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Al Bashir L, Ismail A, Aljunid SM. Parents' and healthcare professionals' perception toward the introduction of a new fully liquid hexavalent vaccine in the Malaysian national immunization program: a cross-sectional study instrument development and its application. Front Immunol 2023; 14:1052450. [PMID: 37180162 PMCID: PMC10172506 DOI: 10.3389/fimmu.2023.1052450] [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: 09/26/2022] [Accepted: 04/04/2023] [Indexed: 05/15/2023] Open
Abstract
A newly developed fully liquid hexavalent vaccine that comprises six antigens for Diphtheria, Tetanus, acellular Pertussis, Inactivated Poliomyelitis, Haemophilus Influenza type b., and Hepatitis B, is proposed to be introduced in the Malaysian national immunization program, instead of the non-fully liquid pentavalent vaccine and monovalent Hepatitis B vaccine that is currently employed in the immunization schedule. Although the introduction of new vaccines is a necessary intervention, it still needs to be accepted by parents and healthcare professionals. Hence, this study aimed to develop three structured questionnaires and to investigate the participants' perception and acceptability toward the incorporation of the new fully liquid hexavalent vaccine. A cross-sectional study was conducted among a sample of 346 parents, 100 nurses, and 50 physicians attending twenty-two primary health care centers in the states of Selangor and the Federal Territory of Kuala Lumpur and Putrajaya during 2019-2020. The study found that Cronbach's alpha coefficients for the study instruments ranged from 0.825 to 0.918. Principal components analysis produced a good fit with KMO>0.6. For the parents' perception questionnaire, the only extracted factor explained 73.9 % of the total variance; for the nurses' perception toward a non-fully and fully liquid combined vaccine, there was a sole extracted factor that explained 65.2 % and 79.2% of the total variance, respectively. Whereas for the physicians' perception, there was one factor extracted that explains 71.8 % of the total variance. The median score for all the questionnaire items ranged from 4 to 5 (Q1 and Q3 vary between 3-5). Parents' ethnicity was significantly associated (P-value ≤ 0.05) with the perception that the new hexavalent vaccine would reduce their transportation expenses. Moreover, a significant association (P-value ≤ 0.05) was found between physicians' age and the perception of the hexavalent vaccine's ability to decrease patient overcrowding in primary healthcare centers. The instruments used in this study were valid and reliable. Parents of Malay ethnicity were the most concerned about transportation expenses since they have the lowest income and are more concentrated in rural areas compared to other races. Younger physicians were concerned about reducing patient crowding and hence reducing their workload and burnout.
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Affiliation(s)
- Lama Al Bashir
- Department of Community Health, Faculty of Medicine, University Kebangsaan Malaysia (UKM), Kuala Lumpur, Malaysia
- International Centre for Casemix and Clinical Coding, Faculty of Medicine, UKM Medical Centre, National University of Malaysia, Kuala Lumpur, Malaysia
| | - Aniza Ismail
- Department of Community Health, Faculty of Medicine, University Kebangsaan Malaysia (UKM), Kuala Lumpur, Malaysia
- Malaysian Health Economic Association (MAHEA), International Centre for Casemix and Clinical Coding, UKM Medical Centre, National University of Malaysia, Kuala Lumpur, Malaysia
- *Correspondence: Aniza Ismail,
| | - Syed Mohamed Aljunid
- International Centre for Casemix and Clinical Coding, Faculty of Medicine, UKM Medical Centre, National University of Malaysia, Kuala Lumpur, Malaysia
- Malaysian Health Economic Association (MAHEA), International Centre for Casemix and Clinical Coding, UKM Medical Centre, National University of Malaysia, Kuala Lumpur, Malaysia
- Department of Health Policy and Management, College of Public Health, Health Science Center, Kuwait University, Kuwait City, Kuwait
- Department of Community Medicine, School of Medicine, International Medical University, Kuala Lumpur, Malaysia
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McCulloh RJ, Darden PM, Snowden J, Ounpraseuth S, Lee J, Clarke M, Newcomer SR, Fu L, Hubberd D, Baldner J, Garza M, Kerns E. Improving pediatric COVID-19 vaccine uptake using an mHealth tool (MoVeUp): study protocol for a randomized, controlled trial. Trials 2022; 23:911. [PMID: 36307830 PMCID: PMC9616622 DOI: 10.1186/s13063-022-06819-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 10/05/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19) vaccines demonstrate excellent effectiveness against infection, severe disease, and death. However, pediatric COVID-19 vaccination rates lag among individuals from rural and other medically underserved communities. The research objective of the current protocol is to determine the effectiveness of a vaccine communication mobile health (mHealth) application (app) on parental decisions to vaccinate their children against COVID-19. METHODS Custodial parents/caregivers with ≥ 1 child eligible for COVID-19 vaccination who have not yet received the vaccine will be randomized to download one of two mHealth apps. The intervention app will address logistical and motivational barriers to pediatric COVID-19 vaccination. Participants will receive eight weekly push notifications followed by two monthly push notifications (cues to action) regarding vaccinating their child. Through branching logic, users will access customized content based on their locality, degree of rurality-urbanicity, primary language (English/Spanish), race/ethnicity, and child's age to address COVID-19 vaccine knowledge and confidence gaps. The control app will provide push notifications and information on general pediatric health and infection prevention and mitigation strategies based on recommendations from the American Academy of Pediatrics (AAP) and the Centers for Disease Control and Prevention (CDC). The primary outcome is the proportion of children who complete COVID-19 vaccination series. Secondary outcomes include the proportion of children who receive ≥ 1 dose of COVID-19 vaccine and changes in parent/caregiver scores from baseline to immediately post-intervention on the modified WHO SAGE Vaccine Hesitancy Scale adapted for the COVID-19 vaccine. DISCUSSION The COVID-19 pandemic inflicts disproportionate harm on individuals from underserved communities, including those in rural settings. Maximizing vaccine uptake in these communities will decrease infection rates, severe illness, and death. Given that most US families from these communities use smart phones, mHealth interventions hold the promise of broad uptake. Bundling multiple mHealth vaccine uptake interventions into a single app may maximize the impact of deploying such a tool to increase COVID-19 vaccination. The new knowledge to be gained from this study will directly inform future efforts to increase COVID-19 vaccination rates across diverse settings and provide an evidentiary base for app-based vaccine communication tools that can be adapted to future vaccine-deployment efforts. CLINICAL TRIALS REGISTRATION ClinicalTrials.gov NCT05386355 . Registered on May 23, 2022.
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Affiliation(s)
- Russell J McCulloh
- Children's Hospital & Medical Center, 8200 Dodge St., Omaha, NE, 68114, USA.
| | - Paul M Darden
- University of Arkansas for Medical Sciences, 4301 West Markham, Little Rock, AR, 72205, USA
| | - Jessica Snowden
- University of Arkansas for Medical Sciences, 4301 West Markham, Little Rock, AR, 72205, USA
| | - Songthip Ounpraseuth
- University of Arkansas for Medical Sciences, 4301 West Markham, Little Rock, AR, 72205, USA
| | - Jeannette Lee
- University of Arkansas for Medical Sciences, 4301 West Markham, Little Rock, AR, 72205, USA
| | - Martina Clarke
- College of Information Science & Technology, University of Nebraska Omaha, 172 Peter Kiewit Institute, 1110 South 67th Street, Omaha, NE, 68182, USA
| | - Sophia R Newcomer
- School of Public Health and Community Health Sciences, University of Montana, Skaggs Building Room 177, 32 Campus Drive, Missoula, MT, 59812, USA
| | - Linda Fu
- Office of the Director, National Institutes of Health, 11601 Landsdown Sreet, Rockville, MD, 20852, USA
| | - DeAnn Hubberd
- University of Arkansas for Medical Sciences, 4301 West Markham, Little Rock, AR, 72205, USA
| | - Jaime Baldner
- University of Arkansas for Medical Sciences, 4301 West Markham, Little Rock, AR, 72205, USA
| | - Maryam Garza
- University of Arkansas for Medical Sciences, 4301 West Markham, Little Rock, AR, 72205, USA
| | - Ellen Kerns
- University of Nebraska Medical Center, 42nd and Emile St., Omaha, NE, 68131, USA
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McCulloh RJ, Darden P, Snowden J, Ounpraseuth S, Lee J, Clarke M, Newcomer SR, Fu L, Hubberd D, Baldner J, Garza M, Kerns E. Improving pediatric COVID-19 vaccine uptake using an mHealth tool (MoVeUP): a randomized, controlled trial. RESEARCH SQUARE 2022:rs.3.rs-2070396. [PMID: 36238712 PMCID: PMC9558439 DOI: 10.21203/rs.3.rs-2070396/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Background: Coronavirus disease 2019 (COVID-19) vaccines demonstrate excellent effectiveness against infection, severe disease, and death. However, pediatric COVID-19 vaccination rates lag among individuals from rural and other medically underserved communities. The research objective of the current protocol is to determine the effectiveness of a vaccine communication mobile health (mHealth) application (app) on parental decisions to vaccinate their children against COVID-19. Methods: Custodial parents/caregivers with ≥1 child eligible for COVID-19 vaccination who have not yet received the vaccine will be randomized to download one of two mHealth apps. The intervention app will address logistical and motivational barriers to pediatric COVID-19 vaccination. Participants will receive eight weekly push notifications followed by two monthly push notifications (cues to action) regarding vaccinating their child. Through branching logic, users will access customized content based on their locality, degree of rurality-urbanicity, primary language (English/Spanish), race/ethnicity, and child's age to address COVID-19 vaccine knowledge and confidence gaps. The control app will provide push notifications and information on general pediatric health and infection prevention and mitigation strategies based on recommendations from the American Academy of Pediatrics (AAP) and the Centers for Disease Control and Prevention (CDC). The primary outcome is the proportion of children who complete COVID-19 vaccination series. Secondary outcomes include the proportion of children who receive ≥1 dose of COVID-19 vaccine and changes in parent/caregiver scores from baseline to immediately post-intervention on the modified WHO SAGE Vaccine Hesitancy Scale adapted for the COVID-19 vaccine. Discussion: The COVID-19 pandemic inflicts disproportionate harm on individuals from underserved communities, including those in rural settings. Maximizing vaccine uptake in these communities will decrease infection rates, severe illness, and death. Given that most US families from these communities use smart phones, mHealth interventions hold the promise of broad uptake. Bundling multiple mHealth vaccine-uptake interventions into a single app may maximize the impact of deploying such a tool to increase COVID-19 vaccination. The new knowledge to be gained from this study will directly inform future efforts to increase COVID-19 vaccination rates across diverse settings and provide an evidentiary base for app-based vaccine communication tools that can be adapted to future vaccine-deployment efforts. Clinical Trials Registration: Name of the registry: clinicaltrials.gov Trial registration number: NCT05386355 Date of registration: May 23, 2022 URL of trial registry record: https://clinicaltrials.gov/ct2/show/NCT05386355.
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How Were Healthcare Workers after Anti-SARS-CoV-2 Vaccination? A Study of the Emotional Side Effects of Vaccination. Vaccines (Basel) 2022; 10:vaccines10060854. [PMID: 35746462 PMCID: PMC9229046 DOI: 10.3390/vaccines10060854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 05/17/2022] [Accepted: 05/18/2022] [Indexed: 02/04/2023] Open
Abstract
Anti-SARS-CoV-2 vaccines appear to be the only escape from the COVID-19 pandemic. As healthcare workers were among the first in society to be vaccinated, understanding their emotional status post-vaccination is fundamental to the promotion of COVID-19 vaccines among the rest of society. The aims of this study were to investigate the predictors of positive and negative emotions experienced by healthcare workers after being vaccinated and to understand whether those emotions were related to the modalities of vaccine promotion within the community. A cohort of 5790 Italian healthcare workers completed an original online survey regarding their experience with anti-SARS-CoV-2 vaccines and reported on a series of personal and environmental factors. The data obtained show that increased risk perception of COVID-19, vaccine confidence and receipt of greater quantities of information regarding vaccines are predictors of a more positive emotional state post-vaccination. Predictors of a more negative emotional state are older age, lower education, lower confidence and receipt of smaller quantities of information, in addition to neurotic personality traits and high risk perception of COVID-19. Importantly, vaccination promotion may be favoured by a happy emotional status after vaccination. This study can serve as a source of guidelines for the promotion of COVID-19 vaccination among healthcare workers and laypeople.
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Albers AN, Thaker J, Newcomer SR. Barriers to and facilitators of early childhood immunization in rural areas of the United States: a systematic review of the literature. Prev Med Rep 2022; 27:101804. [PMID: 35656229 PMCID: PMC9152779 DOI: 10.1016/j.pmedr.2022.101804] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 02/23/2022] [Accepted: 04/18/2022] [Indexed: 12/22/2022] Open
Abstract
Early childhood vaccination coverage is low in rural areas of the United States. Reminder-recall & positive family-provider relationships facilitate vaccine uptake. Parental hesitancy is a barrier to early childhood vaccination in the rural U.S. Vaccine referrals & distance to providers are also rural-specific barriers. To increase vaccine coverage, interventions across rural populations are needed.
Early childhood vaccination rates are lower in rural areas of the U.S. compared with suburban and urban areas. Our aim was to identify barriers to and facilitators of early childhood immunization in rural U.S. communities. We completed a systematic review of original research conducted in the U.S. between January 1, 2000-July 25, 2021. We searched PubMed, Cumulative Index for Nursing and Allied Health Literature, and Web of Science. We included studies that examined barriers to and facilitators of routine immunizations in children <36 months old in rural areas. Following the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines, we reported studies’ methodologies and targeted populations, definitions of rurality, and common themes across studies that reflected barriers to or facilitators of vaccination. Ultimately, 17 papers met inclusion criteria for review. The majority of studies (10/17) were conducted within one U.S. state, and the same number (10/17) were conducted prior to 2005. Facilitators of vaccine uptake in rural communities identified across studies included reminder/recall systems and parents’ relationships with providers. Parental hesitancy, negative clinic experiences, referrals outside of primary care settings, and distance to providers were identified as barriers to vaccination in rural settings. This review revealed a limited scope of evidence on barriers to and facilitators of early childhood immunization in rural communities. More investigations of the causes of low vaccine coverage and the effectiveness of interventions for increasing vaccine uptake are urgently needed in rural pediatric populations to address persistent rural–urban immunization disparities.
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Gennaro E, Caleb S, Torres R, Alexander-Parrish R, Thoburn E, McLaughlin JM, Fu LY. Parental Beliefs, Logistical Challenges, and Improvement Opportunities for Vaccination among Children Ages 19-35 Months Experiencing Homelessness. J Pediatr 2021; 236:246-252. [PMID: 33895206 DOI: 10.1016/j.jpeds.2021.04.029] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 04/15/2021] [Accepted: 04/16/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To examine parental beliefs and logistical challenges to early childhood vaccination completion as well as opportunities to support improved vaccine uptake among families experiencing homelessness. STUDY DESIGN A cross-sectional survey was conducted between February 2018 and October 2019 with parents of children ages 19-35 months old experiencing homelessness. Participants were recruited from 10 locations that serve families experiencing homelessness in Washington, DC and by referral from other participants. Vaccination records were obtained from health care providers to determine the child's up-to-date (UTD) status with a combined 7-vaccine series. RESULTS Of 135 children of participants, only 69 (51.1%) were UTD. Most participants had at least 1 concern about childhood vaccines and at least 1 logistical barrier to completing vaccination (57% and 85.9%, respectively). The most frequent barriers were getting a convenient appointment time (46.3%), remembering appointments (44.8%), and commuting to appointments (44.4%). Although only 53.3% of the participants' children attended a licensed daycare center and only 43.7% received benefits from the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), use of either of these programs that routinely assess vaccination status was associated with over 3 times higher adjusted odds of being UTD (aOR 3.4, 95% CI 1.6-7.3, and aOR 3.1, 95% CI 1.4-6.5, respectively). CONCLUSIONS Logistical barriers to accessing primary care services are common among children experiencing homelessness, underscoring the importance of health care providers offering vaccines at every opportunity. Government-regulated programs are useful for promoting vaccination, and enrollment should be encouraged because many children experiencing homelessness may not access them.
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Affiliation(s)
- Erica Gennaro
- Department of Pediatrics, Children's National Hospital, Washington, DC
| | - Susan Caleb
- Department of Pediatrics, Children's National Hospital, Washington, DC
| | - Rachel Torres
- Center for Translational Research, Children's National Hospital, Washington, DC
| | | | | | | | - Linda Y Fu
- Department of Pediatrics, Children's National Hospital, Washington, DC; Center for Translational Research, Children's National Hospital, Washington, DC
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Malik MN, Awan MS, Saleem T. Social mobilization campaign to tackle immunization hesitancy in Sargodha and Khushab districts of Pakistan. J Glob Health 2021; 10:021302. [PMID: 33312516 PMCID: PMC7719895 DOI: 10.7189/jogh.10.021302] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background Immunization hesitancy is a delay in acceptance or refusal of vaccines despite availability of vaccination services. If people are not engaged appropriately via communication and social mobilization, doubts about the trade-offs between the benefits and potential side effects persist. The objective of this study was to explore strategies for improved social mobilization to reduce immunization hesitancy. Methods Mix of quantitative and qualitative approaches was applied to collect data from a diverse group of respondents in Sargodha and Khushab districts. Quantitative data were collected from 329 community health workers, including vaccinators, lady health workers and lady health supervisors, and school health and nutrition supervisors. In addition, qualitative data were collected from top management of Expanded Programme on Immunization (EPI) through key informant interviews (KIIs) and focus group discussions (FGDs) were conducted with parents. Analysis has been done using SPSS software and detailed transcriptions. Results Advocacy meetings with local influencers, community group sessions, door-to-door visits by community health workers and mosque announcements are considered the most relevant and appropriate interventions for social mobilization. Community Health Workers (CHWs), cognizant of local culture, are being trusted, though optimum performance is achievable with adequate redressal of hesitancy concerns. However, in some cases negative attitudes of people towards immunization hinder trust towards mobilizers or CHWs. Hence, they leverage active participation of local influencers, teachers and health department officials to convince such stubborn parents. Active community involvement through leveraging support from local religious and non-religious influencers in social mobilization activities increases its acceptance. Community engagement is most effective in rural and hard-to-reach areas when community health workers are skilled in interpersonal communication and information education communication. Conclusions Communication committees as oversight mechanism should be established or reactivated to regularly monitor and support mobilization activities through managing affairs like speedy liaison with local administration and local influencers, mobilizers' service related concerns, community-specific hurdles, and deficiencies of awareness-material provision that eventually improves mobilization performance. Resistant community's needs can be redressed through rigorous conduct of men's and women's education sessions by CHWs while giving more time and space to mobilizers to take on board local religious and non-religious influencers to convince conservative/illiterate parents. Higher management should fix policy implementation slippages like training needs assessment of mobilizers and Civil Society Organizations' involvement framework.
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Affiliation(s)
- Muhammad Nauman Malik
- Department of Economics, University of Sargodha, Sargodha, Punjab, Pakistan.,University of Western Australia, Perth, Western Australia, Australia
| | - Masood Sarwar Awan
- Department of Economics, University of Sargodha, Sargodha, Punjab, Pakistan
| | - Tariq Saleem
- District Surveillance Coordinator, Health Department Punjab, Punjab, Pakistan
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Differential Demographic and Clinical Characteristics between MMR Vaccinated and Unvaccinated Children in South Korea: A Nationwide Study. Vaccines (Basel) 2021; 9:vaccines9060653. [PMID: 34203834 PMCID: PMC8232726 DOI: 10.3390/vaccines9060653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 06/07/2021] [Accepted: 06/08/2021] [Indexed: 11/24/2022] Open
Abstract
In the context of recent measles outbreaks, substantial factors associated with measles-mumps-rubella (MMR) unvaccination need to be clarified. This study aimed to identify differential demographic and clinical characteristics between MMR vaccinated and unvaccinated groups. We used a large-linked database to identify children born between 2008 and 2016 by combining data from the Korea Immunization Registry Information System and National Health Information database. The MMR vaccination status was ascertained up to the age of 2 to define MMR vaccinated and unvaccinated groups. We conducted a multivariate logistic regression to estimate odds ratios (ORs) with 95% confidence intervals (CIs) to identify factors associated with MMR unvaccination. Of 3,973,253 children, 75,674 (1.9%) did not receive the MMR vaccine. Compared with the MMR vaccinated group, the underutilization of healthcare resources was more notable in the MMR unvaccinated group (number of outpatient visits (5.73 ± 12.1 vs. 25.8 ± 17.06); days hospitalized (1.69 ± 14.5 vs. 2.32 ± 6.90)). Children were less likely to receive the MMR vaccine if they were born with congenital anomaly (OR 2.12; 95% CI 1.90–2.36), were never admitted to an intensive care unit (1.88; 1.78–1.98), or never visited an emergency room (3.57; 3.53–3.72). There were substantial factors associated with MMR unvaccination, underscoring a need to optimize targeted interventions tailored to the subset of children in South Korea.
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Alam MJ, Afsar MNA, Khanam A, Ahmad SM. Risk factors for delay in starting age-appropriate vaccinations among infants in urban slums of Bangladesh. Hum Vaccin Immunother 2021; 17:3186-3191. [PMID: 34085905 DOI: 10.1080/21645515.2021.1908795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
Age-appropriate vaccination is crucial for infants, protecting them from vaccine-preventable diseases. Delaying in starting initial immunization may result in incomplete or non-vaccination in early life. However, limited vaccine coverage data are available regarding the starting age of vaccination. In this study, we determined the factors associated with the delay in infant immunization. We carried out a cross-sectional study at three maternal-child health clinics in Dhaka city. Mothers visited these clinics for their infant immunization were surveyed with structured questionnaires. A multivariate logistic regression model was used to estimate the significant influencing factors on untimely vaccination. A total of 548 mother-infant pairs were surveyed. 46.5% of mothers did not receive Tetanus (TT) vaccines, and mothers who had a previous pregnancy were less likely to receive TT-vaccine (p < .01). 41.2% of infants did not receive BCG vaccines within 1-week of birth. Mothers working outside the home showed a negative impact on BCG vaccination (p < .05). Among the infants' born in-clinic facilities, 39% were BCG unvaccinated, and 69% had c-section delivery. The median age of infants for starting vaccination was 6.57 wks (95% CI: 6.43-7.14); however, 17.3% infants received vaccination at ≥8 wks of age. Mother's schooling-years and infant normal body-weight positively associated with vaccination at <8 wks, whereas sickness after birth increased the age to start vaccination program recommended at 6 wks. Our analysis suggests the need for specific interventions based on potential maternal determinants, such as educating mothers about the timing and the importance of infant immunization, and addressing programmatic barriers to timely vaccination among infants in Bangladesh.
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Affiliation(s)
- Md Jahangir Alam
- Infectious Diseases Division, icddr, b, Mohakhali, Dhaka, Bangladesh.,Department of Microbiology, Infection and Immunity Program, Biomedicine Discovery Institute, Monash University, Clayton, Victoria, Australia
| | | | - Afsana Khanam
- Infectious Diseases Division, icddr, b, Mohakhali, Dhaka, Bangladesh
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Tkaczyszyn K, Kuchar E, Augustynowicz E, Szenborn L. The Impact of a Single Educational Lecture on the Vaccine Confidence among Pregnant Women and Young Mothers. Vaccines (Basel) 2021; 9:vaccines9030290. [PMID: 33804621 PMCID: PMC8003617 DOI: 10.3390/vaccines9030290] [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: 02/09/2021] [Revised: 03/04/2021] [Accepted: 03/15/2021] [Indexed: 11/23/2022] Open
Abstract
Background: We investigated the impact of a single unstructured educational lecture about vaccinations on the vaccine confidence in volunteer participants. Methods: We conducted a survey-based study during a series of open meetings related to pregnancy and parenting. Before and after the pediatrician’s lecture related to vaccinations, listeners completed the visual analogue scales (VAS, 0–15 cm), evaluating (1) self-declared knowledge on vaccinations and (2) how they perceive the safety and efficacy of this preventive method. Results: In total, 484 women aged 30 ± 4 years participated in the lecture (pregnant = 68%; ≥1 children = 56%). Participants declared to have more comprehensive knowledge on preventive vaccinations and perceived vaccines to be safer and more useful (the role for the immunity) after vs. before the lecture (median VAS: 10.4 vs. 7.2, 10.8 vs. 8.7, and 11.0 vs. 10.4 cm, all p < 0.001). Importantly, the prevalence of vaccine-related adverse events was also assessed as being higher after the lecture (median VAS: 9.9 vs. 8.0 cm, p < 0.001). The increase in self-declared knowledge on vaccinations and perceived need for vaccinations (delta VAS—VAS after minus before the lecture, expressed as % of baseline) was lower among participants who rated the lecture less vs. more useful. Importantly, both participants who liked vs. did not like the lecture comparably rated vaccines safer after vs. before the lecture (delta VAS (median, interquartile range): 16% (0–39%) vs. 18% (2–42%), p = 0.39). Conclusions: An educational lecture on vaccinations positively impacts vaccine confidence in young adult women. Irrespective of the subjective rating of the lecture, all listeners perceived vaccinations to be safer after vs. before the speech.
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Affiliation(s)
- Katarzyna Tkaczyszyn
- Department of Pediatric Infectious Diseases, Wroclaw Medical University, 50-368 Wroclaw, Poland; (K.T.); (L.S.)
- Department of Pediatric Infectious Diseases, University Hospital, 50-556 Wroclaw, Poland
| | - Ernest Kuchar
- Department of Pediatrics with Clinical Assessment Unit, Warsaw Medical University, 02-091 Warsaw, Poland
- Correspondence: ; Tel.: +48-22-317-92-31
| | - Ewa Augustynowicz
- Department of Epidemiology of Infectious Diseases and Surveillance, National Institute of Public Health—National Institute of Hygiene, 00-791 Warsaw, Poland;
| | - Leszek Szenborn
- Department of Pediatric Infectious Diseases, Wroclaw Medical University, 50-368 Wroclaw, Poland; (K.T.); (L.S.)
- Department of Pediatric Infectious Diseases, University Hospital, 50-556 Wroclaw, Poland
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Malik MN, Awan MS, Saleem T. Social mobilization campaign to tackle immunization hesitancy in Sargodha and Khushab districts of Pakistan. J Glob Health 2020. [DOI: 10.7189/jogh.10.0201302] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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CELLA PAOLA, VOGLINO GIANLUCA, BARBERIS ILARIA, ALAGNA ENRICO, ALESSANDRONI CLAUDIA, CUDA ALESSANDRO, D’ALOISIO FRANCESCO, DALLAGIACOMA GIULIA, DE NITTO SARA, DI GASPARE FRANCESCA, GALLIPOLI ORIANA, GENTILE LEANDRO, KUNDISOV LUCIA, NAVARO MONICA, PROVENZANO SANDRO, SANTANGELO OMARENZO, STEFANIZZI PASQUALE, GIANFREDI VINCENZA. Resources for assessing parents' vaccine hesitancy: a systematic review of the literature. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2020; 61:E340-E373. [PMID: 33150224 PMCID: PMC7595070 DOI: 10.15167/2421-4248/jpmh2020.61.3.1448] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Accepted: 07/22/2020] [Indexed: 11/17/2022]
Abstract
The concept of Vaccine Hesitancy has begun to appear in the scientific landscape, referring to the reluctance of a growing proportion of people to accept the vaccination offer. A variety of factors were identified as being associated with vaccine hesitancy but there was no universal algorithm and currently there aren’t any established metrics to assess either the presence or impact of vaccine hesitancy. The aim of this study was to systematically review the published questionnaires evaluating parental vaccine hesitancy, to highlight the differences among these surveys and offer a general overview on this matter. This study offers a deeper perspective on the available questionnaires, helping future researches to identify the most suitable one according to their own aim and study setting.
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Affiliation(s)
- PAOLA CELLA
- Post Graduate School of Hygiene and Preventive Medicine, Department of Medicine and Surgery, University of Parma, Italy
| | - GIANLUCA VOGLINO
- Post Graduate School of Hygiene and Preventive Medicine, Department of Public Health, University of Turin, Italy
| | - ILARIA BARBERIS
- Health Science Department, University of Genoa, Italy
- Correspondence: Ilaria Barberis, Health Science Department, University of Genoa, largo Rosanna Benzi 10, Pad. 3 San Martino Hospital, Italy - Tel./Fax +39 010 3538502 - E-mail:
| | - ENRICO ALAGNA
- Post Graduate School of Hygiene and Preventive Medicine, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties “G. D’Alessandro”, University of Palermo, Italy
| | - CLAUDIA ALESSANDRONI
- Post Graduate School of Hygiene and Preventive Medicine, University of Rome Tor Vergata, Rome, Italy
| | - ALESSANDRO CUDA
- Post Graduate School of Hygiene and Preventive Medicine, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Italy
| | - FRANCESCO D’ALOISIO
- Post Graduate School of Hygiene and Preventive Medicine, Department of Life, Health and Environmental Sciences, University of L’Aquila, Italy
| | - GIULIA DALLAGIACOMA
- Post Graduate School of Hygiene and Preventive Medicine, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Italy
| | - SARA DE NITTO
- Post Graduate School of Hygiene and Preventive Medicine, Department of Biomedical Science and Human Oncology, University of Bari Aldo Moro, Italy
| | - FRANCESCA DI GASPARE
- Post Graduate School of Hygiene and Preventive Medicine, University of Rome Tor Vergata, Rome, Italy
| | - ORIANA GALLIPOLI
- Post Graduate School of Hygiene and Preventive Medicine, Department of Life, Health and Environmental Sciences, University of L’Aquila, Italy
| | - LEANDRO GENTILE
- Post Graduate School of Hygiene and Preventive Medicine, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Italy
| | - LUCIA KUNDISOV
- Post Graduate School of Public Health, University of Siena, Italy
| | - MONICA NAVARO
- Post Graduate School of Hygiene and Preventive Medicine, Department of Experimental Medicine, University of Campania “L. Vanvitelli”, Italy
| | - SANDRO PROVENZANO
- Post Graduate School of Hygiene and Preventive Medicine, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties “G. D’Alessandro”, University of Palermo, Italy
| | - OMAR ENZO SANTANGELO
- Post Graduate School of Hygiene and Preventive Medicine, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties “G. D’Alessandro”, University of Palermo, Italy
| | - PASQUALE STEFANIZZI
- Post Graduate School of Hygiene and Preventive Medicine, Department of Biomedical Science and Human Oncology, University of Bari Aldo Moro, Italy
| | - VINCENZA GIANFREDI
- Post Graduate School of Hygiene and Preventive Medicine, Department of Experimental Medicine, University of Perugia, Italy
- School of Medicine, University Vita-Salute San Raffaele, Milan, Italy
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Reasons for non-vaccination and incomplete vaccinations among children in Pakistan. Vaccine 2018; 36:5288-5293. [PMID: 30054162 DOI: 10.1016/j.vaccine.2018.07.024] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Revised: 07/11/2018] [Accepted: 07/12/2018] [Indexed: 11/21/2022]
Abstract
BACKGROUND Global immunization efforts have received a boost through the introduction of several new vaccines. These efforts however, are threatened by sub-optimal vaccine coverage, particularly in countries with large birth cohorts. Pakistan has one of the largest birth cohorts in the world, where coverage of routine vaccination remains persistently inadequate. We undertook this study to ascertain reasons for non-vaccination or incomplete vaccination of children less than two years in 8 districts of southern Pakistan. METHODS A cross-sectional survey using WHO recommended rapid coverage assessment technique was conducted in 2014. Using probability proportional to size method, we sampled 8400 households with eligible children (aged 4-12 months). Using a structured questionnaire, mothers or other primary caregivers were interviewed to determine vaccination status of an index child. In case of non-vaccination or incomplete vaccination, respondents were asked for reasons leading to low/no vaccine uptake. RESULTS Based on both vaccination record and recall, only 30.8% of children were fully vaccinated, 46% had an incomplete vaccination status while 23%were non-vaccinated. The most frequently reported reasons for non-vaccination included: mothers/caregivers being unaware of the need for vaccination (35.3%), a fear of side effects (23%), mother/caregiver being too busy (16.6%), distance from vaccination centers (13.8%), and non-availability of either vaccinators or vaccines at vaccination centers (10.7%). Reasons identified for incomplete vaccination were similar, with caregivers being unaware of the need for subsequent doses (27.3%), non-availability of vaccinators or vaccines (17.7%), mother/caregiver being too busy (14.8%), fear of side effects (11.2%), and postponement for another time (8.7%). CONCLUSION Various factors result in non-compliance with vaccination schedules and vaccine refusal within the surveyed communities, ranging from lack of knowledge to non-availability of supplies at vaccination centers. These barriers are best addressed through multi-pronged strategies addressing supply gaps, increasing community awareness and enhancing demand for routine vaccination services.
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A systematic review of factors affecting vaccine uptake in young children. Vaccine 2017; 35:6059-6069. [DOI: 10.1016/j.vaccine.2017.09.046] [Citation(s) in RCA: 203] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Revised: 09/11/2017] [Accepted: 09/13/2017] [Indexed: 11/21/2022]
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Ames H, Njang DM, Glenton C, Fretheim A, Kaufman J, Hill S, Oku A, Cliff J, Cartier Y, Bosch-Capblanch X, Rada G, Muloliwa AM, Oyo-Ita A, Kum AP, Lewin S. Stakeholder perceptions of communication about vaccination in two regions of Cameroon: A qualitative case study. PLoS One 2017; 12:e0183721. [PMID: 28859101 PMCID: PMC5578665 DOI: 10.1371/journal.pone.0183721] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Accepted: 08/09/2017] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Understanding stakeholders' (parents', communities' and health workers') perspectives of communication about childhood vaccination, including their preferences for its format, delivery and content, is an important step towards designing better communication strategies and ensuring more informed parents. Our objectives were to explore stakeholders' views, experiences and preferences for childhood vaccination communication in Cameroon. METHODS In 2014, in the Central and North West Regions of Cameron, we gathered qualitative data for our case study using the following methods: semi structured interviews; observations and informal conversations during routine immunization clinics and three rounds of the National Polio Immunization Campaign; document analysis of reports and mass media communications about vaccination; and a survey of parents. We conducted a thematic analysis of the qualitative data to identify themes relating to views, experiences and perceptions of vaccination information and its delivery. Survey data were analysed using simple descriptive statistics. RESULTS All of the parents interviewed felt that vaccinating their child was important, and trusted the information provided by health workers. However, many parents wanted more information. Parents did not always feel that they could ask questions during vaccination appointments. All participants felt that health workers and vaccination clinics were important sources of information. Social mobilisation activities such as door-to-door visits and announcements during religious services were important and accepted ways of communicating information, especially during vaccination campaigns. Information communicated through mass media and text messages was also seen as important. In general, stakeholders believed that more consistent messaging about routine vaccination through community channels would be helpful to remind parents of the importance of routine vaccination during ongoing rounds of vaccination campaigns against polio. CONCLUSIONS This study confirms that parents regard information about childhood vaccination as important, but that health services need to be organized in ways that prioritize and facilitate communication, particularly about routine vaccination.
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Affiliation(s)
- Heather Ames
- Global Health Unit, Norwegian Institute of Public Health, Oslo, Norway
| | - Diangha Mabel Njang
- Department of Anthropology, University of Yaoundé 1, Yaoundé, Central Province, Cameroon
| | - Claire Glenton
- Global Health Unit, Norwegian Institute of Public Health, Oslo, Norway
| | - Atle Fretheim
- Global Health Unit, Norwegian Institute of Public Health, Oslo, Norway
- Institute of Health and Society, University of Oslo, 0318 Oslo Norway
| | - Jessica Kaufman
- Centre for Health Communication and Participation, School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia
| | - Sophie Hill
- Centre for Health Communication and Participation, School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia
| | - Afiong Oku
- University of Calabar, Nigeria, Calabar Municipal, Cross River State, Nigeria
| | - Julie Cliff
- Faculdade de Medicina, Universidade Eduardo Mondlane, Maputo, Mozambique
| | - Yuri Cartier
- International Union for Health Promotion and Education, Cedex, France
| | - Xavier Bosch-Capblanch
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Gabriel Rada
- Evidence-based Healthcare Programme, Pontificia Universidad Católica de Chile, Santiago, Chile
| | | | - Angela Oyo-Ita
- University of Calabar, Nigeria, Calabar Municipal, Cross River State, Nigeria
| | - Awah Paschal Kum
- Department of Anthropology, University of Yaoundé 1, Yaoundé, Central Province, Cameroon
| | - Simon Lewin
- Global Health Unit, Norwegian Institute of Public Health, Oslo, Norway
- Health Systems Research Unit, South African Medical Research Council, Cape Town, South Africa
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Ames HMR, Glenton C, Lewin S. Parents' and informal caregivers' views and experiences of communication about routine childhood vaccination: a synthesis of qualitative evidence. Cochrane Database Syst Rev 2017; 2:CD011787. [PMID: 28169420 PMCID: PMC5461870 DOI: 10.1002/14651858.cd011787.pub2] [Citation(s) in RCA: 146] [Impact Index Per Article: 20.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Childhood vaccination is an effective way to prevent serious childhood illnesses, but many children do not receive all the recommended vaccines. There are various reasons for this; some parents lack access because of poor quality health services, long distances or lack of money. Other parents may not trust vaccines or the healthcare workers who provide them, or they may not see the need for vaccination due to a lack of information or misinformation about how vaccinations work and the diseases they can prevent.Communication with parents about childhood vaccinations is one way of addressing these issues. Communication can take place at healthcare facilities, at home or in the community. Communication can be two-way, for example face-to-face discussions between parents and healthcare providers, or one-way, for instance via text messages, posters or radio programmes. Some types of communication enable parents to actively discuss vaccines and their benefits and harms, as well as diseases they can prevent. Other communication types simply give information about vaccination issues or when and where vaccines are available. People involved in vaccine programmes need to understand how parents experience different types of communication about vaccination and how this influences their decision to vaccinate. OBJECTIVES The specific objectives of the review were to identify, appraise and synthesise qualitative studies exploring: parents' and informal caregivers' views and experiences regarding communication about childhood vaccinations and the manner in which it is communicated; and the influence that vaccination communication has on parents' and informal caregivers' decisions regarding childhood vaccination. SEARCH METHODS We searched MEDLINE (OvidSP), MEDLINE In-process and Other Non-Index Citations (Ovid SP), Embase (Ovid), CINAHL (EbscoHOST), and Anthropology Plus (EbscoHost) databases for eligible studies from inception to 30 August 2016. We developed search strategies for each database, using guidelines developed by the Cochrane Qualitative Research Methods Group for searching for qualitative evidence as well as modified versions of the search developed for three related reviews of effectiveness. There were no date or geographic restrictions for the search. SELECTION CRITERIA We included studies that utilised qualitative methods for data collection and analysis; focused on the views and experiences of parents and informal caregivers regarding information about vaccination for children aged up to six years; and were from any setting globally where information about childhood vaccinations was communicated or distributed. DATA COLLECTION AND ANALYSIS We used maximum variation purposive sampling for data synthesis, using a three-step sampling frame. We conducted a thematic analysis using a constant comparison strategy for data extraction and synthesis. We assessed our confidence in the findings using the GRADE-CERQual approach. High confidence suggests that it is highly likely that the review finding is a reasonable representation of the phenomenon of interest, while very low confidence indicates that it is not clear whether the review finding is a reasonable representation of it. Using a matrix model, we then integrated our findings with those from other Cochrane reviews that assessed the effects of different communication strategies on parents' knowledge, attitudes and behaviour about childhood vaccination. MAIN RESULTS We included 38 studies, mostly from high-income countries, many of which explored mothers' perceptions of vaccine communication. Some focused on the MMR (measles, mumps, rubella) vaccine.In general, parents wanted more information than they were getting (high confidence in the evidence). Lack of information led to worry and regret about vaccination decisions among some parents (moderate confidence).Parents wanted balanced information about vaccination benefits and harms (high confidence), presented clearly and simply (moderate confidence) and tailored to their situation (low confidence in the evidence). Parents wanted vaccination information to be available at a wider variety of locations, including outside health services (low confidence) and in good time before each vaccination appointment (moderate confidence).Parents viewed health workers as an important source of information and had specific expectations of their interactions with them (high confidence). Poor communication and negative relationships with health workers sometimes impacted on vaccination decisions (moderate confidence).Parents generally found it difficult to know which vaccination information source to trust and challenging to find information they felt was unbiased and balanced (high confidence).The amount of information parents wanted and the sources they felt could be trusted appeared to be linked to acceptance of vaccination, with parents who were more hesitant wanting more information (low to moderate confidence).Our synthesis and comparison of the qualitative evidence shows that most of the trial interventions addressed at least one or two key aspects of communication, including the provision of information prior to the vaccination appointment and tailoring information to parents' needs. None of the interventions appeared to respond to negative media stories or address parental perceptions of health worker motives. AUTHORS' CONCLUSIONS We have high or moderate confidence in the evidence contributing to several review findings. Further research, especially in rural and low- to middle-income country settings, could strengthen evidence for the findings where we had low or very low confidence. Planners should consider the timing for making vaccination information available to parents, the settings where information is available, the provision of impartial and clear information tailored to parental needs, and parents' perceptions of health workers and the information provided.
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Affiliation(s)
- Heather MR Ames
- Norwegian Institute of Public HealthGlobal Health UnitPilestredet Park 7OsloNorway0130
- University of OsloInstitute of Health and SocietyOsloNorway
| | - Claire Glenton
- Norwegian Institute of Public HealthGlobal Health UnitPilestredet Park 7OsloNorway0130
| | - Simon Lewin
- Norwegian Institute of Public HealthPO Box 4404OsloNorway0403
- Medical Research Council of South AfricaHealth Systems Research UnitPO Box 19070TygerbergSouth Africa7505
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Crowe S, Utley M, Walker G, Panovska-Griffiths J, Grove P, Pagel C. A novel approach to evaluating the UK childhood immunisation schedule: estimating the effective coverage vector across the entire vaccine programme. BMC Infect Dis 2015; 15:585. [PMID: 26714777 PMCID: PMC4696176 DOI: 10.1186/s12879-015-1299-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2015] [Accepted: 11/30/2015] [Indexed: 11/10/2022] Open
Abstract
Background The availability of new vaccines can prompt policy makers to consider changes to the routine childhood immunisation programme in the UK. Alterations to one aspect of the schedule may have implications for other areas of the programme (e.g. adding more injections could reduce uptake of vaccines featuring later in the schedule). Colleagues at the Department of Health (DH) in the UK therefore wanted to know whether assessing the impact across the entire programme of a proposed change to the UK schedule could lead to different decisions than those made on the current case-by-case basis. This work is a first step towards addressing this question. Methods A novel framework for estimating the effective coverage against all of the diseases within a vaccination programme was developed. The framework was applied to the current (August 2015) UK childhood immunisation programme, plausible extensions to it in the foreseeable future (introducing vaccination against Meningitis B and/or Hepatitis B) and a “what-if” scenario regarding a Hepatitis B vaccine scare that was developed in close collaboration with DH. Results Our applications of the framework demonstrate that a programme-view of hypothetical changes to the schedule is important. For example, we show how introducing Hepatitis B vaccination could negatively impact aspects of the current programme by reducing uptake of vaccines featuring later in the schedule, and illustrate that the potential benefits of introducing any new vaccine are susceptible to behaviour changes affecting uptake (e.g. a vaccine scare). We show how it may be useful to consider the potential benefits and scheduling needs of all vaccinations on the horizon of interest rather than those of an individual vaccine in isolation, e.g. how introducing Meningitis B vaccination could saturate the early (2-month) visit, thereby potentially restricting scheduling options for Hepatitis B immunisation should it be introduced to the programme in the future. Conclusions Our results demonstrate the potential benefit of considering the programme-wide impact of changes to an immunisation schedule, and our framework is an important step in the development of a means for systematically doing so. Electronic supplementary material The online version of this article (doi:10.1186/s12879-015-1299-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Sonya Crowe
- Clinical Operational Research Unit, University College London, 4 Taviton Street, London, WC1H 0BT, UK.
| | - Martin Utley
- Clinical Operational Research Unit, University College London, 4 Taviton Street, London, WC1H 0BT, UK.
| | - Guy Walker
- Department of Health, Area 330, Wellington House, 133-155 Waterloo Road, London, SE1 8UG, UK.
| | | | - Peter Grove
- Department of Health, Area 330, Wellington House, 133-155 Waterloo Road, London, SE1 8UG, UK.
| | - Christina Pagel
- Clinical Operational Research Unit, University College London, 4 Taviton Street, London, WC1H 0BT, UK.
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Ames H, Njang DM, Glenton C, Fretheim A, Kaufman J, Hill S, Oku A, Cliff J, Cartier Y, Bosch-Capblanch X, Rada G, Muloliwa A, Oyo-Ita A, Lewin S. Mapping how information about childhood vaccination is communicated in two regions of Cameroon: What is done and where are the gaps? BMC Public Health 2015; 15:1264. [PMID: 26691846 PMCID: PMC4687068 DOI: 10.1186/s12889-015-2557-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Accepted: 12/01/2015] [Indexed: 11/16/2022] Open
Abstract
Background The ‘Communicate to vaccinate’ (COMMVAC) project builds research evidence for improving communication with parents and communities about childhood vaccinations in low- and middle-income countries. Understanding and mapping the range of vaccination communication strategies used in different settings is an important component of this work. In this part of the COMMVAC project, our objectives were: (1) to identify the vaccination communication interventions used in two regions of Cameroon; (2) to apply the COMMVAC taxonomy, a global taxonomy of vaccination communication interventions, to these communication interventions to help us classify these interventions, including their purposes and target audiences; and identify whether gaps in purpose or target audiences exist; (3) to assess the COMMVAC taxonomy as a research tool for data collection and analysis. Methods We used the following qualitative methods to identify communication strategies in the Central and North West Regions of Cameroon in the first half of 2014: interviews with program managers, non-governmental organizations, vaccinators, parents and community members; observations and informal conversations during routine immunization clinics and three rounds of the National Polio Immunization Campaign; and document analysis of reports and mass media communications about vaccination. A survey of parents and caregivers was also done. We organised the strategies using the COMMVAC taxonomy and produced a map of Cameroon-specific interventions, which we presented to local stakeholders for feedback. Results Our map of the interventions used in Cameroon suggests that most childhood vaccination communication interventions focus on national campaigns against polio rather than routine immunisation. The map also indicates that most communication interventions target communities more broadly, rather than parents, and that very few interventions target health workers. The majority of the communication interventions aimed to inform or educate or remind or recall members of the community about vaccination. The COMMVAC taxonomy provided a useful framework for quickly and simply mapping existing vaccination communication strategies. Conclusions By identifying the interventions used in Cameroon and developing an intervention map, we allowed stakeholders to see where they were concentrating their communication efforts and where gaps exist, allowing them to reflect on whether changes are needed to the communication strategies they are using. Electronic supplementary material The online version of this article (doi:10.1186/s12889-015-2557-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Heather Ames
- Global Health Unit, Norwegian Knowledge Centre for the Health Services, Boks 7004, St Olavs plass, N/0130, Oslo, Norway.
| | - Diangha Mabel Njang
- Department of Anthropology, University of Yaoundé 1, BP 337, Yaoundé, Central Province, Cameroon, Africa.
| | - Claire Glenton
- Global Health Unit, Norwegian Knowledge Centre for the Health Services, Boks 7004, St Olavs plass, N/0130, Oslo, Norway.
| | - Atle Fretheim
- Global Health Unit, Norwegian Knowledge Centre for the Health Services, Boks 7004, St Olavs plass, N/0130, Oslo, Norway. .,Institute of Health and Society, University of Oslo, P.O box 1130 Blindern 0318, Oslo, Norway.
| | - Jessica Kaufman
- Centre for Health Communication and Participation, C/o Department of Human Biosciences, College of Science, Health and Engineering, La Trobe University, Melbourne campus, 3086, VIC, Australia.
| | - Sophie Hill
- Centre for Health Communication and Participation, C/o Department of Human Biosciences, College of Science, Health and Engineering, La Trobe University, Melbourne campus, 3086, VIC, Australia.
| | - Afiong Oku
- University of Calabar, Nigeria, P.M.B 1115, Calabar Municipal, Cross River State, Nigeria.
| | - Julie Cliff
- Faculdade de Medicina, Universidade Eduardo Mondlane, Maputo, Mozambique, Africa.
| | - Yuri Cartier
- International Union for Health Promotion and Education, 42 Blvd. de la Libération, 95203 St, Denis, Cedex, France.
| | - Xavier Bosch-Capblanch
- Swiss Tropical and Public Health Institute, Socinstrasse 57, 4051, Basel, Switzerland. .,University of Basel, Petersplatz 1, 4003, Basel, Switzerland.
| | - Gabriel Rada
- Evidence-based Healthcare Program, Pontificia Universidad Católica de Chile, Avda. Libertador Bernardo O'Higgins 340, Santiago, Chile.
| | - Artur Muloliwa
- Direcção Provincial de Saúde de Nampula, Departamento de Saúde, Av. Samora Machel n° 1016 R/C, C.P. N° 14, Nampula-Moçambique, Africa.
| | - Angela Oyo-Ita
- University of Calabar, Nigeria, P.M.B 1115, Calabar Municipal, Cross River State, Nigeria.
| | - Simon Lewin
- Global Health Unit, Norwegian Knowledge Centre for the Health Services, Boks 7004, St Olavs plass, N/0130, Oslo, Norway. .,Health Systems Research Unit, South African Medical Research Council, Francie van Zijl Drive, Parowvallei, Cape Town, PO Box 19070, 7505, Tygerberg, South Africa.
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Fadda M, Depping MK, Schulz PJ. Addressing issues of vaccination literacy and psychological empowerment in the measles-mumps-rubella (MMR) vaccination decision-making: a qualitative study. BMC Public Health 2015; 15:836. [PMID: 26328551 PMCID: PMC4556054 DOI: 10.1186/s12889-015-2200-9] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Accepted: 08/27/2015] [Indexed: 11/16/2022] Open
Abstract
Background Whether or not to vaccinate one’s child is one of the first health-related decisions parents have to make after their child’s birth. For the past 20 years, the share of parents choosing not to immunize their children has increased in many countries, for various reasons. Among these, rumors affirming that vaccinations contain dangerous chemicals or might trigger severe chronic diseases have negatively affected parental attitudes towards pediatric immunizations, particularly the vaccination against measles, mumps and rubella (MMR), raising a number of public health concerns. The primary aim of this qualitative study is to understand what drives parents’ decision, giving special attention to vaccination literacy and psychological empowerment in such a context. Methods Twenty individual semi-structured interviews were conducted in the Canton of Ticino (Switzerland) between January and June 2014. Participants were either mothers or fathers of children less than 1 year old living in Switzerland. An inductive thematic analysis was performed to identify the main themes with regard to vaccination literacy and psychological empowerment in the MMR vaccination decision-making. Results Parents’ reports yielded four main themes: (a) the paradox of the free choice, referring to the misinterpretation of current vaccination policies; (b) giving up the power, pointing at the outcomes of a low perceived competence; (c) a far-reaching decision, reflecting the importance attributed to the MMR choice and the different levels of impact the decision can have; (d) the demand for shared-decision making, referring to the parental needs in relation to the child’s healthcare provider. Conclusion Understanding what drives parents’ management of their children’s immunization schedule in terms of vaccination literacy and psychological empowerment can help health professionals to communicate more effectively with parents in order to facilitate an informed decision, and stakeholders to design tailored health education programs and materials. This can ultimately help increase the coverage of the MMR vaccination. Electronic supplementary material The online version of this article (doi:10.1186/s12889-015-2200-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Marta Fadda
- Institute of Communication and Health, Faculty of Communication Sciences, University of Lugano, Via G. Buffi 13, 6900, Lugano, Switzerland.
| | - Miriam K Depping
- Institute of Communication and Health, Faculty of Communication Sciences, University of Lugano, Via G. Buffi 13, 6900, Lugano, Switzerland.
| | - Peter J Schulz
- Institute of Communication and Health, Faculty of Communication Sciences, University of Lugano, Via G. Buffi 13, 6900, Lugano, Switzerland.
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Hulsey E, Bland T. Immune overload: Parental attitudes toward combination and single antigen vaccines. Vaccine 2015; 33:2546-50. [PMID: 25891399 DOI: 10.1016/j.vaccine.2015.04.020] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2015] [Revised: 03/30/2015] [Accepted: 04/07/2015] [Indexed: 12/11/2022]
Abstract
Parental concerns have led to a recent decline in immunization coverage, resulting in outbreaks of diseases that were once under control in the US. As the CDC vaccination schedule continues to increase in complexity, the number of required injections per office visit increases as well. Some parents perceive that there is trauma associated with the administration of multiple injections, and research shows that having multiple vaccines due in a single visit is associated with delays and lower immunization rates. Combination vaccines make vaccination more efficient by incorporating the antigens of several different diseases into a single injection, but many parents worry that they may overload the child's developing immune system and leave him or her susceptible to secondary infections. This literature review synthesizes current evidence regarding the parental fear of vaccine-induced immune system overload and the fear of vaccine-associated trauma, in an attempt to understand the scope and nature of these fears. Despite the wealth of knowledge about each of these fears individually, it is still unknown which is of greater concern and how this affects parental decision-making.
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Affiliation(s)
- Ella Hulsey
- University of Tennessee, Knoxville College of Nursing, United States.
| | - Tami Bland
- University of Tennessee, Knoxville College of Nursing, United States
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Does an education seminar intervention improve the parents' knowledge on vaccination? Evidence from Yiwu, East China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 12:3469-79. [PMID: 25811770 PMCID: PMC4410197 DOI: 10.3390/ijerph120403469] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/23/2014] [Revised: 03/16/2015] [Accepted: 03/18/2015] [Indexed: 01/22/2023]
Abstract
BACKGROUND caregivers' knowledge on vaccination is an important impact factor for their children's vaccination status. The aims of this study were to evaluate the caregivers' knowledge of vaccination, and to assess effectiveness of a health education seminar for improving caregivers' knowledge on immunization. METHODS pre- and post-assessment design was adopted for a single group to evaluate the effectiveness of the health education seminar on vaccination. The seminar consisted of a lecture using simple understandable language. Improvements in total knowledge score before and after the seminar were assessed using a validated questionnaire that included ten questions. Description analysis and non-parametric tests were applied to evaluate and compare the vaccination knowledge level before and after the seminar. RESULTS 378 caregivers participated in this study. The majority were mothers. Of the ten questions, the correct response rates had significantly increased for nine questions after the education seminar. The mean total score of the assessment before the seminar was 5.2 ± 1.2 while that was 8.4 ± 0.9 for the assessment after the seminar, with a significant increase of 3.18 points. CONCLUSION a short education seminar designed for caregivers had a remarkable effect on their vaccination knowledge. Health education on vaccination targeting migrant caregivers, caregivers with lower education level or household income, and employed caregivers are needed in future.
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Saeterdal I, Lewin S, Austvoll‐Dahlgren A, Glenton C, Munabi‐Babigumira S. Interventions aimed at communities to inform and/or educate about early childhood vaccination. Cochrane Database Syst Rev 2014; 2014:CD010232. [PMID: 25408540 PMCID: PMC10880811 DOI: 10.1002/14651858.cd010232.pub2] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND A range of strategies are used to communicate with parents, caregivers and communities regarding child vaccination in order to inform decisions and improve vaccination uptake. These strategies include interventions in which information is aimed at larger groups in the community, for instance at public meetings, through radio or through leaflets. This is one of two reviews on communication interventions for childhood vaccination. The companion review focuses on face-to-face interventions for informing or educating parents. OBJECTIVES To assess the effects of interventions aimed at communities to inform and/or educate people about vaccination in children six years and younger. SEARCH METHODS We searched CENTRAL, MEDLINE, EMBASE and five other databases up to July 2012. We searched for grey literature in the Grey Literature Report and OpenGrey. We also contacted authors of included studies and experts in the field. There were no language, date or settings restrictions. SELECTION CRITERIA Individual or cluster-randomised and quasi-randomised controlled trials, interrupted time series (ITS) and repeated measures studies, and controlled before-and-after (CBA) studies. We included interventions aimed at communities and intended to inform and/or educate about vaccination in children six years and younger, conducted in any setting. We defined interventions aimed at communities as those directed at a geographic area, and/or interventions directed to groups of people who share at least one common social or cultural characteristic. Primary outcomes were: knowledge among participants of vaccines or vaccine-preventable diseases and of vaccine service delivery; child immunisation status; and unintended adverse effects. Secondary outcomes were: participants' attitudes towards vaccination; involvement in decision-making regarding vaccination; confidence in the decision made; and resource use or cost of intervention. DATA COLLECTION AND ANALYSIS Two authors independently reviewed the references to identify studies for inclusion. We extracted data and assessed risk of bias in all included studies. MAIN RESULTS We included two cluster-randomised trials that compared interventions aimed at communities to routine immunisation practices. In one study from India, families, teachers, children and village leaders were encouraged to attend information meetings where they received information about childhood vaccination and could ask questions. In the second study from Pakistan, people who were considered to be trusted in the community were invited to meetings to discuss vaccine coverage rates in their community and the costs and benefits of childhood vaccination. They were asked to develop local action plans and to share the information they had been given and continue the discussions in their communities.The trials show low certainty evidence that interventions aimed at communities to inform and educate about childhood vaccination may improve knowledge of vaccines or vaccine-preventable diseases among intervention participants (adjusted mean difference 0.121, 95% confidence interval (CI) 0.055 to 0.189). These interventions probably increase the number of children who are vaccinated. The study from India showed that the intervention probably increased the number of children who received vaccinations (risk ratio (RR) 1.67, 95% CI 1.21 to 2.31; moderate certainty evidence). The study from Pakistan showed that there is probably an increase in the uptake of both measles (RR 1.63, 95% CI 1.03 to 2.58) and DPT (diptheria, pertussis and tetanus) (RR 2.17, 95% CI 1.43 to 3.29) vaccines (both moderate certainty evidence), but there may be little or no difference in the number of children who received polio vaccine (RR 1.01, 95% CI 0.97 to 1.05; low certainty evidence). There is also low certainty evidence that these interventions may change attitudes in favour of vaccination among parents with young children (adjusted mean difference 0.054, 95% CI 0.013 to 0.105), but they may make little or no difference to the involvement of mothers in decision-making regarding childhood vaccination (adjusted mean difference 0.043, 95% CI -0.009 to 0.097).The studies did not assess knowledge among participants of vaccine service delivery; participant confidence in the vaccination decision; intervention costs; or any unintended harms as a consequence of the intervention. We did not identify any studies that compared interventions aimed at communities to inform and/or educate with interventions directed to individual parents or caregivers, or studies that compared two interventions aimed at communities to inform and/or educate about childhood vaccination. AUTHORS' CONCLUSIONS This review provides limited evidence that interventions aimed at communities to inform and educate about early childhood vaccination may improve attitudes towards vaccination and probably increase vaccination uptake under some circumstances. However, some of these interventions may be resource intensive when implemented on a large scale and further rigorous evaluations are needed. These interventions may achieve most benefit when targeted to areas or groups that have low childhood vaccination rates.'
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Affiliation(s)
- Ingvil Saeterdal
- Norwegian Knowledge Centre for the Health ServicesHealth Economics and Drugs UnitPO Box 7004St Olavs PlassOsloNorwayN‐0130
| | - Simon Lewin
- Norwegian Knowledge Centre for the Health ServicesGlobal Health UnitBox 7004 St OlavsplassOsloNorwayN‐0130
- Medical Research Council of South AfricaHealth Systems Research UnitPO Box 19070TygerbergSouth Africa7505
| | | | - Claire Glenton
- Norwegian Knowledge Centre for the Health ServicesGlobal Health UnitBox 7004 St OlavsplassOsloNorwayN‐0130
| | - Susan Munabi‐Babigumira
- Norwegian Knowledge Centre for the Health ServicesGlobal Health UnitBox 7004 St OlavsplassOsloNorwayN‐0130
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Mapatano MA, Kayembe K, Piripiri L, Nyandwe K. Immunisation-related knowledge, attitudes and practices of mothers in Kinshasa, Democratic Republic of the Congo. S Afr Fam Pract (2004) 2014. [DOI: 10.1080/20786204.2008.10873699] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Weddle G, Jackson MA. Vaccine eligibility in hospitalized children: spotlight on a unique healthcare opportunity. J Pediatr Health Care 2014; 28:148-54. [PMID: 23522560 DOI: 10.1016/j.pedhc.2013.01.001] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2012] [Accepted: 01/03/2013] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The goals of this study were to evaluate the effectiveness of an inpatient documentation system for identifying missed vaccine opportunities and to identify parental satisfaction with their vaccination services. METHODS A prospective descriptive study compared inpatient documentation of vaccine history with actual vaccine records, and adherence with the Advisory Committee on Immunization Practices guidelines was assessed. A parental satisfaction survey was administered. RESULTS One hundred sixty pediatric patients ages 2 months to 17 years (mean age 8 years) were enrolled. Seventy-six percent of patients had documentation of vaccine history, and 92% were documented as receiving all age-appropriate vaccines. Actual immunization records showed that 16% percent of patients were in compliance with Advisory Committee on Immunization Practices guidelines. The most commonly missed vaccine was influenza (67%) followed by meningococcal (57%), hepatitis A (48%), and varicella (38%). Ninety percent of parents were satisfied with the vaccination services their child had received. CONCLUSION A review of vaccine records is recommended to accurately assess status. Inpatient hospitalization represents an opportunity to assess vaccination status, address parental concerns, and provide updated vaccinations.
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Beliefs and knowledge about vaccination against AH1N1pdm09 infection and uptake factors among Chinese parents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2014; 11:1989-2002. [PMID: 24534766 PMCID: PMC3945580 DOI: 10.3390/ijerph110201989] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/02/2013] [Revised: 01/28/2014] [Accepted: 01/29/2014] [Indexed: 12/03/2022]
Abstract
Vaccination against AH1N1pdm09 infection (human swine infection, HSI) is an effective measure of preventing pandemic infection, especially for high-risk groups like children between the ages of 6 months and 6 years. This study used a cross-sectional correlation design and aimed to identify predicting factors of parental acceptance of the HSI vaccine (HSIV) and uptake of the vaccination by their preschool-aged children in Hong Kong. A total of 250 parents were recruited from four randomly selected kindergartens. A self-administered questionnaire based on the health belief framework was used for data collection. The results showed that a number of factors significantly affected the tendency toward new vaccination uptake; these factors included parental age, HSI vaccination history of the children in their family, preferable price of the vaccine, perceived severity, perceived benefits, perceived barriers, and motivating factors for taking new vaccines. Using these factors, a logistic regression model with a high Nagelkerke R2 of 0.63 was generated to explain vaccination acceptance. A strong correlation between parental acceptance of new vaccinations and the motivating factors of vaccination uptake was found, which indicates the importance of involving parents in policy implementation for any new vaccination schemes. Overall, in order to fight against pandemics and enhance vaccination acceptance, it is essential for the government to understand the above factors determining parental acceptance of new vaccinations for their preschool-aged children.
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Connors J, Arushanyan E, Bellanca G, Racine R, Hoeffler A, Delgado A, Gibbons S. A description of barriers and facilitators to childhood vaccinations in the military health system. ACTA ACUST UNITED AC 2012. [PMID: 23190129 DOI: 10.1111/j.1745-7599.2012.00780.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
PURPOSE To perform a literature review of barriers to and facilitators of parents' decisions to have their children vaccinated. Both differences and similarities between the civilian sector and the military health system (MHS) were explored. DATA SOURCES Articles and documents were identified from the following databases: CINAHL, PubMed, Defense Technical Information Center (DTIC), ISI, and Google Scholar. Reference lists from articles were reviewed. CONCLUSIONS Common themes identified in the civilian sector and the MHS included an electronic registry, care access issues, provider characteristics, and child illness. Several themes served as a barrier in one system while being a facilitator in the other, such as provider characteristics. Literature addressing the MHS and factors affecting vaccine coverage is scant; however, a large disparity in vaccination coverage exists between the MHS and the civilian sector. IMPLICATIONS The theme of provider characteristics was seen as a barrier in both systems; a better understanding of this theme (i.e., provider effectiveness at interacting with parents) would benefit primary care practice. An electronic vaccine registry and targeted education and media campaign used to facilitate vaccinations in the MHS should be piloted in the civilian sector. Additionally, future studies should be performed on identified themes in the MHS.
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Affiliation(s)
- John Connors
- Graduate School of Nursing, Uniformed Services University, Bethesda, Maryland 20841, USA.
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Saeterdal I, Glenton C, Austvoll-Dahlgren A, Munabi-Babigumira S, Lewin S. Community-directed interventions for informing and/or educating about early childhood vaccination. THE COCHRANE DATABASE OF SYSTEMATIC REVIEWS 2012. [DOI: 10.1002/14651858.cd010232] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Sardy R, Ecochard R, Lasserre E, Dubois JP, Floret D, Letrilliart L. Représentations sociales de la vaccination chez les patients et les médecins généralistes : une étude basée sur l'évocation hiérarchisée. SANTE PUBLIQUE 2012. [DOI: 10.3917/spub.126.0547] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
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Leib S, Liberatos P, Edwards K. Pediatricians' experience with and response to parental vaccine safety concerns and vaccine refusals: a survey of Connecticut pediatricians. Public Health Rep 2011; 126 Suppl 2:13-23. [PMID: 21812165 DOI: 10.1177/00333549111260s203] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES Physicians are seeing increasing numbers of parents who question the safety of vaccines or refuse to vaccinate their children. This study examined how frequently pediatricians in one New England state encounter parental vaccine safety concerns and vaccine refusals, how often physicians dismiss families from their practices for vaccine refusal, and how parental vaccine refusal impacts pediatricians personally. METHODS The study consisted of a quantitative survey of primary care pediatricians in one New England state; 133 pediatricians completed the questionnaire. Variables examined included number of parental vaccine concerns and refusals seen by each physician, physicians' response to parental vaccine concerns and refusals, the personal impact of parental vaccine safety refusals on pediatricians, and respondent estimates of socioeconomic characteristics of families seen in their practices. RESULTS The majority of responding pediatricians reported an increase in parental vaccine safety concerns and refusals. More than 30% of responding pediatricians have dismissed families because of their refusal to immunize. Suburban physicians caring for wealthier, better educated families experience more vaccine concerns and/or refusals and are more likely to dismiss families for vaccine refusal. Vaccine refusals have a negative personal impact on one-third of physician respondents. CONCLUSIONS Pediatricians in Connecticut are reporting increased levels of parental vaccine safety concerns and refusals. Physicians who report more parental vaccine safety concerns and refusals and who care for wealthier, better educated families are more likely to dismiss families who refuse vaccines and to be negatively affected by parental vaccine refusals, which may adversely impact childhood vaccination rates.
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Affiliation(s)
- Susan Leib
- New York Medical College School of Health Sciences and Practice, Valhalla, NY, USA.
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Rand CM, Humiston SG, Schaffer SJ, Albertin CS, Shone LP, Blumkin AK, Stokley S, Szilagyi PG. Parent and adolescent perspectives about adolescent vaccine delivery: practical considerations for vaccine communication. Vaccine 2011; 29:7651-8. [PMID: 21839793 DOI: 10.1016/j.vaccine.2011.08.002] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2011] [Revised: 07/27/2011] [Accepted: 08/01/2011] [Indexed: 10/17/2022]
Abstract
We surveyed parents of adolescents (n=430) and their adolescents ages 15-17 years (n=208) in 9 primary-care settings in Monroe County, NY to assess perceptions about adolescent vaccine delivery. Parents and adolescents most wanted to discuss vaccine side effects and the diseases prevented with the adolescents' provider. Those who perceived vaccines as very safe were more accepting of adolescent vaccines. Most participants agreed with vaccinating the teen during a mild illness and with providing multiple vaccines concomitantly. Participants most preferred medical, as opposed to other settings, for receipt of adolescent vaccines. For parents and adolescents who are wary of vaccination, strategies are needed to enhance communication about risks and benefits of vaccinations.
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Affiliation(s)
- Cynthia M Rand
- Department of Pediatrics, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA. Cynthia
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A survey of children's preferences for influenza vaccine attributes. Vaccine 2011; 29:4334-40. [PMID: 21510993 DOI: 10.1016/j.vaccine.2011.04.018] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2010] [Revised: 03/07/2011] [Accepted: 04/05/2011] [Indexed: 11/23/2022]
Abstract
BACKGROUND While annual influenza vaccination is recommended by the CDC for children 6 months and older, vaccination rates remain suboptimal. For healthy, US children 2 years of age and older, influenza vaccine is available as an intramuscular injection (TIV) or an intranasal spray (LAIV), respectively. Little is known about children's experiences and preferences for influenza vaccine attributes. OBJECTIVE To examine preferences for influenza vaccine attributes and their relative importance among children. METHODS A quantitative web-survey was administered to children aged 8-12 years sampled from a standing online panel representative of the US population. Children were stratified by age, gender and parent's influenza vaccination behavior. The survey included questions to ascertain children's preferences for influenza vaccine attributes, including efficacy, chance of common side effects, and mode of administration. It included conjoint (trade-off) questions in which children traded-off different attributes in their choice between two influenza vaccines with differing features. We also surveyed children's comprehension of and ability to complete the conjoint questions. RESULTS 544 children completed the survey (response rate 37%). Children most frequently selected efficacy as the most important vaccine attribute followed by mode of administration (45% and 31%, respectively). When asked for their preference to receive influenza vaccine as a "shot" or a "nose spray", the majority (69%) preferred the nose spray. An evaluation of children's ability to complete the conjoint survey demonstrated that 85% of the sample was able to complete the conjoint tasks. Analysis of the conjoint responses demonstrated that mode of administration and efficacy had the greatest impact on preferences, with a relative importance of 40.5% and 30.6%, respectively. In a direct comparison of vaccine profiles representing the efficacy, side effects, and other characteristics of LAIV and TIV, 79% of children preferred the LAIV-like profile. CONCLUSION Children in the sample had consistent opinions regarding influenza vaccine attributes and consider vaccine efficacy and mode of administration to be important. Children can be informed participants in influenza prevention and can be included in discussions regarding influenza vaccination.
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Ali H, Seale H, Ward K, Zwar N. A picture speaks a thousand words: evaluation of a pictorial post-vaccination care resource in Australia. Aust J Prim Health 2010; 16:246-51. [PMID: 20815995 DOI: 10.1071/py10002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Evaluating the 'Common Reactions to Vaccination' post-vaccination care resource was seen as an opportunity to contribute to the limited literature base in this important area, learn from the strengths and weaknesses of the resource and gain insight into post-vaccination care practices. Semi-structured in-depth interviews were conducted with 12 general practitioners and 29 practice nurses in New South Wales and Australian Capital Territory, Australia. Structured interview guides were used and data was analysed thematically. A self-administered survey was also distributed to parents or guardians during routine childhood vaccination visits. When compared with previous resources, participants felt the new resource was more appropriate as it had a simple layout; it was colourful, incorporated pictures and had basic and practical information. Information about post-vaccination care and common reactions to vaccination must be provided in written form accompanied by a verbal reinforcement so that patients can revisit the information at a later stage if required. The 'Common Reactions to Vaccination' post-vaccination care resource provides comprehensive information in an easy-to-understand pictorial way and was appreciated by both vaccination providers and patients.
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Affiliation(s)
- Hammad Ali
- School of Public Health and Community Medicine, University of New South Wales, Sydney, NSW 2052, Australia.
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Flood EM, Rousculp MD, Ryan KJ, Beusterien KM, Divino VM, Toback SL, Sasané M, Block SL, Hall MC, Mahadevia PJ. Parents' decision-making regarding vaccinating their children against influenza: A web-based survey. Clin Ther 2010; 32:1448-67. [DOI: 10.1016/j.clinthera.2010.06.020] [Citation(s) in RCA: 86] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/23/2010] [Indexed: 11/25/2022]
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Mennito SH, Darden PM. Impact of practice policies on pediatric immunization rates. J Pediatr 2010; 156:618-22. [PMID: 20056238 DOI: 10.1016/j.jpeds.2009.10.046] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2009] [Revised: 10/05/2009] [Accepted: 10/29/2009] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To describe the relationship between practice policies and rates of up-to-date (UTD). STUDY DESIGN Analysis of data from the 2004-2006 National Immunization Survey (NIS). Practice policies evaluated are immunization provider involvement in a vaccine registry, participation in the Vaccines for Children (VFC) program, and administration of hepatitis B vaccine at birth. The primary outcome is rates of being UTD with the 4:3:1:3:3 vaccination series for children age 19 through 35 months. RESULTS The overall rate of UTD is 80.8%; 53.3% of children had providers administer hepatitis B vaccine at birth, which was associated with significantly higher rates of UTD (79.9% vs. 83.1%, P < .01). Children with multiple vaccine providers had lower rates of UTD versus those with only 1 vaccine provider (77.3% vs 82.5%; P < .01). In multivariable analysis, participation in VFC (OR 1.59, 95%, CI 1.16-2.2) and administration of hepatitis B at birth (OR 1.25, 95% CI 1.05-1.5) increased the odds of UTD. Provider participation in a vaccine registry did not significantly impact rates or likelihood of UTD. CONCLUSIONS Immunization provider policy decisions, including administration of hepatitis B at birth, participation in VFC, and a focus on continuity of care, can improve rates of UTD for children in their practice.
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Affiliation(s)
- Sarah H Mennito
- Medical University of South Carolina, Department of Pediatrics, Division of General Pediatrics, Charleston, South Carolina, USA.
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Danis K, Georgakopoulou T, Stavrou T, Laggas D, Panagiotopoulos T. Socioeconomic factors play a more important role in childhood vaccination coverage than parental perceptions: a cross-sectional study in Greece. Vaccine 2010; 28:1861-9. [DOI: 10.1016/j.vaccine.2009.11.078] [Citation(s) in RCA: 89] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2009] [Revised: 11/29/2009] [Accepted: 11/30/2009] [Indexed: 10/20/2022]
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Sanou A, Simboro S, Kouyaté B, Dugas M, Graham J, Bibeau G. Assessment of factors associated with complete immunization coverage in children aged 12-23 months: a cross-sectional study in Nouna district, Burkina Faso. BMC INTERNATIONAL HEALTH AND HUMAN RIGHTS 2009; 9 Suppl 1:S10. [PMID: 19828054 PMCID: PMC2762310 DOI: 10.1186/1472-698x-9-s1-s10] [Citation(s) in RCA: 66] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background The Expanded Program on Immunization (EPI) is still in need of improvement. In Burkina Faso in 2003, for example, the Nouna health district had an immunization coverage rate of 31.5%, compared to the national rate of 52%. This study identifies specific factors associated with immunization status in Nouna health district in order to advance improved intervention strategies in this district and in those with similar environmental and social contexts. Methods A cross-sectional study was undertaken in 41 rural communities and one semi-urban area (urban in the text). Data on 476 children aged 12 to 23 months were analyzed from a representative sample of 489, drawn from the Nouna Health Research Centre's Demographic Surveillance System (DSS) database. The vaccination history of these children was examined. The relationships between their immunization status and social, economic and various contextual variables associated with their parents and households were assessed using Chi square test, Pearson correlation and logistic regression. Results The total immunization coverage was 50.2% (CI, 45.71; 54.69). Parental knowledge of the preventive value of immunization was positively related to complete immunization status (p = 0.03) in rural areas. Children of parents who reported a perception of communication problems surrounding immunization had a lower immunization coverage rate (p < 0.001). No distance related difference exists in terms of complete immunization coverage within villages and between villages outside the site of the health centres. Children of non-educated fathers in rural areas have higher rates of complete immunization coverage than those in the urban area (p = 0.028). Good communication about immunization and the importance of availability of immunization booklets, as well as economic and religious factors appear to positively affect children's immunization status. Conclusion Vaccination sites in remote areas are intended to provide a greater opportunity for children to access vaccination services. These efforts, however, are often hampered by the poor economic conditions of households and insufficient communication and knowledge regarding immunization issues. While comprehensive communication may improve understanding about immunization, it is necessary that local interventions also take into account religious specificities and critical economic periods. Particular approaches that take into consideration these distinctions need to be applied in both rural and urban settings. Abstract in French See the full article online for a translation of this abstract in French.
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Affiliation(s)
- Aboubakary Sanou
- Université de Montréal, Department of Social and Preventive Medicine, Québec, Canada.
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Borràs E, Domínguez A, Fuentes M, Batalla J, Cardeñosa N, Plasencia A. Parental knowledge of paediatric vaccination. BMC Public Health 2009; 9:154. [PMID: 19473498 PMCID: PMC2701425 DOI: 10.1186/1471-2458-9-154] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2008] [Accepted: 05/27/2009] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Although routine vaccination is a major tool in the primary prevention of some infectious diseases, there is some reluctance in a proportion of the population. Negative parental perceptions of vaccination are an important barrier to paediatric vaccination. The aim of this study was to investigate parental knowledge of paediatric vaccines and vaccination in Catalonia. METHODS A retrospective, cross-sectional study was carried out in children aged < 3 years recruited by random sampling from municipal districts of all health regions of Catalonia. The total sample was 630 children. Parents completed a standard questionnaire for each child, which included vaccination coverage and knowledge about vaccination. The level of knowledge of vaccination was scored according to parental answers. RESULTS An association was observed between greater vaccination coverage of the 4:4:4:3:1 schedule (defined as: 4 DTPa/w doses, 4 Hib doses, 4 OPV doses, 3 MenC doses and 1 MMR dose) and maternal age >30 years (OR: 2.30; 95% CI: 1.20-4.43) and with a knowledge of vaccination score greater than the mean (OR: 0.45; 95% CI: 0.28-0.72). The score increased with maternal educational level and in parents of vaccinated children.A total of 20.47% of parents stated that vaccines could have undesirable consequences for their children. Of these, 23.26% had no specific information and 17.83% stated that vaccines can cause adverse reactions and the same percentage stated that vaccines cause allergies and asthma. CONCLUSION Higher vaccination coverage is associated with older maternal age and greater knowledge of vaccination.Vaccination coverage could be raised by improving information on vaccines and vaccination.
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Affiliation(s)
- Eva Borràs
- CIBER Epidemiología y Salud Pública, Barcelona, Spain.
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Batra JS, Eriksen EM, Zangwill KM, Lee M, Marcy SM, Ward JI. Evaluation of vaccine coverage for low birth weight infants during the first year of life in a large managed care population. Pediatrics 2009; 123:951-8. [PMID: 19255025 DOI: 10.1542/peds.2008-0231] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE There are few recent population-based assessments of vaccine coverage in premature infants available. This study assesses and compares age- and dose-specific immunization coverage in children of different birth weight categories during the first year of life. METHODS We performed a retrospective cohort analysis of computerized vaccination data from a large managed care organization in southern California. The participants were children born between January 1, 1997, and December 31, 2002, and continuously enrolled from birth to at least 12 months of age in the Southern California Kaiser Permanente health plan. We measured age-specific up-to-date and age-appropriate immunization rates according to birth weight (extremely low birth weight: <1000 g; very low birth weight: 1000-1499 g; low birth weight: 1500-2499 g; normal birth weight: >/=2500 g) for 4 vaccines (hepatitis B, diphtheria and tetanus toxoids with pertussis, Haemophilus influenzae type b, and poliovirus) through the first year of life. RESULTS We identified 127 833 infants born during the study period and continuously enrolled through the first year of life; 120 048 were normal birth weight infants; 6491 were low birth weight infants; 788 were very low birth weight infants; and 506 were extremely low birth weight infants. Vaccine-specific age-appropriate immunization rates were 3% to 15% lower for low birth weight infants and 17% to 33% lower for extremely low birth weight infants compared with the rates for normal birth weight infants in the first 6 months of life. Extremely low birth weight infants had the lowest age-specific up-to-date immunization levels (5%-31% lower) compared with normal birth weight infants at each age assessed. By 12 months, extremely low birth weight infants still had significantly lower up-to-date levels (87%) compared with very low birth weight, low birth weight, and normal birth weight infants (91%-92%). CONCLUSIONS Despite recommendations that lower birth weight infants be vaccinated as the same chronological age as normal birth weight infants, extremely low birth weight and very low birth weight infants are immunized at significantly lower rates relative to low birth weight and normal birth weight infants at 2, 4, and 6 months of age. However, by 12 months of age this finding persists only in extremely low birth weight infants.
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Affiliation(s)
- Jagmohan S Batra
- Harbor-UCLA Medical Center, Liu Research Building, 1124 W Carson St, Torrance, CA 90502, USA.
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Parents’ attitudes towards varicella vaccination acceptance in France and Germany: effect of vaccine recommendation and reimbursement (a survey). J Public Health (Oxf) 2008. [DOI: 10.1007/s10389-008-0218-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Taylor JA, Rietberg K, Greenfield L, Bibus D, Yasuda K, Marcuse EK, Duchin JS. Effectiveness of a physician peer educator in improving the quality of immunization services for young children in primary care practices. Vaccine 2008; 26:4256-61. [DOI: 10.1016/j.vaccine.2008.05.047] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2008] [Revised: 05/13/2008] [Accepted: 05/20/2008] [Indexed: 11/25/2022]
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Darden PM, Taylor JA, Brooks DA, Hendricks JW, Massoudi M, Stevenson JM, Bocian AB. How should immunization rates be measured in the office setting? A study from PROS and NMA PedsNet. Clin Pediatr (Phila) 2008; 47:252-60. [PMID: 18057163 DOI: 10.1177/0009922807308743] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The aim of the study was to compare the validity and reliability of 2 sampling methods for measuring immunization rates to a reference standard in a national sample of pediatric office practices. The consecutive method involved patients seen consecutively in the office for any reason; the random record was a random selection of medical records; and the reference standard active method, data of a randomly selected subgroup of children in the random record survey were supplemented with information from a telephone interview. The consecutive method of assessing immunization rates results in rates that are, on average, higher and closer to the reference standard, but also more variable. The random record method rates are lower and further from the study reference standard compared with the consecutive method, but more precise. The consecutive method for measuring practice immunization rates could be a useful quality improvement tool as practices seek to improve immunization delivery and quality of care. It is inexpensive, simple, and easy to implement.
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Affiliation(s)
- Paul M Darden
- Department of Pediatrics, Medical University of South Carolina, Charleston, South Carolina 29425, USA.
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Abhyankar P, O'connor DB, Lawton R. The role of message framing in promoting MMR vaccination: Evidence of a loss-frame advantage. PSYCHOL HEALTH MED 2008; 13:1-16. [DOI: 10.1080/13548500701235732] [Citation(s) in RCA: 112] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Posfay-Barbe KM, Zerr DM, Pittet D. Infection control in paediatrics. THE LANCET. INFECTIOUS DISEASES 2008; 8:19-31. [DOI: 10.1016/s1473-3099(07)70310-9] [Citation(s) in RCA: 75] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Finch SA, Lalama C, Spino C, Schwartz HC, Wasserman RC, McCormick MC, Bernstein HH. Practice-based research network solutions to methodological challenges encountered in a national, prospective cohort study of mothers and newborns. Paediatr Perinat Epidemiol 2008; 22:87-98. [PMID: 18173787 DOI: 10.1111/j.1365-3016.2007.00894.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The emergence of practice-based research networks (PBRN) has facilitated the execution of multifaceted community-based studies. As study complexity increases, so does the number of methodological barriers encountered. This paper's goal was to delineate methodological barriers and to evaluate the effectiveness of selected strategies and approaches developed and implemented in allowing a prospective, national PBRN cohort study to succeed in enrolling geographically dispersed mother/healthy term infant dyads (n = 4300) on the day of post-partum discharge. Specific methodological barriers included: (1) obtaining multiple Institutional Review Board (IRB) approvals; (2) gathering longitudinal data from multiple individuals; (3) soliciting multiple perspectives on discharge decision making; and (4) bolstering minority enrolment. The most effective strategies and approaches we employed to address these methodological challenges were: (1) preparing and distributing the 'IRB Packet'; (2) recruiting multiple practices covered by the same IRB; and (3) obtaining supplemental funding for increasing minority enrolment. We expect that other PBRN investigators can benefit from our experience and solutions in the successful conduct of this multifaceted community-based study.
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Affiliation(s)
- Stacia A Finch
- Pediatric Research in Office Settings (PROS), Department of Research, American Academy of Pediatrics, Elk Grove Village, IL, USA
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Schmitt HJ, Booy R, Aston R, Van Damme P, Schumacher RF, Campins M, Rodrigo C, Heikkinen T, Weil-Olivier C, Finn A, Olcén P, Fedson D, Peltola H. How to optimise the coverage rate of infant and adult immunisations in Europe. BMC Med 2007; 5:11. [PMID: 17535430 PMCID: PMC1903356 DOI: 10.1186/1741-7015-5-11] [Citation(s) in RCA: 74] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2006] [Accepted: 05/29/2007] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Although vaccination has been proved to be a safe, efficacious, and cost-effective intervention, immunisation rates remain suboptimal in many European countries, resulting in poor control of many vaccine-preventable diseases. DISCUSSION The Summit of Independent European Vaccination Experts focused on the perception of vaccines and vaccination by the general public and healthcare professionals and discussed ways to improve vaccine uptake in Europe. Despite the substantial impact and importance of the media, healthcare professionals were identified as the main advocates for vaccination and the most important source of information about vaccines for the general public. Healthcare professionals should receive more support for their own education on vaccinology, have rapid access to up-to-date information on vaccines, and have easy access to consultation with experts regarding vaccination-related problems. Vaccine information systems should be set up to facilitate promotion of vaccination. SUMMARY Every opportunity to administer vaccines should be used, and active reminder systems should be set up. A European vaccine awareness week should be established.
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Affiliation(s)
- Heinz-J Schmitt
- Infectious Diseases Service at the Zentrum für Präventive Pädiatrie, Johannes Gutenberg Universität, Langenbeckstr. 1, 55101 Mainz, Germany
| | - Robert Booy
- National Centre for Immunisation Research & Surveillance (NCIRS), Loked Bag 4001, Westmead NSW 2145, Australia
| | | | - Pierre Van Damme
- Centre for the Evaluation of Vaccination, Department of Epidemiology and Social Medicine, University of Antwerp, Universiteitsplein, 1, 2610 Wilrijk, Belgium
| | - R Fabian Schumacher
- Clinica Pediatrica, Universita' degli Studi di Brescia, Piazzale Spedali Civili 1, 25123 Brescia, Italy
| | - Magda Campins
- Servicio de Medicina Preventiva y Epidemiología, Hospital Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona 08035, Spain
| | - Carlos Rodrigo
- Hospital Universitari 'Germans Trias I Pujol,' Carretera de Canyet s/n 08916, Barcelona, Spain
| | - Terho Heikkinen
- Department of Pediatrics, Turku University Hospital, FI-20520 Turku, Finland
| | | | - Adam Finn
- Institute of Child Life and Health, University of Bristol, UK
| | - Per Olcén
- Department of Clinical Microbiology and Immunology, Örebro University Hospital, Sweden
| | | | - Heikki Peltola
- HUCH Hospital for Children and Adolescents, FI-00029 HUS, Helsinki, Finland
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Miranda VMM, Nascimento-Carvalho CM. Assessing vaccination rates at an emergency room. Am J Infect Control 2007; 35:286-7. [PMID: 17483004 DOI: 10.1016/j.ajic.2006.10.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2006] [Accepted: 10/13/2006] [Indexed: 11/29/2022]
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Adler A, Herring E, Babilsky H, Gazala E, Cohen A, Levy I. Parent-dependent barriers to varicella immunization in Israel: the importance of adequate information. Acta Paediatr 2007; 96:428-31. [PMID: 17407471 DOI: 10.1111/j.1651-2227.2007.00118.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
AIM To examine the parent-dependent barriers to varicella immunization in Israel. METHODS Data were collected by questionnaire from parents of children aged 1 to 18 years who attended an outpatient paediatric centre in five cities in Israel from March to May 2003. RESULTS A total of 1474 parents completed the questionnaire. A history of chicken pox was reported in 850 children (57.8%), mostly (83%) between ages 1-6 years. Of the 624 children without a history of chicken pox, 213 (34.1%) were immunized against varicella. Immunization rates were significantly lower in families with lower parental education and in patients from cities with a lower socioeconomic ranking (p < 0.05). The main reasons for not being vaccinated (49%) were related to insufficient information about the vaccine itself and the vaccination process. These reasons were more common in families with lower parental education and from cities with lower socioeconomic ranking (p < 0.01). Other reasons included fear of adverse effects (12%) and waning immunity (6%), preference of natural illness over immunization (12%), and financial limitations (5%). CONCLUSIONS Promoting parental knowledge about the varicella vaccine appears to be a key factor in improving the immunization rate, especially in families of lower education, and from cities with low socioeconomic ranking.
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Affiliation(s)
- Amos Adler
- Pediatric Infectious Disease Unit, Schneider Children's Medical Center of Israel, Petah Tiqwa and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
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Balinska MA, Léon C. [Attitudes towards immunization]. Rev Med Interne 2006; 28:28-32. [PMID: 17188403 DOI: 10.1016/j.revmed.2006.10.327] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2006] [Revised: 10/06/2006] [Accepted: 10/09/2006] [Indexed: 10/23/2022]
Abstract
PURPOSE Ever since vaccination was introduced, a minority has been opposed to this practice. Recently however, fear of adverse events and a general questioning of the usefulness of certain vaccines have led to wariness on the part of the broader public. In France, this phenomenon is particularly striking since the hepatitis B vaccination campaign. We wished to analyse the situation by drawing on the results of surveys conducted by the French Institute of Prevention and Health Education (Institut national de prévention et d'éducation pour la santé, INPES) which sought to gain a better understanding of health care professionals' and the general public's attitudes towards immunization. MAIN POINTS Although the majority of French men and women are convinced of the overall benefit of vaccination in the past, they increasingly question vaccine safety and usefulness today. PERSPECTIVES In order to prevent further deterioration of the situation, efforts must be made to enhance public and professional awareness as to the stakes involved in the control of vaccine preventable diseases.
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Affiliation(s)
- M-A Balinska
- Institut national de prévention et d'éducation à la santé, 42, boulevard de la Libération, 93203 Saint-Denis cedex, France.
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