C, Blydt-Hansen TD, Morris SK, Sadarangani M, Otley A, Yong E, Mitchell H, Bettinger JA, Top KA. Parent and healthcare provider views of live varicella vaccination of pediatric solid organ transplant recipients. Pediatr Transplant 2023; 27:e14609. [PMID: 37746885 DOI: 10.1111/petr.14609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 07/28/2023] [Accepted: 09/01/2023] [Indexed: 09/26/2023]
Abstract
BACKGROUND Live attenuated varicella vaccine (LAVV) has historically been contraindicated in children who are immunocompromised due to solid organ transplant (SOT) because of safety concerns. Recently, clinical guidelines were developed that support post-transplant varicella vaccination in selected SOT recipients based on emerging evidence of LAVV safety. This qualitative study sought to explore barriers and facilitators to implementing the new guidelines, as well as acceptability of LAVV among healthcare providers (HCPs) and parents. METHODS HCPs and parents of transplant recipients were recruited from four sites using purposive sampling. Data from semi-structured interviews were analyzed using an Interpretive Description approach that incorporated data from the interviews, academic knowledge and clinical experience, and drew from Grounded Theory and Thematic Analysis. The theoretical framework used was Adaptive Leadership. RESULTS Thirty-four participants (16 HCPs and 18 parents) were included in the analysis. Parents developed skills in adaptive leadership that included strategies to protect their child against infectious diseases. Foundational information that live vaccines were absolutely contraindicated post-transplant "stuck" with parents and led them to develop strategies other than vaccination to keep their child safe. Some parents struggled to understand that information previously presented as a certainty (contraindication of LAVV) could change. Their approach to adaptive leadership informed their appraisal of the new vaccination guidelines and willingness to accept vaccination. CONCLUSIONS HCPs should adopt a family-centered approach to communicating changing guidelines that considers parents' approach to adaptive leadership and discusses the changing nature of medical evidence. Trust between HCPs and parents can facilitate these conversations.
Collapse
Affiliation(s)
- Brian Condran
- Canadian Center for Vaccinology, IWK Health, Halifax, Nova Scotia, Canada
| | - Melissa Kervin
- Canadian Center for Vaccinology, IWK Health, Halifax, Nova Scotia, Canada
| | - Catherine Burton
- Stollery Children's Hospital, University of Alberta, Edmonton, Alberta, Canada
| | - Tom D Blydt-Hansen
- Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada
| | - Shaun K Morris
- Clinical Public Health and Centre for Vaccine Preventable Diseases, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Division of Infectious Diseases and Child Health Evaluative Sciences, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Manish Sadarangani
- Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada
- Vaccine Evaluation Center, BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada
| | - Anthony Otley
- Department of Pediatrics, Dalhousie University, Halifax, Nova Scotia, Canada
| | | | - Hana Mitchell
- Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada
- Vaccine Evaluation Center, BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada
| | - Julie A Bettinger
- Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada
- Vaccine Evaluation Center, BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada
| | - Karina A Top
- Canadian Center for Vaccinology, IWK Health, Halifax, Nova Scotia, Canada
- Department of Pediatrics, Dalhousie University, Halifax, Nova Scotia, Canada
| |
Collapse
|
7
|
Marani H, Song MY, Jamieson M, Roerig M, Allin S. Public Officials' Engagement on Social Media During the Rollout of the COVID-19 Vaccine: A Content Analysis of Tweets. JMIR INFODEMIOLOGY 2023. [PMID: 37315194 PMCID: PMC10361259 DOI: 10.2196/41582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
BACKGROUND Social media is an important way for governments to communicate with the public. This is particularly true in times of crisis such as the COVID-19 pandemic, during which time government officials had a strong role in promoting public health measures such as vaccines. OBJECTIVE In Canada, provincial COVID-19 vaccine rollout was delivered in three phases aligned with federal government COVID-19 vaccine guidance for priority populations. In this study, we examined how Canadian public officials used Twitter to engage with the public about vaccine rollout and how this engagement has shaped public response to vaccines across jurisdictions. METHODS We conducted a content analysis of tweets posted between December 28, 2020, and August 31, 2021. Leveraging social media artificial intelligence (AI) tool Brandwatch Analytics©, we constructed a list of public officials in three jurisdictions (Ontario, Alberta and British Columbia) organized across six public official types, then conducted an English/French keyword search for tweets about vaccine rollout and delivery that mentioned, retweeted, or replied to the public officials. We identified the top 30 tweets with the highest impressions in each jurisdiction in each of the three phases (approximately a 26-day window) of the vaccine rollout. The metrics of engagement (impressions, retweets, likes, and replies) from the top 30 tweets per phase in each jurisdiction were then extracted for additional annotation. We specifically annotated sentiment towards public officials' vaccine response (I.e., positive, negative, neutral) in each tweet, and also annotated the type of social media engagement. A thematic analysis of tweets was then conducted to add nuance to extracted data characterizing sentiment and interaction type. RESULTS Of the six categories of public officials, 142 prominent accounts were included from Ontario, Alberta and British Columbia. 270 tweets were included in the content analysis. Public officials mostly used Twitter for information provision (65.6%), followed by horizontal engagement (17.5%), citizen engagement (11.3%), and public service announcements (5.7%). Information provision by government bodies (e.g., provincial government and public health authorities) or municipal leaders are more prominent than tweets by other public official groups. Neutral sentiment accounted for 51.1% of all tweets, while positive sentiment (43.2%) was the second most common sentiment. In Ontario, 60% of the tweets were positive. Negative sentiment (e.g., public officials criticizing vaccine rollout) accounted for 12.6% of all tweets. CONCLUSIONS As governments continue to promote the uptake of the COVID-19 "booster" doses, findings from this study are useful in informing how governments can best utilize social media to engage with the public to achieve democratic goals. CLINICALTRIAL
Collapse
Affiliation(s)
- Husayn Marani
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, CA
- North American Observatory on Health Systems and Policies, University of Toronto, Toronto, CA
| | - Melodie Yunju Song
- North American Observatory on Health Systems and Policies, University of Toronto, Toronto, CA
| | - Margaret Jamieson
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, CA
- North American Observatory on Health Systems and Policies, University of Toronto, Toronto, CA
| | - Monika Roerig
- North American Observatory on Health Systems and Policies, University of Toronto, Toronto, CA
| | - Sara Allin
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, CA
- North American Observatory on Health Systems and Policies, University of Toronto, Toronto, CA
| |
Collapse
|
8
|
Aslan S, Ozkara A, Kasım I, Aksoy H. Why Turkish Parents Refuse Childhood Vaccination? A Qualitative Study. ARCHIVES OF IRANIAN MEDICINE 2023; 26:267-274. [PMID: 38301090 PMCID: PMC10685866 DOI: 10.34172/aim.2023.41] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 04/08/2023] [Indexed: 02/03/2024]
Abstract
BACKGROUND Anti-vaccination is spreading among parents. In 2017, 23000 families in Turkey refused vaccinations for their children. Meanwhile an increase in infectious diseases was observed, which might be caused by vaccination rejection. The reasons why families do not vaccinate their children may be very different, such as side effects, or advocation for "healthy life" by gurus. However, the real reasons for vaccine refusal are unknown. Our aim is to determine the reasons for anti-vaccination in Turkey. METHODS In order to reveal the real reasons for not taking the vaccine, we planned to conduct interviews with the representatives of the vaccine rejection group using qualitative research methodology with the "grounded theory" method. We searched some anti-vaccination blogs to find candidates for interviews. Within the scope of our study, parental concerns about vaccinations were classified by analyzing the data obtained from semi-structured questions and interviews recorded with voice recorders in face-to-face interviews with 21 parents in 13 cities of Turkey. RESULTS The obtained findings were classified under the headings of ''mistrust'', ''vaccine efficacy-importance'', ''decision-making processes - bases'', and ''law-ethics''. Mistrust was the main theme, almost singularly, as the most important reason for vaccine rejection. The salient reasons for mistrusts were: Companies which produce vaccines especially international companies because of conspiratory beliefs; health authorities, because of the belief about non-transparency in epidemiologic data, immunization council etc. and healthcare professionals, because of their non-communicative and non-concerned attitude. CONCLUSION Mistrust is hard to overcome. The beliefs of the patients cannot be easily changed. As a result of our study, we made some recommendations for health authorities, healthcare professionals, companies and other related stakeholders.
Collapse
Affiliation(s)
- Salih Aslan
- Evren Integrated Health Center, Ankara, Türkiye
| | - Adem Ozkara
- Department of Family Medicine University of Health Sciences,, Ankara City Hospital, Ankara, Türkiye
| | - Ismail Kasım
- Department of Family Medicine University of Health Sciences,, Ankara City Hospital, Ankara, Türkiye
| | - Hilal Aksoy
- Department of Family Medicine, Hacettepe University Faculty of Medicine, Ankara, Türkiye
| |
Collapse
|
9
|
White JBC, O'Doherty KC. Constructing the Anti‐Vaxxer: Discursive analysis of public deliberations on childhood vaccination. JOURNAL FOR THE THEORY OF SOCIAL BEHAVIOUR 2023. [DOI: 10.1111/jtsb.12379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/16/2023]
|
10
|
Atkinson KM, Ntacyabukura B, Hawken S, Laflamme L, Wilson K. Effects of the COVID-19 pandemic on self-reported 12-month pneumococcal vaccination series completion rates in Canada. Hum Vaccin Immunother 2022; 18:2158005. [PMID: 36581328 PMCID: PMC9891678 DOI: 10.1080/21645515.2022.2158005] [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: 12/31/2022] Open
Abstract
Routine childhood vaccination improves health and prevents morbidity and mortality from vaccine-preventable diseases. There are indications that the COVID-19 pandemic has negatively impacted immunization rates globally, but systematic studies on this are still lacking in Canada. This study aims to add knowledge on the pandemic's effect on children's immunization rates with pneumococcal vaccine using self-reported immunization data from CANImmunize. An interrupted time series analysis was conducted on aggregated monthly enrollment of children on the platform (2016-2021) and their pneumococcal immunization series completion rates (2016-2020). Predicted trends before and after the onset of the COVID19-related restriction (March 1, 2020) were compared by means of an Autoregressive Integrated Moving Average (ARIMA). The highest monthly enrollment was 3,474 new infant records observed in January 2020, and the lowest was 100 records in December 2021. The highest Self-reported pneumococcal immunization series completion rate was 78.89%, observed in February 2017, and the lowest was 6.94% in December 2021. Enrollment decreased by 1177.52 records (95% CI: -1865.47, -489.57), with a continued decrease of 80.84 records each month. Completion rates had an immediate increase of 14.57% (95% CI 4.64, 24.51), followed by a decrease of 3.54% each month. The onset of the COVID-19 related restrictions impacted the enrollment of children in the CANImmunize digital immunization platform and an overall decrease in self-reported pneumococcal immunization series completion rates. Our findings support efforts to increase catch-up immunization campaigns so that children who could not get scheduled immunization during the pandemic are not missed.
Collapse
Affiliation(s)
| | - Blaise Ntacyabukura
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Steven Hawken
- Clinical Epidemiology Program, Ottawa Hospital Research Institute (OHRI), Ottawa, Canada
| | - Lucie Laflamme
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Kumanan Wilson
- Clinical Epidemiology Program, Ottawa Hospital Research Institute (OHRI), Ottawa, Canada,Bruyere Research Institute, Ottawa, Canada,Department of Medicine, University of Ottawa, Ottawa, Canada,CONTACT Kumanan Wilson Clinical Epidemiology Program, Ottawa Hospital Research Institute (OHRI), Ottawa, Canada
| |
Collapse
|
11
|
de Waal A, Racey CS, Donken R, Plotnikoff K, Dobson S, Smith L, Grennan T, Sadarangani M, Ogilvie G. Factors associated with intention to receive vaccines for bacterial sexually transmitted infections among young HPV-vaccinated Canadian women. CANADIAN JOURNAL OF PUBLIC HEALTH 2022; 113:776-785. [PMID: 35616872 PMCID: PMC9134722 DOI: 10.17269/s41997-022-00648-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 04/20/2022] [Indexed: 11/21/2022]
Abstract
Objective The aim of this study was to explore the acceptability of bacterial STI vaccines among young HPV-vaccinated Canadian women to inform future vaccine program implementation. Methods A 20-item cross-sectional questionnaire was administered from June 2019 to June 2020 to HPV-vaccinated participants of the pan-Canadian QUEST cohort. Multivariable logistic regression models assessed interest in chlamydia, syphilis, and gonorrhea vaccines using a priori variables and factors significant in bivariate analysis. Results Of the 1092 respondents analyzed, 82% indicated interest in receiving one or more future STI vaccines. Respondents had a median age of 19.6 years (range 16.9–23.4), and 75% of respondents identified as white/European descent. In adjusted analyses, intent to engage in positive health behaviours was associated with vaccine interest for syphilis (OR = 5.76, 95% CI 4.03–8.27), chlamydia (OR = 5.27, 95% CI 3.66–7.63), and gonorrhea (OR = 5.96, 95% CI 4.15–8.60). Willingness to pay for an STI vaccine was also associated with vaccine interest for syphilis (OR = 2.02, 95% CI 1.29–3.19), chlamydia (OR = 2.41, 95% CI 1.50–3.90), and gonorrhea (OR = 2.29, 95% CI 1.44–3.63). Ever having sexual intercourse and identifying as LGBTQ were significantly associated with vaccine interest for all infections, while age and ever being immunosuppressed were not significant in any adjusted models. Conclusion Findings indicate over 80% of participants in a cohort of young HPV-vaccinated Canadian women are interested in receiving future bacterial STI vaccines. Further exploration of STI vaccine acceptability among diverse populations is required to inform future bacterial STI vaccine program implementation. Supplementary Information The online version contains supplementary material available at 10.17269/s41997-022-00648-2.
Collapse
Affiliation(s)
- Anna de Waal
- Faculty of Medicine, McGill University, Montreal, Quebec, Canada
- BC Women's Hospital and Health Service, Women's Health Research Institute, Box 42, Room H203G - 4500 Oak Street, Vancouver, BC, V6H 3N1, Canada
- Vaccine Evaluation Center, BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada
| | - C Sarai Racey
- BC Women's Hospital and Health Service, Women's Health Research Institute, Box 42, Room H203G - 4500 Oak Street, Vancouver, BC, V6H 3N1, Canada
- Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Robine Donken
- BC Women's Hospital and Health Service, Women's Health Research Institute, Box 42, Room H203G - 4500 Oak Street, Vancouver, BC, V6H 3N1, Canada
- Vaccine Evaluation Center, BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada
- Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Kara Plotnikoff
- BC Women's Hospital and Health Service, Women's Health Research Institute, Box 42, Room H203G - 4500 Oak Street, Vancouver, BC, V6H 3N1, Canada
| | | | - Laurie Smith
- BC Women's Hospital and Health Service, Women's Health Research Institute, Box 42, Room H203G - 4500 Oak Street, Vancouver, BC, V6H 3N1, Canada
- BC Cancer, Vancouver, British Columbia, Canada
| | - Troy Grennan
- Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
- BC Centre for Disease Control, Vancouver, British Columbia, Canada
| | - Manish Sadarangani
- Vaccine Evaluation Center, BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada
- Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Gina Ogilvie
- BC Women's Hospital and Health Service, Women's Health Research Institute, Box 42, Room H203G - 4500 Oak Street, Vancouver, BC, V6H 3N1, Canada.
- Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
- BC Centre for Disease Control, Vancouver, British Columbia, Canada.
| |
Collapse
|
12
|
Ali S, Kammerer E, Thompson G, Mater A, Rajagopal M, Bone JN, Birnie KA, Oberlander T, Chambers CT, Goldman RD. A multicentre Canadian survey of caregiver perspectives on COVID vaccine-related pain and stress for their family. Br J Pain 2022; 16:490-497. [PMID: 36389007 PMCID: PMC9644106 DOI: 10.1177/20494637221090452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/03/2023] Open
Abstract
Background Caregiver hesitancy for their children to receive the COVID-19 vaccine remains due to concerns regarding safety and efficacy, but also due to fear of vaccine administration-related pain and distress. Study objectives were to determine caregivers' perceptions regarding both their personal and child's COVID-19 vaccine administration-related stress and fear and relate this to their likelihood to allow their child to receive COVID-19 vaccinations. Methods This study was a secondary data analysis of a multicentre, cross-sectional survey of caregivers presenting to four Canadian pediatric emergency departments. Caregivers were surveyed between December 2020 and March 2021 and completed a digital survey on their own smartphones. Results 331 caregivers responded to the survey (mean age 39.9 years [SD 7.71]); 74.2% (245/331) were mothers. Children's mean age was 8.8 years [SD 5.4]; 49.8% (165/331) were female. 64.1% (209/326) of caregivers were willing to vaccinate their child against COVID-19, while 35.9% (117/326) were not. Greater perceived COVID-19 vaccine administration-related pain (0.88 [0.80; 0.95], p = .003) and stress (0.82 [0.76; 0.89], p = <.001) for their child as well as greater perceived personal stress with their own COVID-19 vaccine administration (0.81 [0.75; 0.88], p = <.001) were associated with caregivers being less likely to vaccinate their child. Conclusions During the time period between COVID-19 pandemic waves 2 and 3, and after the vaccine had been federally approved for adults, one-third of Canadian caregivers surveyed reported being unwilling to vaccinate their child against COVID-19 in the future. Managing children's and caregivers' vaccine administration-related fear and stress may improve vaccine uptake for children.
Collapse
Affiliation(s)
- Samina Ali
- Departments of Pediatrics and Emergency
Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB,
Canada
- Women and Children’s Health Research
Institute, University of Alberta, Edmonton, AB, Canada
| | - Elise Kammerer
- Department of Pediatrics, Faculty of
Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
- Solutions for Kids in Pain, Halifax,
Halifax, NS, Canada
| | - Graham Thompson
- Departments of Pediatrics and Emergency
Medicine, University of Calgary, Calgary, AB, Canada
- Alberta Children’s Hospital, Calgary,
AB, Canada
| | - Ahmed Mater
- Pediatric Emergency Medicine,
University of Saskatchewan, Saskatoon, SK, Canada
- Jim Pattison Children’s Hospital,
Saskatoon, SK, Canada
| | - Manasi Rajagopal
- Department of Pediatrics, Faculty of
Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Jeffrey N Bone
- British Columbia Children’s Hospital
Research Institute, Vancouver, BC, Canada
| | - Kathryn A Birnie
- Solutions for Kids in Pain, Halifax,
Halifax, NS, Canada
- Departments of Anesthesiology,
Perioperative and Pain Medicine, and Community Health Sciences, University of
Calgary, Calgary, AB, Canada
| | - Tim Oberlander
- School of Population and Public
Health, University of British Columbia, Vancouver, BC, Canada
- BC Children’s Hospital, Vancouver,
BC, Canada
| | - Christine T Chambers
- Solutions for Kids in Pain, Halifax,
Halifax, NS, Canada
- Departments of Psychology and
Neuroscience and Pediatrics, Dalhousie University, Halifax, Nova Scotia,
Canada
- Centre for Pediatric Pain Research,
IWK Health Centre, Halifax, NS, Canada
| | - Ran D Goldman
- The Pediatric Research in Emergency
Therapeutics (PRETx) Program, Division of Emergency Medicine, Department of
Pediatrics, University of British Columbia, Vancouver, BC, Canada
- Children’s Hospital Research
Institute, Vancouver, BC, Canada
| | | |
Collapse
|
13
|
Soomar SM, Soomar SM, Khan M, Moin G, Azam I. COVID-19 vaccine acceptance and hesitancy among the general population of Pakistan: a population-based survey. BMJ Open 2022; 12:e064096. [PMID: 36115670 PMCID: PMC9485645 DOI: 10.1136/bmjopen-2022-064096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 08/28/2022] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES This study aims to determine the COVID-19 vaccination coverage and the factors associated with vaccine acceptance and hesitancy in the general population of Pakistan. SETTING This population-based study covers all major areas of Pakistan, including Sindh, Punjab, Khyber Pakhtunkhwa and Baluchistan provinces and the capital Islamabad. PARTICIPANTS A total of 541 male and female Pakistani adults above 18 years were interviewed to determine the COVID-19 vaccination coverage and understand the factors associated with vaccine acceptance and hesitancy. OUTCOME The outcome was COVID-19 vaccination status (not vaccinated or vaccinated). RESULTS Of 541 participants, 227 (41.96%) were non-vaccinated and 314 (58.04%) were vaccinated. Two-thirds of the participants from both the non-vaccinated and vaccinated groups (185 (81.50%) vs 236 (75.16%), p=0.008) reside in Sindh. Nearly one-third of participants from both groups were ever infected with COVID-19 (77 (33.92%) and 90 (28.66%)). The odds of COVID-19 vaccination among the age group 34-42 years were 1.75 times higher (95% CI 1.35 to 2.09, p=0.008) than the other age groups. The odds of COVID-19 vaccination among those with COVID-19 ever-infected family members were 1.87 times higher (95% CI 1.56 to 2.34, p=0.032) than those with uninfected family members. CONCLUSIONS Targeted interventions for subsets of populations reluctant to vaccination can improve vaccine coverage. Moreover, advocacy and explaining the public health benefits of vaccination can enhance the coverage in Pakistan.
Collapse
Affiliation(s)
| | | | - Maria Khan
- Medical College, The Aga Khan University, Karachi, Pakistan
| | | | - Iqbal Azam
- Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan
| |
Collapse
|
14
|
Vaccine Coverage in Children Younger Than 1 Year of Age during Periods of High Epidemiological Risk: Are We Preparing for New Outbreaks? CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9091334. [PMID: 36138643 PMCID: PMC9497469 DOI: 10.3390/children9091334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/06/2022] [Revised: 08/27/2022] [Accepted: 08/28/2022] [Indexed: 11/17/2022]
Abstract
Background: According to WHO, infectious disease control can be achieved if the vaccine coverage (VC) exceeds 90%. In recent years there has been a declining trend in VC which could lead to the recurrence of infectious diseases. Objectives: The study analyzed the determinants of VC and of parental decisions regarding immunization in children aged 0−1 year monitored during two high-risk epidemiological periods (the measles epidemic and the COVID-19 pandemic period). Methods: A retrospective observational cohort study-data regarding vaccination of children younger than 1 year of age during the periods January 2019−June 2019 (measles epidemic) and January 2020−June 2020 (COVID-19 pandemic) were analyzed. 2.850 children from 2019 and 2.823 children from 2020 were enrolled. Family physicians interacted with 2840 parents or legal guardians in 2019 and with 2800 parents or legal guardians in 2020, during the infants’ consults providing medical information and answer to their questions and worries regarding their immunization. Data on immunization schedules on the determinants of parents’ decisions regarding vaccination were evaluated. Results: During 2019−2020, VC has followed a declining trend for each type of vaccine included in the Romanian National Immunization Program; the most affected were infants aged 9−12 months during both periods: in 9-month aged infants, the MMR vaccine VC was 67.49% in 2019 vs. 59.04% in 2020 (p < 0.004). In the 12 months aged infants, the MMR VC was 64.29% in 2019 vs. 55.88% in 2020 (p < 0.005). For the Hexavalent vaccine administered at the age of 11 months, the VC was 71.59% in 2019 vs. 62.08% in 2020 (p < 0.001). The determinants of parents’ decisions regarding vaccination included parental hesitance 2019—25% vs. 2020—35%, fear on side effects 2019—32% vs. 2020—45%, vaccination denial 2019—7% vs. 2020—10%. Conclusion: We found a declining trend in the VC in Romania during the epidemic and pandemic periods. The decrease in VC for MMR generated a major risk for new measles outbreaks Permanent awareness educational campaigns regarding infectious disease risk are needed, accompanied by the empowerment of primary care and the emergence of an immunization management program based on national regulatory legislation.
Collapse
|
15
|
MacDonald NE, Dube E, Comeau JL. Have vaccine hesitancy models oversimplified a complex problem to our detriment? The Adapted Royal Society of Canada vaccine uptake framework. Vaccine 2022; 40:3927-3930. [PMID: 35637069 PMCID: PMC9142183 DOI: 10.1016/j.vaccine.2022.05.052] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 04/19/2022] [Accepted: 05/19/2022] [Indexed: 11/29/2022]
Affiliation(s)
- N E MacDonald
- Department of Paediatrics, Dalhousie University and IWK Health Centre, Halifax, Canada.
| | - E Dube
- Institut National de Sante Publique du Quebec, Université Laval, Quebec, Canada
| | - J L Comeau
- Department of Paediatrics, Dalhousie University and IWK Health Centre, Halifax, Canada
| |
Collapse
|
16
|
Basta NE, Sohel N, Sulis G, Wolfson C, Maimon G, Griffith LE, Kirkland S, McMillan JM, Thompson M, Raina P. Factors Associated With Willingness to Receive a COVID-19 Vaccine Among 23,819 Adults Aged 50 Years or Older: An Analysis of the Canadian Longitudinal Study on Aging. Am J Epidemiol 2022; 191:987-998. [PMID: 35166332 PMCID: PMC8903402 DOI: 10.1093/aje/kwac029] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Revised: 02/01/2022] [Accepted: 02/03/2022] [Indexed: 11/13/2022] Open
Abstract
Identifying persons who are least willing to receive a coronavirus disease 2019 (COVID-19) vaccine is critical for increasing uptake via targeted outreach. We conducted a survey of 23,819 Canadian Longitudinal Study on Aging participants from September 29 to December 29, 2020, to assess factors associated with COVID-19 vaccination willingness and reasons for willingness or lack thereof. Among adults aged 50-96 years, 84.1% (95% confidence interval (CI): 83.7, 84.6) were very or somewhat willing to receive a COVID-19 vaccine; 15.9% (95% CI: 15.4, 16.3) were uncertain or very or somewhat unwilling. Based on logistic regression, those who were younger, female, had lower education and income, were non-White, and lived in a rural area were less willing to receive a COVID-19 vaccine. After controlling for these factors, recent receipt of influenza vaccine (adjusted odds ratio = 14.3, 95% CI: 12.5, 16.2) or planning to receive influenza vaccine (adjusted odds ratio = 10.5, 95% CI: 9.5, 11.6), as compared with no receipt or planning, was most strongly associated with COVID-19 vaccination willingness. Willingness was also associated with believing one had never been infected with severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2) and experiencing negative pandemic consequences. Safety concerns were most common among those unwilling. Our comprehensive assessment of COVID-19 vaccination willingness among older adults in Canada, a prioritized group for vaccination due to their risk of severe COVID-19 outcomes, provides a road map for conducting outreach to increase uptake, which is urgently needed.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | | | | | - Parminder Raina
- Correspondence to Dr. Parminder Raina, Department of Health Research Methods, Evidence and Impact, Faculty of Health Sciences, McMaster University, 309A McMaster Innovation Park, 1280 Main Street West, Hamilton, ON L8S 4K1, Canada (e-mail: )
| | | |
Collapse
|
17
|
Patwary MM, Alam MA, Bardhan M, Disha AS, Haque MZ, Billah SM, Kabir MP, Browning MHEM, Rahman MM, Parsa AD, Kabir R. COVID-19 Vaccine Acceptance among Low- and Lower-Middle-Income Countries: A Rapid Systematic Review and Meta-Analysis. Vaccines (Basel) 2022; 10:427. [PMID: 35335059 PMCID: PMC8950670 DOI: 10.3390/vaccines10030427] [Citation(s) in RCA: 84] [Impact Index Per Article: 42.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 02/25/2022] [Accepted: 03/08/2022] [Indexed: 02/01/2023] Open
Abstract
Widespread vaccination against COVID-19 is critical for controlling the pandemic. Despite the development of safe and efficacious vaccinations, low-and lower-middle income countries (LMICs) continue to encounter barriers to care owing to inequitable access and vaccine apprehension. This study aimed to summarize the available data on COVID-19 vaccine acceptance rates and factors associated with acceptance in LMICs. A comprehensive search was performed in PubMed, Scopus, and Web of Science from inception through August 2021. Quality assessments of the included studies were carried out using the eight-item Joanna Briggs Institute Critical Appraisal tool for cross-sectional studies. We performed a meta-analysis to estimate pooled acceptance rates with 95% confidence intervals (CI). A total of 36 studies met the inclusion criteria and were included in the review. A total of 83,867 respondents from 33 countries were studied. Most of the studies were conducted in India (n = 9), Egypt (n = 6), Bangladesh (n = 4), or Nigeria (n = 4). The pooled-effect size of the COVID-19 vaccine acceptance rate was 58.5% (95% CI: 46.9, 69.7, I2 = 100%, 33 studies) and the pooled vaccine hesitancy rate was 38.2% (95% CI: 27.2-49.7, I2 = 100%, 32 studies). In country-specific sub-group analyses, India showed the highest rates of vaccine acceptancy (76.7%, 95% CI: 65.8-84.9%, I2= 98%), while Egypt showed the lowest rates of vaccine acceptancy (42.6%, 95% CI: 16.6-73.5%, I2= 98%). Being male and perceiving risk of COVID-19 infection were predictors for willingness to accept the vaccine. Increasing vaccine acceptance rates in the global south should be prioritized to advance global vaccination coverage.
Collapse
Affiliation(s)
- Muhammad Mainuddin Patwary
- Environment and Sustainability Research Initiative, Khulna 9208, Bangladesh; (M.B.); (A.S.D.); (M.Z.H.); (S.M.B.); (M.P.K.)
- Environmental Science Discipline, Life Science School, Khulna University, Khulna 9208, Bangladesh
| | - Md Ashraful Alam
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo 113-0033, Japan;
- Tokyo Foundation for Policy Research, Tokyo 106-6234, Japan
| | - Mondira Bardhan
- Environment and Sustainability Research Initiative, Khulna 9208, Bangladesh; (M.B.); (A.S.D.); (M.Z.H.); (S.M.B.); (M.P.K.)
- Environmental Science Discipline, Life Science School, Khulna University, Khulna 9208, Bangladesh
| | - Asma Safia Disha
- Environment and Sustainability Research Initiative, Khulna 9208, Bangladesh; (M.B.); (A.S.D.); (M.Z.H.); (S.M.B.); (M.P.K.)
- Environmental Science Discipline, Life Science School, Khulna University, Khulna 9208, Bangladesh
| | - Md. Zahidul Haque
- Environment and Sustainability Research Initiative, Khulna 9208, Bangladesh; (M.B.); (A.S.D.); (M.Z.H.); (S.M.B.); (M.P.K.)
- Environmental Science Discipline, Life Science School, Khulna University, Khulna 9208, Bangladesh
| | - Sharif Mutasim Billah
- Environment and Sustainability Research Initiative, Khulna 9208, Bangladesh; (M.B.); (A.S.D.); (M.Z.H.); (S.M.B.); (M.P.K.)
- Environmental Science Discipline, Life Science School, Khulna University, Khulna 9208, Bangladesh
| | - Md Pervez Kabir
- Environment and Sustainability Research Initiative, Khulna 9208, Bangladesh; (M.B.); (A.S.D.); (M.Z.H.); (S.M.B.); (M.P.K.)
- Environmental Science Discipline, Life Science School, Khulna University, Khulna 9208, Bangladesh
| | | | - Md. Mizanur Rahman
- Hitotsubashi Institute for Advanced Study, Hitotsubashi University, 2-1 Naka Kunitachi, Tokyo 186-8601, Japan;
| | - Ali Davod Parsa
- School of Allied Health, Faculty of Health, Education, Medicine and Social Care, Anglia Ruskin University, Chelmsford CM1 1SQ, UK; (A.D.P.); (R.K.)
| | - Russell Kabir
- School of Allied Health, Faculty of Health, Education, Medicine and Social Care, Anglia Ruskin University, Chelmsford CM1 1SQ, UK; (A.D.P.); (R.K.)
| |
Collapse
|
18
|
Burger R, Köhler T, Golos AM, Buttenheim AM, English R, Tameris M, Maughan-Brown B. Longitudinal changes in COVID-19 vaccination intent among South African adults: evidence from the NIDS-CRAM panel survey, February to May 2021. BMC Public Health 2022; 22:422. [PMID: 35236319 PMCID: PMC8889513 DOI: 10.1186/s12889-022-12826-5] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 02/04/2022] [Indexed: 12/13/2022] Open
Abstract
Background COVID-19 vaccine hesitancy has threatened the ability of many countries worldwide to contain the pandemic. Given the severe impact of the pandemic in South Africa and disruptions to the roll-out of the vaccine in early 2021, slower-than-expected uptake is a pressing public health challenge in the country. We examined longitudinal changes in COVID-19 vaccination intent among South African adults, as well as determinants of intent to receive a vaccine. Methods We used longitudinal data from Wave 4 (February/March 2021) and Wave 5 (April/May 2021) of the National Income Dynamics Study: Coronavirus Rapid Mobile Survey (NIDS-CRAM), a national and broadly representative panel survey of adults in South Africa. We conducted cross-sectional analyses on aggregate and between-group variation in vaccination intent, examined individual-level changes between waves, and modeled demographic predictors of intent. Results We analysed data for 5629 (Wave 4; 48% male, mean age 41.5 years) and 5862 (Wave 5; 48% male, mean age 41.6 years) respondents. Willingness to get a COVID-19 vaccine significantly increased from 70.8% (95% CI: 68.5–73.1) in Wave 4 to 76.1% (95% CI: 74.2–77.8) in Wave 5. Individual-level analyses indicated that only 6.6% of respondents remained strongly hesitant between survey waves. Although respondents aged 18–24 years were 8.5 percentage points more likely to report hesitancy, hesitant respondents in this group were 5.6 percentage points more likely to change their minds by Wave 5. Concerns about rushed testing and safety of the vaccines were frequent and strongly-held reasons for hesitancy. Conclusions Willingness to receive a COVID-19 vaccine has increased among adults in South Africa, and those who were entrenched in their reluctance make up a small proportion of the country’s population. Younger adults, those in formal housing, and those who trusted COVID-19 information on social media were more likely to be hesitant. Given that stated vaccination intent may not translate into behaviour, our finding that three-quarters of the population were willing to accept the vaccine may reflect an upper bound. Vaccination promotion campaigns should continue to frame vaccine acceptance as the norm and tailor strategies to different demographic groups. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-12826-5.
Collapse
Affiliation(s)
- Ronelle Burger
- Research on Socio-Economic Policy, Department of Economics, Stellenbosch University, Stellenbosch, South Africa
| | - Timothy Köhler
- Development Policy Research Unit, School of Economics, University of Cape Town, Cape Town, South Africa
| | - Aleksandra M Golos
- Department of Family and Community Health, University of Pennsylvania School of Nursing, 416 Fagin Hall, 418 Curie Blvd, Philadelphia, PA, 19104, USA.
| | - Alison M Buttenheim
- Department of Family and Community Health, University of Pennsylvania School of Nursing, 416 Fagin Hall, 418 Curie Blvd, Philadelphia, PA, 19104, USA
| | - René English
- Division of Health Systems and Public Health. Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - Michele Tameris
- South African Tuberculosis Vaccine Initiative, Department of Pathology, Institute of Infectious Diseases and Molecular Medicine, University of Cape Town, Cape Town, South Africa
| | - Brendan Maughan-Brown
- Southern Africa Labour and Development Research Unit, School of Economics, University of Cape Town, Cape Town, South Africa
| |
Collapse
|
19
|
Factors Associated with COVID-19 Vaccine Hesitancy among Visible Minority Groups from a Global Context: A Scoping Review. Vaccines (Basel) 2021; 9:vaccines9121445. [PMID: 34960192 PMCID: PMC8708108 DOI: 10.3390/vaccines9121445] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 11/24/2021] [Accepted: 12/02/2021] [Indexed: 11/17/2022] Open
Abstract
Vaccine hesitancy is one of the top ten greatest threats to global health. During the COVID-19 era, vaccine hesitancy poses substantial risks, especially in visible minorities, who are disproportionately affected by the pandemic. Although evidence of vaccine hesitancy exists, there is minimal focus on visible minorities and the reasons for hesitancy in this group are unclear. Identifying these populations and their reasons for vaccine hesitancy is crucial in improving vaccine uptake and curbing the spread of COVID-19. This scoping review follows a modified version of the Arksey and O'Malley strategy. Using comprehensive search strategies, advanced searches were conducted on Medline, CINAHL, and PubMed databases to acquire relevant articles. Full-text reviews using inclusion and exclusion criteria were performed to extract themes of vaccine hesitancy. Themes were grouped into factors using thematic qualitative analysis and were objectively confirmed by principal component analysis (PCA). To complement both analyses, a word cloud of titles and abstracts for the final articles was generated. This study included 71 articles. Themes were grouped into 8 factors and the top 3 recurring factors were safety and effectiveness of the vaccine, mistrust, and socioeconomic characteristics. Shedding light on these factors could help mitigate health inequities and increase overall vaccine uptake worldwide through interventions and policies targeted at these factors. Ultimately, this would help achieve global herd immunity.
Collapse
|
20
|
Hyland P, Vallières F, Hartman TK, McKay R, Butter S, Bentall RP, McBride O, Shevlin M, Bennett K, Mason L, Gibson-Miller J, Levita L, Martinez AP, Stocks TVA, Karatzias T, Murphy J. Detecting and describing stability and change in COVID-19 vaccine receptibility in the United Kingdom and Ireland. PLoS One 2021; 16:e0258871. [PMID: 34731208 PMCID: PMC8565732 DOI: 10.1371/journal.pone.0258871] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 10/06/2021] [Indexed: 01/22/2023] Open
Abstract
COVID-19 continues to pose a threat to global public health. Multiple safe and effective vaccines against COVID-19 are available with one-third of the global population now vaccinated. Achieving a sufficient level of vaccine coverage to suppress COVID-19 requires, in part, sufficient acceptance among the public. However, relatively high rates of hesitance and resistance to COVID-19 vaccination persists, threating public health efforts to achieve vaccine-induced population protection. In this study, we examined longitudinal changes in COVID-19 vaccine acceptance, hesitance, and resistance in two nations (the United Kingdom and the Republic of Ireland) during the first nine months of the pandemic, and identified individual and psychological factors associated with consistent non-acceptance of COVID-19 vaccination. Using nationally representative, longitudinal data from the United Kingdom (UK; N = 2025) and Ireland (N = 1041), we found that (1) COVID-19 vaccine acceptance declined in the UK and remained unchanged in Ireland following the emergence of approved vaccines; (2) multiple subgroups existed reflecting people who were consistently willing to be vaccinated ('Accepters': 68% in the UK and 61% in Ireland), consistently unwilling to be vaccinated ('Deniers': 12% in the UK and 16% in Ireland), and who fluctuated over time ('Moveable Middle': 20% in the UK and 23% in Ireland); and (3) the 'deniers' and 'moveable middle' were distinguishable from the 'accepters' on a range of individual (e.g., younger, low income, living alone) and psychological (e.g., distrust of scientists and doctors, conspiracy mindedness) factors. The use of two high-income, Western European nations limits the generalizability of these findings. Nevertheless, understanding how receptibility to COVID-19 vaccination changes as the pandemic unfolds, and the factors that distinguish and characterise those that are hesitant and resistant to vaccination is helpful for public health efforts to achieve vaccine-induced population protection against COVID-19.
Collapse
Affiliation(s)
- Philip Hyland
- Department of Psychology, Maynooth University, Maynooth, Ireland
| | | | - Todd K. Hartman
- Sheffield Methods Institute, University of Sheffield, Sheffield, England
| | - Ryan McKay
- Department of Psychology, Royal Holloway, University of London, London, England
| | - Sarah Butter
- Department of Psychology, University of Sheffield, Sheffield, England
| | | | - Orla McBride
- School of Psychology, Ulster University, Ulster, Northern Ireland
| | - Mark Shevlin
- School of Psychology, Ulster University, Ulster, Northern Ireland
| | - Kate Bennett
- School of Psychology, University of Liverpool, Liverpool, England
| | - Liam Mason
- Clinical, Education & Health Psychology, University College London, London, England
| | | | - Liat Levita
- Department of Psychology, University of Sheffield, Sheffield, England
| | - Anton P. Martinez
- Department of Psychology, University of Sheffield, Sheffield, England
| | | | - Thanos Karatzias
- School of Health and Social Care, Edinburgh Napier University, Edinburgh, Scotland
| | - Jamie Murphy
- School of Psychology, Ulster University, Ulster, Northern Ireland
| |
Collapse
|
21
|
Yasmin F, Asghar W, Babar MS, Khan H, Ahmad S, Hameed Z, Asghar MS, Nauman H, Khattak AK, Arshad Z, Shah SMI, Siddiqui SA, Osama M, Zarak MS. Acceptance Rates and Beliefs toward COVID-19 Vaccination among the General Population of Pakistan: A Cross-Sectional Survey. Am J Trop Med Hyg 2021; 105:1230-1239. [PMID: 34525449 PMCID: PMC8592216 DOI: 10.4269/ajtmh.21-0297] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 08/01/2021] [Indexed: 01/02/2023] Open
Abstract
Developing countries like Pakistan have previously suffered from barriers to acceptance of vaccination by the public because of financial and belief barriers. This study aims to explore these beliefs and highlight concerns regarding vaccine hesitancy in the general population of Pakistan since they are a hindrance to an effective coronavirus disease-19 (COVID-19) immunization in the country. A cross-sectional study was performed involving 1,778 participants from all four provinces of Pakistan. Results from the study showed more than half of the participants to be unsure of the safety (50%) and efficacy (51%) of the vaccine, whereas 42% were concerned about the side effects of the vaccine. About 72% of the respondents planned to get vaccinated, whereas 28% refused to do so. Internationally made imported vaccines were more trusted by the participants. Forty-four percent of the participants agreed to receive the vaccine upon recommendation from a physician. Lastly, participants who believed in the efficacy of the polio vaccination also considered the COVID-19 vaccine to be safe and effective.
Collapse
Affiliation(s)
- Farah Yasmin
- 1Department of Internal Medicine, Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan
| | - Waleed Asghar
- 2City Gynae Hospital Toba Tek Singh, Medicine, Toba Tek Singh, Punjab, Pakistan
| | - Maryam Salma Babar
- 3Dubai Medical College for Girls, Faculty of Medicine, Dubai, United Arab Emirates
| | - Hiba Khan
- 3Dubai Medical College for Girls, Faculty of Medicine, Dubai, United Arab Emirates
| | - Shoaib Ahmad
- 4General Medicine and Surgery, Punjab Medical College, Faisalabad, Pakistan
| | - Zaid Hameed
- 5Department of Internal Medicine, Allied Hospital, Faisalabad, Pakistan
| | | | - Hamza Nauman
- 1Department of Internal Medicine, Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan
| | | | - Zara Arshad
- 8Department of Internal Medicine, Capital Hospital, Islamabad, Pakistan
| | | | - Sarush Ahmed Siddiqui
- 1Department of Internal Medicine, Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan
| | - Muhammad Osama
- 10Department of General Surgery, Dow University of Health Sciences, Karachi, Pakistan
| | | |
Collapse
|
22
|
Ferrara P, Masuet-Aumatell C, Ramon-Torrell JM. Acceptance of yellow fever vaccine in the older traveller: a cohort study. ACTA BIO-MEDICA : ATENEI PARMENSIS 2021; 92:e2021098. [PMID: 34487067 PMCID: PMC8477116 DOI: 10.23750/abm.v92i4.11619] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 04/26/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND AND AIM Current demographic changes and improvement of quality of life of elderly population have direct consequences on international travelling. The older traveller demands for specific care and precautions to be observed, as for the yellow fever (YF) vaccination, due to the increased incidence rate of adverse events following immunization (AEFI) in people aged 60 years or over. The aim of our study was to determine the adherence to YF vaccine and travel behaviours in a sample of elderly travellers moving to YF endemic areas. METHODS Participants in this cohort study were offered YF vaccine, and informed about the increased risk of AEFIs and the unavoidable risk of acquiring YF at the destination. The research was planned on survey-based design, using pre- and post-travel questionnaires. RESULTS In 2018, 239 travellers aged 60 years or older attended our travel clinic, of whom 36.8% (n = 88) planned to travel to YF endemic areas and 23.0% (n = 55) for the first time. Of these, 63.6% accepted and 36.4% rejected the vaccination, with 15 travellers moving to endemic areas without immunization, including one patient who presented contraindications to YF vaccine. CONCLUSIONS The presence of more than a third of elderly travellers who travelled without vaccination is a substantial public health problem and, since the number of older travellers continues to increase, it becomes necessary to implement robust actions to improve YF vaccine advocacy and adherence.
Collapse
|
23
|
Taye BT, Amogne FK, Demisse TL, Zerihun MS, Kitaw TM, Tiguh AE, Mihret MS, Kebede AA. Coronavirus disease 2019 vaccine acceptance and perceived barriers among university students in northeast Ethiopia: A cross-sectional study. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2021; 12:100848. [PMID: 34395948 PMCID: PMC8351076 DOI: 10.1016/j.cegh.2021.100848] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Revised: 07/20/2021] [Accepted: 07/30/2021] [Indexed: 11/09/2022] Open
Abstract
Background Universities are places where students live and study in close contact to each other. Nowadays, the foundations of this particular group have been affected significantly by the rapid spread of the coronavirus disease 2019. The severity of the COVID-19 pandemic has demanded the emergency use of COVID-19 vaccines. However, there is still limited evidence in COVID-19 vaccine acceptability and perceived barriers among some subgroups, including university students. This study aimed to assess vaccine acceptance, associated factors, and perceived barriers among university students, Ethiopia. Methods A cross-sectional study was conducted in January 2021 at Debre Berhan University among 423 students. The participants were selected using simple random sampling technique. A semi-structured, pretested, and self-administered questionnaire was used to collect the data. Multivariable logistic-regression model was fitted to identify factors associated with vaccine acceptance. An adjusted odds ratio with 95% confidence interval and its p-value of ≤0.05 was used to declare significant association. Results The proportion of the COVID-19 vaccine acceptance was 69.3% (95% CI: 65, 74). Being knowledgeable (AOR: 2.43, CI: 1.57, 3.77), being a health science student (AOR: 2.25, CI: 1.43, 3.54), and being in a family practicing COVID-19 prevention (AOR: 1.73, CI: 1.06, 2.81) were found to be factors associated with COVID-19 vaccine acceptance. Conclusion Though, this study found a 69.3% acceptance of COVID-19 vaccine, there were noticeable perceived barriers and related factors in vaccine acceptance hesitancy. Thus, health education and communication regarding the vaccine are very crucial to alleviate the identified barriers.
Collapse
Affiliation(s)
- Birhan Tsegaw Taye
- Department of Midwifery, College of Medicine and Health Sciences, Debre Berhan University, Debre Berhan Ethiopia
| | - Fetene Kasahun Amogne
- Department of Midwifery, College of Medicine and Health Sciences, Debre Berhan University, Debre Berhan Ethiopia
| | - Tesfanesh Lemma Demisse
- Department of Midwifery, College of Medicine and Health Sciences, Debre Berhan University, Debre Berhan Ethiopia
| | - Mulualem Silesh Zerihun
- Department of Midwifery, College of Medicine and Health Sciences, Debre Berhan University, Debre Berhan Ethiopia
| | - Tebabere Moltot Kitaw
- Department of Midwifery, College of Medicine and Health Sciences, Debre Berhan University, Debre Berhan Ethiopia
| | - Agumas Eskezia Tiguh
- Department of Clinical Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar Ethiopia
| | - Muhabaw Shumye Mihret
- Department of Clinical Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar Ethiopia
| | - Azmeraw Ambachew Kebede
- Department of Clinical Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar Ethiopia
| |
Collapse
|
24
|
Potter J, Lindblad AJ. Vaccine hesitancy in the office: what can I do? CANADIAN FAMILY PHYSICIAN MEDECIN DE FAMILLE CANADIEN 2021; 67:516. [PMID: 34261714 DOI: 10.46747/cfp.6707516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
| | - Adrienne J Lindblad
- Associate Clinical Professor in the Department of Family Medicine at the University of Alberta in Edmonton
| |
Collapse
|
25
|
O'Doherty KC, Crann S, Bucci LM, Burgess MM, Chauhan A, Goldenberg MJ, McMurtry CM, White J, Willison DJ. Deliberation on Childhood Vaccination in Canada: Public Input on Ethical Trade-Offs in Vaccination Policy. AJOB Empir Bioeth 2021; 12:253-265. [PMID: 34328070 DOI: 10.1080/23294515.2021.1941416] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Policy decisions about childhood vaccination require consideration of multiple, sometimes conflicting, public health and ethical imperatives. Examples of these decisions are whether vaccination should be mandatory and, if so, whether to allow for non-medical exemptions. In this article we argue that these policy decisions go beyond typical public health mandates and therefore require democratic input. METHODS We report on the design, implementation, and results of a deliberative public forum convened over four days in Ontario, Canada, on the topic of childhood vaccination. RESULTS 25 participants completed all four days of deliberation and collectively developed 20 policy recommendations on issues relating to mandatory vaccinations and exemptions, communication about vaccines and vaccination, and AEFI (adverse events following immunization) compensation and reporting. Notable recommendations include unanimous support for mandatory childhood vaccination in Ontario, the need for broad educational communication about vaccination, and the development of a no-fault compensation scheme for AEFIs. There was persistent disagreement among deliberants about the form of exemptions from vaccination (conscience, religious beliefs) that should be permissible, as well as appropriate consequences if parents do not vaccinate their children. CONCLUSIONS We conclude that conducting deliberative democratic processes on topics that are polarizing and controversial is viable and should be further developed and implemented to support democratically legitimate and trustworthy policy about childhood vaccination.
Collapse
Affiliation(s)
| | - Sara Crann
- Department of Psychology, University of Guelph, Guelph, Ontario, Canada
| | - Lucie Marisa Bucci
- Immunize Canada, c/o Canadian Public Health Association, Ottawa, Ontario, Canada
| | - Michael M Burgess
- W. Maurice Young Centre for Applied Ethics, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Apurv Chauhan
- Department of Psychology, University of Guelph, Guelph, Ontario, Canada
| | - Maya J Goldenberg
- Department of Philosophy, University of Guelph, Guelph, Ontario, Canada
| | - C Meghan McMurtry
- Department of Psychology, University of Guelph, Guelph, Ontario, Canada
| | - Jessica White
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Donald J Willison
- Department of Psychology, University of Guelph, Guelph and Pediatric Chronic Pain Program, McMaster Children's Hospital, Hamilton, Ontario, Canada
| |
Collapse
|
26
|
Mutyoba JN, Surkan PJ, Makumbi F, Aizire J, Kirk GD, Ocama P, Atuyambe LM. Hepatitis B birth dose vaccination for newborns in Uganda: A qualitative inquiry on pregnant women's perceptions, barriers and preferences. J Virus Erad 2021; 7:100039. [PMID: 34026246 PMCID: PMC8122110 DOI: 10.1016/j.jve.2021.100039] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Revised: 04/26/2021] [Accepted: 04/26/2021] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Sub-Saharan Africa continues with very low hepatitis B (HBV) birth dose vaccination coverage. To guide policy on HBV vaccine for newborns, we explored perceptions, barriers and preferences of pregnant women regarding HBV and the HBV birth dose vaccination. METHODS We conducted eight focus groups discussions (FGDs) among 70 pregnant women, stratified by rural-urban residence, age and education level, using a structured focus group discussion guide to explore birth dose awareness, perceptions, barriers and preferences. Data were transcribed, coded and analysed using framework analysis. RESULTS Perceptions related to HBV and liver cancer causes and prevention were diverse; most FGD participants did not perceive illnesses as distinctly different. Older women-groups, both urban and rural, had never heard about HBV, but were aware of liver cancer, viewing the disease as fatal. No FGD participants were aware of HBV birth dose. Concerns included vaccine safety, its availability to women who deliver outside the health system and mistrust in health-care worker (HCWs) when handling newborns. Rural-dwelling groups perceived absence of HBV services, while FGDs with young participants believed vaccine side-effects hampered birth dose planning. Most women-groups preferred (i) oral to injectable vaccines; (ii) receiving birth dose education during antenatal, to media-based education; (iii) that newborns receive the birth dose immediately after delivery in the mother's presence. CONCLUSION Although the birth dose is acceptable among pregnant women, planners need to continuously engage them as key stakeholders during planning to address concerns, in order to raise confidence, maximize uptake and strengthen HBV eradication efforts.
Collapse
Affiliation(s)
- Joan Nankya Mutyoba
- Department of Epidemiology & Biostatistics, School of Public Health, Makerere University College of Health Sciences, P.O. Box 7072, Kampala, Uganda
| | - Pamela J. Surkan
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Fredrick Makumbi
- Department of Epidemiology & Biostatistics, School of Public Health, Makerere University College of Health Sciences, P.O. Box 7072, Kampala, Uganda
| | - Jim Aizire
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Gregory D. Kirk
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
- Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Ponsiano Ocama
- Department of Medicine, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda
| | - Lynn M. Atuyambe
- Department of Community Health & Behavioral Sciences, School of Public Health, Makerere University College of Health Sciences, Kampala, Uganda
| |
Collapse
|
27
|
Cerda AA, García LY. Hesitation and Refusal Factors in Individuals' Decision-Making Processes Regarding a Coronavirus Disease 2019 Vaccination. Front Public Health 2021; 9:626852. [PMID: 33968880 PMCID: PMC8096991 DOI: 10.3389/fpubh.2021.626852] [Citation(s) in RCA: 78] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 02/23/2021] [Indexed: 12/26/2022] Open
Abstract
Introduction: Considering the global prevalence of coronavirus disease 2019 (COVID-19), a vaccine is being developed to control the disease as a complementary solution to hygiene measures-and better, in social terms, than social distancing. Given that a vaccine will eventually be produced, information will be needed to support a potential campaign to promote vaccination. Objective: The aim of this study was to determine the variables affecting the likelihood of refusal and indecision toward a vaccine against COVID-19 and to determine the acceptance of the vaccine for different scenarios of effectiveness and side effects. Materials and Methods: A multinomial logistic regression method based on the Health Belief Model was used to estimate the current methodology, using data obtained by an online anonymous survey of 370 respondents in Chile. Results: The results indicate that 49% of respondents were willing to be vaccinated, with 28% undecided or 77% of individuals who would potentially be willing to be inoculated. The main variables that explained the probability of rejection or indecision were associated with the severity of COVID-19, such as, the side effects and effectiveness of the vaccine; perceived benefits, including immunity, decreased fear of contagion, and the protection of oneself and the environment; action signals, such as, responses from ones' family and the government, available information, and specialists' recommendations; and susceptibility, including the contagion rate per 1,000 inhabitants and relatives with COVID-19, among others. Our analysis of hypothetical vaccine scenarios revealed that individuals preferred less risky vaccines in terms of fewer side effects, rather than effectiveness. Additionally, the variables that explained the indecision toward or rejection of a potential COVID-19 vaccine could be used in designing public health policies. Conclusions: We discovered that it is necessary to formulate specific, differentiated vaccination-promotion strategies for the anti-vaccine and undecided groups based on the factors that explain the probability of individuals refusing or expressing hesitation toward vaccination.
Collapse
Affiliation(s)
| | - Leidy Y. García
- Faculty of Economics and Business, University of Talca, Talca, Chile
| |
Collapse
|
28
|
Srirangan K, Lavenue A. Helping Québec Pharmacists Seize the Vaccination Service Opportunity: The Pharmacy Best Practice Workshops. PHARMACY 2021; 9:pharmacy9010051. [PMID: 33802564 PMCID: PMC8005967 DOI: 10.3390/pharmacy9010051] [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: 02/02/2021] [Revised: 02/16/2021] [Accepted: 02/24/2021] [Indexed: 11/16/2022] Open
Abstract
Vaccinations are a safe and effective way to protect against infectious diseases. The World Health Organization estimates vaccines have saved more lives than any other interventions and every year about two to three million deaths are averted worldwide through immunization. To improve vaccination coverage, pharmacists have been increasingly involved in immunization roles in their communities-as advocates, educators, and immunizers. Community pharmacy-based vaccination services have increased both in the number of immunization providers and the number of sites where patients can receive immunizations. In Canada, health care is under provincial legislation-and so, there are distinct differences in scope of pharmacist practice across the country. Prior to the COVID-19 outbreak in early 2020, in Québec, Canada's second-largest province, pharmacists did not have the authority to administer vaccines. To help prepare pharmacists in Québec to become immunizers, we developed and deployed a series of accredited workshops. In these facilitated workshops, pharmacists were able to share best practices that may lead to providing effective vaccination services, identify common competency gaps, discuss effective patient communication skills, and determine how to target the most vulnerable population groups. Participants were also asked to evaluate the workshop. Our results indicate the evaluation was very reliable in measuring participant satisfaction (Cronbach's α = 0.94) and pharmacists commented that the workshops' learning outcomes exceeded their expectations, and the topics covered were relevant and applicable. The evaluation also asked participants to identify weaknesses of training, so future educational interventions can be planned accordingly. We believe this work will contribute to the continual growth and advancement of the pharmacy profession in Canada.
Collapse
|
29
|
Assessment of Vaccine Hesitancy to a COVID-19 Vaccine in Cameroonian Adults and Its Global Implication. Vaccines (Basel) 2021; 9:vaccines9020175. [PMID: 33669659 PMCID: PMC7922050 DOI: 10.3390/vaccines9020175] [Citation(s) in RCA: 66] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 02/07/2021] [Accepted: 02/15/2021] [Indexed: 11/16/2022] Open
Abstract
Since the outbreak of COVID-19 in December 2019, no global consensus treatment has been developed and generally accepted for the disease. However, eradicating the disease will require a safe and efficacious vaccine. In order to prepare for the eventual development of a safe and efficacious COVID-19 vaccine and to enhance its uptake, it is imperative to assess vaccine hesitancy in Cameroonians. After obtaining ethical clearance from the Institutional Review Board of the University of Buea, a questionnaire was administered (May–August 2020) to consenting adults either online or in person. A qualitative thematic analysis was done to analyze the participants’ answers to the open questions. A deductive approach was used, that is, the codes and patterns according to the World Health Organization (WHO) Strategic Advisory Group of Experts (SAGE) Working Group Matrix of Determinants of vaccine hesitancy. The number of consenting adult Cameroonians who completed the questionnaire were 2512 (Two thousand five hundred and twelve). Vaccine hesitancy to a COVID-19 vaccine was 84.6% in Cameroonians. Using the WHO recommended Matrix of Determinant of Vaccine hesitancy, the most prominent determinants observed in this study were: Communication and Media Environment, Perception of pharmaceutical industry, Reliability and/or source of vaccine and cost. Most Cameroonians agree that even though there are benefits of a clinical trial, they will prefer it should be done out of the continent and involving African scientists for eventual acceptance and uptake. The concerns of safety, efficacy and confidence has to be addressed using a Public Engagement approach if a COVID-19 vaccine has to be administered successfully in Africa or Cameroon specifically. Since this study was carried out following WHO standards, its result can be compared to those of other studies carried out in different cultural settings using similar standards.
Collapse
|
30
|
Kucukkendirci H, Kara F, Turgut GG. Reasons for Vaccine Rejection in 0 to 2 Years Old Children Registered to Family Health Centers in Konya. J PEDIAT INF DIS-GER 2021. [DOI: 10.1055/s-0041-1722972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
AbstractObjective According to the 2017 report of the World Health Organization (WHO), ∼1.5 million people die from vaccine preventable diseases. The WHO is working to generate and popularize effective vaccination programs. However, the concept of “vaccine rejection,” which first started in Europe and United States, has started to make an impact in Turkey during the past 10 years. It is therefore seen as a growing danger in future. This study was conducted to determine, detect, and prevent the reasons of vaccine rejection that have increased in recent years.Methods A cross-sectional study was conducted between June and December at 2015. In all districts of Konya (n = 31), it was aimed to reach all 242 families who rejected vaccination to their 0 to 2 years old babies. Families having more than one child refused to vaccinate all of their children. A questionnaire consisting of 47 questions was prepared by the researchers, using the standard trainings of the Ministry of Health and the literature. A total of 172 families agreed to participate in this study. The questionnaire was applied to the parents using the telephone interview technique. Data were presented as mean ± standard deviation and percentage.Results About 41.3% (n = 71) of the mothers were high school graduates, 50.6% (n = 87) of their fathers were university graduates. About 82.6% (n = 142) of the participants received examination, treatment and follow-up services from family physicians and family health personnel. About 20.9% (n = 36) of the children were the only children of the family. About 55.8% (n = 96) of the families also refused the vaccination for other children. About 83.7% (n = 144) of the unvaccinated children had infants/children follow-up care. While all participants stated that vaccines had side effects, 31.4% (n = 54) of these believed that vaccines cause autism or paralysis in infants. About 62.2% (n = 107) of their mothers did not receive tetanus vaccine during pregnancy. The highest rate of nonvaccination was with the second dose of hepatitis A vaccine, which 96.5% (n = 166) refused. The most accepted vaccine was the first dose of hepatitis B vaccine, which was refused by 18.0% (n = 31). About 79.7% (n = 137) of the participants did not know the reason for the vaccination and 95.9% (n = 165) thought that the vaccines were not required. All participants received information from the health personnel about the vaccines. While 9.9% (n = 17) of the families thought that vaccines cause infertility, 44.8% (n = 77) did not receive vaccination because the vaccines were produced abroad.Conclusion A growing number of families refuse to have their babies vaccinated. The production of vaccines abroad is a major cause of insecurity. There are also beliefs that vaccines cause infertility. Vaccine production in Turkey should be accelerated and public education about vaccines should be reviewed. Training provided to families about vaccines should also be reviewed.
Collapse
Affiliation(s)
- Hasan Kucukkendirci
- Department of Public Health, Meram Faculty of Medicine, Necmettin Erbakan University, Konya
| | - Fatih Kara
- Department of Public Health, Faculty of Medicine, Selcuk University, Konya
| | | |
Collapse
|
31
|
Cerda AA, García LY. Hesitation and Refusal Factors in Individuals' Decision-Making Processes Regarding a Coronavirus Disease 2019 Vaccination. Front Public Health 2021. [PMID: 33968880 DOI: 10.3389/fpubh.2021.626852/bibtex] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/21/2023] Open
Abstract
Introduction: Considering the global prevalence of coronavirus disease 2019 (COVID-19), a vaccine is being developed to control the disease as a complementary solution to hygiene measures-and better, in social terms, than social distancing. Given that a vaccine will eventually be produced, information will be needed to support a potential campaign to promote vaccination. Objective: The aim of this study was to determine the variables affecting the likelihood of refusal and indecision toward a vaccine against COVID-19 and to determine the acceptance of the vaccine for different scenarios of effectiveness and side effects. Materials and Methods: A multinomial logistic regression method based on the Health Belief Model was used to estimate the current methodology, using data obtained by an online anonymous survey of 370 respondents in Chile. Results: The results indicate that 49% of respondents were willing to be vaccinated, with 28% undecided or 77% of individuals who would potentially be willing to be inoculated. The main variables that explained the probability of rejection or indecision were associated with the severity of COVID-19, such as, the side effects and effectiveness of the vaccine; perceived benefits, including immunity, decreased fear of contagion, and the protection of oneself and the environment; action signals, such as, responses from ones' family and the government, available information, and specialists' recommendations; and susceptibility, including the contagion rate per 1,000 inhabitants and relatives with COVID-19, among others. Our analysis of hypothetical vaccine scenarios revealed that individuals preferred less risky vaccines in terms of fewer side effects, rather than effectiveness. Additionally, the variables that explained the indecision toward or rejection of a potential COVID-19 vaccine could be used in designing public health policies. Conclusions: We discovered that it is necessary to formulate specific, differentiated vaccination-promotion strategies for the anti-vaccine and undecided groups based on the factors that explain the probability of individuals refusing or expressing hesitation toward vaccination.
Collapse
Affiliation(s)
- Arcadio A Cerda
- Faculty of Economics and Business, University of Talca, Talca, Chile
| | - Leidy Y García
- Faculty of Economics and Business, University of Talca, Talca, Chile
| |
Collapse
|
32
|
MacDonald NE, Comeau J, Dubé È, Graham J, Greenwood M, Harmon S, McElhaney J, Meghan McMurtry C, Middleton A, Steenbeek A, Taddio A. Royal society of Canada COVID-19 report: Enhancing COVID-19 vaccine acceptance in Canada. Facets (Ott) 2021. [DOI: 10.1139/facets-2021-0037] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
COVID-19 vaccine acceptance exists on a continuum from a minority who strongly oppose vaccination, to the “moveable middle” heterogeneous group with varying uncertainty levels about acceptance or hesitancy, to the majority who state willingness to be vaccinated. Intention for vaccine acceptance varies over time. COVID-19 vaccination decisions are influenced by many factors including knowledge, attitudes, and beliefs; social networks; communication environment; COVID-19 community rate; cultural and religious influences; ease of access; and the organization of health and community services and policies. Reflecting vaccine acceptance complexity, the Royal Society of Canada Working Group on COVID-19 Vaccine Acceptance developed a framework with four major factor domains that influence vaccine acceptance (people, communities, health care workers; immunization knowledge; health care and public health systems including federal/provincial/territorial/indigenous factors)—each influencing the others and all influenced by education, infection control, extent of collaborations, and communications about COVID-19 immunization. The Working Group then developed 37 interrelated recommendations to support COVID vaccine acceptance nested under four categories of responsibility: 1. People and Communities, 2. Health Care Workers, 3. Health Care System and Local Public Health Units, and 4. Federal/Provincial/Territorial/Indigenous. To optimize outcomes, all must be engaged to ensure co-development and broad ownership.
Collapse
Affiliation(s)
- Noni E. MacDonald
- Department of Pediatrics (Infectious Diseases), Faculty of Medicine, Dalhousie University and IWK Health Centre, Halifax, Canada
| | - Jeannette Comeau
- Division of Infectious Diseases, Dalhousie University and IWK Health Centre, Halifax, Canada
| | - Ève Dubé
- Scientific Group on Immunization at the Quebec National Institute of Public Health, Québec, Canada
- Department of Anthropology, Université Laval, Québec, QC G1V 0A6, Canada
| | - Janice Graham
- Department of Pediatrics, Division of Infectious Diseases, Dalhousie University, Halifax, NS B3H 2Y9, Canada
| | - Margo Greenwood
- School of Education, University of Northern British Columbia, Prince George, BC V2N 4Z9, Canada
- Department of First Nations Studies, University of Northern British Columbia, Prince George, BC V2N 4Z9, Canada
- National Collaborating Centre for Indigenous Health, Prince George, BC V2N 4Z9, Canada
| | - Shawn Harmon
- Department of Pediatrics, Technoscience and Regulation Research Unit, Dalhousie University, Halifax, NS B3H 4R2, Canada
| | - Janet McElhaney
- Medical Sciences Division, Northern Ontario School of Medicine, Sudbury, ON P3E 2C6, Canada
- Health Sciences North Research Institute, Sudbury, ON P3E 2H2, Canada
| | - C. Meghan McMurtry
- Pediatric Pain, Health and Communication Lab (PPHC), University of Guelph, Guelph, ON N1G 2W1, Canada
- Department of Psychology, University of Guelph, Guelph, ON N1G 2W1, Canada
- Clinical and Health Psychologist with the Pediatric Chronic Pain Program, McMaster Children’s Hospital, Hamilton, ON L8N 3Z5, Canada
| | - Alan Middleton
- Schulich Executive Education Centre, York University, North York, ON M3J 1P3, Canada
| | - Audrey Steenbeek
- School of Nursing, Faculty of Health, Dalhousie University, Halifax, NS B3H 4R2, Canada
| | - Anna Taddio
- Clinical Social and Administrative Pharmacy, Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON M5S 3M2, Canada
- The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada
| |
Collapse
|
33
|
Holroyd TA, Sauer MA, Limaye RJ. Vaccine decision-making among parents of children on Medicaid with and without autism spectrum disorder. Vaccine 2020; 38:6777-6784. [PMID: 32917415 DOI: 10.1016/j.vaccine.2020.08.041] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2020] [Revised: 08/03/2020] [Accepted: 08/14/2020] [Indexed: 11/16/2022]
Abstract
BACKGROUND The belief that there is a link between the MMR vaccine and autism has led to a decline in childhood-immunization uptake and a resurgence of preventable infectious diseases. This study aimed to understand how the vaccine decision-making process differed between parents with a child diagnosed with autism and parents with a child that did not have autism. METHODS Interviews were conducted in September-December 2018 with 24 racially and demographically diverse parents of children on Medicaid at two Baltimore clinics serving Medicaid patients, one of which only serves families of children with autism. We conducted a semi-structured, qualitative, in-person in-depth interview study to explore parental perceptions of vaccine-decision making. Interviews with participants were transcribed from audio recordings. We then extracted and analyzed the types of barriers each participant experienced. RESULTS Parent descriptions of their vaccine decision-making process focused on three primary factors: concerns about vaccines, the relationship between the child's provider and the parent, and risk perception. These findings are in line with existing literature that has articulated key factors in the vaccine decision-making process generally. Parents of a child with autism were more likely to consider the idea that vaccines were linked to autism in their decision-making process, and were less likely to be influenced by personalized recommendations from the child's health care provider. CONCLUSION Parental concerns about vaccines, the parent-provider relationship, and vaccine risk perception all contribute to vaccine decision-making among parents of children with and without ASD. However, providers may find it especially difficult to manage parental misconceptions about vaccines and developmental disabilities. Future studies can identify alternative communication techniques and determine what mechanisms may be more effective in encouraging vaccine acceptance among parents of children with ASD.
Collapse
Affiliation(s)
- Taylor A Holroyd
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, United States; International Vaccine Access Center, Johns Hopkins University Bloomberg School of Public Health, United States.
| | - Molly A Sauer
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, United States; International Vaccine Access Center, Johns Hopkins University Bloomberg School of Public Health, United States.
| | - Rupali J Limaye
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, United States; International Vaccine Access Center, Johns Hopkins University Bloomberg School of Public Health, United States; Institute for Vaccine Safety, Johns Hopkins University Bloomberg School of Public Health, United States; Department of Health, Behavior & Society, Johns Hopkins University Bloomberg School of Public Health, United States; Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, United States.
| |
Collapse
|
34
|
Czajka H, Czajka S, Biłas P, Pałka P, Jędrusik S, Czapkiewicz A. Who or What Influences the Individuals' Decision-Making Process Regarding Vaccinations? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E4461. [PMID: 32575879 PMCID: PMC7344516 DOI: 10.3390/ijerph17124461] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 06/05/2020] [Accepted: 06/16/2020] [Indexed: 12/14/2022]
Abstract
Thanks to vaccines, many people are not exposed to the risks associated with vaccine-preventable diseases (VPDs). This, however, results in growing popularity of antivaccine movements and affects global and local epidemiological situation. Vaccine hesitancy has become a significant problem not only for epidemiologists but also for practitioners. Fortunately, the hesitant group seems to be vulnerable to intervention, and studies indicate that these patients can be persuaded to undergo vaccinations. The aim of the present study was to determine the factors most strongly affecting vaccination-related attitudes and decisions. An anonymous, self-administered survey consisting of demographic data and single select multiple-choice questions regarding vaccination was conducted. The voluntary study included secondary school pupils, medical and nonmedical students, healthcare professionals, hospital and clinic patients as well as parents. A total of 7950 survey forms were distributed between January 2018 and June 2019 in south-eastern Poland. A total of 6432 respondents (80.2%) completed a questionnaire that was eligible for analysis. The positive attitude toward vaccination was significantly affected by older age, by the fact of obtaining information on vaccinations from a physician, this information's higher quality (assessed in school grade scale), higher level of knowledge on vaccines and by the fact of denying the association between vaccination and autism in children (p < 0.001). The probability of supporting vaccinations was almost eight-fold lower among respondents believing the vaccine-autism relationship. Chance of supporting vaccination doubled in the group with a higher knowledge level. The individuals not provided with expert information on vaccination were twice as often unconvinced. Age, education and having children significantly affected the attitude toward influenza immunization (p < 0.001). Older, better educated respondents and those having children were more positive about vaccinations. The medical community still exert decisive effects on attitudes toward vaccinations. High-quality information provided by them is of great importance. Skillful and competent provision of evidence-based information disproving the myth about vaccine-autism connection and proper education of medical staff is essential in molding positive attitudes toward vaccinations.
Collapse
Affiliation(s)
- Hanna Czajka
- Faculty of Medicine, University of Rzeszów, 35-959 Rzeszów, Poland;
- St. Louis Regional Specialised Children’s Hospital, 31-503 Krakow, Poland
| | - Szymon Czajka
- Department of Anesthesiology and Intensive Care, School of Medicine in Katowice, Medical University of Silesia in Katowice, 40-752 Katowice, Poland
| | - Paweł Biłas
- Student’s Scientific Society, Faculty of Medicine, University of Rzeszów, 35-959 Rzeszów, Poland; (P.B.); (P.P.); (S.J.)
| | - Paulina Pałka
- Student’s Scientific Society, Faculty of Medicine, University of Rzeszów, 35-959 Rzeszów, Poland; (P.B.); (P.P.); (S.J.)
| | - Szczepan Jędrusik
- Student’s Scientific Society, Faculty of Medicine, University of Rzeszów, 35-959 Rzeszów, Poland; (P.B.); (P.P.); (S.J.)
| | - Anna Czapkiewicz
- Faculty of Management, AGH University of Science and Technology, 30-067 Kraków, Poland;
| |
Collapse
|
35
|
Sondagar C, Xu R, MacDonald NE, Dubé E. Vaccine acceptance: How to build and maintain trust in immunization. CANADA COMMUNICABLE DISEASE REPORT = RELEVE DES MALADIES TRANSMISSIBLES AU CANADA 2020; 46:155-159. [PMID: 32558811 PMCID: PMC7279131 DOI: 10.14745/ccdr.v46i05a09] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
In Canada, over 80% of parents choose to vaccinate their children. Although this may appear positive, it is one of the lowest vaccination rates in the western world, and does not meet the 95% coverage rate needed to prevent outbreaks of vaccine-preventable diseases such as measles. A recent national immunization survey showed approximately 50% of parents are concerned about potential side-effects from vaccines, 25% believe that a vaccine can cause the disease it was meant to prevent, and 13% think alternative practices could eliminate the need for vaccines. In addition, vaccine hesitancy-defined by its determinants: confidence, complacency and convenience-is on rise. To address the complacency and trust (confidence) components of vaccine hesitancy, four best practices to optimize trust in vaccines and promote vaccine acceptance are presented. The first best practice is to understand the concerns; this is done at a population level via research and at individual level via motivational interviewing. The second best practice is to address these concerns by effectively presenting science-based information. This is done at a population level by communicating research and at an individual level by applying this research to the specific concerns, values and norms of the individual. Third, present immunization as a social norm, both in educational materials and in conversations. Finally, resilience is fostered by planning ahead (both at a population level and for individual practitioners) to manage events that can undermine trust and drive negative vaccine concerns, such as a new vaccine being added to the routine schedule or the emergence of an unexpected adverse event. Building and maintaining public trust in immunization takes time. Healthcare practitioners must keep in mind that while trust is a key element in vaccine acceptance, it is not the only element; convenience and access can also impact vaccine uptake. Nurturing trust is but one part of increasing vaccine acceptance and this brief will focus on strategies to build and nurture trust.
Collapse
Affiliation(s)
| | - Ruotian Xu
- Canadian Public Health Association, Ottawa, ON
| | - Noni E MacDonald
- Department of Pediatrics, Dalhousie University, IWK Health Centre, Halifax, NS
| | - Eve Dubé
- Quebec National Institute of Public Health, Québec, QC
| |
Collapse
|
36
|
Abstract
The avalanche of online information on immunization is having a major impact on the percentage of the population who choose to get vaccinated. Vaccine misinformation spreads widely with the interactive Web 2.0 and social media; this can bury science-based information. A plethora of immunization misinformation online is affecting trust in health care professionals and in public immunization programs. There are no simple solutions to this, but seven evidence-based strategies can help. First, listen to patients' and parents' concerns, and demonstrate responsiveness by adopting best immunization practices, such as pain mitigation. Second, recognize and alert others to anti-immunization tactics, namely, conspiracy theories, fake experts, selectivity, demands that vaccines be 100% safe and effective, misrepresentation and false logic. Third, avoid unproductive debates with those who have strongly held views, both in person and when using social media. Be respectful, stick to your key message, identify where to find useful information and exit. Fourth, consider establishing an attractive, easily searchable online presence that reflects the complex art of persuasion. Emphasize the benefits of vaccine, use reader-friendly graphics and highlight facts with stories to strengthen your case. Fifth, work with social media platform providers, not to stifle freedom of expression, but to help ensure that misinformation is not favoured in searches. Sixth, promote curriculum development in the schools to improve students' understanding of the benefits and safety of immunization and to foster critical thinking skills. To do this, optimize the use of age-appropriate comics and interactive learning tools such as electronic games. Seventh, to shift the narrative in specific communities with low vaccination rates, work with community leaders to build tailored programs that foster trust and reflect local values.
Collapse
|
37
|
Vaccine hesitancy and Web 2.0: Exploring how attitudes and beliefs about influenza vaccination are exchanged in online threaded user comments. Vaccine 2019; 37:1769-1774. [DOI: 10.1016/j.vaccine.2019.02.028] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Revised: 11/20/2018] [Accepted: 02/07/2019] [Indexed: 11/23/2022]
|
38
|
Shen SC, Dubey V. Addressing vaccine hesitancy: Clinical guidance for primary care physicians working with parents. CANADIAN FAMILY PHYSICIAN MEDECIN DE FAMILLE CANADIEN 2019; 65:175-181. [PMID: 30867173 PMCID: PMC6515949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
OBJECTIVE To provide primary care physicians with clinical guidance for addressing parental vaccine hesitancy. SOURCES OF INFORMATION The PubMed database was searched for English-language articles published in the 10 years before January 1, 2018. Search terms included vaccine hesitancy or confidence or acceptance, parents or children, and communication, counseling, or clinical practice. References of identified articles were assessed for additional relevant articles. A separate gray literature search was conducted using Google to find best-practice guidelines from public health and health care organizations, knowledge translation materials for health care providers, and resources that could be used in discussions with parents about vaccines. MAIN MESSAGE Practical tips for addressing parental vaccine hesitancy in primary care include starting early, presenting vaccination as the default approach, building trust, being honest about side effects, providing reassurance on a robust vaccine safety system, focusing on protection of the child and community, telling stories, and addressing pain. Also provided are statements that providers could use in vaccination-related conversations; answers to commonly asked questions on benefits, safety, and immunologic aspects of vaccines; and links to a number of online resources for physicians and parents. CONCLUSION Vaccine-hesitant parents who are on the fence far outnumber vaccine refusers; therefore, counseling this group might be more effective. Reasons behind vaccine hesitancy are complex and encompass more than just a knowledge deficit. As a trusted source of information on vaccines, family physicians play a key role in driving vaccine acceptance.
Collapse
Affiliation(s)
- Shixin Cindy Shen
- Resident in the Public Health and Preventive Medicine program at the University of Toronto in Ontario.
| | - Vinita Dubey
- Associate Medical Officer of Health with Toronto Public Health and Adjunct Professor in the Dalla Lana School of Public Health at the University of Toronto
| |
Collapse
|
39
|
Shen SC, Dubey V. Répondre à l’hésitation face à la vaccination. CANADIAN FAMILY PHYSICIAN MEDECIN DE FAMILLE CANADIEN 2019; 65:e91-e98. [PMID: 30867188 PMCID: PMC6515971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Objectif Conseiller aux médecins de première ligne une approche clinique pour parler de l’hésitation face à la vaccination avec les parents. Sources de l’information On a recherché sur PubMed des articles publiés en anglais dans les 10 années ayant précédé le 1er janvier 2018. Les mots-clés anglais étaient vaccine hesitancy ou confidence ou acceptance, parents ou children, et communication, counseling ou clinical practice . On a épluché les références des articles relevés, à la recherche d’autres articles pertinents. Une recherche distincte de la littérature parallèle a été effectuée sur Google pour trouver les lignes directrices de pratique clinique publiées par les organisations de santé publique et de soins de santé, le matériel de transfert des connaissances à l’intention des professionnels de la santé et les ressources pouvant être utilisées durant les conversations avec les parents sur les vaccins. Message principal Les conseils pratiques pour répondre à l’hésitation des parents face à la vaccination dans les soins de première ligne consistent à commencer tôt, à présenter la vaccination comme l’approche par défaut, à établir une relation de confiance, à être honnête quant aux effets secondaires, à rassurer les parents en leur disant que le système d’innocuité vaccinale est solide, à s’attarder sur la protection de l’enfant et de la collectivité, à raconter des histoires et à parler de la douleur. Nous fournissons aussi des énoncés que les professionnels de la santé peuvent utiliser durant les conversations sur les vaccins; des réponses aux questions souvent posées sur les bienfaits, l’innocuité et l’aspect immunologique des vaccins; et des liens vers un certain nombre de ressources en ligne à l’intention des médecins et des parents. Conclusion Les parents qui n’ont pas pris position quant aux vaccins pour leurs enfants sont beaucoup plus nombreux que les parents qui refusent les vaccins; il serait ainsi plus efficace de conseiller ce groupe de parents. Les raisons qui incitent à la réticence chez les parents sont complexes et comprennent plus qu’un simple manque d’information. À titre de sources fiables d’information sur les vaccins, les médecins de famille jouent un rôle de premier plan pour stimuler l’acceptation des vaccins.
Collapse
Affiliation(s)
- Shixin Cindy Shen
- Résidente au programme de santé publique et de médecine préventive à l'Université de Toronto, en Ontario.
| | - Vinita Dubey
- Médecin-hygiéniste adjointe auprès de Toronto Public Health et professeure adjointe à la Faculté de santé publique Dalla Lana de l'Université de Toronto
| |
Collapse
|
40
|
Grace D, Gaspar M, Paquette R, Rosenes R, Burchell AN, Grennan T, Salit IE. HIV-positive gay men's knowledge and perceptions of Human Papillomavirus (HPV) and HPV vaccination: A qualitative study. PLoS One 2018; 13:e0207953. [PMID: 30496221 PMCID: PMC6264470 DOI: 10.1371/journal.pone.0207953] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Accepted: 11/08/2018] [Indexed: 11/22/2022] Open
Abstract
The human papillomavirus (HPV) is the most common sexually transmitted infection worldwide. Gay, bisexual, and other men who have sex with men (GBM) living with HIV are disproportionately impacted by HPV-associated anal cancer, with rates about 100-fold that of the general population. Fortunately, HPV vaccination has proven efficacy in preventing both anogenital warts (condyloma) in males and anal pre-cancers (anal intraepithelial neoplasia; AIN) in GBM up to the age of 26. We conducted in-depth, semi-structured interviews with 25 HIV-positive gay men in Toronto to gain an understanding of their knowledge and experiences related to HPV and the HPV vaccine. These participants were part of The HPV Screening and Vaccine Evaluation (HPV-SAVE) Study, and received invitations to have anal cancer screening from their primary care doctors. Interviews were analyzed following a Grounded Theory Approach. Most participants had not received the HPV vaccine. Men described a lack of prior knowledge of the health consequences of HPV for GBM living with HIV and financial barriers to vaccine access. Participants did not articulate concerns about vaccine safety. Men frequently reported initial beliefs that HPV was predominantly-or exclusively-a risk for females or young girls, and thus they had not considered the vaccine to be necessary. Some participants remained uncertain if the current availability of the vaccine, and their newly acquired knowledge of its importance, was "too little, too late" because of their age and/or HPV exposure. Improving access and uptake of HPV vaccination requires addressing both financial barriers to access as well as increasing HPV health literacy levels, particularly by reframing the long-standing gendered associations of HPV. Physicians should provide clear, tailored messages regarding HPV vaccination.
Collapse
Affiliation(s)
- Daniel Grace
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Mark Gaspar
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | | | - Ron Rosenes
- Canadian HIV/AIDS Legal Network, Toronto, Canada
| | | | - Troy Grennan
- British Columbia Centre for Disease Control, Vancouver, Canada
| | | |
Collapse
|
41
|
Tustin JL, Crowcroft NS, Gesink D, Johnson I, Keelan J, Lachapelle B. User-Driven Comments on a Facebook Advertisement Recruiting Canadian Parents in a Study on Immunization: Content Analysis. JMIR Public Health Surveill 2018; 4:e10090. [PMID: 30249585 PMCID: PMC6231725 DOI: 10.2196/10090] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Revised: 06/30/2018] [Accepted: 07/19/2018] [Indexed: 11/13/2022] Open
Abstract
Background More people are searching for immunization information online and potentially being exposed to misinformation and antivaccination sentiment in content and discussions on social media platforms. As vaccination coverage rates remain suboptimal in several developed countries, and outbreaks of vaccine-preventable diseases become more prevalent, it is important that we build on previous research by analyzing themes in online vaccination discussions, including those that individuals may see without actively searching for information on immunization. Objective The study aimed to explore the sentiments and themes behind an unsolicited debate on immunization in order to better inform public health interventions countering antivaccination sentiment. Methods We analyzed and quantified 117 user-driven open-ended comments on immunization posted in the Comments section of a Facebook advertisement that targeted Canadian parents for recruitment into a larger study on immunization. Then, 2 raters coded all comments using content analysis. Results Of 117 comments, 85 were posted by unique commentators, with most being female (65/85, 77%). The largest proportion of the immunization comments were positive (51/117, 43.6%), followed by negative (41/117, 35.0%), ambiguous (20/117, 17.1%), and hesitant (5/117, 4.3%). Inaccurate knowledge (27/130, 20.8%) and misperceptions of risk (23/130, 17.7%) were most prevalent in the 130 nonpositive comments. Other claims included distrust of pharmaceutical companies or government agencies (18/130, 13.8%), distrust of the health care system or providers (15/130, 11.5%), past negative experiences with vaccination or beliefs (10/130, 7.7%), and attitudes about health and prevention (10/130, 7.7%). Almost 40% (29/74, 39%) of the positive comments communicated the risks of not vaccinating, followed by judgments on the knowledge level of nonvaccinators (13/74, 18%). A total of 10 positive comments (10/74, 14%) specifically refuted the link between autism and vaccination. Conclusions The presence of more than 100 unsolicited user-driven comments on a platform not intended for discussion, nor providing any information on immunization, illustrates the strong sentiments associated with immunization and the arbitrariness of the online platforms used for immunization debates. Health authorities should be more proactive in finding mechanisms to refute misinformation and misperceptions that are propagating uncontested online. Online debates and communications on immunization need to be identified by continuous monitoring in order for health authorities to understand the current themes and trends, and to engage in the discussion.
Collapse
Affiliation(s)
- Jordan Lee Tustin
- School of Occupational and Public Health, Ryerson University, Toronto, ON, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Natasha Sarah Crowcroft
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.,Public Health Ontario, Toronto, ON, Canada.,Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
| | - Dionne Gesink
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Ian Johnson
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Jennifer Keelan
- Department of Public Health, Concordia University of Edmonton, Edmonton, AB, Canada
| | | |
Collapse
|
42
|
Alsabbagh MW, Church D, Wenger L, Papastergiou J, Raman-Wilms L, Schneider E, Waite N. Pharmacy patron perspectives of community pharmacist administered influenza vaccinations. Res Social Adm Pharm 2018; 15:202-206. [PMID: 29724679 DOI: 10.1016/j.sapharm.2018.04.015] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Revised: 04/20/2018] [Accepted: 04/22/2018] [Indexed: 11/26/2022]
Abstract
BACKGROUND One approach to boost influenza vaccination coverage has been to expand immunization authority. In 2012, the province of Ontario gave community pharmacists the authority to administer the influenza vaccine. OBJECTIVE This study investigates the perspectives of Ontario pharmacy patrons, who had not recently received this vaccine from a pharmacist, regarding this pharmacist service. METHODS A survey was administered in six Ontario community pharmacies to pharmacy patrons who had not received an influenza vaccination from a pharmacist during the previous year. The instrument included questions about influenza vaccination, and knowledge of and attitudes toward vaccines and pharmacist-administered immunization. RESULTS A total of 541 pharmacy patrons completed the survey (53.9% response rate). About one-third (30.5%) of respondents were not aware that pharmacists could give the influenza vaccine, with younger individuals being less likely to be aware (OR 0.48, 95% CI 0.29-0.77, p < 0.05) and less likely to receive the vaccine annually (OR 0.28, 95% CI 0.19-0.42, p < 0.05). Leading reasons respondents gave as to why they did not receive their influenza vaccine from a pharmacist included not wanting or feeling they needed to be immunized (41.6%) and being used to receiving the vaccine from a physician (16.5%). Concerns about the experience and training of pharmacists and lack of privacy in a community pharmacy were uncommon. CONCLUSION Reduced awareness of the availability of pharmacist-provided influenza vaccine is still common. Pharmacists have a significant opportunity to address lack of awareness and vaccine hesitancy issues. They can promote this service to increase influenza vaccination rates among pharmacy patrons who do not utilize this professional service.
Collapse
Affiliation(s)
- Mhd Wasem Alsabbagh
- School of Pharmacy, University of Waterloo, 10Victoria St S A, Kitchener, ON, N2G 1C5, Canada; Ontario Pharmacy Evidence Network (OPEN), School of Pharmacy, University of Waterloo, 10 Victoria St S A, Kitchener, ON, N2G 1C5, Canada.
| | - Dana Church
- Ontario Pharmacy Evidence Network (OPEN), School of Pharmacy, University of Waterloo, 10 Victoria St S A, Kitchener, ON, N2G 1C5, Canada
| | - Lisa Wenger
- Ontario Pharmacy Evidence Network (OPEN), School of Pharmacy, University of Waterloo, 10 Victoria St S A, Kitchener, ON, N2G 1C5, Canada
| | - John Papastergiou
- Shoppers Drug Mart, Store Number 500, 1630 Danforth Ave, Toronto, ON, M4C 1H6, Canada; Ontario Pharmacy Evidence Network (OPEN), School of Pharmacy, University of Waterloo, 10 Victoria St S A, Kitchener, ON, N2G 1C5, Canada
| | - Lalitha Raman-Wilms
- Leslie Dan Faculty of Pharmacy, University of Toronto, 144College St, Toronto, ON, M5S 3M2, Canada; Ontario Pharmacy Evidence Network (OPEN), School of Pharmacy, University of Waterloo, 10 Victoria St S A, Kitchener, ON, N2G 1C5, Canada
| | - Eric Schneider
- School of Pharmacy, University of Waterloo, 10Victoria St S A, Kitchener, ON, N2G 1C5, Canada
| | - Nancy Waite
- School of Pharmacy, University of Waterloo, 10Victoria St S A, Kitchener, ON, N2G 1C5, Canada; Ontario Pharmacy Evidence Network (OPEN), School of Pharmacy, University of Waterloo, 10 Victoria St S A, Kitchener, ON, N2G 1C5, Canada
| |
Collapse
|
43
|
Shoukat A, Van Exan R, Moghadas SM. Cost-effectiveness of a potential vaccine candidate for Haemophilus influenzae serotype 'a'. Vaccine 2018; 36:1681-1688. [PMID: 29459062 DOI: 10.1016/j.vaccine.2018.01.047] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Revised: 01/12/2018] [Accepted: 01/17/2018] [Indexed: 02/06/2023]
Abstract
The preceding decade has witnessed the emergence of severe community-acquired acute infections caused by Haemophilus influenzae serotype a (Hia), with alarming incidence rates in North America, particularly among indigenous populations. The remarkable success of Hib conjugate vaccine over the past 20 years signify the development of an Hia vaccine candidate as a prevention measure to reduce the incidence of invasive Hia disease. However, quantifications of the long-term epidemiologic and economic impacts of vaccination are needed to inform decision on investment in Hia vaccine development and immunization programs. We sought to evaluate the cost-effectiveness of an Hia vaccine with a similar routine infant immunization schedules currently in practice for Hib in Canada. We developed and parameterized an agent-based simulation model using age-specific incidence rates reported for Nunavut, a Canadian territory with predominantly aboriginal populations. Our results, based on statistical analyses of the incremental cost-effectiveness ratio, show that an Hia conjugate vaccine is highly cost-effective. Sustaining an immunization program with vaccine coverages of 77% for primary series and 93% for booster dose over a 10-year period reduces the incidence of invasive disease by 63.8% on average from 9.97 to 3.61 cases, per 100,000 population. The overall costs of disease management in year 10 are reduced by 53.4% from CDN $1.863 million (95% CI: $1.229-$2.519 M) to CDN $0.868 million (95% CI: $0.627-$1.120 M). The findings suggest an important role for a conjugate vaccine in managing Hia disease as a growing public health threat.
Collapse
Affiliation(s)
- Affan Shoukat
- Agent-Based Modelling Laboratory, York University, Toronto, Ontario M3J 1P3, Canada.
| | - Robert Van Exan
- Immunization & Policy Translation, 16 Fire Route 105, Trent Lakes, Ontario K0M 1A0, Canada
| | - Seyed M Moghadas
- Agent-Based Modelling Laboratory, York University, Toronto, Ontario M3J 1P3, Canada
| |
Collapse
|
44
|
Perez S, Tatar O, Gilca V, Shapiro GK, Ogilvie G, Guichon J, Naz A, Rosberger Z. Untangling the psychosocial predictors of HPV vaccination decision-making among parents of boys. Vaccine 2017; 35:4713-4721. [DOI: 10.1016/j.vaccine.2017.07.043] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Revised: 07/05/2017] [Accepted: 07/13/2017] [Indexed: 01/27/2023]
|
45
|
Does Canada need to improve its immunization rates? CANADIAN FAMILY PHYSICIAN MEDECIN DE FAMILLE CANADIEN 2017; 63:e18. [PMID: 28115454 PMCID: PMC5257233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
|
46
|
Le Canada doit-il améliorer ses taux de vaccination? CANADIAN FAMILY PHYSICIAN MEDECIN DE FAMILLE CANADIEN 2017; 63:e19. [PMID: 28115455 PMCID: PMC5257234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
|
47
|
MacDonald NE. The long and winding road to improving immunization rates: Sharing best practices in Canada. CANADA COMMUNICABLE DISEASE REPORT = RELEVE DES MALADIES TRANSMISSIBLES AU CANADA 2016; 42:243-245. [PMID: 29769994 PMCID: PMC5757735 DOI: 10.14745/ccdr.v42i12a01] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Vaccines are one of the most effective ways to decrease childhood mortality. Unfortunately, however, Canada placed 28th out of 29 high-income countries in a 2013 UNICEF report that compared national uptake rates of early childhood immunizations. Work is underway to address this issue as reflected in the 2016 federal budget which highlights the importance of improving access to immunization. There are many steps that can be taken to improve vaccine uptake, such as identifying and better understanding the individual and program level factors that underlie delay or refusal to receive vaccines. However, it is challenging to find evidence and ensure its relevancy within the Canadian context. Targeted resources are needed that address the complexity of immunization along the entire continuum from vaccine manufacture through to patient uptake. Although there is a lot of information relevant to Canada, it has not been gathered together in one "go to" site and it is not curated. Canada needs a solid, easily accessible, user-friendly platform for sharing what works in immunization with health care professionals as well as parents and patients. This platform would be a major step in facilitating vaccine acceptance in Canada.
Collapse
Affiliation(s)
- NE MacDonald
- Department of Pediatrics - Infectious Diseases, Faculty of Medicine, Dalhousie University, Halifax, NS
| |
Collapse
|