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Silver ER, Fink L, Baylis KR, Faust RA, Guzman K, Hribar C, Martin L, Navin MC. Challenging the 'acceptable option': Public health's advocacy for continued care in the case of pediatric vaccine refusal. Vaccine 2024:126144. [PMID: 39048468 DOI: 10.1016/j.vaccine.2024.07.045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Revised: 07/07/2024] [Accepted: 07/13/2024] [Indexed: 07/27/2024]
Abstract
BACKGROUND In the United States, nearly half of pediatricians dismiss or refuse to accept families that withhold consent from the administration of childhood vaccines. Since 2016, the American Academy of Pediatrics has called patient dismissal in these cases "an acceptable option." Clinician dismissal and non-acceptance pose a problem to public health because they cluster under-vaccinated children in the practices that remain willing to treat such children, and they decrease access to routine care for children who cannot find practices willing to accept or retain them. This paper reports the emergence of a new consciousness about dismissal and non-acceptance policies in the leadership of a local health department (LHD) of a populous metropolitan county. OBJECTIVES To understand the prevalence and diversity of patient dismissal within Oakland County, Michigan and to measure shifts in clinicians' attitudes about dismissal following an educational intervention. METHODS A preliminary community survey was distributed to immunizing providers during April 2023 with 61 responses measuring the frequency and reasoning for dismissal policies. The results of the survey were used to inform a brief, evidence-backed educational intervention which was delivered in June 2023 to 82 participants from local pediatric medical offices. RESULTS The initial survey was completed by 61 immunizing providers, representing an estimated 37% of vaccinating practices in the county. Half said their practice "always" or "sometimes" dismisses patients due to vaccine refusal. After the educational intervention, the proportion of participants who agreed/strongly agreed with the statement "I believe patient dismissal for vaccine refusal is a good choice for public health" decreased from 36% to 18%. CONCLUSION The changes that we observed between the pre- and post-intervention surveys demonstrate the opportunity that exists for LHD leaders to enter the conversation around patient dismissal and nonacceptance and shed new light on this issue.
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Affiliation(s)
- Emily R Silver
- Oakland County Health Division, Pontiac, MI USA; School of Public Health, University of Michigan, Ann Arbor, MI USA.
| | - Lauren Fink
- Oakland County Health Division, Pontiac, MI USA
| | | | | | - Kate Guzman
- Oakland County Health Division, Pontiac, MI USA
| | | | | | - Mark C Navin
- Department of Philosophy, Oakland University, Rochester, MI USA; Clinical Ethics, Corewell Health East, Southfield, MI USA
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Shook LM, Rosen BL, Mara CA, Mosley C, Thompson AA, Smith-Whitley K, Schwartz L, Barriteau C, King A, Oke E, Jallow F, Murphy B, Crosby L. Attitudes, Beliefs, and Intention to Receive a COVID-19 Vaccine for Pediatric Patients With Sickle Cell Disease. J Pediatr Hematol Oncol 2024; 46:e305-e312. [PMID: 38775380 PMCID: PMC11188626 DOI: 10.1097/mph.0000000000002877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 04/02/2024] [Indexed: 06/22/2024]
Abstract
Sickle cell disease (SCD), which occurs primarily in individuals of African descent, has been identified as a preexisting health condition for COVID-19 with higher rates of hospitalization, intensive care unit admissions, and death. National data indicate Black individuals have higher rates of vaccine hesitancy and lower COVID-19 vaccination rates. Understanding the key predictors of intention to receive a COVID-19 vaccine is essential as intention is strongly associated with vaccination behavior. This multisite study examined attitudes, beliefs, intentions to receive COVID-19 vaccines, and educational preferences among adolescents, young adults, and caregivers of children living with SCD. Participants completed an online survey between July 2021 and March 2022. Multivariate logistic regression was used to examine the association between participant age and COVID-19 vaccine attitudes, beliefs, and vaccine intentions. Of the 200 participants, 65.1% of adolescents, 62.5% of young adults, and 48.4% of caregivers intended to receive a COVID-19 vaccine for themselves or their child. Perception that the vaccine was safe was statistically significant and associated with patient and caregiver intention to receive the COVID-19 vaccine for themselves or their child. Participant age was also statistically significant and associated with the intent to get a booster for patients. Study findings highlight key concerns and influencers identified by patients with SCD and their caregivers that are essential for framing COVID-19 vaccine education during clinical encounters. Study results can also inform the design of messaging campaigns for the broader pediatric SCD population and targeted interventions for SCD subpopulations (eg, adolescents, caregivers).
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Affiliation(s)
- Lisa M. Shook
- Division of Hematology, Cancer and Blood Diseases Institute
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH
| | - Brittany L. Rosen
- Division of Behavioral Medicine & Clinical Psychology, Cincinnati Children's Hospital Medical Center
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH
| | - Constance A. Mara
- Division of Behavioral Medicine & Clinical Psychology, Cincinnati Children's Hospital Medical Center
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH
| | - Cami Mosley
- Division of Hematology, Cancer and Blood Diseases Institute
| | - Alexis A. Thompson
- Department of Pediatrics, University of Pennsylvania Perelman School of Medicine
- Division of Hematology
| | - Kim Smith-Whitley
- Department of Pediatrics, University of Pennsylvania Perelman School of Medicine
- Division of Hematology
| | - Lisa Schwartz
- Department of Pediatrics, University of Pennsylvania Perelman School of Medicine
- Division of Oncology, Children's Hospital of Philadelphia, Philadelphia, PA
| | - Christina Barriteau
- Department of Pediatrics, Division of Hematology, Oncology and Stem Cell Transplant, Ann and Robert Lurie Children's Hospital
- Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Allison King
- Department of Pediatric Hematology/Oncology, St. Louis Children’s Hospital
- Department of Pediatrics, Washington University School of Medicine, Saint Louis, MO
| | - Eniola Oke
- Department of Pediatrics, Division of Hematology, Oncology and Stem Cell Transplant, Ann and Robert Lurie Children's Hospital
| | | | - Bridget Murphy
- Division of Behavioral Medicine & Clinical Psychology, Cincinnati Children's Hospital Medical Center
| | - Lori Crosby
- Division of Behavioral Medicine & Clinical Psychology, Cincinnati Children's Hospital Medical Center
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH
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Rosen BL, Meisman A, Sun Q, Real FJ, Steller A, Chandler E, Crosby L, Frenck R, Klein M, Kahn JA. Factors Associated With Racially and Ethnically Diverse Sample of Adolescents, Young Adults, and Parents' Intention to Receive a COVID-19 Vaccine. Am J Health Promot 2024; 38:672-682. [PMID: 38343081 DOI: 10.1177/08901171241233397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/08/2024]
Abstract
PURPOSE Identify variables, including moderating variables, associated with adolescents, young adults, and parents' intention to receive a COVID-19 vaccine in January 2021. DESIGN Cross-sectional survey. SETTING United States Midwestern academic medical center. SAMPLE Adolescents (n = 242); young adults (n = 333); parents (n = 563). MEASURES Associations between predictors-participant characteristics, general vaccine hesitancy, COVID-19 and vaccine knowledge, perceptions, and normative beliefs-and intention to receive a COVID-19 vaccine (outcome) were assessed. To determine variables impacting the strength of the relationship between predictors and outcome, moderators included 2020/2021 influenza vaccine receipt, having experienced discrimination, and primary sources of information for COVID-19. ANALYSIS Multivariable logistic regression examined associations, including moderating effects, for adolescents, young adults, parents, and parents for child. RESULTS With 20,231 email addresses receiving the survey, 1138 participants were included in the analysis. Intention to receive a COVID-19 vaccine was reported by 60.7% adolescents (n = 147), 65.2% young adults (n = 217), and 38.5% parents (n = 217) and 38.2% parents (n = 215) intended to vaccinate their child. Intention was associated with lower general vaccine hesitancy for adolescents (AOR = 1.50), young adults (AOR = 1.39), parents (AOR = 1.18), and parents' intention for their child (AOR = 1.17). Parents citing reputable medical experts as primary source of COVID-19 information positively moderated vaccine perceptions and intention for self (AOR = 8.25) and child (AOR = 6.37). CONCLUSION Clinician training to address vaccine hesitancy may be effective at promoting positive COVID-19 vaccine perceptions.
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Affiliation(s)
- Brittany L Rosen
- Division of Adolescent and Transition Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Andrea Meisman
- Division of Adolescent and Transition Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Quin Sun
- Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Francis J Real
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
- Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Alyssa Steller
- University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Emmanuel Chandler
- Division of Adolescent and Transition Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Lori Crosby
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
- Division of Behavioral Medicine & Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Robert Frenck
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
- Division of Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Melissa Klein
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
- Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Jessica A Kahn
- Division of Adolescent and Transition Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
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Dever R, Wong CA, Franklin MS, Howard J, Cholera R. Caregiver Perspectives on Barriers and Facilitators to Timely Well-Child Visits for Black Infants. Matern Child Health J 2024; 28:915-925. [PMID: 38300471 DOI: 10.1007/s10995-023-03871-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/15/2023] [Indexed: 02/02/2024]
Abstract
OBJECTIVES Missed infant well-child visits (WCV) result in lost opportunities for critical preventive care. Black infants consistently receive less WCV care than other racial groups. We sought to understand barriers and facilitators to timely infant WCV for Black families in the context of COVID-19. METHODS We conducted 21 semi-structured interviews with caregivers of Medicaid-insured Black children aged 15- to 24-months who attended six or fewer of eight recommended well-child visits within the first 15 months of life. Interviews focused on WCV value, barriers, and facilitators. After developing our initial coding structure through rapid qualitative analysis, we inductively derived the final codebook and themes through line-by-line content analysis. RESULTS Caregivers attended a mean of 3.53 of eight infant visits. Structural (e.g., transportation) and psychological (e.g., maternal depression) barriers delayed Black infant WCV. Families most frequently valued monitoring development and addressing concerns. Caregivers perceived visits as less urgent when infants seemed healthy or more recently avoided visits due to fears around COVID-19. Long waits and feeling rushed/dismissed were linked to WCV delays; positive provider relationships encouraged WCV attendance. Most caregivers reported reluctance to vaccinate. Vaccine hesitancy contributed to delayed infant WCV. CONCLUSIONS Caregivers described several factors that impacted WCV attendance for Black infants. Persistent structural and psychological barriers are compounded by perceptions that caregiver time is not respected and by notable vaccine hesitancy. To address these barriers, well-care can meet Black families in their communities, better address caregiver wellbeing, more efficiently use caregiver and provider time, and cultivate partnerships with Black caregivers.
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Affiliation(s)
- Reilly Dever
- Department of Pediatrics, University of Washington, 4800 Sand Point Way NE, Seattle, WA, 98105, USA.
| | - Charlene A Wong
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Michelle S Franklin
- Duke Margolis Center for Health Policy, 100 Fuqua Drive, Box 90120, Durham, NC, 27708, USA
- Department of Psychiatry, Duke University, 2301 Erwin Rd, Durham, NC, 27707, USA
| | - Janna Howard
- Duke Center for Childhood Obesity Research, 3116 N. Duke Street, Room 1028, Durham, NC, 27704, USA
| | - Rushina Cholera
- Duke Margolis Center for Health Policy, 100 Fuqua Drive, Box 90120, Durham, NC, 27708, USA
- Duke University School of Medicine, 8 Searle Center Dr, Durham, NC, 27710, USA
- Department of Pediatrics, Duke University, 2301 Erwin Rd, Durham, NC, 27707, USA
- Department of Population Health Sciences, Duke University, 215 Morris St, Durham, NC, 27701, USA
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Chinawa AT, Ossai EN, Onukwuli VO, Nduagubam OC, Uwaezuoke NA, Okafor CN, Chinawa JM. Willingness to accept malaria vaccines amongst women presenting at outpatient and immunization clinics in Enugu state, Southeast Nigeria. Malar J 2024; 23:117. [PMID: 38664783 PMCID: PMC11044559 DOI: 10.1186/s12936-024-04914-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 03/21/2024] [Indexed: 04/29/2024] Open
Abstract
BACKGROUND There are giant steps taken in the introduction of the novel malaria vaccine poised towards reducing mortality and morbidity associated with malaria. OBJECTIVES This study aimed to determine the knowledge of malaria vaccine and factors militating against willingness to accept the vaccine among mothers presenting in nine hospitals in Enugu metropolis. METHODS This was a cross-sectional study carried out among 491 mothers who presented with their children in nine hospitals in Enugu metropolis, South-East Nigeria. A pre-tested and interviewer-administered questionnaire was used in this study. RESULTS A majority of the respondents, 72.1% were aware of malaria vaccine. A majority of the respondents, 83.1% were willing to receive malaria vaccine. Similarly, a majority of the mothers, 92.9%, were willing to vaccinate baby with the malaria vaccine, while 81.1% were willing to vaccinate self and baby with the malaria vaccine. The subjects who belong to the low socio-economic class were five times less likely to vaccinate self and baby with malaria vaccine when compared with those who were in the high socio-economic class (AOR = 0.2, 95% CI 0.1-0.5). Mothers who had good knowledge of malaria vaccination were 3.3 times more likely to vaccinate self and baby with malaria vaccine when compared with those who had poor knowledge of malaria vaccination (AOR = 3.3, 95% CI 1-6-6.8). CONCLUSION Although the study documented a high vaccine acceptance among the mothers, there exists a poor knowledge of the malaria vaccine among them.
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Affiliation(s)
- Awoere T Chinawa
- Department of Community Medicine, College of Medicine ESUT, Enugu, Nigeria
| | - Edmund N Ossai
- Department of Community Medicine, Ebonyi State University, Abakaliki, Ebonyi State, Nigeria
| | | | - Obinna C Nduagubam
- Department of Paediatrics, College of Medicine, Enugu State University of Technology, Enugu, Nigeria
| | | | - Chinyere N Okafor
- Department of Community Medicine, College of Medicine UNEC, Enugu, Nigeria.
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Chinawa AT, Ossai EN, Onukwuli VO, Nduagubam OC, Uwaezuoke NA, Okafor CN, Chinawa JM. Willingness to accept malaria vaccines amongst women presenting at outpatient and immunization clinics in Enugu state, Southeast Nigeria. Malar J 2024; 23:117. [DOI: https:/doi.org/10.1186/s12936-024-04914-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 03/21/2024] [Indexed: 04/30/2024] Open
Abstract
Abstract
Background
There are giant steps taken in the introduction of the novel malaria vaccine poised towards reducing mortality and morbidity associated with malaria.
Objectives
This study aimed to determine the knowledge of malaria vaccine and factors militating against willingness to accept the vaccine among mothers presenting in nine hospitals in Enugu metropolis.
Methods
This was a cross-sectional study carried out among 491 mothers who presented with their children in nine hospitals in Enugu metropolis, South-East Nigeria. A pre-tested and interviewer-administered questionnaire was used in this study.
Results
A majority of the respondents, 72.1% were aware of malaria vaccine. A majority of the respondents, 83.1% were willing to receive malaria vaccine. Similarly, a majority of the mothers, 92.9%, were willing to vaccinate baby with the malaria vaccine, while 81.1% were willing to vaccinate self and baby with the malaria vaccine. The subjects who belong to the low socio-economic class were five times less likely to vaccinate self and baby with malaria vaccine when compared with those who were in the high socio-economic class (AOR = 0.2, 95% CI 0.1–0.5). Mothers who had good knowledge of malaria vaccination were 3.3 times more likely to vaccinate self and baby with malaria vaccine when compared with those who had poor knowledge of malaria vaccination (AOR = 3.3, 95% CI 1–6–6.8).
Conclusion
Although the study documented a high vaccine acceptance among the mothers, there exists a poor knowledge of the malaria vaccine among them.
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Abu-Farha RK, Khabour OF, Gharaibeh L, Elrahal YM, Alzoubi KH, Nassar R, Harahsheh MM, Binsaleh AY, Shilbayeh SA. Navigating parental attitudes on childhood vaccination in Jordan: a cross-sectional study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2024:1-13. [PMID: 38620051 DOI: 10.1080/09603123.2024.2342018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Accepted: 04/07/2024] [Indexed: 04/17/2024]
Abstract
This study investigated parental attitudes toward childhood vaccination in Jordan, focusing on acceptance, concerns, and perceptions. A cross-sectional survey conducted from January to February 2024 included 939 parents. Findings indicated that 85.4% (n = 802) of respondents received the COVID-19 vaccine, while only 25% (n = 229) vaccinated their children. Concerns regarding vaccine safety and efficacy were prevalent, with 63.9% (n = 600) expressing worries about side effects and 46.9% (n = 440) trusting immunization programs. Post-pandemic, 34% (n = 319) reported a more negative attitude. Logistic regression showed parents not vaccinating their children against COVID-19 were significantly less likely to exhibit positive attitudes toward childhood vaccination (OR = 0.412, p < 0.001). Older participants were more inclined toward negativity post-pandemic (OR = 1.031, p = 0.007). In conclusion, parental attitudes shifted post-COVID-19, reflecting hesitancy and decreased trust. Addressing concerns and restoring confidence are crucial, especially for children's health. Education through healthcare providers and dispelling social media misinformation are essential. Implementing strategies to enhance post-pandemic vaccine acceptance is imperative for preventing outbreaks of vaccine-preventable diseases.
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Affiliation(s)
- Rana K Abu-Farha
- Clinical Pharmacy and Therapeutics Department, Faculty of Pharmacy, Applied Science Private University, Amman, Jordan
| | - Omar F Khabour
- Department of Medical Laboratory Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Lobna Gharaibeh
- Biopharmaceutics and Clinical Pharmacy Department, Faculty of Pharmacy, Al-Ahliyya Amman University, Amman, Jordan
| | - Yusra M Elrahal
- Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Karem H Alzoubi
- Department of Pharmacy Practice and Pharmacotherapeutics, University of Sharjah, Sharjah, UAE
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Razan Nassar
- Department of Clinical Pharmacy and Therapeutics, Faculty of Pharmacy, Applied Science Private University, Amman, Jordan
| | - Meaad M Harahsheh
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Ammena Y Binsaleh
- Department of Pharmacy Practice, College of Pharmacy, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Sireen A Shilbayeh
- Department of Pharmacy Practice, College of Pharmacy, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
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McKeever R, Sundstrom B, Rhodes ME, Ritter E, McKeever BW. "A Victim of Our Own Success:" Testing Jenny's First Sleepover's Dark Satire to Improve Attitudes Toward Childhood Vaccination. HEALTH COMMUNICATION 2024:1-9. [PMID: 38514995 DOI: 10.1080/10410236.2024.2330121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/23/2024]
Abstract
The COVID-19 pandemic resulted in substantially lower uptake of childhood vaccinations in the U.S. As vaccination rates struggle to rebound, childhood vaccine hesitancy continues to grow. Addressing vaccine disinformation and increasing catch-up vaccination is an urgent public health priority. The purpose of this study was to evaluate the effectiveness of "Jenny's First Sleepover," a darkly humorous satirical book about childhood vaccinations, to influence attitudes of vaccine hesitant parents. This study implemented a randomized pretest - posttest experimental design using a web-based survey with one intervention and one control. "Jenny's First Sleepover" improved attitudes toward vaccination among vaccine hesitant parents. Negative emotions were an important mediator of attitudes toward vaccinations. Findings identify mechanisms that increase effectiveness of satirical approaches, including the presentation of novel information about serious vaccine-preventable diseases with a dark narrative twist. Health communicators may consider a darkly humorous satirical approach to improve attitudes toward childhood vaccination among vaccine hesitant parents.
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Affiliation(s)
- Robert McKeever
- Department of Advertising and Public Relations, University of Alabama
| | | | | | | | - Brooke W McKeever
- Department of Advertising and Public Relations, University of Alabama
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Al-Abdulla O, Alaref M, Kallström A, Kauhanen J. Individual and social determinants of COVID-19 vaccine hesitancy and uptake in Northwest Syria. BMC Health Serv Res 2024; 24:265. [PMID: 38429739 PMCID: PMC10908183 DOI: 10.1186/s12913-024-10756-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Accepted: 02/19/2024] [Indexed: 03/03/2024] Open
Abstract
INTRODUCTION The COVID-19 outbreak devastated the fragmented health system in Syria, a war-torn country, and exaggerated the demands for humanitarian assistance. COVID-19 vaccination was rolled out in Northwest Syria, an area out of government control, in May 2021. However, vaccine acceptance rates are still minimal, which is reflected in the meager percentage of vaccinated people. The study aims to investigate the effectiveness of the humanitarian actors' plans to address the COVID-19 vaccine hesitancy and conclude practical strategies for boosting vaccine uptake in Northwest Syria. METHODS AND MATERIALS Two questionnaires were developed to collect data from humanitarian organizations involved in the COVID-19 vaccination campaign and people from northwest Syria. Data analysis was performed using SPSS 22 data analysis program. RESULTS According to the findings, 55.5% of people refused the COVID-19 vaccine. The results showed a knowledge gap and lack of evidence regarding humanitarian actors' strategies to address the vaccine's low uptake. Besides, it was found that doctors and medical workers were reliable sources of information about the vaccine. However, they were not systematically engaged in community mobilization and risk communication to promote people's perspectives on the vaccine. CONCLUSION Risk communication and community engagement programs were not significantly associated with increasing the COVID-19 acceptance rate. Humanitarian actors must reconsider their strategies to address vaccine hesitancy in Northwest Syria. These strategies should engage medical professionals through dialogue sessions on the realities of the pandemic and vaccine development mechanism based on a compelling and evidence-based approach.
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Affiliation(s)
- Orwa Al-Abdulla
- Institute of Public Health and Clinical Nutrition, Faculty of Health Sciences, The University of Eastern Finland, 70211, Kuopio, P.O. Box 1627, Finland.
| | - Maher Alaref
- Strategic Research Center (Öz SRC), Incili Pinar MAH, Gazi Muhtar Paşa BUL, Doktorlar Sitesi, 38E, 104, 27090, Sehitkamil, Gaziantep, Türkiye
| | - Agneta Kallström
- Institute of Public Health and Clinical Nutrition, Faculty of Health Sciences, The University of Eastern Finland, 70211, Kuopio, P.O. Box 1627, Finland
- Strategic Research Center (Öz SRC), Incili Pinar MAH, Gazi Muhtar Paşa BUL, Doktorlar Sitesi, 38E, 104, 27090, Sehitkamil, Gaziantep, Türkiye
| | - Jussi Kauhanen
- Institute of Public Health and Clinical Nutrition, Faculty of Health Sciences, The University of Eastern Finland, 70211, Kuopio, P.O. Box 1627, Finland
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Chan IL, Schwarz K, Weinstein N, Mansergh G, Nahhas RW, Gelaude D, Alexander R, Rodriguez L, Strauss W, Repetski T, Sullivan N, Long E, Evener SL, Garbarino A, Kollar LMM. An Evaluation of Messages to Promote Parental Intent to Vaccinate Children Aged <12 Years Against COVID-19. Public Health Rep 2024; 139:230-240. [PMID: 38240243 PMCID: PMC10851906 DOI: 10.1177/00333549231218725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2024] Open
Abstract
OBJECTIVES Effective health communication can increase intent to vaccinate. We compared 8 messages that may influence parents' intent to vaccinate their children against COVID-19. METHODS In a cross-sectional survey of adults in the United States administered online in August 2021, 1837 parents and legal guardians were exposed to 8 messages (individual choice, gain/practical benefits, nonexpert, health care provider recommendation, altruism/community good, safety/effectiveness, safety, and effectiveness) to determine message reception and influence on intent to vaccinate their children. Parents responded to 10 questions using a Likert scale. We computed odds ratios (ORs) for each message, with an OR >1.0 indicating greater observed odds of participant agreement with the follow-up statement as compared with a reference message. We compared outcomes individually across messages with ordinal logistic regression fit using generalized estimating equations. RESULTS The individual choice message had the highest odds of agreement for understanding intent (OR = 2.10; 95% CI, 1.94-2.27), followed by the health care provider recommendation message (OR = 1.58; 95% CI, 1.46-1.71). The individual choice message had the highest odds of memorability, relatability, and trustworthiness. The altruism/community good message was at or near second best. The altruism/community good message had the highest or near-highest odds of increasing parents' intent to vaccinate their children, asking friends and family for their thoughts, and searching for additional information. The message that most motivated parents to vaccinate their children depended on parental intent to vaccinate prior to being exposed to the tested messages. CONCLUSIONS Messages with themes of individual choice, health care provider recommendation, and altruism/community good may be used in future message campaigns. Further research is needed to refine message concepts related to altruism/community good.
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Affiliation(s)
| | - Kelsey Schwarz
- Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | - Gordon Mansergh
- Division of HIV Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Ramzi W. Nahhas
- Department of Population and Public Health Sciences, Boonshoft School of Medicine, Wright State University, Dayton, OH, USA
| | - Deborah Gelaude
- Division of HIV Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | | | | | | | - Nancy Sullivan
- Department of Population and Public Health Sciences, Boonshoft School of Medicine, Wright State University, Dayton, OH, USA
| | | | | | | | - Laura M. Mercer Kollar
- Division of Overdose Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
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11
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O'Leary ST, Opel DJ, Cataldi JR, Hackell JM. Strategies for Improving Vaccine Communication and Uptake. Pediatrics 2024; 153:e2023065483. [PMID: 38404211 DOI: 10.1542/peds.2023-065483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/19/2023] [Indexed: 02/27/2024] Open
Abstract
Vaccines have led to a significant decrease in rates of vaccine-preventable diseases and have made a significant impact on the health of children. However, some parents express concerns about vaccine safety and the necessity of vaccines. The concerns of parents range from hesitancy about some immunizations to refusal of all vaccines. This clinical report provides information about the scope and impact of the problem, the facts surrounding common vaccination concerns, and the latest evidence regarding effective communication techniques for the vaccine conversation. After reading this clinical report, readers can expect to: Understand concepts and underlying determinants of vaccine uptake and vaccine hesitancy.Understand the relationship between vaccine hesitancy and costs of preventable medical care.Recognize and address specific concerns (eg, vaccine safety) with caregivers when hesitancy is present.
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Affiliation(s)
- Sean T O'Leary
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado; Adult and Child Center for Outcomes Research and Delivery Science (ACCORDS), University of Colorado School of Medicine/Children's Hospital Colorado, Aurora, Colorado
| | - Douglas J Opel
- Treuman Katz Center for Pediatric Bioethics and Palliative Care, Seattle Children's Research Institute; Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington
| | - Jessica R Cataldi
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado; Adult and Child Center for Outcomes Research and Delivery Science (ACCORDS), University of Colorado School of Medicine/Children's Hospital Colorado, Aurora, Colorado
| | - Jesse M Hackell
- Department of Pediatrics, New York Medical College, Valhalla, New York
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12
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Carrese JA. Everyday Ethics in Ambulatory Pediatrics: Cases and Applications. Pediatr Clin North Am 2024; 71:101-109. [PMID: 37973303 DOI: 10.1016/j.pcl.2023.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Abstract
This article presents three clinical scenarios that might be encountered in ambulatory pediatrics. The framework for ethical analysis presented by Dr Hughes in a separate article in this issue of the Journal is used to examine these clinical scenarios and demonstrate application of the framework. The three cases involve a physician being asked by parents to write a letter for better housing that would require the doctor to be dishonest; parents who decline to have their 8-month-old daughter vaccinated; and a physician who believes contraception is a sin and therefore would not prescribe it to a sexually active 17-year-old girl.
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Affiliation(s)
- Joseph A Carrese
- Division of General Internal Medicine, Johns Hopkins Bayview Medical Center, Core Faculty, Johns Hopkins Berman Institute of Bioethics, Johns Hopkins University, Mason F. Lord Building, Center Tower, Suite 2300, 5200 Eastern Avenue, Baltimore, MD 21224, USA.
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13
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Gonzalez VM, Stewart TJ. COVID-19 vaccine hesitancy among American Indian and Alaska native college students: the roles of discrimination, historical trauma, and healthcare system distrust. J Behav Med 2024; 47:123-134. [PMID: 37634151 DOI: 10.1007/s10865-023-00443-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 08/09/2023] [Indexed: 08/29/2023]
Abstract
For American Indians and Alaska Native (AIAN) and other communities of color, experiences with discrimination and historical trauma may contribute to healthcare system distrust and negatively affect health care decisions, including vaccination. A saturated path analysis was conducted to examine the direct and indirect associations of thoughts regarding historical losses (of culture, language, and traditional ways) and AIAN racial discrimination with historical loss associated distress, healthcare system distrust, and COVID-19 vaccine hesitancy among AIAN college students (N = 391). Historical loss thoughts and experiences with racial discrimination were strongly associated with each other, and both were uniquely associated with greater historical loss associated distress. In turn, historical loss associated distress was associated with greater healthcare system distrust, which in turn was associated with greater likelihood of being COVID-19 vaccine hesitant. While further research is needed, the findings suggest that to address health disparities for AIAN people it is necessary to consider how to best overcome healthcare system distrust and factors that contribute to it, including historical trauma and contemporary experiences with discrimination.
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Affiliation(s)
- Vivian M Gonzalez
- Department of Psychology, University of Alaska Anchorage, 3211 Providence Drive, Anchorage, AK, 4464, 99508, USA.
| | - Tracy J Stewart
- Department of Psychology, University of Alaska Anchorage, 3211 Providence Drive, Anchorage, AK, 4464, 99508, USA
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14
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Isiguzo GC, Stefanovics E, Unamba NN, Mbam TT, Anyaehie UG, Chukwu CC, Anyaehie UB, Osy-Eneze C, Ibezim EO, Okoro UG, Njoku PO, Adimekwe AI, Ibediro K, Stefanovics G, Iheanacho T. Perceptions of the COVID-19 Vaccine and Willingness to Receive Vaccination among Health Workers in Nigeria: A Cross-sectional Study. Niger J Clin Pract 2024; 27:102-108. [PMID: 38317042 DOI: 10.4103/njcp.njcp_537_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Accepted: 12/01/2023] [Indexed: 02/07/2024]
Abstract
BACKGROUND COVID-19 vaccine hesitancy is a major barrier to vaccine uptake, and the achievement of herd immunity is required to reduce morbidity and mortality and protect the most vulnerable populations. In Nigeria, COVID-19 vaccine hesitancy has been high, and uptake remains very low. Healthcare workers (HCWs) in Nigeria can help support public health efforts to increase vaccine uptake. AIM This study evaluates Nigerian HCWs' acceptance and intent to recommend the COVID-19 vaccine. SUBJECTS AND METHODS Cross-sectional survey among 1,852 HCWs in primary, secondary, and tertiary care settings across Nigeria. Respondents included doctors, nurses, pharmacy workers, and clinical laboratory professionals who have direct clinical contact with patients in various healthcare settings. A 33-item questionnaire was used in the study, with two of the questions focused on the COVID-19 vaccine. The responses to the two questions were analyzed using Chi-square (c2) tests and independent t-tests to determine the acceptance of the vaccine. RESULTS The majority of respondents were younger than 34 years (n = 1,227; 69.2%) and primarily worked in hospitals (n = 1,278; 72.0%). Among the respondents, 79.2% (n = 1,467) endorsed the COVID-19 vaccine as a critical tool in reducing the impact of the disease, and 76.2% (n = 1,412) will accept and recommend the vaccine to their patients. The younger HCWs were more likely to endorse and recommend the vaccine to their patients. CONCLUSION There is a moderately high COVID-19 vaccine acceptance rate among HCWs surveyed in our study. The confidence of HCWs in its use and their willingness to recommend it to their patients can provide a potentially useful element in increasing acceptance by the larger population in Nigeria.
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Affiliation(s)
- G C Isiguzo
- Department of Medicine, Alex Ekwueme Federal University Teaching Hospital/Ebonyi State University Abakaliki, Ebonyi State, Nigeria
| | - E Stefanovics
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- U.S. Department of Veterans Affairs New England Mental Illness Research and Education Clinical Center, West Haven, CT, USA
| | - N N Unamba
- Division of Cardiology, University of Port Harcourt Teaching Hospital, Port Harcourt, Rivers State, Nigeria
| | - T T Mbam
- Department of Otorhinolaryngology, Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Ebonyi State, Nigeria
| | - U G Anyaehie
- National Orthopedic Hospital Enugu, Enugu State, Nigeria
| | - C C Chukwu
- Department of Radiology, University of Calabar Teaching Hospital, Calabar, Cross River, Nigeria
| | - U B Anyaehie
- Department of Physiology, University of Nigeria, Enugu Campus, Enugu, Nigeria
| | - C Osy-Eneze
- Colchester GP Vocational Training Scheme, NHS, England, UK
| | - E O Ibezim
- College of Medicine, Imo State University, Owerri, Imo State, Nigeria
| | - U G Okoro
- Family Practice Department, Franciscan Physician Network, Crown Point, Indiana, United States
| | - P O Njoku
- Department of Internal Medicine, University of Nigeria Teaching Hospital, Enugu, Nigeria
| | - A I Adimekwe
- Northallerton GP Vocational Training Scheme, NHS, England, UK
| | - K Ibediro
- Saskatchewan Health Authority, Regina, Saskatchewan, Canada
| | - G Stefanovics
- U.S. Department of Veterans Affairs New England Mental Illness Research and Education Clinical Center, West Haven, CT, USA
| | - T Iheanacho
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- U.S. Department of Veterans Affairs New England Mental Illness Research and Education Clinical Center, West Haven, CT, USA
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15
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Fueta P. Okemena's Legacy: A Resident's Fight for Vaccine Advocacy. Pediatrics 2024; 153:e2022059509. [PMID: 38148736 DOI: 10.1542/peds.2022-059509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/24/2023] [Indexed: 12/28/2023] Open
Affiliation(s)
- Patrick Fueta
- Department of Pediatrics, Driscoll Children's Hospital, Corpus Christi, Texas
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16
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Ryan GW, Goulding M, Beeler AL, Nazarian BL, Pbert L, Rosal MC, Lemon SC. Trends in COVID-19 vaccine administration across visit types in a safety net pediatric practice during the first year of authorization. Front Pediatr 2023; 11:1227115. [PMID: 38027270 PMCID: PMC10657821 DOI: 10.3389/fped.2023.1227115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 10/17/2023] [Indexed: 12/01/2023] Open
Abstract
We explored patterns of COVID-19 vaccination across pediatric visit types using electronic health record data from 7/1/2021 through 7/25/2022 in a pediatric safety-net clinic. We generated frequencies and descriptive statistics for patient demographic and vaccine administration variables. Analyses were stratified into age subgroups of 5-to-11-year-olds and 12- to-17-year-olds. 1,409 children received at least one dose of the COVID-19 vaccine and 2,197 doses were administered in this first year of vaccine delivery. Most vaccines given were first doses in the series (45%), followed by second doses (38%), and then booster doses (17%). First doses tended to be given at well-child (42%) or nurse visits (48%), while second doses were almost entirely given at nurse visits (87%) and booster doses at well-child visits (58%). Efforts to optimize COVID-19 vaccination could leverage clinic workflow systems to provide reminder prompts for vaccination for scheduling future doses and identify strategies to facilitate vaccination at non-well child visits, particularly for booster doses.
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Affiliation(s)
- Grace W. Ryan
- Division of Preventive and Behavioral Medicine, Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA, United States
| | - Melissa Goulding
- Division of Preventive and Behavioral Medicine, Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA, United States
| | - Angela L. Beeler
- Department of Pediatrics, UMass Memorial Health, Worcester, MA, United States
| | - Beverly L. Nazarian
- Department of Pediatrics, UMass Memorial Health, Worcester, MA, United States
- Department of Pediatrics, UMass Chan Medical School, Worcester, MA, United States
| | - Lori Pbert
- Division of Preventive and Behavioral Medicine, Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA, United States
| | - Milagros C. Rosal
- Division of Preventive and Behavioral Medicine, Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA, United States
| | - Stephenie C. Lemon
- Division of Preventive and Behavioral Medicine, Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA, United States
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Yao X, Peng J, Ma Y, Fu M, Fang Y, Fang H, Jiang M. Development of a vaccine hesitancy scale for childhood immunization in China. Vaccine 2023; 41:6870-6877. [PMID: 37821318 DOI: 10.1016/j.vaccine.2023.09.057] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 09/15/2023] [Accepted: 09/27/2023] [Indexed: 10/13/2023]
Abstract
OBJECTIVE Vaccine hesitancy is a primary factor that influences vaccine uptake; however, no specific measurement tool to accurately assess vaccine hesitancy is available in China. This study aimed to develop a general vaccine hesitancy scale for childhood immunization. METHODS We adopted a three-phase process with nine steps to develop and finalize our scale. The scale framework and initial item pool were determined by a literature review. Expert consultation and cognitive interviews with parents were conducted to evaluate content validity. Questionnaire surveys involving parents of children aged <6 years were conducted to select items. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were employed to identify and validate the scale factor structure. The scale's reliability and validity were assessed using multiple indicators. RESULTS Of the initial 38 items, 21 were retained after expert consultation and cognitive interviews. In survey 1, the number of scale items decreased to 16 following item analysis and EFA. In survey 2, four items were added and EFA identified four factors. In survey 3, CFA confirmed the four-factor structure and the reliability indicators were satisfactory for the total scale. The level of vaccine hesitancy assessed by our scale was positively associated with vaccination refusal behavior and the Vaccine Hesitancy Scale score. The final scale comprised four dimensions (confidence, complacency, convenience, and calculation) with 17 items. CONCLUSIONS We developed a validated and reliable measurement to assess vaccine hesitancy among parents of children, which promises to be suitable for wide use in China.
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Affiliation(s)
- Xuelin Yao
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Xi'an, China; Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an, China
| | - Jin Peng
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Xi'an, China; Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an, China
| | - Yue Ma
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Xi'an, China; Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an, China
| | - Mao Fu
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Xi'an, China; Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an, China
| | - Yu Fang
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Xi'an, China; Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an, China.
| | - Hai Fang
- China Center for Health Development Studies, Peking University, Beijing, China; Peking University Health Science Center, Chinese Center for Disease Control and Prevention Joint Research Center for Vaccine Economics, Beijing, China.
| | - Minghuan Jiang
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Xi'an, China; Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an, China; Institute for Global Health and Development, Peking University, Beijing, China.
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Alharbi HS. Review: Factors influencing parents' decisions to vaccinate children against COVID-19. Vaccine 2023; 41:6419-6425. [PMID: 37735055 DOI: 10.1016/j.vaccine.2023.09.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 08/16/2023] [Accepted: 09/12/2023] [Indexed: 09/23/2023]
Abstract
INTRODUCTION Vaccination is a cornerstone of public health, significantly safeguarding children's health. Despite the imperative of achieving extensive COVID-19 vaccine coverage, vaccine hesitancy poses a major challenge. OBJECTIVE This review's aim is to analyze parental COVID-19 vaccine acceptance and hesitancy during the COVID-19 pandemic and elucidate the factors that influenced their decisions. METHODS A search of Medline (PubMed), Embase, and Psycinfo was conducted on February 1, 2022. The inclusion criteria were limited to observational studies that specifically evaluated parental COVID-19 vaccine acceptance or hesitancy for children, published in English. Studies that did not focus on this specific assessment, interventional studies, clinical trials, and secondary literature were excluded. RESULTS In reviewing 27 articles, parental vaccination acceptance rates were found to be different worldwide. Despite this, most of the articles found the same set of factors impacting parental COVID-19 vaccine acceptance and hesitancy. Parents' age, education, race, children's age, and annual household income were the main sociodemographic factors in vaccination decisions. Other common factors were the perceived risk and benefits of the COVID-19 vaccine, the source of information, parents' acceptance of receiving vaccinations themselves, and previous acceptance of the influenza vaccine. By reviewing parents' willingness to accept the COVID-19 vaccine for their children, it became clear that a lack of information about vaccine safety and efficacy was the most common factor affecting their decision. CONCLUSION This review identified critical factors affecting parents' vaccination behavior for their children. Awareness of these factors may reduce parents' COVID-19 vaccine refusal for their children and guide future planning and development of public health studies.
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Affiliation(s)
- Haifa S Alharbi
- Department of Pharmaceutical Sciences, College of Pharmacy, Nova Southeastern University, Fort Lauderdale, FL, USA.
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19
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Albers AN, Wright E, Thaker J, Conway K, Daley MF, Newcomer SR. Childhood Vaccination Practices and Parental Hesitancy Barriers in Rural and Urban Primary Care Settings. J Community Health 2023; 48:798-809. [PMID: 37119349 PMCID: PMC10148012 DOI: 10.1007/s10900-023-01226-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/16/2023] [Indexed: 05/01/2023]
Abstract
The purpose of our study was to identify primary care providers' (PCPs') practices in promoting childhood vaccination and their perceptions regarding barriers to vaccination in a primarily rural state. In January-May 2022, we conducted a mail and online survey of PCPs across Montana (n = 829). The survey included modules on routine immunizations in children 0-2 years old and COVID-19 vaccination in children 5-17 years old. The survey response rate was 36% (298/829). We categorized PCPs as working in rural (n = 218) or urban areas (n = 80), based on Rural-Urban Commuting Area codes. We then compared responses between rural and urban PCPs using chi-square tests. Urban PCPs (90-94%, depending on vaccine) stocked routinely recommended vaccines more frequently than rural PCPs (71-84%), but stocked the COVID-19 vaccine less often than rural PCPs (44% vs. 71%, respectively, p < 0.001). A higher percentage of rural providers reported parental beliefs that vaccine-preventable diseases are not severe enough to warrant vaccination (48% vs. 31%, p = 0.01) and concerns that vaccination will weaken their child's immune system (29% vs. 6%, p < 0.001). More rural (74%) compared to urban (59%) PCPs identified a social media campaign from local health departments promoting early childhood vaccinations as an effective strategy to increase childhood vaccination rates (p = 0.01). We identified key differences in some childhood vaccination practices and barriers between rural and urban PCPs. Interventions to increase rural vaccination rates could include increasing the number of providers stocking all recommended vaccines, identifying strategies to address parents' concerns regarding vaccine necessity, and collaborations with public health departments.
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Affiliation(s)
- Alexandria N Albers
- Center for Population Health Research, University of Montana, Missoula, MT, USA.
- School of Public and Community Health Sciences, University of Montana, Missoula, MT, USA.
- , 32 Campus Drive, Missoula, MT, 59812, USA.
| | - Emma Wright
- Family Medicine Residency of Western Montana, University of Montana, Missoula, MT, USA
- Partnership Health Center, Missoula, MT, USA
| | - Juthika Thaker
- Center for Population Health Research, University of Montana, Missoula, MT, USA
- School of Public and Community Health Sciences, University of Montana, Missoula, MT, USA
| | - Kathrene Conway
- Center for Population Health Research, University of Montana, Missoula, MT, USA
- School of Public and Community Health Sciences, University of Montana, Missoula, MT, USA
| | - Matthew F Daley
- Institute for Health Research, Kaiser Permanente Colorado, Aurora, CO, USA
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, USA
| | - Sophia R Newcomer
- Center for Population Health Research, University of Montana, Missoula, MT, USA
- School of Public and Community Health Sciences, University of Montana, Missoula, MT, USA
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20
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Albaker AR, Azer SA, AlKhorayef M, Dakheel NKB, AlMutairi S, AlHelal S, Aljohani R, Maghrabi S. Physicians' knowledge, attitude and perceptions towards vaccine-hesitant parents: a cross-sectional study. BMC MEDICAL EDUCATION 2023; 23:637. [PMID: 37667302 PMCID: PMC10478439 DOI: 10.1186/s12909-023-04590-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Accepted: 08/16/2023] [Indexed: 09/06/2023]
Abstract
OBJECTIVES Research has shown that physicians are encountering an increase in vaccine-hesitant parents (VHPs) numbers. This study examined physicians' vaccination knowledge, vaccine-related discussions with VHPs, beliefs about and responses to vaccine hesitancy, and challenges faced while discussing immunization with VHPs. METHODS This cross-sectional, descriptive study was performed at King Saud University Medical City (KSUMC), Riyadh, Saudi Arabia, in September 2020. The data were collected through a questionnaire distributed via email. The sample comprised 90 physicians who routinely treat children and reported they frequently have appropriate vaccine discussions when encountering VHPs. RESULTS Ninety participants (59% were females) completed the questionnaire. Of these, 37.8% were from family medicine, 7.8% from primary care, and 54.4% from paediatrics. The most discussed topics were vaccine necessity, reasons for vaccine refusal, and vaccine safety. Seventeen participants (18.8%) reported being extremely confident, and (42.2%) were confident in their vaccine-specific knowledge. Regarding confidence in communication skills, 22.2% reported being extremely confident and (45.6%) were confident. Determinants of higher confidence in the knowledge and communication skills were physician age (p = 0.001 and p = 0.0001, respectively), years of practice (p = 0.002 and (p = 0.005), and patients seen per workday (p = 0.0001 and p = 0.024). Other factors such as physician sex (p = 0.062), the field of practice (p = 0.329), and hours of work per week (p = 0.061) were not significantly different. Forty-six (51%) physicians sometimes find it challenging to conduct appropriate vaccine-related discussions because of having too many other issues to discuss during the consultation. Furthermore, 53 (59%) participants agreed/strongly agreed that parental refusal to vaccinate would raise suspicions of negligence. On the other hand, 59 (65%) disagreed/strongly disagreed that parental refusal of vaccines is a parental right. Participants expressed the need to refer VHPs to a specialised advisory clinic with excellent experience and negotiation skills to overcome the challenges. CONCLUSION Vaccine safety and necessity are the topics of most concern to VHPs, and a knowledgeable physician with competent communication skills is critical in responding to such situations. This study highlights the most reported barriers to successful vaccine-related discussions. It raises underlying ethical principles such as parental autonomy and the need to train physicians in VHPs. To train physians for succucful vaccine counceling of VHPs.
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Affiliation(s)
- Asma R. Albaker
- Department of Paediatrics, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Samy A. Azer
- College of Medicine, Department of Medical Education, King Saud University, P O Box 2925, 11461 Riyadh, Saudi Arabia
| | | | | | | | - Sarah AlHelal
- King Saud University, College of Medicine, Riyadh, Saudi Arabia
| | - Roaa Aljohani
- King Saud University, College of Medicine, Riyadh, Saudi Arabia
| | - Sarah Maghrabi
- King Saud University, College of Medicine, Riyadh, Saudi Arabia
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Hou Z, Lai X, Liu Y, Jit M, Larson HJ, Fang H. Assessing the impact of the 2018 Changchun Changsheng vaccine incident on childhood vaccination in China. COMMUNICATIONS MEDICINE 2023; 3:114. [PMID: 37608146 PMCID: PMC10444794 DOI: 10.1038/s43856-023-00339-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 07/25/2023] [Indexed: 08/24/2023] Open
Abstract
BACKGROUND The 2018 Changchun Changsheng vaccine incident is an emergent public health event in China with reports of DTaP vaccines with compromised efficacy. This study aimed to estimate the impact of the vaccine incident on real-world vaccination behaviors in China. METHODS A cross-sectional survey was conducted in ten provinces in 2019. Vaccination records were collected from 5294 children aged 6-59 months, with information on 75,579 vaccine doses for seven National Immunization Program (NIP) vaccines and two non-NIP vaccines received from 2014 to 2019. Chi-square test, interrupted time series, and logistic regression were used to evaluate the impacts of vaccine incident on vaccination delay, measured as the proportion of delayed doses out of total doses in schedule. RESULTS Here we show significant increases in doses delayed ≤ 3 months (19.12% to 22.51%, p = 0.000) and > 3 months (7.17% to 11.82%, p = 0.000) for DTaP vaccine after the incident. By scaling nationally, there will be extra 2.1 million doses delayed ≤ 3 months and 2.8 million doses delayed > 3 months in the year following this incident. More guardians choose expensive private-market substitutes containing DTaP elements over government-funded DTaP vaccines. Controlling for socio-demographic factors, doses scheduled after the incident have higher odds of delays for DTaP vaccine (OR: 3.49, 95% CI: 3.08-3.96) and other NIP vaccines (OR: 2.76, 95% CI: 2.55-2.99), but not for non-NIP vaccines. CONCLUSIONS The observed delays in the incident-involved DTaP vaccine immunization reflect the negative effects of the vaccine incident on vaccination behaviors under the NIP. However, its effects seem minimal for non-NIP vaccines.
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Affiliation(s)
- Zhiyuan Hou
- School of Public Health, NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China
| | - Xiaozhen Lai
- Department of Health Policy and Management, School of Public Health, Peking University, Beijing, China
- Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Yang Liu
- Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
- Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene and Tropical Medicine, London, UK
| | - Mark Jit
- Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
- Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene and Tropical Medicine, London, UK
- School of Public Health, University of Hong Kong, Hong Kong SAR, China
| | - Heidi J Larson
- Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Hai Fang
- China Center for Health Development Studies, Peking University, Beijing, China.
- Peking University Health Science Center-Chinese Center for Disease Control and Prevention Joint Research Center for Vaccine Economics, Peking University, Beijing, China.
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22
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Ryan GW, Miotto MB, McReynolds C, Lemon SC, Pbert L, Trivedi M. Pediatricians' perspectives on COVID-19 and HPV vaccine hesitancy. Hum Vaccin Immunother 2023; 19:2225388. [PMID: 37347712 PMCID: PMC10288893 DOI: 10.1080/21645515.2023.2225388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 06/09/2023] [Indexed: 06/24/2023] Open
Abstract
Rises in parental vaccine hesitancy, observed during the COVID-19 pandemic, threaten public health. This is especially concerning for vaccines not typically required for school-entry, such as the vaccines for COVID-19 and human papillomavirus (HPV), both of which also have much lower rates of completion compared to other adolescent vaccines. Pediatricians are well-positioned to address vaccine hesitancy and can offer insights into parents' perspectives in this area. There is evidence that pediatricians' sharing their own vaccine stories may help to address parents' concerns; yet we have little information on pediatricians' or their children's COVID-19 vaccine uptake. To address these gaps, we conducted a cross-sectional survey about Massachusetts pediatricians' behaviors and perspectives on vaccines that face significant resistance: HPV and COVID-19 vaccines. A total of 144 people initiated the survey, and 109 participants were eligible and completed the survey. Participants reported high levels of COVID-19 vaccine uptake for themselves (97%) and their children (98%). Similarities in parents' resistance toward both vaccines were identified: fear of side effects; general vaccine resistance. Pediatricians reported a rise in vaccine hesitancy since the beginning of the COVID-19 pandemic. Future research should focus on identifying strategies to build overall vaccine confidence and streamline these efforts for pediatricians.
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Affiliation(s)
- Grace W. Ryan
- Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA, USA
| | - Mary Beth Miotto
- Mattapan Community Health Center, Boston, MA, USA
- Department of Pediatrics, University of Massachusetts Chan Medical School, Worcester, MA, USA
| | | | - Stephenie C. Lemon
- Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA, USA
| | - Lori Pbert
- Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA, USA
| | - Michelle Trivedi
- Division of Pulmonology, Department of Pediatrics, University of Massachusetts Chan Medical School, Worcester, MA, USA
- Child Health Equity Center, Department of Pediatrics, UMass Chan Medical School, UMass Memorial Children’s Medical Center, Worcester, MA, USA
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Habib MA, Tabassum F, Hussain I, Khan TJ, Syed N, Shaheen F, Soofi SB, Bhutta ZA. Exploring Knowledge and Perceptions of Polio Disease and Its Immunization in Polio High-Risk Areas of Pakistan. Vaccines (Basel) 2023; 11:1206. [PMID: 37515022 PMCID: PMC10386680 DOI: 10.3390/vaccines11071206] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 06/15/2023] [Accepted: 06/27/2023] [Indexed: 07/30/2023] Open
Abstract
Pakistan is one of the few countries where poliovirus transmission still persists, despite intensive efforts to eradicate the disease. Adequate vaccination coverage is essential to achieve polio eradication, but misconceptions about polio vaccines have hindered vaccination efforts. To address this issue, we conducted a mixed-methods study to explore knowledge and perceptions regarding polio disease and immunization in high-risk areas of Pakistan. We collected quantitative data from 3780, 1258, and 2100 households in Karachi, Bajaur, and Pishin, respectively, and supplemented this with qualitative data from focus group discussions and in-depth interviews. Our findings reveal a high level of awareness about polio and its immunization; however, misperceptions about the polio vaccine persist, leading to refusal for both polio vaccines and routine immunizations. Our study provides up-to-date data on knowledge and perceptions of polio and its immunization and identifies critical gaps. These findings can inform the development of future strategies and innovative approaches to improve the success of the polio program in Pakistan.
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Affiliation(s)
- Muhammad Atif Habib
- Centre of Excellence in Women and Child Health, Aga Khan University, Karachi 74800, Pakistan
| | - Farhana Tabassum
- Centre of Excellence in Women and Child Health, Aga Khan University, Karachi 74800, Pakistan
| | - Imtiaz Hussain
- Centre of Excellence in Women and Child Health, Aga Khan University, Karachi 74800, Pakistan
| | - Tooba Jawed Khan
- Centre of Excellence in Women and Child Health, Aga Khan University, Karachi 74800, Pakistan
| | - Nazia Syed
- Centre of Excellence in Women and Child Health, Aga Khan University, Karachi 74800, Pakistan
| | - Fariha Shaheen
- Centre of Excellence in Women and Child Health, Aga Khan University, Karachi 74800, Pakistan
| | - Sajid Bashir Soofi
- Centre of Excellence in Women and Child Health, Aga Khan University, Karachi 74800, Pakistan
- Institute for Global Health and Development, Aga Khan University, Karachi 74800, Pakistan
| | - Zulfiqar A Bhutta
- Centre of Excellence in Women and Child Health, Aga Khan University, Karachi 74800, Pakistan
- Institute for Global Health and Development, Aga Khan University, Karachi 74800, Pakistan
- Centre for Global Child Health, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
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24
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Leonardelli M, Mele F, Marrone M, Germinario CA, Tafuri S, Moscara L, Bianchi FP, Stefanizzi P. The Effects of the COVID-19 Pandemic on Vaccination Hesitancy: A Viewpoint. Vaccines (Basel) 2023; 11:1191. [PMID: 37515007 PMCID: PMC10386622 DOI: 10.3390/vaccines11071191] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 06/23/2023] [Accepted: 06/30/2023] [Indexed: 07/30/2023] Open
Abstract
Vaccination hesitancy is considered by the World Health Organization as a danger to global health. In recent years, vaccine hesitancy rates to COVID-19 have been studied worldwide. In our study, we aim to provide an overview of the concept of vaccine hesitancy, with regard to the post-COVID era, and to provide prevention and management strategies. A search of the international literature until March 2023 was conducted in the PubMed database. The 5723 papers found were divided into two groups: prior to the COVID-19 era and from 2021 onward. Papers about the vaccine hesitation phenomenon are becoming more common during the SARS-CoV-2 pandemic and following the marketing that the vaccine companies have carried out on the different types of COVID-19 vaccines. It is advisable that healthcare authorities, at the national and international level, as well as healthcare professionals, at the local level, should promote a series of activities to reduce the vaccine hesitancy rate.
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Affiliation(s)
- Mirko Leonardelli
- Section of Legal Medicine, Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy
| | - Federica Mele
- Section of Legal Medicine, Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy
| | - Maricla Marrone
- Section of Legal Medicine, Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy
| | | | - Silvio Tafuri
- Interdisciplinary Department of Medicine, Aldo Moro University of Bari, 70124 Bari, Italy
| | - Lorenza Moscara
- Interdisciplinary Department of Medicine, Aldo Moro University of Bari, 70124 Bari, Italy
| | | | - Pasquale Stefanizzi
- Interdisciplinary Department of Medicine, Aldo Moro University of Bari, 70124 Bari, Italy
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25
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Pulgaron ER, D’Agostino EM, Johnson SB, Ko LK, Drain PK, Duran MC, Keener Mast D, Kay S, Layer MA, Kenworthy T, Dozier A. Reflections From School Communities in Underserved Populations on Childhood COVID-19 Vaccination. Pediatrics 2023; 152:e2022060352M. [PMID: 37394501 PMCID: PMC10312275 DOI: 10.1542/peds.2022-060352m] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/04/2023] [Indexed: 07/04/2023] Open
Abstract
OBJECTIVES Outbreaks in vaccine-preventable diseases among children have increased, primarily among under- or unvaccinated subgroups. The influence and interaction of a child's school community on parental health care decisions, such as vaccination, has not been explored. Our study examined childhood coronavirus disease 2019 (COVID-19) vaccine hesitancy within the context of school communities. METHODS This study combines data from 4 independent research studies funded by the National Institutes of Health Rapid Acceleration of Diagnostics Underserved Populations Return to School Initiative. We examined focus group data to better understand the apprehension surrounding parental and child COVID-19 vaccination among underserved school populations. RESULTS Across all study sites, 7 main themes emerged with regard to COVID-19-related vaccination concerns for children: (1) potential side effects, (2) vaccine development, (3) misinformation (subthemes: content of vaccine and negative intent of the vaccine), (4) vaccine effectiveness, (5) timing of vaccine administration/availability for children, (6) fear of needles, and (7) mistrust. CONCLUSIONS School settings offered unique access to youth and family perspectives in underserved communities. Our studies highlighted several factors contributing to COVID-19 vaccine hesitancy in school communities, which align with existing literature on vaccine hesitancy. These concerns centered primarily on potential harm of vaccines, as well as misinformation, mistrust, and timing of vaccines. Related recommendations for increasing vaccination rates are provided. Developing specific strategies that address parent and child concerns will be critical to reducing health inequities related to COVID-19 vaccination.
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Affiliation(s)
- Elizabeth R. Pulgaron
- Department of Pediatrics, University of Miami Miller School of Medicine, Miami, Florida
| | - Emily M. D’Agostino
- Departments of Orthopedic Surgery
- Population Health Sciences, Duke University School of Medicine, Durham, North Carolina
| | - Sara B. Johnson
- Division of General Pediatrics, Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Linda K. Ko
- Department of Health Systems and Population Health
| | - Paul K. Drain
- Global Health, Medicine, and Epidemiology, University of Washington, Seattle, Washington
| | | | | | | | | | - Tara Kenworthy
- Department of Pediatrics, University of Miami Miller School of Medicine, Miami, Florida
| | - Ann Dozier
- Public Health Sciences, University of Rochester, Rochester, New York
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26
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Dean A, Rose F, Jones K, Scantlebury A, Adamson J, Knapp P. Why do people take part in vaccine trials? A mixed methods narrative synthesis. PATIENT EDUCATION AND COUNSELING 2023; 114:107861. [PMID: 37354732 DOI: 10.1016/j.pec.2023.107861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 06/12/2023] [Accepted: 06/16/2023] [Indexed: 06/26/2023]
Abstract
OBJECTIVES To understand why individuals do or do not take part in vaccine trials, exploring the motivators and barriers to identify effective strategies to optimise recruitment in vaccine research. METHODS Qualitative studies and quantitative surveys capturing data on reasons for trial participation/decline were included. Six databases were searched from 1996 to October 2021. Two reviewers independently screened and assessed risk of bias. Results were reported narratively and analysed using thematic analysis. RESULTS We included 32 studies (17 qualitative; 12 quantitative; 3 mixed-methods) that covered a wide range of populations, geographical areas and disease types. Eight themes were identified 1) altruism; 2) potential for personal benefit; 3) perceived risks; 4) trust or distrust; 5) social networks; 6) stigma; 7) practical implications; 8) research vanguard. CONCLUSION Our findings provide a detailed description of how potential participants weigh up their decisions to participate in vaccine trials, which could inform the planning and implementation of studies to enhance recruitment. PRACTICE IMPLICATIONS Clinical trial researchers should consider a patient-centered approach to recruitment, tailoring promoting material and attempt to understand fears, stigma and perceived risks. In addition, recognising the importance of trust and the key role friends, communities, family, and those in supervisory positions play in decisions.
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Affiliation(s)
- Alex Dean
- MSc student, Department of Health Sciences, University of York, York, UK; York Trials Unit, Department of Health Sciences, University of York, York, UK
| | - Fi Rose
- York Trials Unit, Department of Health Sciences, University of York, York, UK
| | - Katherine Jones
- York Trials Unit, Department of Health Sciences, University of York, York, UK; Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, UK
| | | | - Joy Adamson
- York Trials Unit, Department of Health Sciences, University of York, York, UK
| | - Peter Knapp
- Department of Health Sciences, University of York, and the Hull York Medical School, York, UK.
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27
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Hamel BL, Patel J, Still J, Joshi A. A diagnostic quandary: Rotavirus vaccine associated diarrhea. Vaccine 2023:S0264-410X(23)00715-6. [PMID: 37336660 DOI: 10.1016/j.vaccine.2023.06.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 06/10/2023] [Accepted: 06/11/2023] [Indexed: 06/21/2023]
Abstract
The patient is an otherwise healthy two-month-old boy who received the recommended vaccinations for his age group, which included the rotavirus pentavalent vaccine (RV5; RotaTeq) at his two-month well child visit. Three days later, he developed prolonged non-bloody diarrhea and was found to have persistently positive rotavirus antigen in his stool. Subsequent workup revealed mild defects in his functional T-cell immunocompetence. Genetic testing was obtained through the Invitae panel and was negative for hereditary forms of primary immunodeficiencies. The rotavirus antigen was found to have cleared from his stool around four months after receiving the RV5. Unfortunately, the source of the rotavirus infection was unable to be determined. The caregivers had misconceptions about the vaccine and the child's immune system function which led to refusal of any further vaccinations. Healthcare providers should strive to develop honest and respectful relationships with parents to have thoughtful dialogues regarding vaccine safety and efficacy.
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Affiliation(s)
- Benjamin L Hamel
- Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN 55902, United States.
| | - Jenny Patel
- Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN 55902, United States
| | - Jenna Still
- Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN 55902, United States
| | - Avni Joshi
- Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN 55902, United States; Division of Pediatric Allergy and Immunology, Mayo Clinic, Rochester, MN 55902, United States
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28
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Mondal P, Sinharoy A. The influence of pediatricians' recommendation on caregivers' COVID-19 vaccine acceptance for children: A nationwide cross-sectional survey study from USA. Front Pediatr 2023; 11:1149125. [PMID: 37228435 PMCID: PMC10203465 DOI: 10.3389/fped.2023.1149125] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Accepted: 04/03/2023] [Indexed: 05/27/2023] Open
Abstract
Background The influence of pediatricians on parental acceptance of COVID-19 vaccine for children has not been well studied. We designed a survey to estimate the impact of pediatricians' recommendations on caregivers' vaccine acceptance while accounting for participants' socio-demographic and personal characteristics. The secondary objectives were to compare childhood vaccination rates among different age groups and categorize caregivers' concerns about vaccinating young (under-five) children. Overall, the study aimed to provide insight into potential pro-vaccination strategies that could integrate pediatricians to alleviate parental vaccine hesitancy. Methods We conducted an online cross-sectional survey study using Redcap, in August 2022. We enquired COVID-19 vaccination status of the children in the family (≥five years). The survey questionnaire included socio-demographic and personal characteristics: age, race, sex, education, financial status, residence, healthcare worker, COVID-19 vaccination status and side effects, children's influenza vaccination status, and pediatricians' recommendations (1-5 scale). Logistic regression and neural network models were used to estimate the influence of socio-demographic determinants on children's vaccine status and build predictors' ranking. Results The participants (N = 2,622) were predominantly white, female, middle-class, and vaccinated against COVID-19 (89%). The logistic regression model was significant vs. the null (likelihood-ratio χ2 = 514.57, p < 0.001, pseudo-R2 = .440). The neural network model also demonstrated strong prediction ability with a correct prediction rates of 82.9% and 81.9% for the training and testing models, respectively. Both models identified pediatricians' recommendations, self-COVID-19 vaccination status, and post-vaccination side effects as dominant predictors of caregivers' vaccine acceptance. Among the pediatricians, 70.48% discussed and had an affirmative opinion about COVID-19 vaccine for children. Vaccine acceptance was lower for children aged 5-8 years compared to older age groups (9-12 and 13-18 years), and acceptance varied significantly among the three cohorts of children (χ2 = 65.62, p < 0.001). About half of the participants were concerned about inadequate availability of vaccine safety information for under-five children. Conclusions Pediatricians' affirmative recommendation was significantly associated with caregivers' COVID-19 vaccine acceptance for children while accounting for participants' socio-demographic characteristics. Notably, vaccine acceptance was lower among younger compared to older children, and caregivers' uncertainty about vaccine safety for under-five children was prevalent. Thus, pro-vaccination strategies might incorporate pediatricians to alleviate parental concerns and optimize poor vaccination rate among under-five children.
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Affiliation(s)
- Pritish Mondal
- Department of Pediatrics, Penn State College of Medicine, Hershey, PA, United States
| | - Ankita Sinharoy
- Heart and Vascular Institute, Penn State College of Medicine, Hershey, PA, United States
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29
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Wilson OF, Mote SL, Morse BL. Addressing Vaccine Hesitancy Among Students and Families: Interventions for School Nurses. NASN Sch Nurse 2023; 38:146-154. [PMID: 35786090 DOI: 10.1177/1942602x221106945] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Vaccine hesitance is a public health issue that school nurses often address in practice. It has become even more prevalent during the coronavirus disease 2019 (COVID-19) pandemic. Vaccine compliance among schoolchildren is essential to the health of an entire community, given that many pediatric illnesses are vaccine-preventable. School nurses are involved in the promotion of vaccines in a school district, as they provide health education to students and families and are responsible for vaccine surveillance. Promoting vaccine compliance as a matter of public health can be challenging for school nurses, especially if a community holds strong beliefs regarding the necessity of pediatric vaccines. This article reviews the history of vaccine mandates, addresses challenges associated with vaccine compliance, and provides interventions school nurses can use when providing care to students and families regarding vaccine hesitancy. In following the nursing process, a school nurse is able to identify students missing vaccine(s) and evaluate for hesitancy, before implementing interventions that provide education to students and families. Several cost-efficient and accessible interventions can facilitate effective education and promote vaccine compliance. School nurses can forge trusting relationships and engage in compassionate dialogue to support vaccine compliance in the school.
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Affiliation(s)
- Olivia F Wilson
- Solomont School of Nursing, University of Massachusetts Lowell, Lowell, MA
| | - Sandra L Mote
- Solomont School of Nursing, University of Massachusetts Lowell, Lowell, MA
| | - Brenna L Morse
- Solomont School of Nursing, University of Massachusetts Lowell, Lowell, MA
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30
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Zhang Q, Zhang R, Wu W, Liu Y, Zhou Y. Impact of social media news on COVID-19 vaccine hesitancy and vaccination behavior. TELEMATICS AND INFORMATICS 2023; 80:101983. [PMID: 37122766 PMCID: PMC10122563 DOI: 10.1016/j.tele.2023.101983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 04/10/2023] [Accepted: 04/18/2023] [Indexed: 05/02/2023]
Abstract
In order to take advantage of the power of social media to promote vaccination, this study reveals the mechanisms of positive and negative impacts of social media news on vaccine hesitancy and vaccination behavior. Based on the stimulus-organism-response (S-O-R) framework, we developed a research model to understand the effects of vaccine safety news and risk news from social media (external stimuli) on individuals' psychological organism (i.e., safety perception and risk perception) and consequent behavioral response, vaccine hesitancy and vaccination behavior. The proposed model was tested by partial least square structural equation modeling (PLS-SEM) on a sample gathered in China from September 2021 to November 2021 and from February 2022 to April 2022 (valid responses = 1579). The results found that the relationship between vaccine risk news from social media and risk perception was higher than the relationship between vaccine safety news from social media and safety perception. Individuals are more sensitive to vaccine risk news than safety news on social media. Moreover, both safety perception and risk perception explained the critical psychological mechanisms behind vaccine hesitancy. Interestingly, ego network density mitigated the effect of safety news on safety perception and the effect of risk news on risk perception. The findings contribute to the S-O-R model, the research on social media effects, and the literature on vaccination attitudes and behaviors. This study also informs public health officials about leveraging the power of social media to motivate the public to accept the COVID-19 vaccines.
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Affiliation(s)
- Qianyao Zhang
- Department of Information Management, School of Economics and Management, Beijing Jiaotong University, Beijing 100044, China
| | - Runtong Zhang
- Department of Information Management, School of Economics and Management, Beijing Jiaotong University, Beijing 100044, China
| | - Wen Wu
- Department of Business Management, School of Economics and Management, Beijing Jiaotong University, Beijing 100044, China
| | - Yang Liu
- School of Mechanical, Electronic and Control Engineering, Beijing Jiaotong University, Beijing 100044, China
| | - Yu Zhou
- Department of Information Management, School of Economics and Management, Beijing Jiaotong University, Beijing 100044, China
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31
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Wong LP, Alias H, Wong YL, Megat Hashim MMAA, Lin Y, Hu Z. COVID-19 Anti-Vaccine Sentiments in Malaysia: Narratives of Comments from Facebook Post. Vaccines (Basel) 2023; 11:vaccines11040834. [PMID: 37112746 PMCID: PMC10146169 DOI: 10.3390/vaccines11040834] [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: 03/05/2023] [Revised: 03/27/2023] [Accepted: 04/11/2023] [Indexed: 04/29/2023] Open
Abstract
The anti-vaccination movement was an ongoing issue in Malaysia, a Muslim-majority country, even before the COVID-19 pandemic. It is unclear whether the introduction of new COVID-19 vaccines would similarly provoke anti-vaccine sentiments. This study analyzed COVID-19 anti-vaccine sentiments in the Malaysian community. Anti-vaccine comments from Facebook page posts were extracted. The qualitative software QSR-NVivo 10 was used to manage, code and analyze the data. The fast-track COVID-19 vaccine evoked the fear of unknown long-term effects, safety, effectiveness and the duration of protection. The halal status of the COVID-19 vaccines is important. Although it is permissible to use vaccines that are not certified halal under the state of darurah (emergency), there was doubt that the current state has reached the stage of darurah that warrants the use of vaccines. COVID-19 vaccine microchip conspiracy theories were raised. COVID-19 is viewed as only severe for vulnerable populations, and hence vaccination is not needed for the healthy. There were opinions that coronavirus treatments would be more beneficial than vaccination. The anti-COVID-19 vaccine sentiments uncovered in this study provide important insights for the formulation of public health messages to instill confidence in new COVID-19 vaccines. Despite the pandemic being nearly over and many people worldwide having received COVID-19 vaccines, the findings provide important insight into potential issues regarding the introduction of new vaccines in the event of future pandemics.
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Affiliation(s)
- Li Ping Wong
- Centre for Epidemiology and Evidence-Based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur 50603, Malaysia
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou 350122, China
| | - Haridah Alias
- Centre for Epidemiology and Evidence-Based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur 50603, Malaysia
| | - Yee Lian Wong
- Jepak Health Clinic, Kampung Baru Sebuan Besar, Bintulu 97000, Sarawak, Malaysia
| | | | - Yulan Lin
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou 350122, China
| | - Zhijian Hu
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou 350122, China
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32
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Yorulmaz DS, Kocoglu-Tanyer D. A vaccine literacy scale for childhood vaccines: Turkish validity and reliability vaccine literacy scale. J Public Health (Oxf) 2023. [DOI: 10.1007/s10389-023-01878-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/13/2023] Open
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33
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Ustuner Top F, Çevik C, Bora Güneş N. The relation between digital literacy, cyberchondria, and parents' attitudes to childhood vaccines. J Pediatr Nurs 2023; 70:12-19. [PMID: 36753874 DOI: 10.1016/j.pedn.2023.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 01/26/2023] [Accepted: 01/27/2023] [Indexed: 02/08/2023]
Abstract
PURPOSE This study aimed to examine the relationship between digital literacy, cyberchondria and parents' hesitancy about childhood vaccines. DESIGN AND METHODS The study was cross-sectional, and parents with children aged 3-5 years who had access to the questionnaire were sent online and volunteered to participate. RESULTS The total mean score of the Parents' Attitude to Childhood Vaccines Scale was 44.89 ± 14.99, 31.3% of the parents were hesitant about childhood vaccines. Parental hesitancy about childhood vaccinations was 3.26 times (95% CI, 1.56-6.81) for single participants and 2.77 times (95% CI, 1.33-5.74) for the participants with a high school diploma than primary school graduates, 4.69 times for the participants who did not have a healthcare professional in their family (95% CI, 2.08-10.59), 16.02 times (95% CI, 6.61-10.80) for the participants who did not have a full round of vaccines, 1.81 times higher (95% CI, 1.13-2.88) than the participants who did not have enough information about vaccines. Hesitancy increased as the cyberchondria severity score increased (95% CI, 1.02-1.09), and digital literacy decreased (95% CI, 0.34-0.87). CONCLUSIONS One-third of the parents had hesitations about childhood vaccines. Vaccine hesitancy is affected negatively by digital literacy and positively by cyberchondria. PRACTICE IMPLICATION Meeting parents' accurate and reliable vaccine information will positively affect their attitudes and behaviours. Therefore, the level of cyberchondria among parents should be reduced, and their digital literacy should be increased.
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Affiliation(s)
- Fadime Ustuner Top
- Faculty of Health Sciences, Department of Child Health and Disease Nursing, Giresun University, Giresun, Turkey.
| | - Celalettin Çevik
- Faculty of Health Sciences, Department of Public Health Nursing, Balıkesir University, Balıkesir, Turkey.
| | - Nebahat Bora Güneş
- Department of Pediatric Nursing, Faculty of Nursing, Hacettepe University, Ankara, Turkey
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34
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Xia Y, Li Q, Jiao W, Lan Y. Dynamic mechanism of eliminating COVID-19 vaccine hesitancy through web search. Front Public Health 2023; 11:1018378. [PMID: 36794073 PMCID: PMC9922755 DOI: 10.3389/fpubh.2023.1018378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Accepted: 01/12/2023] [Indexed: 02/03/2023] Open
Abstract
This research focuses on the research problem of eliminating COVID-19 vaccine hesitancy through web search. A dynamic model of eliminating COVID-19 vaccine hesitancy through web search is constructed based on the Logistic model, the elimination degree is quantified, the elimination function is defined to analyze the dynamic elimination effect, and the model parameter estimation method is proposed. The numerical solution, process parameters, initial value parameters and stationary point parameters of the model are simulated, respectively, and the mechanism of elimination is deeply analyzed to determine the key time period. Based on the real data of web search and COVID-19 vaccination, data modeling is carried out from two aspects: full sample and segmented sample, and the rationality of the model is verified. On this basis, the model is used to carry out dynamic prediction and verified to have certain medium-term prediction ability. Through this research, the methods of eliminating vaccine hesitancy are enriched, and a new practical idea is provided for eliminating vaccine hesitancy. It also provides a method to predict the quantity of COVID-19 vaccination, provides theoretical guidance for dynamically adjusting the public health policy of the COVID-19, and can provide reference for the vaccination of other vaccines.
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Affiliation(s)
| | | | | | - Yuexin Lan
- Research Center of Network Public Opinion Governance, China People's Police University, Langfang, China
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35
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Lip A, Pateman M, Fullerton MM, Chen HM, Bailey L, Houle S, Davidson S, Constantinescu C. Vaccine hesitancy educational tools for healthcare providers and trainees: A scoping review. Vaccine 2023; 41:23-35. [PMID: 36437208 PMCID: PMC9688224 DOI: 10.1016/j.vaccine.2022.09.093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 09/27/2022] [Accepted: 09/29/2022] [Indexed: 11/27/2022]
Abstract
In the era of vaccine hesitancy, highlighted by the current SARS-CoV2 pandemic, there is an acute need to develop an approach to reduce and address apprehension towards vaccinations. We sought to map and present an overview of existing educational interventions for healthcare providers (HCPs) on strategies to engage in effective vaccine discussion. We applied the Joanna Briggs Institute methodology framework in this scoping review. We searched five relevant databases (MEDLINE, CINAHL, EMBASE, PsycInfo, and SCOPUS) and grey literature through the Google search engine using keywords and subject headings that were systematically identified. We identified 3384 citations in peer-reviewed literature and 41 citations in grey literature. After screening for our inclusion criteria, we included 28 citations from peer reviewed literature and 16 citations from grey literature for analysis. We identified a total of 41 unique education interventions. Interventions were available from multiple disciplines, training levels, clinical settings, and diseases/vaccines. Interventions predominantly centered around two foci: knowledge sharing and communication training. Most interventions identified from peer-reviewed literature were facilitated and were applied with multiple modes of delivery. Interventions from grey literature were more topical and generally self-directed. We identified several gaps in knowledge. Firstly, accessibility and generalizability of interventions was limited. Secondly, distribution of interventions did not adequately address nursing and pharmacy disciplines, and did not cover the breadth of medical specialties for whom vaccine discussions apply. Thirdly, no interventions addressed self monitoring and the clinicians' recognition and management of emotions during difficult conversations. There is a need to address this gap and provide available, credible and comprehensive educational interventions that will support our healthcare providers in effective communication with vaccine hesitant patients.
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Affiliation(s)
- A Lip
- Division of Respirology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada.
| | - M Pateman
- Faculty of Nursing, University of Calgary, Calgary, Alberta, Canada; 19 to Zero Inc., Rocky Mountain House, Alberta, Canada
| | - M M Fullerton
- Faculty of Nursing, University of Calgary, Calgary, Alberta, Canada; 19 to Zero Inc., Rocky Mountain House, Alberta, Canada
| | - H M Chen
- 19 to Zero Inc., Rocky Mountain House, Alberta, Canada
| | - L Bailey
- School of Nursing, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - S Houle
- School of Pharmacy, Faculty of Science, University of Waterloo, Waterloo, Ontario, Canada
| | - S Davidson
- Faculty of Nursing, University of Calgary, Calgary, Alberta, Canada
| | - C Constantinescu
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Pediatric Infectious Diseases, Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
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36
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Cao M, Zhao J, Huang C, Wang X, Ye L, Han X, Yu W, Yin Z, Zhang J, Liu Y. Assessing vaccine hesitancy using the WHO scale for caregivers of children under 3 years old in China. Front Public Health 2023; 11:1090609. [PMID: 37124767 PMCID: PMC10130458 DOI: 10.3389/fpubh.2023.1090609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Accepted: 03/17/2023] [Indexed: 05/02/2023] Open
Abstract
Introduction Vaccine hesitancy may increase infectious disease burden and impede disease control efforts, while few studies have measured such a phenomenon with a standardized tool in China. This study aimed to test the validation of the Vaccine Hesitancy Scale (VHS) developed by the WHO SAGE Working Group among caregivers and examine demographic characteristics associated with caregiver hesitancy in six provinces of China. Methods Using a multistage sampling design, this study was conducted in 36 immunization clinics in six provinces from December 2019 to August 2020. Caregivers of children aged 0-3 years were included. The VHS was used to assess vaccine hesitancy. The construct validity and internal consistency of the scale were assessed. Associations between caregivers' characteristics and vaccine hesitancy were examined by simple and multiple linear regression models. Results Of the 3,359 participants included, a two-factor structure within the scale was identified, consisting of "lack of confidence" (1.89 ± 0.53) and "risks" (3.20 ± 0.75). Caregivers engaged in medical work expressed more confidence and were less concerned about risks compared to those of non-medical staff (p < 0.05). Participants with higher income levels were more confident (p < 0.05), while those surveyed after the COVID-19 pandemic, who were mothers, who had an older child, or who were raising a second or above birth child, had less concern about risks (p < 0.05). Discussion We found that the VHS had acceptable reliability and construct validity and caregivers' hesitancy was driven more by concerns about risks than by the lack of confidence. Countering these concerns will be particularly important among non-medical staff, lower income, child's fathers, having a younger child, or raising first-birth child groups.
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Affiliation(s)
- Man Cao
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Jinhong Zhao
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Cunrong Huang
- Yale Graduate School of Arts and Sciences, New Haven, CT, United States
| | - Xianglin Wang
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Lihong Ye
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Xueyan Han
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Wenzhou Yu
- National Immunization Program, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Zundong Yin
- National Immunization Program, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Juan Zhang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
- *Correspondence: Juan Zhang, ; Yuanli Liu,
| | - Yuanli Liu
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
- *Correspondence: Juan Zhang, ; Yuanli Liu,
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Gao Y, Gao H, Xiao H, Yao F. Vaccine supply chain coordination using blockchain and artificial intelligence technologies. COMPUTERS & INDUSTRIAL ENGINEERING 2023; 175:108885. [PMID: 36505091 PMCID: PMC9722244 DOI: 10.1016/j.cie.2022.108885] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 10/24/2022] [Accepted: 12/02/2022] [Indexed: 06/17/2023]
Abstract
Currently, the global spread of COVID-19 is taking a heavy toll on the lives of the global population. There is an urgent need to improve and strengthen the coordination of vaccine supply chains in response to this severe pandemic. In this study, we consider a vaccine supply chain based on a combination of artificial intelligence and blockchain technologies and model the supply chain as a two-player dynamic game with inventory level as the dynamic equation of the system. The study focuses on the applicability and effectiveness of the two technologies in the vaccine supply chain and provides management insights. The impact of the application of the technologies on environmental performance is also considered in the model. We also examine factors such as the number of people vaccinated, positive and side effects of vaccines, vaccine decay rate, revenue-sharing/cost-sharing ratio, and commission ratio. The results are as follows: the correlation between the difficulty in obtaining certified vaccines and the profit of a vaccine manufacturer is not monotonous; the vaccine manufacturer is more sensitive to changes in the vaccine attenuation rate. The study's major conclusions are as follows: First, the vaccine supply chain should estimate the level of consumers' difficulty in obtaining a certified vaccine source and the magnitude of the production planning and demand forecasting error terms before adopting the two technologies. Second, the application of artificial intelligence (AI) technology is meaningful in the vaccine supply chain when the error terms satisfy a particular interval condition.
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Affiliation(s)
- Ye Gao
- School of Business, Qingdao University, Qingdao, 266071, PR China
| | - Hongwei Gao
- School of Mathematics and Statistics, Qingdao University, Qingdao, 266071, PR China
| | - Han Xiao
- School of Business, Qingdao University, Qingdao, 266071, PR China
| | - Fanjun Yao
- School of Business, Qingdao University, Qingdao, 266071, PR China
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38
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Nguyen CG, Pogemiller MI, Cooper MT, Garbe MC, Darden PM. Characteristics of Oklahoma Pediatricians Who Dismiss Families for Refusing Vaccines. Clin Pediatr (Phila) 2023; 62:24-32. [PMID: 35883261 DOI: 10.1177/00099228221108801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Vaccine refusal is increasing. Objectives were to assess frequency of declining or dismissing patients who refuse vaccines, which vaccine(s) prompt pediatricians to decline/dismiss patients, and demographics of pediatricians who decline/dismiss patients. Active members of the Oklahoma American Academy of Pediatricians (AAP) were surveyed. Chi-square tests with non-overlapping 95% confidence intervals compared proportions of providers across various metrics. In all, 47% (48/103) versus 35% (34/98) reported declining versus dismissing patients for refusing vaccines, respectively. Pediatricians were unlikely to decline/dismiss patients if they refused influenza, human papilloma virus (HPV), or MenB vaccines. Pediatricians with more years in practice were less likely to decline 15% (9/62) versus 44% (16/36), P = 0.002 and dismiss 8% (5/62) versus 33% (12/36), P = 0.002 patients. Rural pediatricians were less likely than urban to decline 12% (2/17) versus 29% (26/89), P = NS and dismiss patients 0% (0/17) versus 21% (19/89), P = 0.04. Dismissing/declining patients for vaccine refusal is more common among Oklahoma pediatricians than nationally reported. Patterns differ by practice setting, years in practice, and specific vaccine refused.
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Affiliation(s)
| | - Mark I Pogemiller
- University of Oklahoma College of Medicine, Oklahoma City, OK, USA
- Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- Section of General and Community Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Michael T Cooper
- Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- Section of General and Community Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - M Connor Garbe
- Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- Section of General and Community Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Paul M Darden
- Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- Section of General and Community Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
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Talking about the Vaccine after the Pandemic: A Cross-Sectional Study among Youth in Turkey and Ethical Issues. Vaccines (Basel) 2023; 11:vaccines11010104. [PMID: 36679949 PMCID: PMC9860747 DOI: 10.3390/vaccines11010104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Revised: 12/22/2022] [Accepted: 12/29/2022] [Indexed: 01/04/2023] Open
Abstract
Examining the factors that affect the vaccination rate among young people in an ethical frame can support vaccination promotion. Therefore, this study will elaborate, through an ethical lens, on young people's hesitation about and decisions regarding getting vaccinated. The cross-sectional study was conducted with 2428 people aged 15-30 in Turkey in June 2022. The questionnaire included the following subtitles: psycho-social situation, health services and health policies, COVID-19 vaccine, and predictions about life and health after the pandemic. The average age was 22.9 years. In the study sample, 80% were vaccinated, while 20% were not. Vaccinated participants acted more cautiously to protect their health. Receiving accurate and sufficient information on proposed vaccines affects vaccination status. The primary reason for getting vaccinated was "to protect their health, families, and relatives", and the primary reason for not getting vaccinated was "not trusting the vaccine content or the country where the vaccine was produced". Specifically, those vaccinated felt more relaxed physically, psychologically, and socially. In addition, the expectations for the future of those vaccinated were significantly higher. Accurate and adequate information is essential for reducing vaccine hesitancy. In addition, promoting prosocial behaviors in young people and highlighting related values will support vaccination.
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Ergin A, Kılıç BB, Gökdeniz CG. Evaluation of Medical Students’ Knowledge and Attitude Towards Vaccines. GÜNCEL PEDIATRI 2022. [DOI: 10.4274/jcp.2022.30316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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Navin MC, Kozak AT, Attwell K. School staff and immunization governance: Missed opportunities for public health promotion. Vaccine 2022; 40:7433-7439. [PMID: 34579977 DOI: 10.1016/j.vaccine.2021.07.061] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 06/21/2021] [Accepted: 07/20/2021] [Indexed: 01/28/2023]
Abstract
BACKGROUND In US states, childhood immunization mandates are enforced for school registration by front-line school staff, usually secretaries. Despite substantial changes to mandate policies in several states and many countries, little attention has been paid to the people who enforce them. This qualitative pilot study aimed to uncover beliefs, attitudes, and practices regarding immunization governance of Michigan school staff. METHOD Front-line administrative workers from Michigan schools and district offices were solicited by email. Sixteen were interviewed remotely. RESULTS Front-line school staff believed in vaccines, but did not advocate for vaccination while registering children. Instead, they sought low-friction bureaucratic transactions, privileging the collection of data over the promotion of public health goals. This revealed a mismatch between the goals of the front-line staff who enforce vaccine mandates in schools and the goals of the policymakers who created school vaccine mandates. CONCLUSIONS This study found low mobilization of front-line enforcers of mandates in public-facing school administration roles, a problem likely to afflict the majority of American states with the 'mandates + exemptions' model of immunization governance. Schools would have stronger incentives to promote vaccination if state funding were better tied to immunization compliance. Front-line staff could better enforce vaccine mandates if they were provided with resources and training about vaccine promotion.
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Affiliation(s)
- Mark C Navin
- Department of Philosophy, Oakland University, Mathematics and Science Center, Room 746, 146 Library Drive, Rochester, MI 48309-4479, USA.
| | - Andrea T Kozak
- Department of Psychology, Oakland University, Pryale Hall, Room 210, 654 Pioneer Drive, Rochester, MI 48309-4482, USA.
| | - Katie Attwell
- Political Science and International Relations, University of Western Australia, 35 Stirling Highway, Crawley 6009, Australia.
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Vasudevan L, Stinnett SS, Hart L, Gomez Altamirano P, Gonzalez A, Weaver K, Gray B, Bartlett J. Pregnant individuals' information needs and intention to vaccinate their children with routine and COVID-19 vaccines: Findings from a cross-sectional survey. Int J Gynaecol Obstet 2022:10.1002/ijgo.14571. [PMID: 36353745 PMCID: PMC9877590 DOI: 10.1002/ijgo.14571] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Revised: 10/26/2022] [Accepted: 11/09/2022] [Indexed: 11/11/2022]
Abstract
OBJECTIVE The current study assessed pregnant individuals' intention to accept routine and COVID-19 vaccines for their baby after birth, and to identify key demographic (e.g., age) and nondemographic characteristics (e.g., prior birth) associated with vaccination intention. METHODS The authors conducted a cross-sectional survey with pregnant individuals attending prenatal practices affiliated with a large academic medical center and two rural county health departments in the southeastern United States. The survey included 11 questions and was self-administered by pregnant individuals in clinic settings. The final analysis included responses from 443 pregnant individuals. RESULTS Only 67% of pregnant individuals planned to vaccinate their baby with all recommended routine vaccines; an additional 22% reported having questions about recommendations. Only 35% of pregnant individuals said they would vaccinate their baby as soon as possible with a COVID-19 vaccine. Younger pregnant individuals and those identifying as Black or African American had lower routine and COVID-19 vaccination intention. Routine vaccination, but not COVID-19 vaccination intention, was associated with familiarity with routine vaccination schedule, trimester of pregnancy, Hispanic ethnicity, history of prior birth, and having access to a computer. CONCLUSION Study findings support differential tailoring of future interventions targeting pregnant individuals to promote routine and COVID-19 vaccines for children.
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Affiliation(s)
- Lavanya Vasudevan
- Department of Family Medicine and Community HealthDuke University School of MedicineDurhamNorth CarolinaUSA,Duke Global Health InstituteDurhamNorth CarolinaUSA,Hubert Department of Global HealthRollins School of Public Health, Emory UniversityAtlantaGeorgiaUSA
| | - Sandra S. Stinnett
- Department of Biostatistics and BioinformaticsDuke University School of MedicineDurhamNorth CarolinaUSA
| | - Lauren Hart
- Department of Family Medicine and Community HealthDuke University School of MedicineDurhamNorth CarolinaUSA
| | - Pedro Gomez Altamirano
- Department of Family Medicine and Community HealthDuke University School of MedicineDurhamNorth CarolinaUSA
| | - Angel Gonzalez
- Department of Family Medicine and Community HealthDuke University School of MedicineDurhamNorth CarolinaUSA
| | - Kristin Weaver
- Department of Obstetrics and GynecologyDuke University School of MedicineDurhamNorth CarolinaUSA
| | - Beverly Gray
- Department of Obstetrics and GynecologyDuke University School of MedicineDurhamNorth CarolinaUSA
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43
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Egge JA, Anderson RH, Schimelpfenig MD. Care of the Well Newborn. Pediatr Rev 2022; 43:676-690. [PMID: 36450636 DOI: 10.1542/pir.2022-005511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
Care of the newborn infant is a critical skill for general pediatricians and other providers in the practice of pediatric medicine. Optimal care relies on a thorough understanding of risk factors that may be present during the pregnancy and delivery, as well as the ability to recognize and address unanticipated problems in the postnatal period. This article focuses on antenatal care of the newborn, issues that present in the immediate postdelivery period, and care of the newborn after discharge. It also includes updated information on current topics in pediatric practice, such as the importance of vaccination, parental hesitancy in accepting common medical interventions, and updated guidelines related to the coronavirus disease 2019 pandemic. At the conclusion of the article, the reader should have a general understanding of antenatal risk factors that could affect the transition from the intrauterine environment and have the knowledge to address common issues that arise in the care of newborn infants.
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Affiliation(s)
- Justin A Egge
- Sanford School of Medicine, University of South Dakota, Sioux Falls, SD
| | | | - Michelle D Schimelpfenig
- Sanford School of Medicine, University of South Dakota, Sioux Falls, SD.,Department of Pediatrics, Sanford School of Medicine, University of South Dakota, Sioux Falls, SD
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44
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Life Satisfaction and Influenza Vaccination Among Older Adults in Canada. Can J Aging 2022; 41:514-522. [PMID: 35899995 DOI: 10.1017/s0714980822000204] [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: 12/14/2022] Open
Abstract
Older adults have an increased risk of complications or death from influenza. Despite the benefits of vaccination for older adults, vaccination coverage among older adults ages 65 years and over is still below Canada's national target of 80 per cent. As health-care-seeking behaviours are influenced by several factors, including life satisfaction, we investigated the relationship between life satisfaction and influenza vaccination among older adults. A sample (n = 22,424) from the 2015-2016 Canadian Community Health Survey data was analysed using descriptive and multinomial logistic regression analyses. Higher life satisfaction was associated with a more recent influenza vaccination history. Vaccination differed by gender, age, and self-reported health status, as women, much older adults, and those with the poorest health status were more likely to be vaccinated. The study suggests an association between life satisfaction and influenza vaccination. More research into the factors that impact influenza vaccination in older adults is needed to increase vaccination coverage in the older adult population.
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45
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Morozov NG, Dror AA, Daoud A, Eisenbach N, Kaykov E, Barhoum M, Sheleg T, Sela E, Edelstein M. Reasons underlying the intention to vaccinate children aged 5-11 against COVID-19: A cross-sectional study of parents in Israel, November 2021. Hum Vaccin Immunother 2022; 18:2112879. [PMID: 36037533 DOI: 10.1080/21645515.2022.2112879] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Vaccination is a key tool to mitigate impacts of the COVID-19 pandemic. In Israel, COVID-19 vaccines became available to adults in December 2020 and to 5-11-year-old children in November 2021. Ahead of the vaccine roll-out in children, we aimed to determine whether surveyed parents intended to vaccinate their children and describe reasons for their intentions. We collected information on parental socio-demographic characteristics, COVID-19 vaccine history, intention to vaccinate their children against COVID-19, and reasons for parental decisions using an anonymous online survey. We identified associations between parental characteristics and plans to vaccinate children using a logistic regression model and described reasons for intentions to vaccinate or not. Parental non-vaccination and having experienced major vaccination side effects were strongly associated with non-intention to vaccinate their children (OR 0.09 and 0.18 respectively, p < .001). Parents who were younger, lived in the socio-economically deprived periphery, and belonged to the Arab population had lower intentions to vaccinate their children. Reasons for non-intention to vaccinate included concerns about vaccine safety and efficacy (53%, 95%CI 50-56) and the belief that COVID-19 is a mild disease (73%, 95%CI 73-79), while a frequent motive for vaccination was the return to normal social and educational life (89%, 95%CI 87-91). Understanding rationales for COVID-19 vaccine rejection or acceptance, as well as parental demographic data, can pave the way for intentional educational campaigns to encourage not only vaccination against COVID-19, but also regular childhood vaccine programming.
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Affiliation(s)
| | - Amiel A Dror
- Galilee Medical Center, Nahariyah, Israel.,Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
| | - Amani Daoud
- Galilee Medical Center, Nahariyah, Israel.,Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
| | - Netanel Eisenbach
- Galilee Medical Center, Nahariyah, Israel.,Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
| | - Edward Kaykov
- Galilee Medical Center, Nahariyah, Israel.,Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
| | - Masad Barhoum
- Galilee Medical Center, Nahariyah, Israel.,Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
| | - Tsvi Sheleg
- Galilee Medical Center, Nahariyah, Israel.,Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
| | - Eyal Sela
- Galilee Medical Center, Nahariyah, Israel.,Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
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Cunningham-Erves J, Hull PC, Wilkins CH, Edwards KM, Davis M, Jones J, Graham J, Adekunle A, Dempsey AF. Healthcare providers' practice protocols, strategies, and needed tools to address parental HPV vaccine hesitancy: An exploratory study. Hum Vaccin Immunother 2022; 18:2136862. [PMID: 36375029 DOI: 10.1080/21645515.2022.2136862] [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: 11/16/2022] Open
Abstract
Parental hesitancy related to human papillomavirus (HPV) vaccines has increased during the pandemic, and there is a call to action by the National HPV Vaccination Roundtable to improve vaccination rates. While there are evidence-based strategies available to address parental hesitancy, there are few clear guidelines on how to engage parents to build confidence in the HPV vaccine within the clinical settings. The purpose of this investigation is to explore practice protocols, individual provider strategies, and perceived tools needed to address HPV vaccine hesitant parents from the perspective of providers during the COVID-19 pandemic in the United States. Fifteen healthcare providers participated in qualitative, semi-structured interviews between May 2021 and March 2022. An inductive, qualitative content analysis approach was used to analyze the data. Five themes were described: 1) Provider experiences engaging with HPV vaccine hesitant parents; 2) Existing protocols in the clinics to address HPV vaccine hesitant parents; 3) Strategies used by providers to address parental HPV vaccine hesitancy; 4) Sample message content used by providers to address parental HPV vaccine concerns; and 5) Perceived strategies and tools needed to address parental vaccine hesitancy. Recommendations to address parental hesitancy include recommending HPV vaccinationat 9 years, using a strong recommendation and continued discussion, applying evidence-based approaches and/or promising strategies, linking parents to credible outside sources, and ongoing follow-up if delayed or declined. These findings can be used by researchers and clinicians to improve strategies and messages to inform the development of a protocol to standardize encounters and communication for patient-parent-provider encounters that can influence parental decision-making around HPV vaccine uptake.
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Affiliation(s)
| | - Pamela C Hull
- College of Medicine Department of Behavioral Science, Department of Behavioral Science, Markey Cancer Center, University of Kentucky, Lexington, KY, USA
| | - Consuelo H Wilkins
- Office of Health Equity, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Kathryn M Edwards
- Department of Pediatrics, Division of Infectious Diseases, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Megan Davis
- School of Medicine, Vanderbilt University, Nashville, TN, USA
| | | | - Jenee Graham
- Meharry Medical College, School of Medicine, Nashville, TN, USA
| | - Abiola Adekunle
- Meharry Medical College, School of Medicine, Nashville, TN, USA
| | - Amanda F Dempsey
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, USA.,Adult & Child Consortium for Health Outcomes Research and Delivery Science (ACCORDS), University of Colorado School of Medicine, Aurora, CO, USA.,Merck and Company, Wales, PA, USA
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Ilesanmi MM, Abonyi S, Pahwa P, Gerdts V, Scwandt M, Neudorf C. Trends, barriers and enablers to measles immunisation coverage in Saskatchewan, Canada: A mixed methods study. PLoS One 2022; 17:e0277876. [PMID: 36417461 PMCID: PMC9683619 DOI: 10.1371/journal.pone.0277876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 11/04/2022] [Indexed: 11/25/2022] Open
Abstract
Many social, cultural, and systemic challenges affect the uptake of measles immunisation services. Prior studies have looked at the caregivers' perspectives, but little is known about the perspectives of the health care providers on the barriers of measles immunisation services in Canada. This study examined measles immunisation coverage trends across the regional health authorities in Saskatchewan and explored the barriers and enablers to measles immunisation coverage from providers' perspectives. The study adopted an explanatory sequential mixed method. We utilized the entire population of 16,582 children under two years of age available in the Saskatchewan Immunisation Management System (SIMS) registry for 2002 and 2013 in aggregate format and interviewed 18 key informants in pre-determined two-stages in 2016 and 2017. The quantitative analysis was done with Joinpoint regression modelling, while the qualitative interview data was analyzed using hybrid inductive and deductive thematic approaches. There was a 16.89%-point increase in measles immunisation coverage in the province from 56.32% to 73.21% between 2002 and 2013. There was also a persistently higher coverage among the affluent (66.95% - 82.37%) than the most deprived individuals (45.79% - 62.60%) in the study period. The annual rate of coverage change was marginally higher among the most deprived (16.81%; and average annual percentage change (AAPC) 2.0, 95% CI 1.7-2.2) than among the affluent group (15.42% and AAPC 3.0; 95% CI 2.0-4.0). While access-related issues, caregivers' fears, hesitancy, anti-vaccination challenges, and resource limitations were barriers to immunisation, improving community engagement, service delivery flexibility, targeted social responses and increasing media role were found useful to address the uptake of measles and other vaccine-preventable diseases immunisation. There is low coverage and inequity in measles immunisation uptake in Saskatchewan from social and institutional barriers. Even though there is evidence of disparity reduction among the different groups, the barriers to increasing measles immunisation coverage have implications for the health of the socio-economically deprived groups, the healthcare system and other vaccination programs. There is a need to improve policy framework for community engagement, targeted programs, and public health discourse.
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Affiliation(s)
- Marcus M. Ilesanmi
- Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
- * E-mail:
| | - Sylvia Abonyi
- Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
- Saskatchewan Population Health and Evaluation Research Unit (SPHERU), University of Saskatchewan, Saskatoon, SK, Canada
| | - Punam Pahwa
- Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, SK, Canada
| | - Volker Gerdts
- Vaccine and Infectious Disease Organization-International Vaccine Centre (VIDO-InterVac), University of Saskatchewan, Saskatoon, SK, Canada
- Department of Veterinary Microbiology, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - Michael Scwandt
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
- Vancouver Coastal Health, Office of the Chief Medical Health Officer, Vancouver, BC, Canada
| | - Cordell Neudorf
- Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
- Health Surveillance & Reporting, Saskatchewan Health Authority (SHA), Saskatoon, SK, Canada
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48
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Jamison KC, Ahmed AH, Spoerner DA, Kinney D. Best shot: A motivational interviewing approach to address vaccine hesitancy in pediatric outpatient settings. J Pediatr Nurs 2022; 67:124-131. [PMID: 36108393 DOI: 10.1016/j.pedn.2022.08.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 08/01/2022] [Accepted: 08/15/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Vaccine hesitancy in parents and childhood vaccine refusal is increasing. A standard of care to address this problem has not been identified. PURPOSE To identify if the use of motivational interviewing by pediatric providers during routine well child visits, when compared to standard of care, would increase vaccine rates in children 0-12 months of age. Factors associated with vaccine hesitancy were also investigated. METHODS A quasi-experimental study was completed on a convenience sample of pediatric providers (N = 6) and caregivers of children 0-12 months of age (N = 66). Four providers were trained to use motivational interviewing. During the well child visit the Parent Attitudes About Childhood Vaccines survey was completed, and the motivational interviewing intervention was implemented. Clinic's data were compared with other clinic data of non-trained providers. FINDINGS Vaccine refusal/delays rate was 11.4% among caregivers. Vaccine refusal rate decreased after the intervention (9.00% pre-intervention and 6.40% post-intervention). An ordinal regression identified caregivers with higher vaccine hesitancy scores and more children were more likely to delay or refuse vaccines, while caregivers ≥30 years or with high income were less likely to delay/refuse vaccines. A difference in difference analysis identified that an additional 2.6% of children received vaccines when seen by trained providers compared to non-trained (β = -0.330, OR = 0.719, p = 0.470). DISCUSSION Findings indicate a condensed motivational interviewing education session may be clinically significant in decreasing vaccine hesitancy among this population. APPLICATIONS TO PRACTICE A more robust study to confirm these findings is recommended prior to practice implementation.
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Affiliation(s)
- Kristin C Jamison
- Advanced Practice Nursing, Beacon Medical Group, Indiana, United States; Purdue University School of Nursing, 502 North University Street, West Lafayette, IN 47907, United States.
| | - Azza H Ahmed
- Purdue University School of Nursing, 502 North University Street, West Lafayette, IN 47907, United States.
| | - Deborah A Spoerner
- Purdue University School of Nursing, 502 North University Street, West Lafayette, IN 47907, United States.
| | - Daniel Kinney
- Pediatrician, Beacon Medical Group, 1815 E Ireland Rd, South Bend, Indiana, United States.
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Romate J, Rajkumar E, Gopi A, Abraham J, Rages J, Lakshmi R, Jesline J, Bhogle S. What Contributes to COVID-19 Vaccine Hesitancy? A Systematic Review of the Psychological Factors Associated with COVID-19 Vaccine Hesitancy. Vaccines (Basel) 2022; 10:vaccines10111777. [PMID: 36366286 PMCID: PMC9698528 DOI: 10.3390/vaccines10111777] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 08/10/2022] [Accepted: 08/12/2022] [Indexed: 11/06/2022] Open
Abstract
Vaccine hesitancy plays a crucial role in worldwide pandemic-control efforts. The multifaceted nature of vaccine hesitancy entails many psychological factors that are widely discussed in the literature, although few studies specifically compile these factors. Thus, this systematic review aims to synthesize the psychological factors contributing to vaccine hesitancy. As per the PRISMA (preferred reporting items for systematic reviews and meta-analyses) guidelines, a systematic search was conducted on electronic databases PubMed, Scopus, Science Direct, PsycNET, and Web of Science, and a manual search was conducted on Google Scholar. Out of the 2289 articles obtained, 79 studies that met the inclusion criteria were deemed eligible for the review. The findings highlight appraisals of the COVID-19 pandemic, vaccine safety and side effects, vaccine confidence/trust, trust in government and healthcare professionals, scepticism around vaccine production, conspiracy beliefs, emotions, and information and knowledge about the vaccine as the major psychological factors contributing to vaccine hesitancy. Concerningly, misinformation on COVID-19 vaccination spread through social media platforms, increasing vaccine hesitancy. Recommendations for government authorities, healthcare professionals, and implications for future research are also outlined.
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Affiliation(s)
- John Romate
- Department of Psychology, Central University of Karnataka, Kalaburagi 585367, India
| | - Eslavath Rajkumar
- Department of Psychology, Central University of Karnataka, Kalaburagi 585367, India
- Correspondence:
| | - Aswathy Gopi
- Department of Psychology, Central University of Karnataka, Kalaburagi 585367, India
| | - John Abraham
- St. John’s Medical College, St. John’s National Academy of Health Sciences, Bangalore 560034, India
| | - John Rages
- Government College of Teacher Education, Calicut 673004, India
| | - R. Lakshmi
- Department of Psychology, Central University of Karnataka, Kalaburagi 585367, India
| | - Joshy Jesline
- Department of Psychology, Central University of Karnataka, Kalaburagi 585367, India
| | - Sudha Bhogle
- Psychology & Head, Student Solutions, Eduquity Career Technologies, Bangalore 560095, India
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Ryan GW, Goulding M, Borg A, Minkah P, Hermann S, Fisher L, Rosal MC, Lemon SC. Clinician perspectives on pediatric COVID-19 vaccination: A qualitative study in central and western, Massachusetts. Prev Med Rep 2022; 29:101966. [PMID: 36065256 PMCID: PMC9434951 DOI: 10.1016/j.pmedr.2022.101966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 07/29/2022] [Accepted: 08/25/2022] [Indexed: 11/25/2022] Open
Abstract
We explored perspectives of clinicians in central and western Massachusetts about efforts to vaccinate pediatric patients against COVID-19 as well as best practices and challenges for vaccine delivery. We conducted semi-structured qualitative interviews (n = 16) with family practice and pediatric clinicians between late October and early December 2021. Our interviews addressed: process for vaccination and vaccine promotion, parental receptivity to COVID-19 vaccination, receptivity to other pediatric vaccines, resources needed to support vaccine promotion, and best practices developed to encourage hesitant parents. Using a multi-prong recruitment strategy we invited clinicians to participate in telephone interviews, which were audio-recorded and transcribed. We used rapid qualitative analysis to produce summary templates for each interview which were ultimately combined into a matrix summary. The majority of participants (n = 10) were offering the vaccine in their own clinics, while the remainder cited challenges related to staffing, logistics, and space that prevented them from offering the vaccine. Clinicians reported parents fall into three groups: vaccine-accepting, hesitant but potentially accepting, and refusers. Strategies they identified that worked to encourage hesitant parents were sharing personal vaccine stories, acknowledging parents' fears about the vaccine, and being persistent with the most hesitant parents. Yet resources are needed including educational materials and training in how to have these conversations. While challenges related to staffing and space will be difficult to overcome for clinics to be able to offer vaccination on-site, our results highlight the importance of developing effective messaging strategies and training clinicians in how to integrate them into routine practice.
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Affiliation(s)
- Grace W. Ryan
- Division of Preventive and Behavioral Medicine, Department of Population and Quantitative, Health Sciences, University of Massachusetts Chan Medical School, 368 Plantation St, Worcester MA 01605, United States
- Department of Healthcare Delivery and Population Sciences, UMass Chan-Baystate Baystate Health, 3601 Main Street, Springfield, MA, 01107, United States
- Corresponding author.
| | - Melissa Goulding
- Division of Preventive and Behavioral Medicine, Department of Population and Quantitative, Health Sciences, University of Massachusetts Chan Medical School, 368 Plantation St, Worcester MA 01605, United States
| | - Amy Borg
- Division of Preventive and Behavioral Medicine, Department of Population and Quantitative, Health Sciences, University of Massachusetts Chan Medical School, 368 Plantation St, Worcester MA 01605, United States
| | - Princilla Minkah
- Division of Preventive and Behavioral Medicine, Department of Population and Quantitative, Health Sciences, University of Massachusetts Chan Medical School, 368 Plantation St, Worcester MA 01605, United States
| | - Sophie Hermann
- Holyoke Health Center, 230 Maple St, Holyoke MA 01040, United States
| | - Lloyd Fisher
- Department of Pediatrics, UMass Memorial Health, 55 Lake Avenue North, Worcester MA 01605, United States
- Reliant Medical Group, 5 Neponset St, Worcester, MA 01605, United States
| | - Milagros C. Rosal
- Division of Preventive and Behavioral Medicine, Department of Population and Quantitative, Health Sciences, University of Massachusetts Chan Medical School, 368 Plantation St, Worcester MA 01605, United States
| | - Stephenie C. Lemon
- Division of Preventive and Behavioral Medicine, Department of Population and Quantitative, Health Sciences, University of Massachusetts Chan Medical School, 368 Plantation St, Worcester MA 01605, United States
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