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de Souza Amorim Matos CC, Couto MT, Oduwole EO, Shey Wiysonge C. Caregivers' perceptions on routine childhood vaccination: A qualitative study on vaccine hesitancy in a South Brazil state capital. Hum Vaccin Immunother 2024; 20:2298562. [PMID: 38196242 PMCID: PMC10793707 DOI: 10.1080/21645515.2023.2298562] [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: 07/03/2023] [Accepted: 12/20/2023] [Indexed: 01/11/2024] Open
Abstract
Immunization programs worldwide have been facing challenges in keeping vaccination coverage high. Even though universally known for its robust National Immunization Program, Brazil has also faced significant challenges regarding vaccination coverage. One of the reasons for this is vaccine hesitancy, a complex, multi-causal, and context-specific phenomenon. This qualitative study aims to understand the factors associated with decision-making and the drivers of vaccine hesitancy in Florianopolis, Santa Catarina state capital, regarding caregivers' perceptions of routine childhood vaccination. In-depth interviews were conducted in the Capital city of Santa Catarina State. Families with children up to 6 years old were included. Data were analyzed based on thematic content analysis. Twenty-nine caregivers in 18 families were interviewed. These caregivers were mainly mothers and fathers. Three themes emerged: 1. Access to information and the decision-making process, where we discuss the role of social circles, healthcare workers, and the internet; 2. Individual-institutions power relationships: Perceptions about the State's role and the Health institutions: 3. Reasons and motivations: The senses and meanings behind non-vaccination, where we discuss the drivers of vaccine hesitancy related to risk perception, caregivers' opinions on the medical-pharmaceutical industry, vaccines' composition and their side effects, families' lifestyles and worldviews, and the childhood routine vaccination schedule. The results of this study reaffirm the complexity of the decision-making process in childhood vaccination and further enable a better contextual understanding of the complex and challenging phenomenon of vaccine hesitancy.
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Affiliation(s)
- Camila Carvalho de Souza Amorim Matos
- Departamento de Medicina Preventiva, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil
- Departamento de Ciências da Saúde, Universidade Federal de Santa Catarina, Araranguá, Brazil
| | - Marcia Thereza Couto
- Departamento de Medicina Preventiva, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Elizabeth O. Oduwole
- Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa
| | - Charles Shey Wiysonge
- Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa
- Division of Epidemiology and Biostatistics, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
- Vaccine-Preventable Diseases Programme, Universal Health Coverage/Communicable and Non-Communicable Diseases Cluster, World Health Organization Regional Office for Africa, Brazzaville, Congo
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Gialama M, Kleisiaris C, Malliarou M, Papagiannis D, Papathanasiou IV, Karavasileiadou S, Almegewly WH, Tsaras K. Validity and Reliability of the Greek Version of Adult Vaccine Hesitancy Scale in Terms of Dispositional Optimism in a Community-Dwelling Population: A Cross-Sectional Study. Healthcare (Basel) 2024; 12:1460. [PMID: 39120164 PMCID: PMC11311501 DOI: 10.3390/healthcare12151460] [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: 06/12/2024] [Revised: 07/05/2024] [Accepted: 07/20/2024] [Indexed: 08/10/2024] Open
Abstract
Vaccine hesitancy is an important public health issue referring to concerns about the safety and efficacy of vaccination. Within a framework, this study aimed to assess the cultural adaptation, validity, and reliability of the Greek version of the adult Vaccine Hesitancy Scale (aVHS) as well as to identify the determinants of vaccine hesitancy among a large regional population in central Greece. A cross-sectional study was conducted enrolling 300 adults who had received primary healthcare services in the Health Centers and Local Health Units of the Magnesia Region from October to December 2022. The aVHS and the Life Orientation Test-Revised (LOT-R) were used to identify vaccine hesitancy and the dispositional level of optimism, respectively. For survey translation, the procedure of forward and backward translation was followed. Also, the aVHS was tested in a pilot study with a sample of 18 responders. Construct validity and internal consistency reliability were investigated via exploratory and confirmatory factor analysis and Cronbach's alpha coefficients, respectively. Simple and multiple linear regression analysis were used to determine predictors for vaccine hesitancy. Factor analyses indicated that the aVHS comprises two constructs ("lack of confidence" and "risk perception") explaining 68.9% of the total variance. The Cronbach's alpha of the total scale was 0.884, indicating its high internal consistency. Participants who lived in rural areas, had a lower annual income, and reported a lower level of optimism showed a higher lack of confidence in vaccination. On the other hand, people aged above 45 years old who had graduated from high school or elementary school and were unemployed showed greater aversion to the risks of side effects. Finally, certain socio-demographic characteristics were associated with vaccine hesitancy. Our data suggest that the aVHS is a valid and reliable instrument for measuring vaccine-related attitudes and perceptions in Greek society, providing meaningful insight into designing vaccination-related preventive interventions in the community.
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Affiliation(s)
- Marilena Gialama
- Department of Nursing, School of Health Sciences, University of Thessaly, 41500 Larissa, Greece
| | - Christos Kleisiaris
- Department of Nursing, School of Health Sciences, University of Thessaly, 41500 Larissa, Greece
| | - Maria Malliarou
- Department of Nursing, School of Health Sciences, University of Thessaly, 41500 Larissa, Greece
| | - Dimitrios Papagiannis
- Department of Nursing, School of Health Sciences, University of Thessaly, 41500 Larissa, Greece
| | - Ioanna V Papathanasiou
- Department of Nursing, School of Health Sciences, University of Thessaly, 41500 Larissa, Greece
| | - Savvato Karavasileiadou
- Department of Community and Psychiatric Mental Health Nursing, College of Nursing, Princess Nourah bint Abdulrahman University, Riyadh 11671, Saudi Arabia
| | - Wafa Hamad Almegewly
- Department of Community and Psychiatric Mental Health Nursing, College of Nursing, Princess Nourah bint Abdulrahman University, Riyadh 11671, Saudi Arabia
| | - Konstantinos Tsaras
- Department of Nursing, School of Health Sciences, University of Thessaly, 41500 Larissa, Greece
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Procianoy GS, Procianoy RS, Silveira RC. Regional disparities in BCG vaccination coverage and tuberculosis incidence in infants among Brazilian states. J Trop Pediatr 2024; 70:fmae023. [PMID: 39122656 DOI: 10.1093/tropej/fmae023] [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] [Indexed: 08/12/2024]
Abstract
Bacillus Calmette-Guerin (BCG) vaccination and tuberculosis (TB) incidence in children under 1 year of age are critical public health indicators in Brazil. The coronavirus disease 2019 pandemic disrupted vaccination coverage (VC), potentially impacting TB incidence. Understanding regional disparities in VC and TB incidence can inform targeted interventions. We conducted an observational and ecological study using BCG vaccination data (2019-21) and TB incidence (2020-22) for all births in Brazil. Data were collected from public health databases, stratified by state, and analyzed using descriptive and analytical statistics to explore VC and TB incidence. Between 2019 and 2021, average BCG VC was 79.59%, with significant variation among states (P < .001). Only four states achieved minimum recommended coverage (>90%). TB incidence varied significantly among states (P = .003). There was a notable decline in VC from 2019 (90.72%) to 2021 (78.67%) (P < .001). This study highlights regional disparities in BCG VC and TB incidence among Brazilian states. Lower VC post-pandemic may increase TB incidence, requiring targeted interventions in states with inadequate coverage. The findings underscore the importance of sustaining vaccination programs amidst public health crises and implementing strategies to enhance access and uptake.
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Affiliation(s)
- Guilherme S Procianoy
- School of Medicine, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Brazil
| | - Renato S Procianoy
- Department of Pediatrics, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Rita C Silveira
- Department of Pediatrics, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
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Smith DG, Smith CD, DeLeon JA, Sandoz JL, Ochoa CO, Pearson MP, Macena RHM. Factors influencing COVID-19 vaccine uptake among Latinos: A cross-sectional study. PLoS One 2024; 19:e0302332. [PMID: 38968176 PMCID: PMC11226026 DOI: 10.1371/journal.pone.0302332] [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: 12/05/2023] [Accepted: 04/02/2024] [Indexed: 07/07/2024] Open
Abstract
Vaccination against COVID-19 can prevent severe illness and reduce hospitalizations and deaths. Understanding and addressing determinants contributing to vaccine uptake among high-risk groups, such as Latinos, are pivotal in ensuring equitable vaccine distribution, promoting health equity, and fostering community engagement to bridge the gap in vaccine acceptance and ultimately enhance public health. This study aimed to examine factors influencing vaccine uptake among Latinos. We conducted a cross-sectional study using an online platform (n = 242). The survey was administered using a multimodal approach. Strategies for recruitment included community outreach, social media, and targeting community networks serving Latinos. Descriptive statistics, chi-square, and multivariable analysis were performed. Overall, 81.4% of respondents had received at least one dose of the COVID-19 vaccine, with 77.0% recommending it and 70.6% believing it to be safe, 66.7% believing in its efficacy, 62.3% able to find trustful information in Spanish or Portuguese, and almost 40% who relied on health organizations as their primary resource for COVID-19 vaccine information. Factors significantly associated with vaccine uptake included higher education level (p<0.001), English level (p = 0.023), living in an urban area (p = 0.048), having insurance (p<0.001), and having a healthcare provider (p = 0.007). Furthermore, belief in vaccine safety and efficacy, trust in public health authorities, concerns about COVID-19, the ability to determine true/false vaccine information during the pandemic, and the availability of trustworthy information in Spanish/Portuguese had statistically significant associations (p<0.05) with COVID-19 vaccine uptake. COVID-19 vaccine uptake differed based on sociodemographic and other modifiable factors. Our findings emphasize the importance of implementing targeted interventions and culturally sensitive communication strategies to improve vaccination uptake among the Latino community in the United States.
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Affiliation(s)
- Deborah G Smith
- Department of Public Health, Louisiana State University Health Science Center Shreveport, Shreveport, Louisiana, United States of America
| | - Corey D Smith
- Department of Medicine, Louisiana State University Health Science Center Shreveport, Shreveport, Louisiana, United States of America
| | - Jennifer A DeLeon
- Department of Public Health, Louisiana State University Health Science Center Shreveport, Shreveport, Louisiana, United States of America
| | - Jillian L Sandoz
- Department of Medicine, Louisiana State University Health Science Center Shreveport, Shreveport, Louisiana, United States of America
| | - Carolina O Ochoa
- Department of Medicine, Louisiana State University Health Science Center Shreveport, Shreveport, Louisiana, United States of America
| | - Martha P Pearson
- Department of Nursing, Northwestern State University of Louisiana, Shreveport, Louisiana, United States of America
| | - Raimunda H M Macena
- Department of Medicine, Federal University of Ceara, Fortaleza, Ceara, Brazil
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Roberti J, Ini N, Belizan M, Alonso JP. Barriers and facilitators to vaccination in Latin America: a thematic synthesis of qualitative studies. CAD SAUDE PUBLICA 2024; 40:e00165023. [PMID: 38922226 PMCID: PMC11192573 DOI: 10.1590/0102-311xen165023] [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: 09/05/2023] [Revised: 04/01/2024] [Accepted: 04/09/2024] [Indexed: 06/27/2024] Open
Abstract
Vaccines are often undervalued or underused for a variety of reasons, and vaccine hesitancy is a global challenge that threatens vaccine acceptance and the goals of immunization programs. This review aimed to describe the barriers and facilitators to vaccination in Latin America. The study design was a systematic review and thematic synthesis of qualitative studies reporting on the knowledge or attitudes of adults, parents of children at vaccination age, adolescents and health professionals towards vaccination in Latin America. The databases searched were PubMed, CENTRAL, Scopus, LILACS, SciELO, and CINAHL. A total of 56 studies were included. Facilitators included vaccination being recognized as an effective strategy for preventing infectious diseases and as a requirement for access to social assistance programs, schooling or employment. Recommendations from health professionals and positive experiences with health services were also identified as facilitators. The main barriers were lack of information or counseling, structural problems such as shortages of vaccines and limited hours of operation, the inability to afford over-the-counter vaccines or transportation to health facilities, certain religious beliefs, misconceptions and safety concerns. Qualitative research can contribute to understanding perceptions and decision-making about vaccination and to designing policies and interventions to increase coverage.
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Affiliation(s)
- Javier Roberti
- Instituto de Efectividad Clínica y Sanitaria, Buenos Aires, Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas, Buenos Aires, Argentina
| | - Natalí Ini
- Instituto de Efectividad Clínica y Sanitaria, Buenos Aires, Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas, Buenos Aires, Argentina
| | - Maria Belizan
- Instituto de Efectividad Clínica y Sanitaria, Buenos Aires, Argentina
| | - Juan Pedro Alonso
- Consejo Nacional de Investigaciones Científicas y Técnicas, Buenos Aires, Argentina
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Khoury G, Ward JK, Mancini J, Gagneux-Brunon A, Luong Nguyen LB. Health Literacy and Health Care System Confidence as Determinants of Attitudes to Vaccines in France: Representative Cross-Sectional Study. JMIR Public Health Surveill 2024; 10:e45837. [PMID: 38713494 PMCID: PMC11109853 DOI: 10.2196/45837] [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: 01/19/2023] [Revised: 10/05/2023] [Accepted: 01/25/2024] [Indexed: 05/08/2024] Open
Abstract
BACKGROUND Health literacy involves individuals' knowledge, personal skills, and confidence to take action to evaluate and appraise health-related information and improve their health or that of their community. OBJECTIVE This study aimed to analyze the association between health literacy and attitude toward vaccines, adjusted with other factors. METHODS We used the SLAVACO Wave 3, a survey conducted in December 2021 among a sample of 2022 individuals, representative of the French adult population. We investigated factors associated with the attitude toward vaccines using respondents' different sociodemographic data, health literacy levels, and the health care system confidence levels using a multinomial logistic regression analysis. RESULTS Among the participants, 440.4 (21.8%) were classified as "distrustful of vaccines in general," 729.2 (36.1%) were "selectively hesitant," and 852.4 (42.2%) were "nonhesitant." In our model, the level of health literacy was not statistically different between the "distrustful of vaccines in general" and the "selectively hesitant" (P=.48), but it was associated with being a "nonhesitant" (adjusted odds ratio [aOR] 1.86, 95% CI 1.25-2.76). The confidence in the health care system was a strong predictor for a "nonhesitant" attitude toward vaccines (aOR 12.4, 95% CI 7.97-19.2). We found a positive correlation of 0.34 (P<.001) between health literacy and confidence in the health care system, but the interaction term between health literacy and health care system confidence was not significant in our model. CONCLUSIONS Health literacy was associated with a "nonhesitant" attitude toward vaccines. The findings demonstrated that health literacy and confidence in the health care system are modestly correlated. Therefore, to tackle the subject of vaccine hesitancy, the main focus should be on increasing the population's confidence and on increasing their health literacy levels or providing vaccine information addressing the needs of less literate citizens.
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Affiliation(s)
- Georges Khoury
- CIC Cochin Pasteur, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Jeremy K Ward
- Cermes3, CNRS, INSERM, Université Paris Cité, Paris, France
| | - Julien Mancini
- Cancer, Biomedicine & Society Group, APHM, Hop Timone, Public Health Department (BIOSTIC), INSERM, IRD, ISSPAM, SESSTIM, Aix-Marseille University, Marseille, France
| | - Amandine Gagneux-Brunon
- Centre International de Recherche en Infectiologie, Team GIMAP, Inserm, U1111, CNRS, UMR530, CHU de Saint-Etienne, Saint-Etienne, France
| | - Liem Binh Luong Nguyen
- CIC Cochin Pasteur, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, Paris, France
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Borges LCR, Marcon SS, Brito GS, Terabe M, Pleutim NI, Mendes AH, Teston EF. Adherence to Covid-19 vaccination during the pandemic: the influence of fake news. Rev Bras Enferm 2024; 77:e20230284. [PMID: 38655979 PMCID: PMC11034379 DOI: 10.1590/0034-7167-2023-0284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 11/17/2023] [Indexed: 04/26/2024] Open
Abstract
OBJECTIVES to understand how fake news has influenced adherence to Covid-19 immunization, from the perspective of health professionals. METHODS a qualitative, descriptive-exploratory study was conducted in Campo Grande - MS. Twenty nursing professionals working in vaccine rooms or managing immunobiologicals participated through semi-structured interviews. The interviews were audio-recorded, fully transcribed, and subjected to thematic content analysis. RESULTS two categories emerged in which the professionals highlighted an increase in vaccine hesitancy among the population, influenced by fake news and denialist actions, which negatively interfered with the population's trust in vaccines and in the professionals administering them. FINAL CONSIDERATIONS concerns about vaccine safety and denialist actions by authorities and media outlets can contribute to the phenomenon of non-vaccination. The valorization of science, the promotion of educational actions, and raising public awareness about immunization were presented as strategies to increase vaccine coverage.
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Affiliation(s)
| | | | | | - Miriam Terabe
- Universidade Estadual de Maringá, Maringá, Paraná, Brazil
| | | | | | - Elen Ferraz Teston
- Universidade Federal de Mato Grosso do Sul. Campo Grande, Mato Grosso do Sul, Brazil
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Mabale MAA, Tejero LMS, Montes LA, Collante MTM, Tempongko MSB, Tolabing MCC. Implications of information heard about Dengvaxia on Filipinos' perception on vaccination. Vaccine 2024; 42:1673-1681. [PMID: 38350770 DOI: 10.1016/j.vaccine.2024.01.097] [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: 09/09/2023] [Revised: 12/30/2023] [Accepted: 01/29/2024] [Indexed: 02/15/2024]
Abstract
Issues that arose from the Dengvaxia vaccination program in the Philippines in 2017 were followed by a remarkable decline in immunization coverage in the country. This study intended to describe the Filipinos' perceptions about vaccination after hearing about the Dengvaxia vaccine and the vaccination program and determine its potential relationship with selected demographic factors and other variables such as: health literacy, sources of information on Dengvaxia, information heard about the vaccine, healthcare visits, and perceived health status. The study utilized secondary data derived from a national health literacy survey in the Philippines. A total of 1992 respondents were included in the analysis. Majority were females, had reached college, residing in urban areas, and were unemployed. Most obtained information about Dengvaxia from media, particularly the television and heard that it caused death and prevents dengue. Seventy-one per cent had negative vaccination perception upon obtaining information about Dengvaxia. Sex, residence type, and income were found to be associated with vaccination perception. Females and those living in rural areas were more likely to have a negative vaccination perception while those with the highest income were less likely to have negative vaccination perception. Respondents who heard that Dengvaxia prevents dengue, those who obtained Dengvaxia information from health professionals, and those who visited both public and private health facilities in the last 12 months were less likely to have negative vaccination perception. On the other hand, those with inadequate functional health literacy were more likely to have negative vaccination perception. The study presents the implications of information heard about Dengvaxia on Filipinos' perception on vaccination through selected variables and other factors. The findings are important in designing strategies in communicating health information, building public trust, and in reinforcing policies to improve vaccination uptake.
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Affiliation(s)
| | - Lourdes Marie S Tejero
- College of Nursing, University of the Philippines Manila, Manila, Philippines; Technology Transfer and Business Development Office, University of the Philippines Manila, Manila, Philippines
| | - Lucille A Montes
- College of Education, De La Salle University Manila, Manila, Philippines
| | | | - Ma Sandra B Tempongko
- Southeast Asian Ministers of Education Organization (SEAMEO) Tropical Medicine and Public Health Network, Bangkok, Thailand
| | - Ma Carmen C Tolabing
- College of Public Health, University of the Philippines Manila, Manila, Philippines
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Chen X, Wang L, Huang Y, Zhang L. Risk perception and trust in the relationship between knowledge and HPV vaccine hesitancy among female university students in China: a cross-sectional study. BMC Public Health 2024; 24:667. [PMID: 38429644 PMCID: PMC10908003 DOI: 10.1186/s12889-024-18166-w] [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: 08/05/2023] [Accepted: 02/20/2024] [Indexed: 03/03/2024] Open
Abstract
BACKGROUND Cervical cancer poses a heavy health burden in China, with the second highest incidence and mortality rate among female tumors, yet human papillomavirus (HPV) vaccination rate among female university students remain remains low. This study conducted a cross-sectional survey to assess the degree of HPV vaccine hesitancy among female university students and to explore the potential association between knowledge, risk perception, trust, and HPV vaccine hesitancy. METHODS A total of 1,438 female university students from four Chinese cities were recruited through stratified, multistage, cluster sampling method. The mediation model was constructed using the Bootstrap method, introducing trust and risk perception as mediating variables to examine the effect of knowledge on HPV vaccine hesitancy. RESULTS The study found that 8.9% (95%CI:7.4%∼10.4%) of the female university students exhibited HPV vaccine hesitancy. Pearson's correlation analysis revealed a negative association between vaccine hesitancy and knowledge, risk perception, and trust. The mediation model showed that knowledge had significant indirect effects on HPV vaccine hesitancy through trust (indirect effect: -0.224, 95% CI: -0.293 ∼ -0.167) and risk perception (indirect effect: -0.013, 95% CI: -0.033 ∼ -0.002). CONCLUSION HPV vaccine hesitancy among female university students has mitigated, but still needs to be addressed. In addition, trust and risk perception are mediators mediating the relationship between knowledge with HPV vaccine hesitancy. Therefore, there is a need to strengthen public health education to improve knowledge, with a particular focus on providing information about trust and risk perception to reduce HPV vaccine hesitancy.
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Affiliation(s)
- Xing Chen
- School of Public Health, Fudan University, Shanghai, PR China
| | - Lei Wang
- School of Public Administration and Emergency Management, Institute of Public Policy, Jinan University, Guangzhou, PR China
| | - Yan Huang
- Center for Chinese Public Administration Research, School of Government, Sun Yat-sen University, Guangzhou, PR China
| | - Luying Zhang
- School of Public Health, Fudan University, Shanghai, PR China.
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Araújo DABS, Correia LL, Lima PLGDSB, Vasconcelos SC, Farías-Antúnez S, Gomes YVC, Nogueira DL, Castro MC, Machado MMT. Coverage and determinants of childhood vaccination during the COVID-19 pandemic in Fortaleza, Northeastern Brazil: a longitudinal analysis. CAD SAUDE PUBLICA 2024; 40:e00074723. [PMID: 38324862 PMCID: PMC10841349 DOI: 10.1590/0102-311xen074723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Revised: 09/15/2023] [Accepted: 10/19/2023] [Indexed: 02/09/2024] Open
Abstract
Brazil has seen a decrease in vaccination coverage since 2016. This study analyzes the immunization status of children born during the COVID-19 pandemic in Fortaleza, Northeastern Brazil. This is a longitudinal analysis that included vaccination data of 313 children aged 12 and 18 months. Vaccination cards were checked for dose application considering the schedule of immunization recommended by the Brazilian Ministry of Health. Factors associated with no retention of vaccination cards and incomplete immunization by 18 months were identified by Tobit regression analysis. About 73% of mothers presented their child's vaccination card. Non-availability of vaccination cards was associated with maternal age < 25 years and mothers with paid jobs. Only 33% and 45% of the children aged 12 and 18 months had all vaccines up to date, respectively. For 3-dose vaccines, the delay rate was around 10% for the first dose application, but 40% for the third dose. Despite delays, most children with available vaccine cards had coverage above 90% by 18 months of age. Adjusted factors associated with incomplete vaccination included living in a household with more than one child (p = 0.010) and monthly income of less than one minimum wage (p = 0.006). Therefore, delays in child vaccine application were high during the COVID-19 pandemic but a considerable uptake by 18 months of age was found. Poorer families with more than one child were particularly at risk of not fully immunizing their children and should be the target of public policies.
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Affiliation(s)
| | | | | | | | - Simone Farías-Antúnez
- Departamento de Ciencias da Saúde, Universidade Federal de Santa Catarina, Araranguá, Brasil
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Abenova M, Shaltynov A, Jamedinova U, Semenova Y. Worldwide Child Routine Vaccination Hesitancy Rate among Parents of Children Aged 0-6 Years: A Systematic Review and Meta-Analysis of Cross-Sectional Studies. Vaccines (Basel) 2023; 12:31. [PMID: 38250844 PMCID: PMC10819761 DOI: 10.3390/vaccines12010031] [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: 10/23/2023] [Revised: 12/13/2023] [Accepted: 12/14/2023] [Indexed: 01/23/2024] Open
Abstract
Routine vaccine hesitancy is a major global health challenge observed in over 190 countries worldwide. This meta-analysis aims to determine the worldwide prevalence of routine vaccination hesitancy among parents of children aged 0-6. An extensive search was conducted in four scientific databases: PubMed, Scopus, Web of Science, and the Cochrane Library. Studies were included if they reported hesitancy related to WHO-recommended routine immunizations for children under 7 years of age. A single-arm meta-analysis was performed using the OpenMeta[Analyst] software. An initial search retrieved 5121 articles, of which only 23 publications, involving 29,131 parents, guardians, and caregivers from over 30 countries met the inclusion criteria and quality assessment. The cumulative prevalence of parental vaccine hesitancy was found to be 21.1% (95% CI = 17.5-24.7%, I2 = 98.86%, p < 0.001). When stratifying the prevalence of vaccine hesitancy per WHO region, significant variations were observed, ranging from 13.3% (95% CI = 6.7-19.9%, I2 = 97.72%, p < 0.001) in the Region of the Americas to 27.9% (95% CI = 24.3-31.4%) in the Eastern Mediterranean region. The study findings highlight the need for healthcare providers and governments to develop and improve comprehensive programs with communication strategies to reduce parental vaccine hesitancy.
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Affiliation(s)
- Madina Abenova
- Department of Biostatistics and Epidemiology, Semey Medical University, Semey 071400, Kazakhstan; (M.A.); (A.S.); (U.J.)
| | - Askhat Shaltynov
- Department of Biostatistics and Epidemiology, Semey Medical University, Semey 071400, Kazakhstan; (M.A.); (A.S.); (U.J.)
| | - Ulzhan Jamedinova
- Department of Biostatistics and Epidemiology, Semey Medical University, Semey 071400, Kazakhstan; (M.A.); (A.S.); (U.J.)
| | - Yuliya Semenova
- School of Medicine, Nazarbayev University, Astana 010000, Kazakhstan
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12
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de Melo EB, Almeida PD, Pereira BM, Borges PDTM, Gir E, de Araújo TME. Vaccination hesitation in children under five years of age: a scoping review. Rev Bras Enferm 2023; 76:e20220707. [PMID: 38018617 PMCID: PMC10680390 DOI: 10.1590/0034-7167-2022-0707] [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: 12/02/2022] [Accepted: 05/08/2023] [Indexed: 11/30/2023] Open
Abstract
OBJECTIVES to synthesize scientific evidence on vaccine hesitancy in children under five years of age and its associated factors. METHODS a scoping review, conducted according to the methodological structure proposed by the JBI. Searches were carried out in the Latin American and Caribbean Center on Health Sciences Information, Scientific Electronic Library Online and PubMed databases, including gray literature. Studies in English, Spanish and Portuguese were included, without temporal delimitation. Editorials, studies that did not address vaccine hesitancy in children under five years of age and were not aligned with the objective and research question were excluded. The sample consisted of 18 articles. RESULTS misinformation, concern about adverse effects, distrust about efficacy, affliction regarding administration simultaneously, and insecurity in relation to the laboratories were the reported reasons. CONCLUSIONS strategies are needed to combat the lack of information about immunobiological agents, as misinformation was the main factor in parents' vaccine hesitation.
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Affiliation(s)
| | | | | | | | - Elucir Gir
- Universidade de São Paulo. Ribeirão Preto, São Paulo, Brazil
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Santos Júnior CJD, Silva MRD, Costa PJMDS. Psychometric properties and reliability of the Brazilian version of Parent Attitudes about Childhood Vaccine (PACV-BR). REVISTA PAULISTA DE PEDIATRIA : ORGAO OFICIAL DA SOCIEDADE DE PEDIATRIA DE SAO PAULO 2023; 42:e2023019. [PMID: 37729243 PMCID: PMC10508042 DOI: 10.1590/1984-0462/2024/42/2023019] [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: 02/03/2023] [Accepted: 05/05/2023] [Indexed: 09/22/2023]
Abstract
OBJECTIVE To evaluate the psychometric properties and reliability of the Brazilian version of the tool Parent Attitudes about Childhood Vaccine (PACV-BR). METHODS The sample included 110 parents of children up to two years old served by Family Health Basic Units. The tool's internal consistency and factor validity were respectively assessed by Cronbach's alpha and exploratory factor analysis (EFA). The test-retest reliability was assessed by the intraclass correlation coefficient (ICC). RESULTS The EFA results indicated a proper structural adequacy of the PACV-BR (15 items and two factors). The reliability generated Cronbach's alpha values between 0.715 and 0.854 for the items, of 0.918 for the tool as a whole, of 0.877 for factor 1 and of 0.825 for factor 2, in addition to an ICC of 0.984. CONCLUSIONS The PACV-BR showed evidence of construct validity and reliability.
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Seara-Morais GJ, Avelino-Silva TJ, Couto M, Avelino-Silva VI. The pervasive association between political ideology and COVID-19 vaccine uptake in Brazil: an ecologic study. BMC Public Health 2023; 23:1606. [PMID: 37612648 PMCID: PMC10464231 DOI: 10.1186/s12889-023-16409-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Accepted: 07/27/2023] [Indexed: 08/25/2023] Open
Abstract
BACKGROUND Despite the unequivocal benefits of vaccination, vaccine coverage has been falling in several countries in the past few years. Studies suggest that vaccine hesitancy is an increasingly significant phenomenon affecting adherence to vaccines. More recently, during the COVID-19 pandemic, political views have emerged as an additional influencing factor for vaccine hesitancy. METHODS In this ecologic study, we used information from publicly available databases to investigate the association between political ideology, depicted by the percentage of votes for the right-wing candidate Jair Bolsonaro in the presidential elections of 2018 and 2022, and COVID-19 vaccination in Brazilian municipalities. The primary endpoint was the COVID-19 vaccination index, calculated as the number of COVID-19 vaccine doses administered up to September 2022 divided by the number of inhabitants in each municipality. The analysis was conducted using Pearson correlation coefficients and linear regression models adjusted for HDI, the percentage of male voters, the percentage of voters who were older than 50 years old, and the percentage of voters with a middle school education or less. In addition, we explored whether the effect of the percentage of Bolsonaro voters on the COVID-19 vaccination index was modified in different quartiles of HDI using an interaction term. RESULTS Five thousand five hundred sixty-three Brazilian municipalities were included in the analysis. For both the 2018 and 2022 elections, the percentage of votes for Jair Bolsonaro was significantly and inversely associated with COVID-19 vaccine uptake after adjustment for the sociodemographic characteristics of the voters (change in mean vaccination index in 2018 for each 1% increase in Bolsonaro voters -0.11, 95% confidence interval [CI] -0.13 to -0.08, p < 0.001; change in mean vaccination index in 2022 for each 1% increase in Bolsonaro voters -0.09, 95% CI -0.11 to -0.07, p < 0.001). We also found a statistically significant interaction between the primary predictor of interest and HDI scores, with a more significantly detrimental effect of the right-wing political stance in municipalities in the lower HDI quartiles (interaction p < 0.001 for the first HDI quartile; p = 0.001 for the second HDI quartile). CONCLUSION Our findings suggest that political ideologies have influenced COVID-19 vaccine hesitancy in Brazilian municipalities, affecting communities inequitably. The politicization of vaccines is a new challenge for vaccine programs. Strategies to face these challenges should include joint efforts from governments and civil society for a common public health goal.
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Affiliation(s)
- Gabriel J Seara-Morais
- Faculdade Israelita de Ciências da Saúde Albert Einstein, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
| | - Thiago J Avelino-Silva
- Faculdade Israelita de Ciências da Saúde Albert Einstein, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
- Laboratorio de Investigacao Medica Em Envelhecimento (LIM-66), Servico de Geriatria, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, São Paulo, SP, Brazil
- Atlantic Fellowship for Equity in Brain Health at the Global Brain Health Institute, University of California, San Francisco, CA, USA
| | - Marcia Couto
- Department of Preventive Medicine, Faculdade de Medicina, Universidade de Sao Paulo, São Paulo, SP, Brazil
| | - Vivian I Avelino-Silva
- Faculdade Israelita de Ciências da Saúde Albert Einstein, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
- Department of Preventive Medicine, Faculdade de Medicina, Universidade de Sao Paulo, São Paulo, SP, Brazil
- Department of Infectious and Parasitic Diseases, Faculdade de Medicina, Universidade de Sao Paulo, São Paulo, SP, Brazil
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dos Santos KCO, Junqueira-Marinho MDF, Reis AT, Camacho KG, Nehab MF, Abramov DM, de Azevedo ZMA, de Menezes LA, Salú MDS, Figueiredo CEDS, Moreira MEL, de Vasconcelos ZFM, de Carvalho FAA, de Mello LDR, Correia RF, Gomes Junior SCDS, Moore DCBC. Social Representations of Hesitant Brazilians about Vaccination against COVID-19. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6204. [PMID: 37444052 PMCID: PMC10340750 DOI: 10.3390/ijerph20136204] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 03/22/2023] [Accepted: 06/14/2023] [Indexed: 07/15/2023]
Abstract
BACKGROUND The control of the COVID-19 pandemic has been a great challenge. Understanding the thoughts and beliefs underlying vaccine hesitancy can help in the formulation of public policies. The present study aimed to analyze the social representations of hesitant Brazilians about vaccination against COVID-19. METHODS Qualitative research guided by the Theory of Social Representations, carried out through an online survey among Brazilian adults living in Brazil. The data were analyzed using the IRaMuTeQ software. RESULTS Of the 173,178 respondents, 10,928 were hesitant and declared reasons for vaccination hesitation. The analysis generated three classes: mistrust of the vaccine and underestimation of the severity of the pandemic; (dis)information and distrust of political involvement; and fear of adverse reactions to COVID-19 vaccines. CONCLUSIONS Social knowledge, presented by the representations apprehended in this study, demonstrates difficulty in discerning the reliability of information and a social imagination full of doubts and uncertainties. Understanding the internal dynamics of these groups, with their representations of the world, is important to propose policies and actions that echo and cause changes in the understanding of the role of immunization. It is essential to shed light on the sociological imagination so that gaps filled with false information can be dismantled and confronted with scientific knowledge accessible to the population.
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Affiliation(s)
- Keila Cristina Oliveira dos Santos
- National Institute of Women, Children and Adolescents Health Fernandes Figueira (IFF-FIOCRUZ), Rio de Janeiro 22250-020, Brazil
- Institute of Child Care and Pediatrics Martagao Gesteira, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro 21941-912, Brazil
| | | | - Adriana Teixeira Reis
- National Institute of Women, Children and Adolescents Health Fernandes Figueira (IFF-FIOCRUZ), Rio de Janeiro 22250-020, Brazil
- State of Rio de Janeiro University, Pedro Ernesto Hospital, Rio de Janeiro 20551-030, Brazil
| | - Karla Gonçalves Camacho
- National Institute of Women, Children and Adolescents Health Fernandes Figueira (IFF-FIOCRUZ), Rio de Janeiro 22250-020, Brazil
- State of Rio de Janeiro University, Pedro Ernesto Hospital, Rio de Janeiro 20551-030, Brazil
| | - Marcio Fernandes Nehab
- National Institute of Women, Children and Adolescents Health Fernandes Figueira (IFF-FIOCRUZ), Rio de Janeiro 22250-020, Brazil
| | - Dimitri Marques Abramov
- National Institute of Women, Children and Adolescents Health Fernandes Figueira (IFF-FIOCRUZ), Rio de Janeiro 22250-020, Brazil
| | - Zina Maria Almeida de Azevedo
- National Institute of Women, Children and Adolescents Health Fernandes Figueira (IFF-FIOCRUZ), Rio de Janeiro 22250-020, Brazil
- School of Medicine Unigranrio, University of Grande Rio, Duque de Caxias 25071-202, Brazil
| | - Livia Almeida de Menezes
- National Institute of Women, Children and Adolescents Health Fernandes Figueira (IFF-FIOCRUZ), Rio de Janeiro 22250-020, Brazil
| | - Margarida dos Santos Salú
- National Institute of Women, Children and Adolescents Health Fernandes Figueira (IFF-FIOCRUZ), Rio de Janeiro 22250-020, Brazil
| | | | - Maria Elisabeth Lopes Moreira
- National Institute of Women, Children and Adolescents Health Fernandes Figueira (IFF-FIOCRUZ), Rio de Janeiro 22250-020, Brazil
| | | | | | - Livia de Rezende de Mello
- National Institute of Women, Children and Adolescents Health Fernandes Figueira (IFF-FIOCRUZ), Rio de Janeiro 22250-020, Brazil
| | - Roberta Fernandes Correia
- National Institute of Women, Children and Adolescents Health Fernandes Figueira (IFF-FIOCRUZ), Rio de Janeiro 22250-020, Brazil
| | | | - Daniella Campelo Batalha Cox Moore
- National Institute of Women, Children and Adolescents Health Fernandes Figueira (IFF-FIOCRUZ), Rio de Janeiro 22250-020, Brazil
- School of Medicine, Internal Medicine (UFF), Fluminense Federal University, Niterói 24020-000, Brazil
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Li M, Luo Y, Watson R, Zheng Y, Ren J, Tang J, Chen Y. Healthcare workers' (HCWs) attitudes and related factors towards COVID-19 vaccination: a rapid systematic review. Postgrad Med J 2023; 99:520-528. [PMID: 37319159 DOI: 10.1136/postgradmedj-2021-140195] [Citation(s) in RCA: 122] [Impact Index Per Article: 122.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 05/29/2021] [Indexed: 01/24/2023]
Abstract
Herd immunity through vaccination is a key measure to control COVID-19 pandemic. However, vaccine hesitancy remains a public health threat, which is still common among healthcare workers (HCWs). This systematic review aimed to synthesise evidence on HCWs' attitudes towards COVID-19 vaccination and analyse associated factors to provide information for vaccine policy development and practice. We searched PubMed, Embase, ScienceDirect, Web of Science and three Chinese databases for literature published on 12 February 2021. Two researchers screened the literature independently, and 13 studies were included in the systematic review. Vaccine acceptance varied widely and ranged from 27.7% to 77.3%. HCWs had positive attitudes towards future COVID-19 vaccines, while vaccine hesitancy was still common. Demographic variables such as men, older age and physicians were positive predictive factors. Women and nurses had more vaccine hesitancy. Previous influenza vaccination and self-perceived risk were facilitators. Concerns for safety, efficacy and effectiveness and distrust of the government were barriers. Influences of direct (COVID-19) patient care towards vaccination intention were less conclusive. Tailored communication strategies were needed to increase the uptake rate of COVID-19 vaccines among HCWs. More importantly, more data and information on the safety and efficacy of vaccines should be provided with transparency.
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Affiliation(s)
- Mei Li
- School of Nursing, Southwest Medical University, Luzhou, Sichuan, China
| | - Yue Luo
- School of Nursing, Southwest Medical University, Luzhou, Sichuan, China
| | - Roger Watson
- Health and Social Care Faculty, University of Hull, Hull, UK
| | - Yu Zheng
- Department of Rheumatism and Immunology, the Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
| | - Jianlan Ren
- Department of Anesthesiology, the Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Jian Tang
- Department of Central Sterile Supply, the Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
| | - Yanhua Chen
- Department of Nursing, the Affiliated Hospital of Southwest Medical University, Luzhou, China
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Marvila Garcia É, Lima de Souza E, Penido Matozinhos F, Moreira Ribeiro da Silva T, Alves Waldman E, Sato APS. Associated factors with vaccine hesitancy in mothers of children up to two years old in a Brazilian city. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0002026. [PMID: 37289722 DOI: 10.1371/journal.pgph.0002026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 05/15/2023] [Indexed: 06/10/2023]
Abstract
This study aims to evaluate maternal vaccine hesitancy and its associated factors. This is a cross-sectional study of a probabilistic sample of 450 mothers of children born in 2015, living in a Brazilian city, and who was, at the time of data collection, more than two years old. We used the tool proposed by the World Health Organization (10-item Vaccine Hesitancy Scale). To assess its structure, we performed, exploratory and confirmatory factor analyses. We performed linear regression models to evaluate the factors associated with vaccine hesitancy. The factor analysis showed two components for the vaccine hesitancy scale: lack of confidence in vaccines and risk perception of vaccines. High family income was associated with lower vaccine hesitancy (greater confidence in vaccines and lower risk perception of vaccines), while the presence of other children, regardless of birth order, in the family was associated with lower confidence in vaccines. A good rapport with health professionals, willingness to wait for the vaccination and the getting vaccinated through campaigns were associated with greater confidence in vaccines. The deliberate delay or decision not to vaccinate their children and previous experience with adverse reactions to the vaccine were associated with lower confidence in vaccines and greater risk perception of vaccines. Health care providers, especially nurses, play a relevant role to address vaccine hesitancy, guiding vaccination through a trustworthy rapport.
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18
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Alzahrani AA, Alghamdi AN. Vaccine Hesitancy Among Parents and Its Determinants During the Era of COVID-19 in Taif City, Saudi Arabia. Cureus 2023; 15:e40404. [PMID: 37456420 PMCID: PMC10347883 DOI: 10.7759/cureus.40404] [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] [Accepted: 06/14/2023] [Indexed: 07/18/2023] Open
Abstract
Background Vaccine hesitancy is a growing concern worldwide, particularly during the COVID-19 pandemic. The aim was to investigate vaccine hesitancy and its determinants among parents in Taif, Saudi Arabia. Methods A cross-sectional study was conducted among parents using a validated and reliable questionnaire, the parent attitudes about childhood vaccines (PACV). Parents of children aged (two months to seven years) attending primary health care centers (PHCC) outpatient clinics were selected using a stratified sampling technique and interviewed to fill out the pre-structured questionnaire. Result The study included 301 parents, with 41.2% between the ages of 30-39 years and 25.2%% between 40-49 years. Mothers constituted 69.1% of the respondents. The most common sources of information regarding vaccinations were the doctor (34.9%), the internet (27.9%), and social media (16.6%). COVID-19 influenced the beliefs of more than half (52.5%) of parents regarding the importance of vaccinations. The median PACV score for vaccination hesitancy was 23.3/100, interquartile range (IQR) (13.3-33.3). The highest hesitation was among the age group of 30-39 years old (21.6%) and those whose beliefs were not influenced by the COVID-19 pandemic (16.1% vs. 5.7%) (p-value=0.003). The study found a significant difference in vaccine hesitancy rates between the different sources of information (p-value <0.001); parents who got their information about vaccinations from social media were more likely to be hesitant about vaccinations (40%). Concerns about side effects (93.8%), thinking that vaccines are not safe (84.4%), and thinking that fewer vaccines are needed (78.1%) were the top three factors influencing vaccine hesitancy. Conclusion This study urges promoting vaccine uptake through healthcare providers and combating vaccine misinformation on social media. Additionally, addressing safety concerns and misconceptions about vaccine necessity, and focusing on first-time parents, younger parents, and those with lower socioeconomic status are recommended strategies to improve vaccine uptake rates.
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Soleimanpour H, Sarbazi E, Esmaeili ED, Mehri A, Fam SG, Nikbakht HA, Saadati M, Sedighi S, Vali M, Azizi H. Predictors of receiving COVID-19 vaccine among adult population in Iran: an observational study. BMC Public Health 2023; 23:490. [PMID: 36918858 PMCID: PMC10012284 DOI: 10.1186/s12889-023-15409-0] [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: 06/30/2022] [Accepted: 03/09/2023] [Indexed: 03/16/2023] Open
Abstract
BACKGROUND Vaccination is one of the best ways to stop the transmission of coronavirus disease 2019 (COVID-19). In this regard, uunderstanding the features related to the intention of different populations to receive the COVID-19 vaccine is essential for an effective vaccination program. This study aimed to investigate the vaccination intention predictors in the general adult population of Iran. METHODS A cross-sectional, web-based survey was conducted on social networks, including Telegram, WhatsApp, LinkedIn, Instagram, and Facebook. Multinomial logistic regression models were used to investigate predictors associated with the intention to receive COVID-19 vaccines, including sociodemographic characteristics, trust, worry, sources of information, and conspiracy beliefs. The main outcomes included unwillingness, undecidedness, and intention to receive the COVID-19 vaccine. RESULTS Out of 780 respondents, 481 (61.6%) reported an intention to be vaccinated, 214 (27.4%) expressed their undecided status, and 85 (10.9%) reported unwillingness to receive any type of COVID-19 vaccine. A higher age (OR undecided = 0.97, 95% CI (0.96-0.99)), (OR unwilling = 0.97, 95% CI (0.95-0.99)); exposure with COVID-19 (OR unwilling = 0.82, 95% CI (0.76-0.89)), (OR undecided = 0.87, 95% CI (0.83-0.93)) were positively associated with vaccination intentions. No/low trust in vaccines, institutions, concerns about the future of the pandemic, and conspiracy beliefs were strongly and negatively associated with COVID-19 vaccination intentions. CONCLUSION Most Iranians intended to get a COVID-19 vaccine. Higher vaccine acceptance needs to consider demographic features, exposure history, confidence in vaccines, trust in institutions, concerns, and conspiracy beliefs of people.
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Affiliation(s)
- Hassan Soleimanpour
- Emergency Medicine Research Team, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ehsan Sarbazi
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran.
- Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
| | | | - Ahmad Mehri
- Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Saber Ghaffari Fam
- Department of Epidemiology, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Hossein-Ali Nikbakht
- Social Determinants of Health Research Center, Health Research Institute, Department of Biostatistics & Epidemiology, School of Public Health, Babol University of Medical Sciences, Babol, Iran
| | - Mohammad Saadati
- Department of Public Health, Khoy University of Medical Sciences, Khoy, Iran
| | - Saman Sedighi
- Department of Neurosurgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Mohebat Vali
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hosein Azizi
- Women's Reproductive Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
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Cordella B, Signore F, Andreassi S, De Dominicis S, Gennaro A, Iuso S, Mannarini T, Kerusauskaite S, Kosic A, Reho M, Rochira A, Rocchi G, Salvatore S. How socio-institutional contexts and cultural worldviews relate to COVID-19 acceptance rates: A representative study in Italy. Soc Sci Med 2023; 320:115671. [PMID: 36702028 PMCID: PMC9839458 DOI: 10.1016/j.socscimed.2023.115671] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 12/09/2022] [Accepted: 01/09/2023] [Indexed: 01/15/2023]
Abstract
RATIONALE Despite its importance to counter the COVID-19 pandemic, vaccination has raised hesitation in large segments of the population. This hesitation makes it important to understand the mechanisms underlying vaccine acceptance. To this end, the study adopts the Semiotic Cultural Psychology Theory, holding that social behaviors - and therefore, vaccination acceptance - depend on the cultural meanings in terms of which people interpret the social world. OBJECTIVE The study aims at estimating the impact a) of the way people interpret the socio-institutional context of the pandemic and b) of the underlying cultural worldviews on vaccine acceptance. More particularly, the study tested the three following hypotheses. a) The meanings grounding the interpretation of the socio-institutional framework - that is, trust in institutions and political values - are an antecedent of vaccination acceptance. b) The impact of these meanings is moderated by the cultural worldviews (operationalized as symbolic universes). And c), the magnitude of the symbolic universes' moderator effect depends on the uncertainty to which the respondent is exposed. The exposure to uncertainty was estimated in terms of socioeconomic status - the lower the status, the high the exposure to uncertainty. METHODS An Italian representative sample (N = 3020) completed a questionnaire, measuring vaccination acceptance, the meanings attributed to the socio-institutional context - that is, political values and trust in institutions - and symbolic universes. RESULTS The findings were consistent with the hypotheses. a) Structural equation modelling proved that vaccine acceptance was predicted by trust in institutions. b) Multigroup analysis revealed that symbolic universes moderated the correlation between trust in institutions and vaccine acceptance. And c), the moderation effect of symbolic universes proved to occur only in the segment of lower socio-economic status (i.e., the group exposed to higher uncertainty). CONCLUSIONS Vaccination acceptance is not only a medical issue; it is also dependent upon the rationalization of the socio-institutional context. Implications for the promotion of vaccination acceptance are discussed.
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Affiliation(s)
- Barbara Cordella
- Department of Dynamic and Clinical Psychology, And Health Studies, Sapienza University of Rome, Via Degli Apuli, 1, 00183, Rome, Italy
| | - Fulvio Signore
- Department of Human and Social Sciences, University of Salento, Via di Valesio 24, 73100, Lecce, Italy
| | - Silvia Andreassi
- Department of Dynamic and Clinical Psychology, And Health Studies, Sapienza University of Rome, Via Degli Apuli, 1, 00183, Rome, Italy
| | | | - Alessandro Gennaro
- Department of Dynamic and Clinical Psychology, And Health Studies, Sapienza University of Rome, Via Degli Apuli, 1, 00183, Rome, Italy
| | - Salvatore Iuso
- Department of Clinical and Experimental Medicine, University of Foggia, Via A. Gramsci, N. 89/91, 71122, Foggia, Italy
| | - Terri Mannarini
- Department of Human and Social Sciences, University of Salento, Via di Valesio 24, 73100, Lecce, Italy
| | - Skaiste Kerusauskaite
- Department of Dynamic and Clinical Psychology, And Health Studies, Sapienza University of Rome, Via Degli Apuli, 1, 00183, Rome, Italy
| | - Ankica Kosic
- Department of Developmental and Social Psychology, Sapienza University of Rome, Via Dei Marsi, 78, 00185, Rome, Italy
| | - Matteo Reho
- Department of Dynamic and Clinical Psychology, And Health Studies, Sapienza University of Rome, Via Degli Apuli, 1, 00183, Rome, Italy
| | - Alessia Rochira
- Department of Human and Social Sciences, University of Salento, Via di Valesio 24, 73100, Lecce, Italy
| | - Giulia Rocchi
- Department of Dynamic and Clinical Psychology, And Health Studies, Sapienza University of Rome, Via Degli Apuli, 1, 00183, Rome, Italy
| | - Sergio Salvatore
- Department of Human and Social Sciences, University of Salento, Via di Valesio 24, 73100, Lecce, Italy.
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21
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Olbrich Neto J, Olbrich SRLR. Attitudes, hesitancy, concerns, and inconsistencies regarding vaccines reported by parents of preschool children. REVISTA PAULISTA DE PEDIATRIA : ORGAO OFICIAL DA SOCIEDADE DE PEDIATRIA DE SAO PAULO 2023; 41:e2022009. [PMID: 36921172 PMCID: PMC10014028 DOI: 10.1590/1984-0462/2023/41/2022009] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 07/26/2022] [Indexed: 03/16/2023]
Abstract
OBJECTIVE This study aimed to assess attitudes, concerns, information and knowledge about vaccines among parents of preschool children attending kindergartens in a city in the interior of São Paulo, Brazil, using a self-administered questionnaire. METHODS Cross-sectional, questionnaire-based study of knowledge and attitudes regarding vaccination among parents of children aged up to 72 months from public and private schools, between 2018 and 2019. RESULTS Among the 2,528 questionnaires, 1,261 were answered and grouped by respondents' educational level. According to information, 96.6% of the children were up to date with vaccines. The prevalence of vaccine hesitancy was 5.0%. The lower the educational level, the lower was the income, the larger the number of household members, and the greater the lack of knowledge about vaccines. The higher the educational level, the lower was the vaccine hesitancy, and the greater the dissatisfaction with the information received. CONCLUSIONS Generally, parents consider vaccines to be important for preventing diseases and to be safe, with their benefits outweighing the risks. Positive comments were accompanied by doubts, concerns, hesitancy, and inconsistencies. The level of educational attainment makes a difference in the access to information, medical care provided by pediatricians, and the feeling of obligation to vaccinate. Parents have vaccinated and still intend to vaccinate their children, but ensuring adequate levels of vaccination coverage will be a post-pandemic challenge.
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Affiliation(s)
- Jaime Olbrich Neto
- Universidade Estadual Paulista "Júlio de Mesquita Filho", Botucatu, SP, Brazil
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22
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Ferreira LS, Darcie Marquitti FM, Paixão da Silva RL, Borges ME, Ferreira da Costa Gomes M, Cruz OG, Kraenkel RA, Coutinho RM, Prado PI, Bastos LS. Estimating the impact of implementation and timing of the COVID-19 vaccination programme in Brazil: a counterfactual analysis. LANCET REGIONAL HEALTH. AMERICAS 2023; 17:100397. [PMID: 36439909 PMCID: PMC9676113 DOI: 10.1016/j.lana.2022.100397] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 09/30/2022] [Accepted: 10/27/2022] [Indexed: 11/22/2022]
Abstract
Background Vaccines developed between 2020 and 2021 against the SARS-CoV-2 virus were designed to diminish the severity and prevent deaths due to COVID-19. However, estimates of the effectiveness of vaccination campaigns in achieving these goals remain a methodological challenge. In this work, we developed a Bayesian statistical model to estimate the number of deaths and hospitalisations averted by vaccination of older adults (above 60 years old) in Brazil. Methods We fit a linear model to predict the number of deaths and hospitalisations of older adults as a function of vaccination coverage in this group and casualties in younger adults. We used this model in a counterfactual analysis, simulating alternative scenarios without vaccination or with faster vaccination roll-out. We estimated the direct effects of COVID-19 vaccination by computing the difference between hypothetical and realised scenarios. Findings We estimated that more than 165,000 individuals above 60 years of age were not hospitalised due to COVID-19 in the first seven months of the vaccination campaign. An additional contingent of 104,000 hospitalisations could have been averted if vaccination had started earlier. We also estimated that more than 58 thousand lives were saved by vaccinations in the period analysed for the same age group and that an additional 47 thousand lives could have been saved had the Brazilian government started the vaccination programme earlier. Interpretation Our estimates provided a lower bound for vaccination impacts in Brazil, demonstrating the importance of preventing the suffering and loss of older Brazilian adults. Once vaccines were approved, an early vaccination roll-out could have saved many more lives, especially when facing a pandemic. Funding The Coordenação de Aperfeiçoamento de Pessoal de Nível Superior-Brazil (Finance Code 001 to F.M.D.M. and L.S.F.), Conselho Nacional de Desenvolvimento Científico e Tecnológico - Brazil (grant number: 315854/2020-0 to M.E.B., 141698/2018-7 to R.L.P.d.S., 313055/2020-3 to P.I.P., 311832/2017-2 to R.A.K.), Fundação de Amparo à Pesquisa do Estado de São Paulo - Brazil (contract number: 2016/01343-7 to R.A.K.), Fundação de Amparo à Pesquisa do Estado do Rio de Janeiro - Brazil (grant number: E-26/201.277/2021 to L.S.B.) and Inova Fiocruz/Fundação Oswaldo Cruz - Brazil (grant number: 48401485034116) to L.S.B., O.G.C. and M.G.d.F.C. The funding agencies had no role in the conceptualization of the study.
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Affiliation(s)
- Leonardo Souto Ferreira
- Instituto de Física Teórica, Universidade Estadual Paulista, São Paulo, Brazil,Observatório COVID-19 BR, Brazil
| | - Flavia Maria Darcie Marquitti
- Observatório COVID-19 BR, Brazil,Instituto de Física ‘Gleb Wataghin’ and Instituto de Biologia, Universidade Estadual de Campinas, Campinas, Brazil,Corresponding author. Instituto de Física ‘Gleb Wataghin’, Rua Sérgio Buarque de Holanda, 777 - Cidade Universitária, Universidade Estadual de Campinas, Campinas, Brazil Zip-code: 13083-859
| | - Rafael Lopes Paixão da Silva
- Instituto de Física Teórica, Universidade Estadual Paulista, São Paulo, Brazil,Observatório COVID-19 BR, Brazil
| | | | | | - Oswaldo Gonçalves Cruz
- Observatório COVID-19 BR, Brazil,Fundação Oswaldo Cruz, Programa de Computação Científica, Rio de Janeiro, Brazil
| | - Roberto André Kraenkel
- Instituto de Física Teórica, Universidade Estadual Paulista, São Paulo, Brazil,Observatório COVID-19 BR, Brazil
| | - Renato Mendes Coutinho
- Observatório COVID-19 BR, Brazil,Centro de Matemática, Computação e Cognição, Universidade Federal do ABC, Santo André, Brazil
| | - Paulo Inácio Prado
- Observatório COVID-19 BR, Brazil,Instituto de Biociências, Universidade de São Paulo, São Paulo, Brazil
| | - Leonardo Soares Bastos
- Observatório COVID-19 BR, Brazil,Fundação Oswaldo Cruz, Programa de Computação Científica, Rio de Janeiro, Brazil
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Soysal G, Akdur R. Investigating Vaccine Hesitancy and Refusal Among Parents of Children Under Five: A Community-based Study. GÜNCEL PEDIATRI 2022. [DOI: 10.4274/jcp.2022.01488] [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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24
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Carvalho EDM, Santos Junior MAD, Neves LFF, Oliveira TMD, Massarani L, Carvalho MS. [Vaccines and social media: a debate around vaccines on Instagram and Facebook during the COVID-19 pandemic (2020-2021)]. CAD SAUDE PUBLICA 2022; 38:e00054722. [PMID: 36541963 DOI: 10.1590/0102-311xpt054722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 10/14/2022] [Indexed: 12/23/2022] Open
Abstract
Considering that the Internet and especially social media work as a locus for the circulation of information on COVID-19, this study aimed to assess the attention given to the vaccine theme on Instagram and Facebook in posts throughout two years of pandemic, identifying the temporality in which discussion about the different immunizing agents in social media and highlighting the actors who permeated the discussions on the subject. Data were collected using the CrowdTangle graphical interface, based on search terms in Portuguese related to vaccines approved for use in Brazil and it included posts from public Facebook pages and open Instagram profiles made from January 1st, 2020, to December 31st, 2021. The database included 3,876,408 posts (2,901,457 on Facebook and 974,952 on Instagram). The results showed an alternation of Pfizer, CoronaVac, AstraZeneca, and Janssen vaccines as the focus of discussion, following the public debate established in the country around the dilemmas and advances related to the development, production, distribution, and application of immunizing agents. References to institutions involved in the acquisition and production of immunizing agents were also identified, such as the Brazilian Ministry of Health, the Butantan Institute, and the Oswaldo Cruz Foundation, present among the thousand social actors that most generated comments from users in both networks. It was evidenced that the debate on immunizing agents, in the analyzed channels and period, was permeated by social media related to journalism and politicians and celebrities' pages and profiles.
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Affiliation(s)
| | | | | | | | - Luisa Massarani
- Casa de Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil.,Instituto Nacional de Comunicação Pública da Ciência e Tecnologia, Rio de Janeiro, Brasil
| | - Marilia Sá Carvalho
- Programa de Computação Científica, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil
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25
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Bussink-Voorend D, Hautvast JLA, Vandeberg L, Visser O, Hulscher MEJL. A systematic literature review to clarify the concept of vaccine hesitancy. Nat Hum Behav 2022; 6:1634-1648. [PMID: 35995837 DOI: 10.1038/s41562-022-01431-6] [Citation(s) in RCA: 64] [Impact Index Per Article: 32.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 07/13/2022] [Indexed: 11/25/2022]
Abstract
Vaccine hesitancy (VH) is considered a top-10 global health threat. The concept of VH has been described and applied inconsistently. This systematic review aims to clarify VH by analysing how it is operationalized. We searched PubMed, Embase and PsycINFO databases on 14 January 2022. We selected 422 studies containing operationalizations of VH for inclusion. One limitation is that studies of lower quality were not excluded. Our qualitative analysis reveals that VH is conceptualized as involving (1) cognitions or affect, (2) behaviour and (3) decision making. A wide variety of methods have been used to measure VH. Our findings indicate the varied and confusing use of the term VH, leading to an impracticable concept. We propose that VH should be defined as a state of indecisiveness regarding a vaccination decision.
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Affiliation(s)
- Daphne Bussink-Voorend
- Radboud University Medical Center, Radboud Institute for Health Sciences, Primary and Community Care, Nijmegen, the Netherlands.
| | - Jeannine L A Hautvast
- Radboud University Medical Center, Radboud Institute for Health Sciences, Primary and Community Care, Nijmegen, the Netherlands
| | - Lisa Vandeberg
- Behavioural Science Institute, Radboud University, Nijmegen, the Netherlands
| | - Olga Visser
- Radboud University Medical Center, Radboud Institute for Health Sciences, Primary and Community Care, Nijmegen, the Netherlands
| | - Marlies E J L Hulscher
- Radboud University Medical Center, Radboud Institute for Health Sciences, IQ Healthcare, Nijmegen, the Netherlands
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26
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de Medeiros PM, Muniz de Medeiros P. Fake news mediate the relationship between sociopolitical factors and vaccination intent in Brazil. Health Promot Int 2022; 37:6827741. [DOI: 10.1093/heapro/daac110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Summary
Vaccination hesitancy has become a central concern and is a barrier to overcoming the coronavirus disease (COVID-19) crisis. Studies have indicated that mis/disinformation plays a role on the attitudes and behaviours towards vaccination. However, further formal statistical models are required to investigate how fake news relates to vaccination intent and how they mediate the relationship between socioeconomic/political factors and vaccination intent. We studied a sample of 500 Brazilians and found that people were mostly not susceptible to vaccine mis/disinformation. In addition, we found that their vaccination intent was high. However, suspicions that fake news could be true raised doubts over the vaccination intention. Although age and political orientation directly influenced vaccination intent, we found that the relationship between socioeconomic/political factors and vaccination intent was strongly mediated by belief in fake news. Our results raise the need to create multiple strategies to combat the dissemination and acceptance of such content.
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Affiliation(s)
- Priscila Muniz de Medeiros
- Instituto de Ciências Humanas, Comunicação e Arte, Universidade Federal de Alagoas , Av. Lourival Melo Mota, S/N—Tabuleiro dos Martins, 57072-900, Maceió, Alagoas , Brazil
| | - Patrícia Muniz de Medeiros
- Campus de Engenharias e Ciências Agrárias, Universidade Federal de Alagoas , BR 104, Mata do Rolo, 57100000, Rio Largo, Alagoas , Brazil
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27
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Jiang F, Zhao Y, Bai J, Yang X, Zhang J, Lin D, Li X. Perceived health literacy and COVID-19 vaccine acceptance among Chinese college students: A mediation analysis. PLoS One 2022; 17:e0273285. [PMID: 36054110 PMCID: PMC9439250 DOI: 10.1371/journal.pone.0273285] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 08/05/2022] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Although COVID-19 vaccines hold the potential to dramatically alter the COVID-19 pandemic, vaccine hesitancy remains a serious threat to the management and control of COVID-19 infections. Vaccination of young adults plays a crucial role in achieving herd immunity. However, the determinants of COVID-19 vaccine acceptance among the youth in China have not been fully explored. Our study aims to investigate the direct and indirect effects of perceived health literacy on COVID-19 vaccine acceptance. METHODS This survey was conducted among Chinese college students during September and October, 2020. COVID-19 vaccine acceptance was defined as the likelihood that participants would get a COVID-19 vaccine. A mediation analysis was employed to explore the direct and indirect effects of perceived health literacy on COVID-19 vaccine acceptance. RESULTS A total of 2,587 college students were included in our study. The results of the survey revealed that the majority (80.40%) of the participants expressed high COVID-19 vaccine acceptance. After controlling for demographic characteristics, the relationship between perceived health literacy and COVID-19 vaccine acceptance was mediated by positive attitudes toward general vaccination (std.β = 0.004, p = 0.037) and self-efficacy of COVID-19 vaccine (std.β = 0.053, p < 0.001). CONCLUSIONS The findings suggest that interventions targeting health literacy to promote COVID-19 vaccination coverage might consider placing greater emphasis on enhancing the positive attitude towards and self-efficacy of vaccines among youth.
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Affiliation(s)
- Fangfang Jiang
- Department of Mathematical Sciences, School of Social Sciences, University of Southampton, Southampton, Hampshire, United Kingdom
| | - Yang Zhao
- Department of Epidemiology and Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Jianling Bai
- Department of Epidemiology and Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Xueying Yang
- South Carolina SmartState Center for Healthcare Quality, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, United States of America
- Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, United States of America
| | - Jiajia Zhang
- South Carolina SmartState Center for Healthcare Quality, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, United States of America
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, United States of America
| | - Danhua Lin
- Institute of Developmental Psychology, Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Xiaoming Li
- South Carolina SmartState Center for Healthcare Quality, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, United States of America
- Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, United States of America
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Evaluation of early innate and adaptive immune responses to the TB vaccine Mycobacterium bovis BCG and vaccine candidate BCGΔBCG1419c. Sci Rep 2022; 12:12377. [PMID: 35858977 PMCID: PMC9300728 DOI: 10.1038/s41598-022-14935-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 05/03/2022] [Indexed: 12/30/2022] Open
Abstract
The vaccine Mycobacterium bovis Bacillus Calmette-Guérin (BCG) elicits an immune response that is protective against certain forms of tuberculosis (TB); however, because BCG efficacy is limited it is important to identify alternative TB vaccine candidates. Recently, the BCG deletion mutant and vaccine candidate BCGΔBCG1419c was demonstrated to survive longer in intravenously infected BALB/c mice due to enhanced biofilm formation, and better protected both BALB/c and C57BL/6 mice against TB-induced lung pathology during chronic stages of infection, relative to BCG controls. BCGΔBCG1419c-elicited protection also associated with lower levels of proinflammatory cytokines (i.e. IL6, TNFα) at the site of infection in C57BL/6 mice. Given the distinct immune profiles of BCG- and BCGΔBCG1419c-immunized mice during chronic TB, we set out to determine if there are early immunological events which distinguish these two groups, using multi-dimensional flow cytometric analysis of the lungs and other tissues soon after immunization. Our results demonstrate a number of innate and adaptive response differences between BCG- and BCGΔBCG1419c-immunized mice which are consistent with the latter being longer lasting and potentially less inflammatory, including lower frequencies of exhausted CD4+ T helper (TH) cells and higher frequencies of IL10-producing T cells, respectively. These studies suggest the use of BCGΔBCG1419c may be advantageous as an alternative TB vaccine candidate.
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29
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Santos Júnior CJD, Costa PJMDS. [Cross-cultural adaptation and validation for Brazilian Portuguese of the Parent Attitudes about the Childhood Vaccine (PACV) questionnaire]. CIENCIA & SAUDE COLETIVA 2022; 27:2057-2070. [PMID: 35544831 DOI: 10.1590/1413-81232022275.11802021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Accepted: 07/29/2021] [Indexed: 11/22/2022] Open
Abstract
Despite vaccine hesitancy being a recognized problem in Brazil, the extent of the problem is still a challenge. However, it is acknowledged that identifying parents who are hesitant about vaccines is a fundamental condition for the implementation of efficient health communication programs. Thus, the scope of this work was to carry out the cross-cultural adaptation and validation of the Parent Attitudes About Childhood Vaccine (PACV) questionnaire in Brazilian Portuguese. It is a cross-cultural adaptation study with the following steps: translation, synthesis, back-translation, quality assessment, expert committee, pre-test, reliability assessment and, finally, submission and approval. After carrying out these steps, it was observed that, in the evaluation of the Content Validity Index (CVI), no PACV question obtained CVI<0.80 in the dimensions of semantic, idiomatic, conceptual and cultural equivalence. In the global IVC, the Brazilian version of the PACV reached 0.91, indicating good interappraiser agreement and evidence of content-based validity. Cronbach's alpha for the instrument was 0.91. The PACV was adapted to Brazilian Portuguese, giving rise to the PAVC-Brasil version, which presented evidence of content-based validity, in addition to good internal consistency.
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Affiliation(s)
- Claudio José Dos Santos Júnior
- Programa de Pós-Graduação em Ensino em Saúde e Tecnologia, Universidade Estadual de Ciências da Saúde de Alagoas (UNCISAL). R. Dr. Jorge de Lima 113, Trapiche da Barra. 57010-300 Maceió AL Brasil. claudiosantos_al@ hotmail.com
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30
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The Attitudes of Undergraduate Nursing Students to Childhood Vaccines. JOURNAL OF CONTEMPORARY MEDICINE 2022. [DOI: 10.16899/jcm.1033147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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31
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Gökçe A, Karakaş N, Özer A, Bentli R. Investigation of knowledge, attitude and behaviours of parents refusing childhood vaccines in Malatya, an eastern city of Turkey. Cent Eur J Public Health 2021; 29:183-186. [PMID: 34623116 DOI: 10.21101/cejph.a6153] [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: 02/23/2020] [Accepted: 07/27/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVES The modern rise of vaccine rejection in society can alter the current progress that has been made towards the control and prevention of certain diseases, possibly even resulting in epidemics involving these preventable diseases. The aim of this study is to analyse the knowledge, attitude and behaviours of parents in Malatya city who rejected childhood vaccines. METHODS This descriptive, cross-sectional study was conducted between September-November 2019. The study includes parents who rejected vaccines and are registered in the family medicine clinics of Malatya city - total of 453 participants. The objective was to include all parents and avoid a sampling procedure. However, only 151 (33%) parents agreed to participate. These parents who rejected vaccines were individually contacted by phone. Descriptive data was represented by number (n) and percentage (%). The chi-square test was utilized in the statistical analysis of data and p < 0.05 was considered significant in all evaluations. RESULTS Mothers in the study group had a mean age of 26.07 ± 3.64, while the fathers were on average 30.03 ± 4.59 years of age; 98% of parents were aware of the health risks that vaccine rejection presented; 93% of parents were not satisfied with the explanation, insight, and advice that the healthcare personnel provided regarding vaccines. All parents of the study group stated the following: vaccines should not be administered because other children in their close environment acquired a disease as a result of vaccination, vaccines can harm the immune system of children - not yet fully developed, vaccines are unsafe and endanger the health of children. CONCLUSIONS It can be said that parents who have obtained a lot of false information possess altered decisions and views on vaccinations, to the point where they accept the risks presented by preventable diseases. In addition, individuals lose trust following negative experiences with vaccination.
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Affiliation(s)
- Ayşe Gökçe
- Bingol Provincial Health Directorate, Bingol, Turkey
| | - Neşe Karakaş
- Department of Emergency Aid and Disaster Management, Faculty of Health Sciences, Turgut Ozal University, Malatya, Turkey
| | - Ali Özer
- Department of Public Health, Medical Faculty, Inonu University, Malatya, Turkey
| | - Recep Bentli
- Malatya Provincial Health Directorate, Malatya, Turkey
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Moore DCBC, Nehab MF, Camacho KG, Reis AT, Junqueira-Marinho MDF, Abramov DM, Azevedo ZMAD, Menezes LAD, Salú MDS, Figueiredo CEDS, Moreira MEL, Vasconcelos ZFMD, Carvalho FAAD, Mello LDRD, Correia RF, Junior SCDSG. Low COVID-19 vaccine hesitancy in Brazil. Vaccine 2021; 39:6262-6268. [PMID: 34535318 PMCID: PMC8421107 DOI: 10.1016/j.vaccine.2021.09.013] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 09/02/2021] [Accepted: 09/03/2021] [Indexed: 12/29/2022]
Abstract
Background The COVID-19 pandemic has affected the entire world, and the vaccine has emerged as a source of hope for return to normal life. Still, various countries have reported high vaccine hesitancy rates. It is important to know the vaccine hesitancy profile in Brazil to help design adequate communication strategies. Methods A voluntary, anonymous online survey was conducted from January 22 to 29, 2021, including resident Brazilian adults to assess factors related to vaccine hesitancy. Sociodemographic and epidemiological data were analyzed. A bivariate analysis was conducted with the independent variables, with vaccine hesitancy as the outcome variable, and a multivariate logistic model was used to calculated adjusted odds ratios. Results The sample included 173,178 respondents, and vaccine hesitancy was found in 10.5%. The principal factors associated with vaccine hesitancy were the following: assigning importance to the vaccinés efficacy (AOR = 16.39), fear of adverse reactions (AOR = 11.23), and assigning importance to the vaccinés country of origin (AOR = 3.72). Other risk factors were the following: male gender (AOR = 1.62), having children (AOR = 1.29), 9 years of schooling or less (AOR = 1.31), living in the Central-West region (AOR = 1.19), age ≥ 40 years (AOR = 1.17), and monthly income < U$788.68 (AOR = 1.13). The two vaccines available in Brazil, Covishield and CoronaVac, showed similar confidence, 80.13% and 76.36%, respectively, despite the higher rejection of the latter vaccinés Chinese origin. Interpretation This online survey confirms the low vaccine hesitancy rate among Brazilians and allowed the identification of a profile that can assist the elaboration of communication strategies to increase vaccine adherence. Funding National Institute of Women, Children and Adolescents Health Fernandes Figueira, FIOCRUZ, Rio de Janeiro, Brazil.
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Affiliation(s)
- Daniella Campelo Batalha Cox Moore
- National Institute of Women, Children and Adolescents' Health Fernandes Figueira, FIOCRUZ, Avenue Rui Barbosa, 716, Flamengo, Rio de Janeio, RJ 22250-020, Brazil; Fluminense Federal University, faculty of Medicine, Internal Medicine Department.
| | - Marcio Fernandes Nehab
- National Institute of Women, Children and Adolescents' Health Fernandes Figueira, FIOCRUZ, Avenue Rui Barbosa, 716, Flamengo, Rio de Janeio, RJ 22250-020, Brazil.
| | - Karla Gonçalves Camacho
- National Institute of Women, Children and Adolescents' Health Fernandes Figueira, FIOCRUZ, Avenue Rui Barbosa, 716, Flamengo, Rio de Janeio, RJ 22250-020, Brazil
| | - Adriana Teixeira Reis
- National Institute of Women, Children and Adolescents' Health Fernandes Figueira, FIOCRUZ, Avenue Rui Barbosa, 716, Flamengo, Rio de Janeio, RJ 22250-020, Brazil; State University of Rio de Janeiro, Department of perinatology, Rio de Janeiro.
| | - Maria de Fátima Junqueira-Marinho
- National Institute of Women, Children and Adolescents' Health Fernandes Figueira, FIOCRUZ, Avenue Rui Barbosa, 716, Flamengo, Rio de Janeio, RJ 22250-020, Brazil
| | - Dimitri Marques Abramov
- National Institute of Women, Children and Adolescents' Health Fernandes Figueira, FIOCRUZ, Avenue Rui Barbosa, 716, Flamengo, Rio de Janeio, RJ 22250-020, Brazil.
| | - Zina Maria Almeida de Azevedo
- National Institute of Women, Children and Adolescents' Health Fernandes Figueira, FIOCRUZ, Avenue Rui Barbosa, 716, Flamengo, Rio de Janeio, RJ 22250-020, Brazil; University of Grande Rio, Medicine faculty UNIGRANRIO
| | - Livia Almeida de Menezes
- National Institute of Women, Children and Adolescents' Health Fernandes Figueira, FIOCRUZ, Avenue Rui Barbosa, 716, Flamengo, Rio de Janeio, RJ 22250-020, Brazil.
| | - Margarida Dos Santos Salú
- National Institute of Women, Children and Adolescents' Health Fernandes Figueira, FIOCRUZ, Avenue Rui Barbosa, 716, Flamengo, Rio de Janeio, RJ 22250-020, Brazil.
| | - Carlos Eduardo da Silva Figueiredo
- National Institute of Women, Children and Adolescents' Health Fernandes Figueira, FIOCRUZ, Avenue Rui Barbosa, 716, Flamengo, Rio de Janeio, RJ 22250-020, Brazil.
| | - Maria Elisabeth Lopes Moreira
- National Institute of Women, Children and Adolescents' Health Fernandes Figueira, FIOCRUZ, Avenue Rui Barbosa, 716, Flamengo, Rio de Janeio, RJ 22250-020, Brazil
| | - Zilton Farias Meira de Vasconcelos
- National Institute of Women, Children and Adolescents' Health Fernandes Figueira, FIOCRUZ, Avenue Rui Barbosa, 716, Flamengo, Rio de Janeio, RJ 22250-020, Brazil.
| | - Flavia Amendola Anisio de Carvalho
- National Institute of Women, Children and Adolescents' Health Fernandes Figueira, FIOCRUZ, Avenue Rui Barbosa, 716, Flamengo, Rio de Janeio, RJ 22250-020, Brazil.
| | - Livia de Rezende de Mello
- National Institute of Women, Children and Adolescents' Health Fernandes Figueira, FIOCRUZ, Avenue Rui Barbosa, 716, Flamengo, Rio de Janeio, RJ 22250-020, Brazil
| | - Roberta Fernandes Correia
- National Institute of Women, Children and Adolescents' Health Fernandes Figueira, FIOCRUZ, Avenue Rui Barbosa, 716, Flamengo, Rio de Janeio, RJ 22250-020, Brazil.
| | - Saint Clair Dos Santos Gomes Junior
- National Institute of Women, Children and Adolescents' Health Fernandes Figueira, FIOCRUZ, Avenue Rui Barbosa, 716, Flamengo, Rio de Janeio, RJ 22250-020, Brazil
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Boz G, Gokce A, Yigit E, Aslan M, Ozer A. Knowledge and behaviors of nurses working at Inonu University Turgut Ozal Medical Center on childhood vaccine refusal. Hum Vaccin Immunother 2021; 17:4512-4517. [PMID: 34473585 DOI: 10.1080/21645515.2021.1963170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
Among 10 global problems of 2019 determined by the World Health Organization, vaccine refusal was one of the problems mentioned. In this context, health services and health personnel whose main objectives are to keep individuals healthy and to prevent diseases have major responsibilities. This study aims to analyze knowledge and behavior of nurses working at Inonu University Turgut Ozal Medical Center on childhood vaccine refusal.This study, conducted between June and July 2019, is a descriptive cross-sectional study. It was conducted in a hospital located in Malatya in eastern Turkey. At the time of the study, 850 nurses work in this hospital. Sample size was calculated to be 263 at a confidence interval of 95% and strength of 80%. Chi-square test and Fisher's exact test were used in statistical analyses.In the present study, 31.7% of the participating nurses stated that they had concerns about childhood vaccines. Two-thirds of nurses stated that their knowledge on vaccines was from their education. The level of hesitance in those agreeing to the fact that vaccines caused autism and infertility, those stating that they did not trust vaccine-producing companies, and those stating that catching the disease was a better immunization method than vaccination was significantly higher than those not agreeing to these and those who were indecisive (p < .05).One-third of nurses was proven to have hesitance on childhood vaccines, and this rate is rather high. Nurses, being both health personnel and the communication channel for guiding parents, should be provided necessary training and practices in order to ease their hesitance on vaccination.
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Affiliation(s)
- Gulseda Boz
- Department of Public Health, Medical Faculty, Inonu University, Malatya, Turkey
| | - Ayse Gokce
- Ministry of Health, Bingol Provincial Health Directorate, Bingol, Turkey
| | - Esra Yigit
- Department of Public Health, Medical Faculty, Inonu University, Malatya, Turkey
| | - Mehmet Aslan
- Department of Pediatrics, Medical Faculty, Inonu University, Malatya, Turkey
| | - Ali Ozer
- Department of Public Health, Medical Faculty, Inonu University, Malatya, Turkey
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Silva AMODAD, Santos RCS, Araujo MGS, Silva LHL, Santos DFD. Intramuscular injection safety without aspiration in the ventro-gluteal region during vaccination: randomized clinical trial. Rev Bras Enferm 2021; 75:e20201119. [PMID: 34431926 DOI: 10.1590/0034-7167-2020-1119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Accepted: 03/29/2021] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES to compare adverse events after administrating hepatitis A vaccine intramuscularly in the ventro-gluteal region between techniques with and without aspiration. METHODS randomized double-blind clinical trial, using hepatitis A vaccine (inactivated) in the ventro-gluteal region, with a sample of 74 participants in the intervention group, vaccinated with the slow injection technique without aspiration, and 74 participants in the control group undergoing slow injection with aspiration. Daily assessment of participants was carried out in the 72 hours after vaccination, in order to ascertain local, systemic adverse events, local and contralateral temperatures. RESULTS the occurrence of local and systemic adverse events was homogeneous between the groups in the three days after vaccination (p>0.05). There was no influence of sex, race, pre-existing disease and use of medication. CONCLUSIONS the intramuscular vaccination technique without aspiration in the ventro-gluteal region is safe for adverse events following immunization compared to the conventional technique with aspiration.
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González-Block MÁ, Pelcastre-Villafuerte BE, Riva Knauth D, Fachel-Leal A, Comes Y, Crocco P, Noboa L, Rodríguez Zea B, Ruoti M, Díaz Portillo SP, Sarti E. Influenza vaccination hesitancy in large urban centers in South America. Qualitative analysis of confidence, complacency and convenience across risk groups. PLoS One 2021; 16:e0256040. [PMID: 34383834 PMCID: PMC8360613 DOI: 10.1371/journal.pone.0256040] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 07/28/2021] [Indexed: 12/16/2022] Open
Abstract
Influenza vaccination coverage in countries of Latin America is low among priority risk groups, ranging from 5 to 75% among older people. This paper aims to describe and analyze the determinants of influenza vaccination hesitancy through the lens of the 3C model of confidence, complacency and convenience among middle-class, urban risk group populations in Brazil, Chile, Paraguay, Peru, Uruguay, countries in South America with contrasting vaccination coverage. Focus groups were conducted among four risk groups: pregnant women, mothers of children aged <6 years, adults with risk factors, and adults aged ≥60 years in samples of urban residents. Adults with risk factors expressed the most detailed perceptions about confidence in the vaccine. A wide range of perceptions regarding complacency were expressed across risk groups and countries, with pregnant women and mothers showing greater concerns while convenience had a narrower and generally more positive range of perceptions. Participants from Chile and Paraguay expressed the most contrasts regarding confidence and complacency. Information and communication strategies need to be tailored for risk groups while confidence and complacency should be addressed in synergy.
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Affiliation(s)
- Miguel Ángel González-Block
- Universidad Anáhuac, Mexico City, Mexico
- Instituto Nacional de Salud Pública, Cuernavaca, Mexico
- Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- * E-mail:
| | | | | | | | - Yamila Comes
- Maestría en Sistemas de Salud y Seguridad social, Universidad ISALUD, Buenos Aires, Argentina
| | - Pedro Crocco
- Escuela de Salud Pública de Chile, Santiago, Chile
| | - Laura Noboa
- Facultad de Ciencias Sociales, Universidad de la República, Montevideo, Uruguay
| | | | | | | | - Elsa Sarti
- Sanofi Pasteur LATAM, Mexico City, Mexico
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Lu X, Lu J, Zhang L, Mei K, Guan B, Lu Y. Gap between willingness and behavior in the vaccination against influenza, pneumonia, and herpes zoster among Chinese aged 50-69 years. Expert Rev Vaccines 2021; 20:1147-1152. [PMID: 34287096 DOI: 10.1080/14760584.2021.1954910] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Vaccination uptake of influenza vaccine, 23-valent pneumococcal polysaccharide vaccine (PPV23) and herpes zoster vaccine (HZV) remains low among Chinese aged 50-69 years, posing a significant public health concern. This study's aim is to determine the gap between the vaccination willingness and uptake. RESEARCH DESIGN AND METHODS We conducted a face-to-face questionnaire survey among the persons aged 50-69 years in 13 communities in Shanghai in November-December 2020 to measure vaccination willingness, vaccine price sensitivity, vaccination service accessibility, and vaccine hesitancy. Then, we explored the factors influencing the vaccination uptake using a structural equation model. RESULTS Vaccination willingness was 70.5% (self-paid influenza vaccine), 79.4% (free PPV23 for local persons), 54.7% (self-paid PPV23 for non-local persons), and 16.6% (self-paid HZV); however, actual uptake was 10.8% (influenza vaccine), 11.0% (free PPV23), and 2.5% (self-paid PPV23). Moreover, vaccination uptake was strongly influenced by service accessibility (β = 0.941), followed by willingness (β = 0.201), price sensitivity (β = -0.188), and medical history of vaccine-preventable diseases and underlying diseases (β = 0.176). Related knowledge (β = 0.017) and vaccine hesitancy (β = -0.003) affected the uptake indirectly. CONCLUSION There is a gap between the vaccination willingness and uptake in Chinese elderly. It warrants specific measures, including increasing service accessibility and reforming payment mechanism, to bridge the gap.
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Affiliation(s)
- Xinyue Lu
- Department of Epidemiology, Ministry of Education Key Laboratory of Public Health Safety, Fudan School of Public Health, Shanghai, China
| | - Jia Lu
- Department of Immunization Planning, Minhang District Center for Disease Control and Prevention, Shanghai, China.,Minhang Branch, Fudan School of Public Health, Shanghai, China
| | - Liping Zhang
- Department of Immunization Planning, Minhang District Center for Disease Control and Prevention, Shanghai, China.,Minhang Branch, Fudan School of Public Health, Shanghai, China
| | - Kewen Mei
- Department of Immunization Planning, Minhang District Center for Disease Control and Prevention, Shanghai, China.,Minhang Branch, Fudan School of Public Health, Shanghai, China
| | - Baichu Guan
- Department of Epidemiology, Ministry of Education Key Laboratory of Public Health Safety, Fudan School of Public Health, Shanghai, China
| | - Yihan Lu
- Department of Epidemiology, Ministry of Education Key Laboratory of Public Health Safety, Fudan School of Public Health, Shanghai, China
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Gentile A, Pacchiotti AC, Giglio N, Nolte MF, Talamona N, Rogers V, Berenstein A, Castellano VE. Vaccine hesitancy in Argentina: Validation of WHO scale for parents. Vaccine 2021; 39:4611-4619. [PMID: 34238609 DOI: 10.1016/j.vaccine.2021.06.080] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 06/17/2021] [Accepted: 06/25/2021] [Indexed: 01/22/2023]
Abstract
BACKGROUND The WHO SAGE Working Group on Vaccine Hesitancy developed the Vaccine Hesitancy Scale (VHS) to identify and compare hesitancy in different global settings. The objectives of the study were to describe and analyze vaccine hesitancy and to validate the VHS in a group of parents in Buenos Aires city, Argentina. METHODS A cross-sectional survey was conducted in parents of 1-3 and 12-15 year-old children at three health centres in Buenos Aires City, between June 2018 and May 2019. Sociodemographic data were collected together with history of refusal and/or delay in children's vaccination (defined as hesitancy). The 10-item VHS using 5-point Likert-scale (higher scores indicating lower hesitancy) was administered and children's immunization record cards were verified. Link between hesitancy and socio-demographic variables, and hesitancy and vaccination status was analyzed for five specific vaccines. Cronbach's α was used to determine internal consistency reliability and factor analysis to confirm survey subdomains. Simple and multiple regression analysis was used to examine associations between VHS scores and hesitancy, and VHS scores and vaccination status. RESULTS Six hundred parents were surveyed and 469 immunization cards verified; 11.5% (n = 69) parents were hesitant. High maternal educational level showed significant association with hesitancy (OR 2.66 95% CI: 1.20-5.9) in the adjusted model. Hesitancy was significantly associated with incomplete MMR vaccination in children (OR 4.43 95% CI: 1.08-8.20) and HPV vaccination in adolescents (OR 3.75 95% CI: 1.54-9.12). Cronbach's α was 0.66 and factor analysis identified three underlying constructs: "Benefits", "Harms" and "Confidence in healthcare system". High scores in VHS were associated with lack of hesitancy (OR 1.2 95% CI: 1.13-1.27) and complete vaccination status (OR 1.07 95% CI: 1.02-1.12). CONCLUSIONS Hesitancy was associated with high maternal educational level, and incomplete MMR and HPV immunization status in children and adolescents. VHS was a reliable and valid tool in this population.
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Affiliation(s)
- Angela Gentile
- Hospital de Niños Ricardo Gutiérrez, Gallo 1330, C1425EFD Buenos Aires, Argentina
| | | | - Norberto Giglio
- Hospital de Niños Ricardo Gutiérrez, Gallo 1330, C1425EFD Buenos Aires, Argentina
| | | | - Natalia Talamona
- Hospital de Niños Ricardo Gutiérrez, Gallo 1330, C1425EFD Buenos Aires, Argentina
| | - Viviana Rogers
- Hospital Alemán, Pueyrredon 1640, C1118AAT Buenos Aires, Argentina
| | - Ada Berenstein
- Centro de Salud y Acción Comunitaria N° 15, Humberto 1° 470, C1103ACJ Buenos Aires, Argentina
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Ilogu LC, Lugovska O, Vojtek I, Prugnola A, Callegaro A, Mazzilli S, Van Damme P. The intent of students to vaccinate is influenced by cultural factors, peer network, and knowledge about vaccines. Hum Vaccin Immunother 2021; 18:1938492. [PMID: 34191678 PMCID: PMC8920151 DOI: 10.1080/21645515.2021.1938492] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Young adults are the future vaccine decision-makers as parents or health-care professionals. To understand their attitudes and behaviors toward vaccination, we conducted a cross-sectional survey of 2079 students attending the University of Antwerp, Belgium and the University of Pisa, Italy. Principal component analysis was used to investigate associations between survey responses and the intent to vaccinate. Vaccination knowledge, attitudes, and behaviors among university students in Italy and Belgium were high. However, only one-half of respondents displayed an intent to vaccinate. High levels of knowledge, positive attitudes, and confidence in vaccines were positively associated with age, higher level of study, being a medical student, a recent vaccination experience, and not knowing trusted persons who did not believe in vaccines. Country of origin was highly correlated with the survey responses and was clustered with lifestyle, family, and data source variables, suggesting a strong modifying effect of culture and family attitudes on how vaccines are perceived in this age-group. Recent meningococcal vaccination campaigns and public discussions around mandatory vaccination in Italy may have influenced these results. We show that the intent to vaccinate was correlated with two main clusters of variables linked to culture (country, family, lifestyle), and to scholarship (knowledge, attitudes, data source) that together influence the behavior of students with respect to vaccination. Our study reinforces previous findings that knowledge about vaccines is key to shaping attitudes and behaviors, but also shows that cultural and lifestyle factors are another platform that could be leveraged in promoting vaccination among young people.
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Affiliation(s)
- Laura Chinenye Ilogu
- Département Biologie, Faculté des Sciences et Techniques, Université Claude Bernard Lyon 1, Villeurbanne, France
| | - Olga Lugovska
- Département Biologie, Faculté des Sciences et Techniques, Université Claude Bernard Lyon 1, Villeurbanne, France
| | | | | | | | - Sara Mazzilli
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
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Hou Z, Tong Y, Du F, Lu L, Zhao S, Yu K, Piatek SJ, Larson HJ, Lin L. Assessing COVID-19 Vaccine Hesitancy, Confidence, and Public Engagement: A Global Social Listening Study. J Med Internet Res 2021; 23:e27632. [PMID: 34061757 PMCID: PMC8202656 DOI: 10.2196/27632] [Citation(s) in RCA: 90] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 05/12/2021] [Accepted: 05/17/2021] [Indexed: 01/12/2023] Open
Abstract
Background Monitoring public confidence and hesitancy is crucial for the COVID-19 vaccine rollout. Social media listening (infoveillance) can not only monitor public attitudes on COVID-19 vaccines but also assess the dissemination of and public engagement with these opinions. Objective This study aims to assess global hesitancy, confidence, and public engagement toward COVID-19 vaccination. Methods We collected posts mentioning the COVID-19 vaccine between June and July 2020 on Twitter from New York (United States), London (United Kingdom), Mumbai (India), and Sao Paulo (Brazil), and Sina Weibo posts from Beijing (China). In total, we manually coded 12,886 posts from the five global metropolises with high COVID-19 burdens, and after assessment, 7032 posts were included in the analysis. We manually double-coded these posts using a coding framework developed according to the World Health Organization’s Confidence, Complacency, and Convenience model of vaccine hesitancy, and conducted engagement analysis to investigate public communication about COVID-19 vaccines on social media. Results Among social media users, 36.4% (571/1568) in New York, 51.3% (738/1440) in London, 67.3% (144/214) in Sao Paulo, 69.8% (726/1040) in Mumbai, and 76.8% (2128/2770) in Beijing indicated that they intended to accept a COVID-19 vaccination. With a high perceived risk of getting COVID-19, more tweeters in New York and London expressed a lack of confidence in vaccine safety, distrust in governments and experts, and widespread misinformation or rumors. Tweeters from Mumbai, Sao Paulo, and Beijing worried more about vaccine production and supply, whereas tweeters from New York and London had more concerns about vaccine distribution and inequity. Negative tweets expressing lack of vaccine confidence and misinformation or rumors had more followers and attracted more public engagement online. Conclusions COVID-19 vaccine hesitancy is prevalent worldwide, and negative tweets attract higher engagement on social media. It is urgent to develop an effective vaccine campaign that boosts public confidence and addresses hesitancy for COVID-19 vaccine rollouts.
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Affiliation(s)
- Zhiyuan Hou
- School of Public Health, Fudan University, Shanghai, China.,National Health Commission Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China.,Global Health Institute, Fudan University, Shanghai, China
| | - Yixin Tong
- School of Public Health, Fudan University, Shanghai, China
| | - Fanxing Du
- School of Public Health, Fudan University, Shanghai, China
| | - Linyao Lu
- School of Public Health, Fudan University, Shanghai, China
| | - Sihong Zhao
- School of Public Health, Fudan University, Shanghai, China
| | - Kexin Yu
- School of Public Health, Fudan University, Shanghai, China
| | - Simon J Piatek
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Heidi J Larson
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Leesa Lin
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, United Kingdom.,Laboratory of Data Discovery for Health, Hong Kong Science Park, Hong Kong SAR, China
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Frugoli AG, Prado RDS, Silva TMRD, Matozinhos FP, Trapé CA, Lachtim SAF. Vaccine fake news: an analysis under the World Health Organization's 3Cs model. Rev Esc Enferm USP 2021; 55:e03736. [PMID: 34076180 DOI: 10.1590/s1980-220x2020028303736] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 12/03/2020] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To analyze fake news about immunobiologicals using as reference vaccine hesitancy in the World Health Organization's 3Cs model (confidence, complacency and convenience). METHOD This is an exploratory qualitative research that used content analysis to analyze fake news on three national news-checking sites. RESULTS Twenty fake news related to immunobiologicals were analyzed, with 55% published in 2018 and 63% related to yellow fever vaccine. From analysis of results, two empirical categories have emerged: Immunobiologicals have a potential risk of death/sequel; Immunobiologicals are ineffective. CONCLUSION Fake news have the potential to produce vaccine hesitancy based on the 3Cs model. Therefore, it is necessary to rethink communicative health practices that do not underestimate the asymmetries and inequities that characterize the unequal Brazilian society. Considering that nursing is the largest workforce in immunization rooms, there is a need for professionals' engagement as an active vehicle of truthful information in immunobiologicals for the population.
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Affiliation(s)
- Alice Gomes Frugoli
- Universidade Federal de Minas Gerais, Escola de Enfermagem, Belo Horizonte, MG, Brasil
| | - Raquel de Souza Prado
- Universidade Federal de Minas Gerais, Escola de Enfermagem, Belo Horizonte, MG, Brasil
| | - Tercia Moreira Ribeiro da Silva
- Universidade Federal de Minas Gerais, Escola de Enfermagem, Departamento de Enfermagem Materno Infantil e Saúde Pública, Belo Horizonte, MG, Brasil
| | - Fernanda Penido Matozinhos
- Universidade Federal de Minas Gerais, Escola de Enfermagem, Departamento de Enfermagem Materno Infantil e Saúde Pública, Belo Horizonte, MG, Brasil
| | - Carla Andrea Trapé
- Universidade de São Paulo, Escola de Enfermagem, Departamento de Enfermagem em Saúde Pública, São Paulo, SP, Brasil
| | - Sheila Aparecida Ferreira Lachtim
- Universidade Federal de Minas Gerais, Escola de Enfermagem, Departamento de Enfermagem Materno Infantil e Saúde Pública, Belo Horizonte, MG, Brasil
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Gencer H, Özkan S, Vardar O, Serçekuş P. The effects of the COVID 19 pandemic on vaccine decisions in pregnant women. Women Birth 2021; 35:317-323. [PMID: 34088595 PMCID: PMC8133382 DOI: 10.1016/j.wombi.2021.05.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 05/09/2021] [Accepted: 05/17/2021] [Indexed: 12/29/2022]
Abstract
Background Pregnancy is an important time for developing attitudes and beliefs about childhood vaccinations. Vaccinations are among the most effective way of preventing some infectious diseases. Discussions on vaccinations have increased due to the Covid-19 pandemic and there is an opportunity to give society correct information on vaccinations. Aim The aim of the study was to determine the opinions of pregnant women on vaccinations in pregnancy and childhood and the effect of the Covid-19 pandemic on these views. Methods The study was conducted as a cross-sectional study. The sample included 152 pregnant women. Data were collected through a 25-item online questionnaire created by the researchers. Results It was found in our study that 29.6% of pregnant women using forum websites exhibited hesitant attitudes towards vaccinations. The vaccine hesitancy rate was found to be high in pregnant women who said that their economic level was low and who worried about the risks of vaccination. The Covid-19 pandemic was reported to be the cause of a decrease in vaccine hesitancy in 28.9% of the participants. Conclusion The events surrounding the pandemic provided an opportunity to explain how pregnant women feel about vaccinations. Providing pregnant women with access to correct information from health workers may reduce the problem of trust, which is among the most important reasons for vaccine hesitancy.
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Affiliation(s)
- Hatice Gencer
- Pamukkale University, Faculty of Health Sciences, Denizli, Turkey.
| | - Sevgi Özkan
- Pamukkale University, Faculty of Health Sciences, Denizli, Turkey.
| | - Okan Vardar
- Pamukkale University, Faculty of Health Sciences, Denizli, Turkey.
| | - Pınar Serçekuş
- Pamukkale University, Faculty of Health Sciences, Denizli, Turkey.
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de Oliveira BLCA, Campos MAG, Queiroz RCDS, Alves MTSSDBE, de Souza BF, dos Santos AM, da Silva AAM. Prevalence and factors associated with covid-19 vaccine hesitancy in Maranhão, Brazil. Rev Saude Publica 2021; 55:12. [PMID: 33909868 PMCID: PMC8046425 DOI: 10.11606/s1518-8787.2021055003417] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 12/29/2020] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVES To estimate the prevalence and factors associated with hesitancy in getting the vaccine against SARS-CoV-2 in Maranhão, Brazil. METHODS This is a cross-sectional population-based study conducted from October 19 to 30, 2020. The estimates were calculated based on clustering, stratification, and non-response. A three-stage sampling was adopted, considering stratum, census tracts, and domicile. After systematic analysis, thirty sectors were selected in each stratum, totaling 150 sectors. Each sector contained a fixed number of 34 households, thus totaling 5,100 households. One individual within each household (resident for at least six months and aged one year or more) was selected by a simple random sampling. We questioned participants about their vaccination intention. Univariate association between independent variables and the outcome were verified using descriptive analysis (weighted frequencies) and Pearson's chi-square test (p < 0.05). Robust multivariate analysis was performed using a three-level hierarchical model. RESULTS We found 17.5% (95%CI 16.1-19.1%) of the 4,630 individuals interviewed to report hesitancy to be vaccinated against covid-19. After final model adjustment, vaccination hesitancy was statistically higher among residents of the cities of Imperatriz (24.0%; RP = 1.48; IC95% 1.09-2.02) and municipalities of the Grande Ilha de São Luís (20.7%; RP = 1.34; 95%CI 1.02-1.76), female individuals (19.8%; RP = 1.44; 95%CI 1.20-1.75), older adults (22.8%; RP = 1.79; IC95% 1.30-2.46), evangelicals (24.1%; RP = 1.49; 95%CI 1.24-1.79), and those without reported symptoms (18.6%; RP = 1.24; 95%CI 1.02-1.51). We found no statistical differences for other socioeconomic and demographic characteristics, as well as variables related to the labor market, behaviors, and health conditions of the interviewees. CONCLUSION The prevalence of vaccine hesitancy in Maranhão and its association with individual, contextual, and clinical factors enable us to identify the groups and contexts of greatest resistance, requiring special attention from public strategies to ensure wide vaccination.
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Affiliation(s)
| | | | - Rejane Christine de Sousa Queiroz
- Universidade Federal do MaranhãoDepartamento de Saúde PúblicaSão LuísMABrasilUniversidade Federal do Maranhão. Departamento de Saúde Pública. São Luís, MA, Brasil
| | | | - Bruno Feres de Souza
- Universidade Federal do MaranhãoDepartamento de Engenharia da ComputaçãoSão LuísMABrasilUniversidade Federal do Maranhão. Departamento de Engenharia da Computação. São Luís, MA, Brasil
| | - Alcione Miranda dos Santos
- Universidade Federal do MaranhãoDepartamento de Saúde PúblicaSão LuísMABrasilUniversidade Federal do Maranhão. Departamento de Saúde Pública. São Luís, MA, Brasil
| | - Antônio Augusto Moura da Silva
- Universidade Federal do MaranhãoDepartamento de Saúde PúblicaSão LuísMABrasilUniversidade Federal do Maranhão. Departamento de Saúde Pública. São Luís, MA, Brasil
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Matos CCDSA, Gonçalves BA, Couto MT. Vaccine hesitancy in the global south: Towards a critical perspective on global health. Glob Public Health 2021; 17:1087-1098. [PMID: 33843459 DOI: 10.1080/17441692.2021.1912138] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
The complex phenomenon of vaccine hesitancy has been causing increasing global concern. This systematic review aims at analysing the state of art of scientific literature concerning vaccine hesitancy in Latin America and Africa, observing if: (i) they use the same research trends as the global North; and (ii) the parameters recommended by the World Health Organization (WHO) and taken from the experience of the global North are adequate to the Global South's context. This review analyses empirical, qualitative, quantitative, or mixed-study publications, from 2015 to 2020, available at five different databases. The studies produced in the Global South bring up important context-specific issues, such as issues of access (that are not included in the WHO's definition of vaccine hesitancy), cultural and religious issues, reactions to governments, reactions to recent episodes of vaccine tests on populations, and reactions to past of colonial violence. Initiatives to understand the phenomenon based on methodological and conceptual frameworks from the global North alone can cause wrongful conclusions.
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Shacham M, Greenblatt-Kimron L, Hamama-Raz Y, Martin LR, Peleg O, Ben-Ezra M, Mijiritsky E. Increased COVID-19 Vaccination Hesitancy and Health Awareness amid COVID-19 Vaccinations Programs in Israel. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:3804. [PMID: 33917327 PMCID: PMC8038659 DOI: 10.3390/ijerph18073804] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Revised: 03/18/2021] [Accepted: 03/31/2021] [Indexed: 12/12/2022]
Abstract
In January 2021, Israel started vaccinating healthcare workers (HCWs) and individuals older than 65 years with COVID-19 vaccines. Scientific literature points to vaccine hesitancy as being a major health concern. During time of pandemics, increased consciousness of health behaviors may be encountered. The current study aimed to assess attitudes to general vaccines and to COVID-19 vaccines in particular among adult (>18) Israeli general public, and among Israeli dentists and dental hygienists. Cross-sectional surveys were filled out by a total of 501 participants (361 Israeli adults >18 years, 73 dental hygienists, and 67 dentists). Along with basic demographics, participants responded to the Hebrew VAX, COVID-VAX and HCS scales. Group comparisons were analyzed using t tests and ANOVAs with Scheffe's test used for post hoc comparisons. Dental hygienists demonstrated significantly higher anti-vaccinations approaches than both dentists (p < 0.01) and the general public (p < 0.05). In all groups, attitudes towards the COVID-19 vaccines were more negative compared to attitudes towards general vaccines, with hygienists demonstrating significant negative attitudes compared to dentists (p < 0.05). The general public (p = 0.56) and hygienists demonstrated increased health awareness compared to dentists (p < 0.05). As health awareness has increased during the COVID-19 pandemic primary strategies to combat vaccine hesitancy should be implemented in the general public, and in particular, an dental teams.
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Affiliation(s)
- Maayan Shacham
- School of Social Work, Ariel University, Ariel 40700, Israel; (M.S.); (L.G.-K.); (Y.H.-R.); (M.B.-E.)
| | - Lee Greenblatt-Kimron
- School of Social Work, Ariel University, Ariel 40700, Israel; (M.S.); (L.G.-K.); (Y.H.-R.); (M.B.-E.)
| | - Yaira Hamama-Raz
- School of Social Work, Ariel University, Ariel 40700, Israel; (M.S.); (L.G.-K.); (Y.H.-R.); (M.B.-E.)
| | - Leslie R. Martin
- Department of Psychology, La Sierra University, Riverside, CA 92515, USA;
| | - Oren Peleg
- Tel-Aviv Sourasky Medical Center, Department of Otolaryngology, Head and Neck and Maxillofacial Surgery, Sackler Faculty of Medicine, Tel Aviv 6139001, Israel;
| | - Menachem Ben-Ezra
- School of Social Work, Ariel University, Ariel 40700, Israel; (M.S.); (L.G.-K.); (Y.H.-R.); (M.B.-E.)
| | - Eitan Mijiritsky
- Tel-Aviv Sourasky Medical Center, Department of Otolaryngology, Head and Neck and Maxillofacial Surgery, Sackler Faculty of Medicine, Tel Aviv 6139001, Israel;
- The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
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Werneck GL, Faerstein E. Willingness to vaccinate against influenza A (H1N1)pdm09 among Brazilian civil servants: Pró-Saúde cohort study. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2021; 24:e210014. [PMID: 33825774 DOI: 10.1590/1980-549720210014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Accepted: 11/24/2020] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To investigate sociodemographic factors associated with the willingness to take the pandemic influenza vaccine. METHODS This is a cross-sectional study of Brazilian civil servants participating in the fourth wave (2012-2013) of the longitudinal Pró-Saúde Study. Associations were expressed as odds ratios (OR) and 95% confidence intervals (95%CI), estimated by multivariate logistic regression models. RESULTS Among 2,828 participants, 15.9% would not be willing to vaccinate in the future if the Brazilian Ministry of Health promoted a new vaccination campaign against pandemic influenza. Not willing to vaccinate in the future was strongly associated with not taking the pandemic influenza vaccine in 2010 (OR = 9.0, 95%CI 6.9 - 11.6). Among the unvaccinated, females, those aged > 60 years, and non-health care workers were less willing to vaccinate in the future. Again, in the vaccinated group, females were less willing to vaccinate. CONCLUSION Multidisciplinary efforts should be encouraged in order to identify reasons for refusing vaccination, focusing on the individual and group perceptions of susceptibility, severity, benefits, and barriers to vaccination. Such information is needed to identify target groups for the delivery of customized interventions towards preventing emerging pandemics, such as avian influenza and COVID-19.
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Affiliation(s)
- Guilherme Loureiro Werneck
- Department of Epidemiology, Institute of Social Medicine, Universidade do Estado do Rio de Janeiro - Rio de Janeiro (RJ), Brazil.,Institute of Collective Health Studies, Universidade Federal do Rio de Janeiro - Rio de Janeiro (RJ), Brazil
| | - Eduardo Faerstein
- Department of Epidemiology, Institute of Social Medicine, Universidade do Estado do Rio de Janeiro - Rio de Janeiro (RJ), Brazil
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Who Guides Vaccination in the Portuguese Press? An Analysis of Information Sources. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18042189. [PMID: 33672276 PMCID: PMC7926976 DOI: 10.3390/ijerph18042189] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 02/15/2021] [Accepted: 02/18/2021] [Indexed: 11/17/2022]
Abstract
Sources of information are a key part of the news process as it guides certain topics, influencing the media agenda. The goal of this study is to examine the most frequent voices on vaccines in the Portuguese press. A total of 300 news items were analysed via content analysis using as sources two newspapers from 2012 to 2017. Of all the articles, 97.7% included a source (n = 670). The most frequent were “governmental organisations”, “professional associations” and the “media”. Less frequent sources were “university scientists”, “governmental scientific bodies”, “consumer groups”, “doctors”, “scientific companies”, “NGOs” and “scientific journals”. Most articles used only non-scientific sources (n = 156). A total of 94 articles used both categories and 43 used exclusively scientific sources. Our findings support the assertion that media can be an instrument to disseminate information on vaccines. Nevertheless, despite being present in most articles, the number of sources per article was low, therefore not presenting a diversity of opinions and there was a lack of scientific voices, thus suggesting lower quality of the information being offered to the audience.
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Abstract
AIMS: The COVID-19 pandemic suddenly and significantly increased hospitalizations for pneumonia with systemic inflammatory disease. Since its appearance, COVID-19 has affected more than 200 countries, with more than 90 million cases and almost 2 million deaths. So far, there is no quality evidence regarding the specific pharmacological therapy for COVID-19; most treatments usually involve off-label use of existing drugs and have unproven efficacy. The global effort converges on the development of a vaccine; however, the greatest challenge is to achieve collective immunization in the face of increasing vaccination hesitancy.METHODS: This study investigated the impact of vaccine hesitancy movements on the goal of COVID-19 immunization in Brazil. An integrative bibliographic review was performed with an electronic search on PubMed and SciELO that yielded 13.535 articles. Inclusion and exclusion criteria were applied which included 29 interventional and descriptive studies.RESULTS: The results of the 29 studies revealed that the most frequent reasons for hesitation is skepticism about the true interests of the industry and politicians, the lack of trust in research, and inaccurate information on social media.CONCLUSION: The main factors that lead the population not to believe in vaccines were the real interests of industry and politicians, lack of confidence in research, and the amount of false information that circulates massively on social media and because of that it is possible that Brazil will face some challenges in achieving collective immunity due to the anti-vaccine movement.
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Moura LDL, Codeço CT, Luz PM. Human papillomavirus (HPV) vaccination coverage in Brazil: spatial and age cohort heterogeneity. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2020; 24:e210001. [PMID: 33331411 DOI: 10.1590/1980-549720210001] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Accepted: 07/17/2020] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To estimate the coverage of the first and second dose of the human papillomavirus (HPV) vaccine in Brazil according to microregion, comparing cohorts of girls aged 14, 15, and 16 years in 2017, and investigate the association between spatial heterogeneity in vaccination coverage and sociodemographic variables. METHODS Information about the doses administered from 2013 to 2017 by age was gathered from the National Immunization Program. The number of girls aged seven, eight, and nine years living in each microregion in 2010 was obtained from the 2010 Brazilian Census. For the analysis, the cumulated vaccination coverage per microregion (n = 558) was categorized as low (< 80%) and adequate (≥ 80%), and a random intercept logistic model was adjusted, with adequate vaccination coverage as the outcome. The random effect (federative unit) was included to identify the correlation between microregions that belong to the same state. RESULTS The percentage of microregions with adequate vaccination coverage was significantly higher in the first dose (between 91.8 and 159.2%), regardless of the cohort. The coverage of the second dose was lower (between 7 and 79.9%), with heterogeneity associated with the degree of urbanization and households with private bathrooms in the municipality. The random effect showed a strong explanatory power, suggesting important differences among Brazilian states as to the outreach of vaccination coverage. CONCLUSION Although the HPV vaccine is available through the Immunization Program, the findings of the present study point to a difficulty in achieving adequate vaccination coverage.
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Affiliation(s)
- Lívia de Lima Moura
- Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz - Rio de Janeiro (RJ), Brasil
| | - Claudia Torres Codeço
- Programa de Computação Científica, Fundação Oswaldo Cruz - Rio de Janeiro (RJ), Brasil
| | - Paula Mendes Luz
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz - Rio de Janeiro (RJ), Brasil
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Sato APS. Pandemic and vaccine coverage: challenges of returning to schools. Rev Saude Publica 2020; 54:115. [PMID: 33175029 PMCID: PMC7647469 DOI: 10.11606/s1518-8787.2020054003142] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 09/16/2020] [Indexed: 12/16/2022] Open
Abstract
Since March 2020, Brazil has faced the pandemic of the coronavirus disease 2019 (Covid-19), which has severely modified the way in which the population lives and uses health services. As such, face-to-face attendance has dropped dramatically, even for child vaccination, due to measures of social distancing to mitigate the transmission of the virus. Several countries have recorded a substantial drop in vaccination coverage in children, especially of those under two years of age. In Brazil, administrative data indicate the impact of the covid-19 pandemic on this downward trend, which was already an important challenge of the National Immunization Program in recent years. Many children will be susceptible to immunopreventable diseases, which reinforces the need to assess the vaccine status of schoolchildren before returning to face-to-face classes.
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Affiliation(s)
- Ana Paula Sayuri Sato
- Universidade de São Paulo. Faculdade de Saúde Pública. Departamento de Epidemiologia. São Paulo, SP, Brasil
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Du F, Chantler T, Francis MR, Sun FY, Zhang X, Han K, Rodewald L, Yu H, Tu S, Larson H, Hou Z. The determinants of vaccine hesitancy in China: A cross-sectional study following the Changchun Changsheng vaccine incident. Vaccine 2020; 38:7464-7471. [DOI: 10.1016/j.vaccine.2020.09.075] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 09/16/2020] [Accepted: 09/25/2020] [Indexed: 01/01/2023]
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