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Yuan J, Li L, Dong M, So HC, Cowing BJ, Ip DKM, Liao Q. Parental vaccine hesitancy and influenza vaccine type preferences during and after the COVID-19 Pandemic. COMMUNICATIONS MEDICINE 2024; 4:165. [PMID: 39152249 PMCID: PMC11329729 DOI: 10.1038/s43856-024-00585-w] [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: 01/25/2024] [Accepted: 07/31/2024] [Indexed: 08/19/2024] Open
Abstract
BACKGROUND Seasonal influenza vaccine (SIV) greatly reduces disease burden among school-aged children, yet parental vaccine hesitancy remains a persistent challenge. Two types of SIV are available for children in Hong Kong and other locations: inactivated influenza vaccine (IIV), administered through intramuscular injection, and live attenuated influenza vaccine (LAIV), administered via nasal spray. We aimed to understand how vaccine hesitancy shaped parental preference for LAIV versus IIV, particularly amidst important public health events, such as the COVID-19 pandemic and the massive rollout of COVID-19 vaccination campaigns. METHODS We employed a concurrent mixed-methods design. The quantitative part involves longitudinal surveys spanning three years, from pre-pandemic to post-pandemic periods, tracking parental vaccine hesitancy and preference for SIV types. The qualitative part involves 48 in-depth interviews, providing insights into parental preference for SIV types, underlying reasons, and related values. RESULTS Our quantitative analyses show an overall increase in parental vaccine hesitancy and preference for LAIV over IIV after the onset of the COVID-19 pandemic and especially after the rollout of the COVID-19 vaccination campaign. Further logistic regression modelling based on the cohort data shows that higher vaccine hesitancy, coupled with the COVID-19 vaccination campaign rollout, predicts a greater preference for LAIV over IIV. The qualitative analysis complements these results, highlighting that LAIV's non-invasive nature aligns with parental values of prioritizing natural immunity and concerns about overmedication, leading to a more acceptable attitude towards LAIV. CONCLUSIONS Leveraging the higher acceptability of LAIV compared to IIV among parents with high vaccine hesitancy could promote childhood vaccination uptake.
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Affiliation(s)
- Jiehu Yuan
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Lan Li
- Centre for Digital Public Health in Emergencies, Institute for Risk and Disaster Reduction, University College London, London, UK
| | - Meihong Dong
- Hospital-Acquired Infection Control Department, Affiliated Foshan Hospital of Southern Medical University, Foshan, Guangdong, China
| | - Hau Chi So
- World Health Organization Collaborating Center for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Benjamin J Cowing
- World Health Organization Collaborating Center for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
- Laboratory of Data Discovery for Health Limited, Hong Kong Science and Technology Park, New Territories, Hong Kong, China
| | - Dennis Kai Ming Ip
- World Health Organization Collaborating Center for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Qiuyan Liao
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China.
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Pennisi F, Genovese C, Gianfredi V. Lessons from the COVID-19 Pandemic: Promoting Vaccination and Public Health Resilience, a Narrative Review. Vaccines (Basel) 2024; 12:891. [PMID: 39204017 PMCID: PMC11359644 DOI: 10.3390/vaccines12080891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2024] [Revised: 07/15/2024] [Accepted: 08/05/2024] [Indexed: 09/03/2024] Open
Abstract
The COVID-19 pandemic has underscored the critical importance of adaptable and resilient public health systems capable of rapid response to emerging health crises. This paper synthesizes the lessons learned from the COVID-19 vaccination campaign and explores strategies to enhance vaccine uptake in the post-pandemic era. Key challenges identified include logistical, economic, sociocultural, and policy dimensions that impact vaccination efforts, particularly in low-resource settings. The analysis highlights the need for resilient supply chains, effective communication, community engagement, and equitable access to healthcare resources. The rapid development and deployment of mRNA vaccines exemplify the potential of innovative vaccine technologies, though public trust and acceptance remain crucial. Strategies such as partnerships with local leaders, tailored messaging, and integration of digital tools are essential for combating vaccine hesitancy. By applying these insights, future vaccination campaigns can be more efficient, equitable, and resilient, ultimately improving public health outcomes globally. This paper aims to inform policy and practice, ensuring that public health strategies are evidence based and context specific, thus better preparing for future health challenges.
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Affiliation(s)
- Flavia Pennisi
- Faculty of Medicine, University Vita-Salute San Raffaele, 20132 Milan, Italy
| | - Cristina Genovese
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, 98125 Messina, Italy
| | - Vincenza Gianfredi
- Department of Biomedical Sciences for Health, University of Milan, Via Pascal 36, 20133 Milan, Italy
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Lohiniva AL, Pensola A, Hyökki S, Sivelä J, Härmä V, Tammi T. Identifying factors influencing COVID-19 vaccine uptake in Finland - a qualitative study using social media data. Front Public Health 2023; 11:1138800. [PMID: 37361144 PMCID: PMC10288145 DOI: 10.3389/fpubh.2023.1138800] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 05/23/2023] [Indexed: 06/28/2023] Open
Abstract
Introduction Vaccine demand creation requires understanding what is driving the uptake of the vaccine. 24 Qualitative research methods are paramount to gaining a localized understanding of behavioral 25 drivers and barriers to vaccine uptake, but they are often underutilized. Methods This is a qualitative study that 26 used public comments on the Facebook and Twitter posts of the Finnish Institute for Health and 27 Welfare (THL) as data sources to identify behavioral drivers for COVID-19 vaccine uptake in 28 Finland. The participatory data analysis utilized thematic analysis and the Theoretical Domains 29 Framework (TDF). NVIVO was used to assist in the coding process. Results The greatest number of FB and 30 Twitter comments were linked with six TDF domains: knowledge, environmental context and 31 resources, beliefs in consequences, beliefs in capabilities, social and professional role, and social 32 influences. The domains included 15 themes that were interlinked. The knowledge domain 33 overlapped with all other domains. Discussion By using public discourse on Facebook and Twitter, and rapid 34 qualitative data analysis methods within a behavioral insight framework, this study adds to the 35 emerging knowledge about behavioral drivers of COVID-19 vaccines that can be used by public 36 health experts to enhance the uptake of vaccines during future pandemics and epidemics.
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Wagner AL, Moniz MH, Stout MJ, Townsel C, Hawley ST, Zikmund-Fisher BJ. Experiences, risk perceptions, and COVID-19 vaccination outcomes among hospital workers. Vaccine 2023; 41:1247-1253. [PMID: 36639271 PMCID: PMC9826991 DOI: 10.1016/j.vaccine.2023.01.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 04/29/2022] [Accepted: 01/05/2023] [Indexed: 01/11/2023]
Abstract
BACKGROUND Although COVID-19 vaccinations have been available to hospital workers in the U.S. since December 2020, coverage is far from universal, even in groups with patient contact. The aim of this study was to describe COVID-19-related experiences at work and in the personal lives of nurses, allied health workers, and non-clinical staff with patient contact, and to assess whether these experiences relate to COVID-19 vaccination. METHODS Health care workers at a large Midwestern hospital in the U.S. were contacted to participate in an online cross-sectional survey during February 2021. A logistic regression model was used to estimate odds ratios (OR) for vaccination by different experiences, and we assessed mediation through models that also included measures of risk perceptions. RESULTS Among 366 nurse practitioners / nurse midwives / physician assistant, 1,698 nurses, 1,798 allied health professionals, and 1,307 non-clinical staff with patient contact, the proportions who had received or intended to receive a COVID-19 vaccination were 94 %, 87 %, 82 %, and 88 %, respectively. Working and being physically close to COVID-19 patients was not significantly associated with vaccine intent. Vaccination intent was significantly lower among those with a previous COVID-19 diagnosis vs not (OR = 0.33, 95 % CI: 0.27, 0.40) and higher for those who knew close family members of friends hospitalized or died of COVID-19 (OR = 1.33, 95 % CI: 1.10, 1.60). CONCLUSION Even when COVID-19 vaccination was available in February 2021, a substantial minority of hospital workers with patient contact did not intend to be vaccinated. Moreover, their experiences working close to COVID-19 patients were not significantly related to vaccination intent. Instead, personal experiences with family members and friends were associated with vaccination intent through changes in risk perceptions. Interventions to increase uptake among hospital workers should emphasize protection of close family members or friends and the severity of COVID-19.
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Affiliation(s)
- Abram L Wagner
- Department of Epidemiology, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI 48109, USA.
| | - Michelle H Moniz
- Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, University of Michigan, Ann Arbor, MI, USA; Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI, USA; Program on Women's Healthcare Effectiveness Research, University of Michigan, Ann Arbor, MI, USA
| | - Molly J Stout
- Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Courtney Townsel
- Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Sarah T Hawley
- Department of Internal Medicine, Division of General Medicine, University of Michigan, Ann Arbor, MI, USA; Department of Health Management and Policy, School of Public Health, University of Michigan, Ann Arbor, MI, USA; Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI, USA; Ann Arbor VA Center for Clinical Management Research, Ann Arbor, MI, USA
| | - Brian J Zikmund-Fisher
- Department of Internal Medicine, Division of General Medicine, University of Michigan, Ann Arbor, MI, USA; Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI, USA; Center for Bioethics and Social Sciences in Medicine, University of Michigan, Ann Arbor, MI, USA
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Nucci D, Santangelo OE, Provenzano S, Nardi M, Firenze A, Gianfredi V. Altered Food Behavior and Cancer: A Systematic Review of the Literature. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191610299. [PMID: 36011935 PMCID: PMC9407804 DOI: 10.3390/ijerph191610299] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 08/16/2022] [Accepted: 08/16/2022] [Indexed: 05/09/2023]
Abstract
There is evidence of an association between cancer and certain types of altered eating behaviors, including orthorexia, food cravings, and food addiction. Given the growing interest in the topic throughout the scientific community we conducted a systematic review to summarize current evidence on the development of altered food behavior, including food addiction and cancer. The Cochrane Collaboration and the Meta-analysis Of Observational Studies in Epidemiology guidelines were followed to perform this systematic review. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement was used to report the process and results. The structured literature search was conducted on 19 April 2022, on PubMed/Medline and Scopus, combining free-text terms and medical subject headings. A total of seven articles were included once the selection process was completed. Food craving has been associated with different types of cancer in adults and young patients, as well as with orthorexia; conversely, compulsive eating has only been explored in patients with prolactinoma treated with dopamine agonists. This systematic review explored a new area of research that warrants further investigation. More research is required to better understand the relationship between cancer and food behavior.
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Affiliation(s)
- Daniele Nucci
- Nutritional Support Unit, Veneto Institute of Oncology IOV-IRCCS, Via Gattamelata, 64, 35128 Padua, Italy
| | - Omar Enzo Santangelo
- Regional Health Care and Social Agency of Lodi, ASST Lodi, Piazza Ospitale, 10, 26900 Lodi, Italy
- Correspondence:
| | | | - Mariateresa Nardi
- Nutritional Support Unit, Veneto Institute of Oncology IOV-IRCCS, Via Gattamelata, 64, 35128 Padua, Italy
| | - Alberto Firenze
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (ProMISE) “G. D’Alessandro”, University of Palermo, Via del Vespro, 133, 90127 Palermo, Italy
| | - Vincenza Gianfredi
- Department of Biomedical Sciences for Health, University of Milan, Via Pascal, 36, 20133 Milan, Italy
- CAPHRI Care and Public Health Research Institute, Maastricht University, 6200 MD Maastricht, The Netherlands
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Hijazi R, Gesser-Edelsburg A, Feder-Bubis P, Mesch GS. Pro-vaccination Groups Expressing Hesitant Attitudes: A Cross-Sectional Study About the Difference Between Attitudes and Actual Behavior in Israel. Front Public Health 2022; 10:871015. [PMID: 35570981 PMCID: PMC9092369 DOI: 10.3389/fpubh.2022.871015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 04/04/2022] [Indexed: 11/21/2022] Open
Abstract
Background Vaccines have contributed to the decline in mortality, morbidity, and even the eradication of various infectious diseases. Over time, the availability of information to the public and the request for public involvement in the health decision-making process have risen, and the confidence in vaccines has dropped. An increasing number of parents and individuals are choosing to delay or refuse vaccines. Objectives (1) Identifying hesitant attitudes among pro-vaccination parents; (2) testing the difference between the rate of hesitant attitudes and the rate of hesitancy in practice among pro-vaccination parents; and (3) examining the association of sociodemographic characteristics (gender, age, marital status education and religious affiliation) with the difference between hesitant attitudes and hesitancy in practice among pro-vaccination parents. Methods Descriptive cross-sectional survey using an online survey that measured vaccine hesitancy among pro-vaccination parents (n = 558) whose children were in kindergarten (3–5 years), according to a variety of sociodemographic characteristics. Results A significant difference was found between the rate of hesitant attitudes and the rate of hesitation in actual vaccination among pro-vaccination and hesitant parents, where despite that 26% of the parents had hesitant attitudes, only 19% hesitated in practice [P = 0.0003]. There was also a significant difference between the rate of hesitant attitudes and the rate of hesitancy in practice among women [P = 0.0056] and men [P = 0.0158], parents between 30 and 39 years of age [P = 0.0008], traditional parents [P = 0.0093], Non-academic parents [P = 0.0007] and parents with BA degree [P = 0.0474]. Conclusion Pro-vaccination individuals may have hesitant attitudes regarding vaccines. Therefore, it is very important for health authorities to address the public's fears and concerns, including those who are classified as pro-vaccination.
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Affiliation(s)
- Rana Hijazi
- School of Public Health, University of Haifa, Mount Carmel, Haifa, Israel
| | - Anat Gesser-Edelsburg
- Head of the Health Promotion Program and Head of the Health and Risk Communication Lab, School of Public Health, University of Haifa, Mount Carmel, Haifa, Israel
| | - Paula Feder-Bubis
- Department of Health Policy and Management, Faculty of Health Sciences and Guilford Glazer Faculty of Business and Management, Ben-Gurion University of the Negev, Be'er Sheva, Israel
| | - Gustavo S Mesch
- Department of Sociology, University of Haifa, Mount Carmel, Haifa, Israel
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Ferrara P, Albano L, Gianfredi V. Measuring meningococcal vaccination coverage among adolescents in Italy: state-of-the-art and regional challenges. ACTA BIO-MEDICA : ATENEI PARMENSIS 2022; 93:e2022069. [PMID: 35775770 PMCID: PMC9335428 DOI: 10.23750/abm.v93i3.12533] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 11/12/2021] [Indexed: 11/15/2022]
Affiliation(s)
- Pietro Ferrara
- Center for Public Health Research, University of Milan – Bicocca, Monza, Italy, IRCCS MultiMedica, Sesto San Giovanni, Milan, Italy
| | - Luciana Albano
- Department of Experimental Medicine, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Vincenza Gianfredi
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
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Hesitancy to Return to the Pre-pandemic Routine. JOURNAL OF RATIONAL-EMOTIVE AND COGNITIVE-BEHAVIOR THERAPY 2022; 40:23-39. [PMID: 33967389 PMCID: PMC8094127 DOI: 10.1007/s10942-021-00396-1] [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] [Accepted: 04/25/2021] [Indexed: 01/07/2023]
Abstract
The goal of the present study was to explore COVID-19 related hesitancy, which represents the inability of people to return to previous levels of functioning after a major medical crisis like the current pandemic. A new questionnaire was developed to evaluate participants' hesitancy. The study was conducted online in November, 2020, using convenience sampling. A total of 538 individuals from the general Greek population participated in the study and completed the Hesitancy Questionnaire, the Generalized Anxiety Disorder 2-item (GAD-2), the Short Health Anxiety Inventory and a COVID-19-related worry question. The Hesitancy Questionnaire proved to have adequate psychometric properties. Correlation with anxiety as assessed by GAD-2 proved to be significant but low, indicating that the two scales are measuring two different concepts. The greatest hesitancy was observed in older adults for both genders (males, M = 40.86, SD = 15.24; females, M = 49.34, SD = 14.74). Women in general appeared more hesitant than men scoring higher (males, M = 36.13, SD = 15.25; females, M = 42.63, SD = 17.31) with a statistically significant difference [t(536) = - 3.706, p = .001). This study provided a tool to informed understanding on how citizens perceive the new normality after the COVID-19 pandemic. If not appropriately addressed, hesitancy may increase stress levels and result in mental health or socialization problems.
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Gallant AJ, Nicholls LAB, Rasmussen S, Cogan N, Young D, Williams L. Changes in attitudes to vaccination as a result of the COVID-19 pandemic: A longitudinal study of older adults in the UK. PLoS One 2021; 16:e0261844. [PMID: 34941951 PMCID: PMC8699689 DOI: 10.1371/journal.pone.0261844] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 12/10/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The rapid development of COVID-19 vaccines has brought an unprecedented focus on public attitudes to vaccines, with intention to accept a COVID-19 vaccine fluctuating during the pandemic. However, it is unclear how the pandemic may influence attitudes and behaviour in relation to vaccines in general. The aim of the current study is to examine older adults' changes in vaccination attitudes and behaviour over the first year of the pandemic. METHODS In February-March 2020 (before the first COVID-19 national lockdown in the UK), 372 older adults (aged 65+) provided sociodemographic information, self-reported influenza vaccine uptake, and completed two measures of vaccination attitudes: the 5C scale and the Vaccination Attitudes Examination Scale. One-year later, following rollout of COVID-19 vaccines to older adults, participants provided information on their COVID-19 and influenza vaccine uptake in the previous 12 months, and completed the 5C and VAX scales again. Paired samples t-tests were used to examine changes in vaccination attitudes over time. RESULTS Almost all participants (98.7%) had received at least one dose of a COVID-19 vaccine, and a significant increase in influenza uptake was identified (83.6% in 2020 to 91.6% in 2021). Complacency, mistrust of vaccine benefit, concerns about commercial profiteering, and constraints to vaccination had significantly decreased between Time 1 and Time 2, and collective responsibility had significant increased. However, calculation and worries about unforeseen future effects had increased, indicating that participants now perceived higher risks related to vaccination and were taking a more deliberative information-seeking approach. CONCLUSION The results show significant changes in vaccination attitudes across the pandemic. These changes suggest that while older adults became less complacent about the importance of vaccines, concerns about potential risks associated with vaccination increased. It will be important for public health communication to address these concerns for all vaccines offered to this group.
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Affiliation(s)
| | - Louise A. Brown Nicholls
- School of Psychological Sciences & Health, University of Strathclyde, Glasgow, Scotland, United Kingdom
| | - Susan Rasmussen
- School of Psychological Sciences & Health, University of Strathclyde, Glasgow, Scotland, United Kingdom
| | - Nicola Cogan
- School of Psychological Sciences & Health, University of Strathclyde, Glasgow, Scotland, United Kingdom
| | - David Young
- Department of Mathematics & Statistics, University of Strathclyde, Glasgow, Scotland, United Kingdom
| | - Lynn Williams
- School of Psychological Sciences & Health, University of Strathclyde, Glasgow, Scotland, United Kingdom
- * E-mail:
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Odone A, Gianfredi V, Sorbello S, Capraro M, Frascella B, Vigezzi GP, Signorelli C. The Use of Digital Technologies to Support Vaccination Programmes in Europe: State of the Art and Best Practices from Experts' Interviews. Vaccines (Basel) 2021; 9:1126. [PMID: 34696234 PMCID: PMC8538238 DOI: 10.3390/vaccines9101126] [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: 09/01/2021] [Revised: 09/27/2021] [Accepted: 09/28/2021] [Indexed: 12/22/2022] Open
Abstract
Digitalisation offers great potential to improve vaccine uptake, supporting the need for effective life-course immunisation services. We conducted semi-structured in-depth interviews with public health experts from 10 Western European countries (Germany, Greece, Italy, Luxembourg, Malta, the Netherlands, Norway, Poland, Portugal, and the United Kingdom) to assess the current level of digitalisation in immunisation programmes and retrieve data on interventions and best practices. Interviews were performed using an ad hoc questionnaire, piloted on a sample of national experts. We report a mixed level of digital technologies deployment within vaccination services across Europe: Some countries are currently developing eHealth strategies, while others have already put in place robust programmes. Institutional websites, educational videos, and electronic immunisation records are the most frequently adopted digital tools. Webinars and dashboards represent valuable resources to train and support healthcare professionals in immunisation services organisation. Text messages, email-based communication, and smartphone apps use is scattered across Europe. The main reported barrier to the implementation of digital-based programmes is the lack of resources and shared standards. Our study offers a comprehensive picture of the European context and shows the need for robust collaboration between states and international institutions to share best practices and inform the planning of digital intervention models with the aim of countering vaccine hesitancy and increasing vaccine uptake.
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Affiliation(s)
- Anna Odone
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy;
| | - Vincenza Gianfredi
- School of Medicine, Vita-Salute San Raffaele University, Via Olgettina 58, 20132 Milan, Italy; (V.G.); (M.C.); (B.F.); (G.P.V.); (C.S.)
| | - Sebastiano Sorbello
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy;
| | - Michele Capraro
- School of Medicine, Vita-Salute San Raffaele University, Via Olgettina 58, 20132 Milan, Italy; (V.G.); (M.C.); (B.F.); (G.P.V.); (C.S.)
| | - Beatrice Frascella
- School of Medicine, Vita-Salute San Raffaele University, Via Olgettina 58, 20132 Milan, Italy; (V.G.); (M.C.); (B.F.); (G.P.V.); (C.S.)
| | - Giacomo Pietro Vigezzi
- School of Medicine, Vita-Salute San Raffaele University, Via Olgettina 58, 20132 Milan, Italy; (V.G.); (M.C.); (B.F.); (G.P.V.); (C.S.)
| | - Carlo Signorelli
- School of Medicine, Vita-Salute San Raffaele University, Via Olgettina 58, 20132 Milan, Italy; (V.G.); (M.C.); (B.F.); (G.P.V.); (C.S.)
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Safety and Efficacy of Spray Intranasal Live Attenuated Influenza Vaccine: Systematic Review and Meta-Analysis. Vaccines (Basel) 2021; 9:vaccines9090998. [PMID: 34579235 PMCID: PMC8472940 DOI: 10.3390/vaccines9090998] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 08/31/2021] [Accepted: 09/03/2021] [Indexed: 01/15/2023] Open
Abstract
Although influenza is a major public health concern, little is known about the use of spray live attenuated influenza vaccine (LAIV) among adults. For this reason, we conducted a systematic review and meta-analysis to investigate the efficacy and safety of LAIV, especially in adults with/without clinical conditions and children <2 years, with the final aim of possibly extending the clinical indications. PubMed/MEDLINE and Scopus were the two databases consulted through February 2021. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. A critical appraisal was conducted. Analyses were performed by using ProMeta3 software. Twenty-two studies were included, showing that LAIV was associated with a higher probability of seroconversion when compared with a placebo and considering the A/H1N1 serotype (pooled OR = 2.26 (95% CI = 1.12–4.54), p-value = 0.022; based on 488 participants, without heterogeneity (I2 = 0.0%)). The meta-analysis also confirmed no significant association with systemic adverse events. Only rhinorrhea, nasal congestion, and sore throat were significantly associated with LAIV compared to the placebo. Despite limited available evidence, LAIV has proved to be a safe and effective flu vaccination, also due to its very low invasiveness, and our review’s results can be considered a starting point for guiding future research and shaping forthcoming vaccination campaigns.
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Fedele F, Aria M, Esposito V, Micillo M, Cecere G, Spano M, De Marco G. COVID-19 vaccine hesitancy: a survey in a population highly compliant to common vaccinations. Hum Vaccin Immunother 2021; 17:3348-3354. [PMID: 34096836 DOI: 10.1080/21645515.2021.1928460] [Citation(s) in RCA: 47] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Vaccination is a key protective factor against COVID-19. Some vaccines have already received emergency authorization from Health Agencies, but growing skepticism and vaccine hesitancy will probably affect COVID-19 vaccination campaigns. In the attempt to shed light on this issue, we conducted an online survey in a population of parents referring to 4 pediatric practices in Naples, Italy in whom we evaluated potential vaccine acceptability in relation to socio-demographic characteristics, perception of personal health and of the impact of COVID-19, and attitudes toward general vaccination practices. Vaccination rates were analyzed also in the corresponding pediatric population.Almost 27% of participants declared they were in favor of vaccinations, and in fact real life vaccination rates in children exceeded the national mean. Only 26.5% of respondents declared they would receive COVID-19 vaccine. Vaccine refusal was attributed to safety concerns in 76% of parents. Specific vaccine attributes further reduced the acceptance rate. Female gender, younger age and lower education level were associated with non-adherence to vaccination. Among extrinsic factors of COVID-19 vaccination, only information from National Health Authorities was significantly associated to vaccine acceptance.The rate of potential COVID-19 vaccine acceptability was very poor in our population of parents. Vaccine hesitancy was mainly due to safety concerns. Demographic and educational factors were correlated to vaccine acceptability. Health education and communication strategies are needed to achieve large-scale vaccine acceptability and finally herd immunity.
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Affiliation(s)
- Flora Fedele
- Department of Pediatrics, University Federico II of Naples, Naples, Italy
| | - Massimo Aria
- Department of Economics and Statistics, University Federico II of Naples, Naples, Italy
| | | | - Maria Micillo
- ASL Napoli 1 Centro, Distretto Sanitario 28, Naples, Italy
| | - Gaetano Cecere
- ASL Napoli 1 Centro, Distretto Sanitario 28, Naples, Italy
| | - Maria Spano
- Department of Economics and Statistics, University Federico II of Naples, Naples, Italy
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Gianfredi V, Pennisi F, Lume A, Ricciardi GE, Minerva M, Riccò M, Odone A, Signorelli C. Challenges and Opportunities of Mass Vaccination Centers in COVID-19 Times: A Rapid Review of Literature. Vaccines (Basel) 2021; 9:574. [PMID: 34205891 PMCID: PMC8230199 DOI: 10.3390/vaccines9060574] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 05/27/2021] [Accepted: 05/28/2021] [Indexed: 12/26/2022] Open
Abstract
A mass vaccination center is a location, normally used for nonhealthcare activities, set up for high-volume and high-speed vaccinations during infectious disease emergencies. The high contagiousness and mortality of COVID-19 and the complete lack of population immunity posed an extraordinary threat for global health. The aim of our research was to collect and review previous experiences on mass vaccination centers. On 4 April 2021, we developed a rapid review searching four electronic databases: PubMed/Medline, Scopus, EMBASE, Google Scholar and medRxiv. From a total of 2312 papers, 15 of them were included in the current review. Among them, only one article described a COVID-19 vaccination center; all of the others referred to other vaccinations, in particular influenza. The majority were conducted in the United States, and were simulations or single-day experiences to practice a mass vaccination after bioterrorist attacks. Indeed, all of them were published after September 11 attacks. Regarding staff, timing and performance, the data were highly heterogenous. Several studies used as a model the Center for Disease Control and Prevention guidelines. Results highlighted the differences around the definition, layout and management of a mass vaccination center, but some aspects can be considered as a core aspect. In light of this, we suggested a potential definition. The current review answers to the urgency of organizing a mass vaccination center during the COVID-19 pandemic, highlighting the most important organizational aspects that should be considered in the planning.
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Affiliation(s)
- Vincenza Gianfredi
- School of Medicine, Vita-Salute San Raffaele University, 20132 Milan, Italy; (F.P.); (A.L.); (G.E.R.); (M.M.); (C.S.)
- Care and Public Health Research Institute (CAPHRI), Maastricht University, 6211 Maastricht, The Netherlands
| | - Flavia Pennisi
- School of Medicine, Vita-Salute San Raffaele University, 20132 Milan, Italy; (F.P.); (A.L.); (G.E.R.); (M.M.); (C.S.)
| | - Alessandra Lume
- School of Medicine, Vita-Salute San Raffaele University, 20132 Milan, Italy; (F.P.); (A.L.); (G.E.R.); (M.M.); (C.S.)
| | - Giovanni Emanuele Ricciardi
- School of Medicine, Vita-Salute San Raffaele University, 20132 Milan, Italy; (F.P.); (A.L.); (G.E.R.); (M.M.); (C.S.)
| | - Massimo Minerva
- School of Medicine, Vita-Salute San Raffaele University, 20132 Milan, Italy; (F.P.); (A.L.); (G.E.R.); (M.M.); (C.S.)
| | - Matteo Riccò
- AUSL-IRCCS di Reggio Emilia, Servizio di Prevenzione e Sicurezza Negli Ambienti di Lavoro (SPSAL), Via Amendola n.2, 42122 Reggio Emilia, Italy;
| | - Anna Odone
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy;
| | - Carlo Signorelli
- School of Medicine, Vita-Salute San Raffaele University, 20132 Milan, Italy; (F.P.); (A.L.); (G.E.R.); (M.M.); (C.S.)
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Gkentzi D, Tsagri C, Kostopoulou E, Fouzas S, Vantarakis A, Dimitriou G, Varvarigou A. Attitudes and beliefs of parents about routine childhood vaccination in Greece. Hum Vaccin Immunother 2021; 17:3066-3072. [PMID: 33970788 DOI: 10.1080/21645515.2021.1914805] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Vaccine hesitancy remains one of the 10 major global threats as per the WHO report in 2019. The aim of the present study is to assess attitudes and perceptions of vaccine hesitant parents in Greece with a view to implementing strategies to increase vaccine uptake. A cross-sectional questionnaire-based prospective survey was conducted between September 2019 and June 2020 on parents of children attending primary education in the city of Patras in Western Greece. Data on parental attitudes and beliefs about vaccinations were collected and analyzed. Multivariable logistic regression was used to investigate factors associated with vaccine uptake. Out of 2154 distributed questionnaires, 1227 were completed and returned (response rate 56.9%). The main vaccine information source for Greek parents was their primary care pediatrician (90.8%). Doubts still exist amongst approximately one-third of them (33.5%) regarding a possible relationship between vaccines and autism. Of note, 44% of the study participants believe that unvaccinated children could attend school. 84.6% of the parents in our cohort admitted that they had fully vaccinated their children. In the multivariable analysis, marital status (p < .002) and Greek nationality (p < .001) were found to be the most significant determinants of vaccine uptake. Overall, we found that the percentage of parents in Greece that are vaccine hesitant is small yet not negligible. Based on our results, targeted public health interventions should particularly focus on single parents and those with non-Greek nationality. Training healthcare professionals to provide adequate information is crucial to clarify misperceptions.
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Affiliation(s)
- Despoina Gkentzi
- Department of Paediatrics, Medical School, University of Patras, Patras, Greece
| | - Charalampia Tsagri
- Department of Paediatrics, Medical School, University of Patras, Patras, Greece
| | - Eirini Kostopoulou
- Department of Paediatrics, Medical School, University of Patras, Patras, Greece
| | - Sotirios Fouzas
- Department of Paediatrics, Medical School, University of Patras, Patras, Greece
| | - Apostolos Vantarakis
- Department of Public Health, Medical School, University of Patras, Patras, Greece
| | - Gabriel Dimitriou
- Department of Paediatrics, Medical School, University of Patras, Patras, Greece
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