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Hodwitz K, Wigle J, Juando-Prats C, Allan K, Li X, Fallon B, Birken CS, Maguire JL, Parsons JA. Physicians' perspectives on COVID-19 vaccinations for children: a qualitative exploration in Ontario, Canada. BMJ Open 2024; 14:e081694. [PMID: 39025822 PMCID: PMC11288156 DOI: 10.1136/bmjopen-2023-081694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 06/27/2024] [Indexed: 07/20/2024] Open
Abstract
OBJECTIVES Parents' decisions to vaccinate their children against COVID-19 are complex and often informed by discussions with primary care physicians. However, little is known about physicians' perspectives on COVID-19 vaccinations for children or their experiences counselling parents in their decision-making. We explored physicians' experiences providing COVID-19 vaccination recommendations to parents and their reflections on the contextual factors that shaped these experiences. DESIGN We conducted an interpretive qualitative study using in-depth interviews. We analyzed the data using reflexive thematic analysis and a socioecological framework. SETTING This study involved primary care practices associated with The Applied Research Group for Kids (TARGet Kids!) primary care research network in the Greater Toronto Area, Ontario, Canada. PARTICIPANTS Participants were 10 primary care physicians, including family physicians, paediatricians and paediatric subspecialists. RESULTS Participants discussed elements at the individual level (their identity, role, and knowledge), the interpersonal level (their relationships with families, responsiveness to parents' concerns, and efforts to build trust) and structural level (contextual factors related to the evolving COVID-19 climate, health system pandemic response, and constraints on care delivery) that influenced their experiences providing recommendations to parents. Our findings illustrated that physicians' interactions with families were shaped by a confluence of their own perspectives, their responses to parents' perspectives, and the evolving landscape of the broader pandemic. CONCLUSIONS Our study underscores the social and relational nature of vaccination decision-making and highlights the multiple influences on primary care physicians' experiences providing COVID-19 vaccination recommendations to parents. Our findings offer suggestions for future COVID-19 vaccination programmes for children. Delivery of new COVID-19 vaccinations for children may be well suited within primary care offices, where trusting relationships are established, but physicians need support in staying knowledgeable about emerging information, communicating available evidence to parents to inform their decision-making and dedicating time for vaccination counselling.
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Affiliation(s)
- Kathryn Hodwitz
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
| | - Jannah Wigle
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
| | - Clara Juando-Prats
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Kate Allan
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
| | - Xuedi Li
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Barbara Fallon
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
| | - Catherine S. Birken
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Pediatrics, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Jonathon L. Maguire
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
- Department of Pediatrics, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Janet A. Parsons
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
- Department of Occupational Science & Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
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Kim SE, Turner BJ, Steinberg J, Solano L, Hoffman E, Saluja S. Partners in vaccination: A community-based intervention to promote COVID-19 vaccination among low-income homebound and disabled adults. Disabil Health J 2024; 17:101589. [PMID: 38341354 DOI: 10.1016/j.dhjo.2024.101589] [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: 09/30/2023] [Revised: 01/25/2024] [Accepted: 01/27/2024] [Indexed: 02/12/2024]
Abstract
BACKGROUND Care managers (CM) for low-income disabled clients may address COVID-19 vaccine hesitancy with specific training. OBJECTIVE To assess the Partners in Vaccination (PIV) that trained CMs of a homecare program for disabled adults to promote COVID-19 vaccination. METHODS We randomized 78 CMs to PIV intervention (N = 38) or control (N = 40). PIV featured motivational interviewing (MI) skills and educational materials for unvaccinated clients. The primary outcome was first COVID-19 vaccination between December 1, 2021 and June 30, 2022 for clients of intervention CMs versus control CMs. Mixed method analysis included key informant interviews conducted from 5/24/22 to 7/25/22 with CMs, administrators, and clients about the PIV intervention. RESULTS Among 1939 clients of 78 study CMs, 528 (26.8 %) were unvaccinated by December 1, 2021 (274 clients of intervention CMs; 254 clients of control CMs). These clients' mean age was 62.3 years old (SD = 22.4) and 54 % were Black or Hispanic/Latino. First vaccination rate did not differ for intervention and control groups (6.2 % vs. 5.9 %, p = .89) by 6/30/2022. Barriers to addressing COVID-19 vaccination from interviews with 7 CMs and administrators were competing responsibilities and potentially antagonizing clients. Seven interviewed clients (five vaccinated and two unvaccinated) cited concerns about vaccination they heard from their family/friends and belief that risks of COVID-19 infection may be less than vaccination. Yet, some clients were receptive to physician recommendations. CONCLUSION Training CMs to promote COVID-19 vaccination for disabled clients did not increase first vaccination rates. CMs preferred their usual role of coordinating care and, even after the training, expressed discomfort with this potentially polarizing topic.
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Affiliation(s)
- Sue E Kim
- Keck School of Medicine of University of Southern California, Department of Population and Public Health Sciences, 1845 N. Soto Street, Los Angeles, CA, 90089-9239, USA; Gehr Family Center for Health Systems Science and Innovation, Keck Medicine of University of Southern California, 2250 Alcazar Street, Los Angeles, CA, 90033, USA.
| | - Barbara J Turner
- Gehr Family Center for Health Systems Science and Innovation, Keck Medicine of University of Southern California, 2250 Alcazar Street, Los Angeles, CA, 90033, USA.
| | - Jane Steinberg
- Keck School of Medicine of University of Southern California, Department of Population and Public Health Sciences, 1845 N. Soto Street, Los Angeles, CA, 90089-9239, USA.
| | - Laura Solano
- Gehr Family Center for Health Systems Science and Innovation, Keck Medicine of University of Southern California, 2250 Alcazar Street, Los Angeles, CA, 90033, USA.
| | - Eric Hoffman
- University of Southern California/Los Angeles General Medical Center Internal Medicine Residency Program, 2020 Zonal Avenue, IRD, 620, Los Angeles, CA, 90033, USA.
| | - Sonali Saluja
- Gehr Family Center for Health Systems Science and Innovation, Keck Medicine of University of Southern California, 2250 Alcazar Street, Los Angeles, CA, 90033, USA.
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Yoo YM, Katz MA, Greenberg D, Marcenac P, Newes-Adeyi G, Fowlkes A, Hirsch A, Martin E, Monto A, Thompson M, Azziz-Baumgartner E, Duca LM, Peretz A. Knowledge, attitudes, and practices associated with influenza vaccine uptake among healthcare personnel in Israel during three influenza seasons, 2016-2019. Vaccine 2024:S0264-410X(24)00705-9. [PMID: 38926070 DOI: 10.1016/j.vaccine.2024.06.031] [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: 02/08/2024] [Revised: 06/07/2024] [Accepted: 06/11/2024] [Indexed: 06/28/2024]
Abstract
INTRODUCTION Despite a longstanding Israel Ministry of Health recommendation that all healthcare personnel (HCP) receive a seasonal influenza vaccine, vaccine uptake among HCP remains below the country's target of 60% coverage. To understand factors related to vaccine hesitancy, we used data from a prospective three-year (2016-2019) influenza vaccine effectiveness study among Israeli HCP to examine knowledge, attitudes, and practices (KAP) about influenza vaccination and their association with vaccine uptake. METHODS At the start of each influenza season, all participating HCP completed a questionnaire that included questions about socio-demographic and occupational characteristics, health status, and KAP related to seasonal influenza vaccination. We extracted vaccination history from electronic medical records and employee vaccination registries. We used logistic regression models to identify demographic and occupational factors, and KAP about influenza vaccination, associated with receipt of vaccination. RESULT A total of 2,126 HCP were enrolled and had available data on vaccination history. Their median age was 42 years [IQR 35-52], and 73 % self-identified as female. Influenza vaccine uptake in 2016, 2017 and 2018 was 46 %, 48 % and 47 %, respectively. Overall, 36 % of HCP had received an influenza vaccine in ≥ 4 of the eight years prior. HCP aged 35-49 years were less likely to receive influenza vaccine compared to HCP aged ≥ 50 years (OR: 0.81 [95 % CI: 0.67-0.98]). Nurses and allied personnel were less likely to receive influenza vaccine compared to physicians (OR: 0.63 [95 % CI: 0.50-0.78] and OR: 0.53 [95 % CI: 0.40-0.70], respectively). The emotional benefit of vaccination (e.g., anticipating regret if not vaccinated) and the perception of vaccine safety were factors associated with vaccine uptake (OR: 7.60 [95 % CI: 6.27-9.22] and OR: 3.43 [95 % CI:2.91-4.03], respectively). CONCLUSION Among HCP at two hospitals in Israel, less than half received an annual influenza vaccine. Older HCP, physicians, and those who reported the emotional benefit of vaccination or agreed that influenza vaccines are safe were more likely to be vaccinated. Future influenza vaccination campaigns could focus on these demographic groups and tailor messages emphasizing the emotional benefits of vaccination and vaccine safety to increase seasonal influenza vaccine uptake among HCP in Israel.
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Affiliation(s)
| | | | - David Greenberg
- Soroka University Medical Center, Clalit Health Services, Beersheba, Israel
| | | | | | | | | | - Emily Martin
- University of Michigan School of Public Health, USA
| | - Arnold Monto
- University of Michigan School of Public Health, USA
| | | | | | | | - Alon Peretz
- Rabin Medical Center, Clalit Health Services, Petah Tikva, Israel
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Ramot S, Tal O. Perceptions of Risk, Benefit and Trust - A Comparative Assessment Between Healthcare Workers and the General Public Towards 3 Medical Technologies. Risk Manag Healthc Policy 2024; 17:1587-1598. [PMID: 38894817 PMCID: PMC11184229 DOI: 10.2147/rmhp.s462411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Accepted: 05/08/2024] [Indexed: 06/21/2024] Open
Abstract
Background and Objective While there is a substantial amount of research on risk perception, there has been less focus on the way medical technologies are perceived by experts as opposed to lay individuals. We investigated the factors that may influence the risk perception of healthcare workers (HCWs) and the general public regarding 3 distinct medical technologies: magnetic resonance imaging (MRI), laser-assisted in situ keratomileusis (LASIK) and the Covid-19 vaccine. Methods A cross-sectional study conducted in 2021 among 2 populations: HCWs employed at a general public hospital and a sample of outpatients and individuals who are not medical professionals. The participants completed an electronic questionnaire. Results In total, 739 respondents were included: 197 HCWs (26.7%) and 542 members of the public (73.3%). Most of the respondents (89.4%) reported being vaccinated against Covid-19, 43.8% had previously undergone an MRI but 90% had not undergone LASIK. Overall, all 3 technologies assessed in the study were rated by the respondents as having a high benefit and low risk. HCWs and the public showed statistically significant differences in perceived risk towards MRI and LASIK, as well as in some of the risk perception characteristics of each technology. In contrast, no differences in risk perception towards the Covid-19 vaccine were found between HCWs and the public. Both study populations showed a significant negative correlation between trust in the MoH and the perceived risk towards MRI and the Covid-19 vaccine. Both study populations regarded information provided by medical sources as the most reliable for decision-making. Conclusion The perceptions and concerns towards medical technologies influence individuals' behavior and acceptance of technologies. They are also essential for risk communication. The study contributes to the understanding of attitudes towards various medical technologies, including risk perception, risk characteristics, trust and sources of information pertaining to each of the technologies, by examining the differences between HCWs and the general public.
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Affiliation(s)
- Shira Ramot
- Department of Management, Health Systems Management Program, Bar Ilan University, Ramat Gan, Israel
| | - Orna Tal
- Department of Management, Health Systems Management Program, Bar Ilan University, Ramat Gan, Israel
- Shamir Medical Center (Assaf Harofeh), Zerifin, Israel
- ICET - Israeli Center for Emerging Technologies, Zerifin, Israel
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Stefanizzi P, Bianchi FP, Moscara L, Martinelli A, Di Lorenzo A, Gesualdo L, Simone S, Rendina M, Tafuri S. Determinants of compliance to influenza and COVID-19 vaccination in a cohort of solid organ transplant patients in Puglia, Southern Italy (2017-2022). Hum Vaccin Immunother 2023; 19:2266932. [PMID: 37842986 PMCID: PMC10580794 DOI: 10.1080/21645515.2023.2266932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Accepted: 09/30/2023] [Indexed: 10/17/2023] Open
Abstract
Influenza and Coronavirus Disease 2019 (COVID-19) vaccination are recommended in both solid organ transplant (SOT) candidates and recipients. In Puglia, Southern Italy, an active vaccination offer program has been activated targeting these patients. This study aims at investigating vaccination coverage (VC) for both vaccines in a SOT patients' cohort, as well as at identifying the vaccination compliance determinant. This is a retrospective, population-based study. The study population consists of the SOT patients who accessed Bari's "Policlinico" General Hospital during 2017-2022. Patients were contacted and, after providing their consent, asked their immunization status regarding influenza and COVID-19 and whether they had already undergone transplant or were waiting to do so. Regression models were fitted to investigate the determinants of VCs for influenza vaccination (2021/22 and 2022/23 seasons) and for COVID-19 vaccination (three-dose base cycle, first and second booster doses). Three-hundred and ten SOT patients were identified; 85.2% (264/310) had already undergone SOT. VCs were suboptimal, especially for constant yearly influenza vaccination (17.7%) and COVID-19 vaccination's second booster (1.94%). Logistic regression highlighted that influenza VCs are higher for SOT recipients than SOT candidates, as well as for older patients, although when considering both vaccination seasons only age significantly impact the vaccination uptake. Older age was the only influential variable for COVID-19 VC. VCs for SOT patients seem to be unsatisfying. Stronger interventions are required.
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Affiliation(s)
- Pasquale Stefanizzi
- Hygiene Unit – Interdisciplinary Department of Medicine, University of Bari Aldo Moro, Bari, Italy
| | - Francesco Paolo Bianchi
- Hygiene Unit – Interdisciplinary Department of Medicine, University of Bari Aldo Moro, Bari, Italy
| | - Lorenza Moscara
- Hygiene Unit – Interdisciplinary Department of Medicine, University of Bari Aldo Moro, Bari, Italy
| | - Andrea Martinelli
- Hygiene Unit – Interdisciplinary Department of Medicine, University of Bari Aldo Moro, Bari, Italy
| | - Antonio Di Lorenzo
- Hygiene Unit – Interdisciplinary Department of Medicine, University of Bari Aldo Moro, Bari, Italy
| | - Loreto Gesualdo
- Nephrology, Dialysis and Transplantation Unit, Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), University of Bari Aldo Moro, Bari, Italy
| | - Simona Simone
- Nephrology, Dialysis and Transplantation Unit, Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), University of Bari Aldo Moro, Bari, Italy
| | - Maria Rendina
- Section of Gastroenterology, Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy
| | - Silvio Tafuri
- Hygiene Unit – Interdisciplinary Department of Medicine, University of Bari Aldo Moro, Bari, Italy
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Damnjanović K, Ilić S, Kušić M, Lazić M, Popović D. Psychological Factors of Vaccination Intent among Healthcare Providers, Parents, and Laypeople. Vaccines (Basel) 2023; 11:1816. [PMID: 38140220 PMCID: PMC10748119 DOI: 10.3390/vaccines11121816] [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: 10/01/2023] [Revised: 11/16/2023] [Accepted: 11/17/2023] [Indexed: 12/24/2023] Open
Abstract
The interrelatedness of social-structural aspects and psychological features with vaccination intention provides the context to explore personal psychological features related to vaccination. Specifically, we focused on general decision making and vaccine-related dispositions, and their contribution to the intention to vaccinate, within post-pandemic circumstances, after the imposed possibility of choosing a vaccine brand. Our study aimed to map the function (promotive, protective, risk, vulnerability) of a set of personal psychological aspects in the intention to vaccinate among people holding different social roles regarding the vaccination. We surveyed three samples of people: healthcare providers (HPs), parents, and laypeople, within the post-pandemic context. Negative vaccine attitudes lower intention to vaccinate in all regression models (all βs ranging from -0.128 to -0.983, all ps < 0.01). The main results indicate that, regardless of the sample/social role, there is a shared attitudinal core for positive vaccination intention. This core consists of [high] trust in large corporations, government, and healthcare systems, as well as perceived consensus on vaccine safety/efficacy and experience of freedom (protective factors), and [low] vaccination conspiracy beliefs, trust in social media, and choice overload (risk and vulnerability factors, respectively). There are no common promotive factors of intention to vaccinate: for parents, perceived consensus on vaccines, and trust in corporations and the healthcare system, play such roles; for HPs, the experience of freedom is obtained as a unique promotive factor. In contrast, for laypeople, no unique promotive factors were found. Our findings provide insights into the function of psychological factors of vaccination intention across different social roles, particularly healthcare providers, parents, and laypeople, and emphasize the need for tailored immunization interventions in the post-pandemic landscape.
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Affiliation(s)
- Kaja Damnjanović
- Laboratory for Experimental Psychology, Department of Psychology, Institute of Philosophy, Faculty of Philosophy, University of Belgrade, 11000 Beograd, Serbia
| | - Sandra Ilić
- Laboratory for Experimental Psychology, Department of Psychology, Faculty of Philosophy, University of Belgrade, 11000 Beograd, Serbia;
| | - Marija Kušić
- Laboratory for Research of Individual Differences, Department of Psychology, Faculty of Philosophy, University of Belgrade, 11000 Beograd, Serbia;
| | - Milica Lazić
- Faculty of Philosophy, University of Novi Sad, 21000 Novi Sad, Serbia;
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Ramot S, Tal O. Attitudes of Healthcare Workers in Israel towards the Fourth Dose of COVID-19 Vaccine. Vaccines (Basel) 2023; 11:vaccines11020385. [PMID: 36851263 PMCID: PMC9966952 DOI: 10.3390/vaccines11020385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 01/10/2023] [Accepted: 02/06/2023] [Indexed: 02/10/2023] Open
Abstract
Attitudes of healthcare workers (HCWs) toward vaccines are extremely important for increasing vaccination coverage. We conducted a cross-sectional study at the beginning of the fourth COVID-19 vaccination dose campaign among 124 HCWs to evaluate attitudes towards the fourth dose and willingness to get vaccinated. At that time, Israel was the first country to approve the fourth vaccine dose. Most women were unwilling to get the fourth vaccine dose compared to men; 53.9% of physicians were unwilling to get vaccinated compared to 83.3% of nurses and 69% of other HCWs professions. The most frequent concerns regarding the vaccine were its efficacy, benefit, and necessity. The perceived risk and perceived severity of the health risk involved with getting vaccinated with the fourth dose were higher among HCWs who stated that they would not get vaccinated compared to those who were vaccinated or intended to get vaccinated. In contrast, HCWs who were vaccinated with the fourth dose, or those who were planning to get vaccinated, gave higher scores to the perceived benefit of the booster, its advantages, its perceived safety, its ability to protect from severe illness, and the perceived extent of scientific information about the risk associated with the booster. A logistic regression model revealed that perception of the fourth dose's benefits and risk significantly predict the willingness of HCWs to get vaccinated. Willingness to vaccinate their own children, acceptance of a hypothetical annual booster vaccine, and having less severe adverse effects after prior vaccination were also associated with willingness to get the fourth dose. These findings could help policy makers in developing strategies to expand the acceptance and coverage of the COVID-19 booster doses.
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Affiliation(s)
- Shira Ramot
- Department of Management, Health Systems Management Program, Bar Ilan University, Ramat Gan 5290002, Israel
- Correspondence:
| | - Orna Tal
- Department of Management, Health Systems Management Program, Bar Ilan University, Ramat Gan 5290002, Israel
- Shamir Medical Center (Assaf Harofeh), Zerifin 7033001, Israel
- ICET—Israeli Center for Emerging Technologies, Zerifin 7033001, Israel
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Caspi I, Freund O, Pines O, Elkana O, Ablin JN, Bornstein G. Effect of patient COVID-19 vaccine hesitancy on hospital care team perceptions. World J Clin Cases 2023; 11:821-829. [PMID: 36818615 PMCID: PMC9928691 DOI: 10.12998/wjcc.v11.i4.821] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 12/12/2022] [Accepted: 01/16/2023] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic posed new challenges in patient care worldwide. Vaccinations, which have proven efficacious in lowering the COVID-19 hospital burden, are still avoided by large populations. We, therefore, hypothesized that hospital care teams would have worse perceptions regarding the characteristics and care of patients with vaccine hesitancy.
AIM To evaluate whether patient vaccine hesitancy affected the hospital care team (HCT) perceptions.
METHODS We performed a prospective clinical study using structured questionnaires. We approached physicians and nurses with previous experience caring for COVID-19 patients from 11 medical centers across Israel during the fourth COVID-19 surge (September and October 2021). The participants completed a questionnaire with the following parts: (1) Sociodemographic characteristics; (2) Assessment of anger (STAXI instrument) and chronic workplace stress (Shirom-Melamed burnout measure); and (3) Three tools to assess the effect of patient vaccine hesitancy on the HCT perceptions (the difficult doctor-patient relation questionnaire, the medical staff perception of patient’s responsibility questionnaire and the characterological derogation questionnaire). Results were evaluated according to each part of the questionnaire and the questionnaire as a whole. Associations between HCT perceptions and their baseline characteristics, anger or chronic workplace stress were assessed.
RESULTS The HCT experienced their relationship with unvaccinated patients as more difficult (P < 0.001, Cohen’s d = 0.85), perceived unvaccinated patients as responsible for their medical condition (P < 0.001, d = 1.39) and perceived vaccinated patients as having a higher character value (P < 0.001, d = 1.03). Unvaccinated patients were considered selfish (P < 0.001), less mature (P < 0.001) and less satisfying to care for (P < 0.001). The relationship with unvaccinated patients was more difficult among HCT with higher burnout (r = 0.37, n = 66, P = 0.002). No correlations with baseline characteristics were found. All three study tools showed high internal consistency (α between 0.72 and 0.845).
CONCLUSION Our results should raise awareness of the possible effects of vaccine hesitancy on HCT perceptions regarding unvaccinated patients. In order to minimize the potential negative impact on patient care, designated departments should promote specific patient-centered preparations. Further investigations should assess whether vaccine hesitancy directly affects patient quality of care.
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Affiliation(s)
- Inbar Caspi
- Internal Medicine Department B, Tel-Aviv Sourasky Medical Center and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6423906, Israel
| | - Ophir Freund
- Internal Medicine Department B, Tel-Aviv Sourasky Medical Center and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6423906, Israel
| | - Omer Pines
- Behavioral Sciences Department, Academic College of Tel Aviv-Yaffo, Tel Aviv 6818211, Israel
| | - Odelia Elkana
- Behavioral Sciences Department, Academic College of Tel Aviv-Yaffo, Tel Aviv 6818211, Israel
| | - Jacob N Ablin
- Internal Medicine Department H, Tel Aviv Sourasky Medical Center and Sackler School of Medicine, Tel Aviv 6423906, Israel
| | - Gil Bornstein
- Internal Medicine Department B, Tel-Aviv Sourasky Medical Center and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6423906, Israel
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Midwives' Knowledge, Attitudes, and Practice Regarding COVID-19 Vaccination for Pregnant Women: A Nationwide Web-Based Survey in Italy. Vaccines (Basel) 2023; 11:vaccines11020222. [PMID: 36851098 PMCID: PMC9961665 DOI: 10.3390/vaccines11020222] [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: 12/30/2022] [Revised: 01/07/2023] [Accepted: 01/17/2023] [Indexed: 01/20/2023] Open
Abstract
This cross-sectional survey investigated the knowledge, attitudes, and practices concerning the COVID-19 vaccination for pregnant women among midwives in Italy and the associated factors. Midwives with at least five years of midwifery education and who had received information about the COVID-19 vaccination from official government organizations or scientific journals were more likely to know in which trimester this vaccine can be administered. A higher perceived utility of this vaccination was observed among midwives working in the public sector, in those concerned by being infected by SARS-CoV-2, who have received at least one dose of this vaccination, in those who considered COVID-19 a severe disease for pregnant women and their fetus, and who believed that the vaccination is safe. One-third of the midwives routinely provided information and half recommended this vaccination. Midwives with more years of activity, who received information about the vaccination from official government organizations or scientific journals, those who had never assisted patients with SARS-CoV-2, and those who believed in midwives' role in COVID-19 prevention were more likely to routinely provide information. Participants who perceived a higher utility of this vaccination, those who believed in midwives' role in COVID-19 prevention, those who received information from official government organizations or scientific journals were more likely to routinely provide a recommendation for the vaccine. Midwives' knowledge must be improved for ensuring that they communicate and recommend the vaccination to their patients.
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Tatarkova M, Ulbrichtova R, Svihrova V, Zibolenova J, Novak M, Svihra J, Hudeckova H. Secondary School Teachers and Outpatient Physicians: Differences in Attitudes towards Vaccination against COVID-19 in Slovakia. Vaccines (Basel) 2022; 10:1858. [PMID: 36366366 PMCID: PMC9697559 DOI: 10.3390/vaccines10111858] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 10/31/2022] [Accepted: 11/01/2022] [Indexed: 11/26/2023] Open
Abstract
The aim of this study was to evaluate the differences in attitudes towards vaccination against COVID-19 among secondary school teachers and outpatient physicians. A cross-sectional study was realised using anonymous questionnaires. The EPI Info 7 program and R software, version 4.0.2 were used for statistical analysis. The questionnaire was completed by 868 respondents (teaching staff N = 451; outpatient physician N = 417). The number of employees vaccinated against COVID-19 was 742 (85.5%). The number of those vaccinated against COVID-19 and influenza (last season) was 192 (21.9%). The statistically significant predictors were the level of fear of COVID-19 (OR 1.40; 95% CI 1.29-1.52), profession-outpatient physicians (OR 2.56; 95% CI 1.55-4.23), history of COVID-19 (OR 0.34; 95% CI 0.22-0.54), gender (OR 0.55; 95% CI 0.33-0.89) and influenza vaccination at any time in the past (OR 3.52; 95% CI 1.10-11.31). The strongest motivation for vaccination against COVID-19 among physicians was the prevention of the spread of COVID-19 during the performance of their profession (N = 336; 87%); among teachers, it was the protection of family members (N = 258; 73%). The most common reason for vaccine hesitancy was concern about vaccine safety (N = 80; 63.5%).
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Affiliation(s)
- Maria Tatarkova
- Department of Public Health, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Mala Hora 11149/4B, 036 01 Martin, Slovakia
| | - Romana Ulbrichtova
- Department of Public Health, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Mala Hora 11149/4B, 036 01 Martin, Slovakia
| | - Viera Svihrova
- Department of Public Health, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Mala Hora 11149/4B, 036 01 Martin, Slovakia
| | - Jana Zibolenova
- Department of Public Health, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Mala Hora 11149/4B, 036 01 Martin, Slovakia
| | - Martin Novak
- Department of Public Health, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Mala Hora 11149/4B, 036 01 Martin, Slovakia
| | - Jan Svihra
- Clinic of Urology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Kollarova 2, 036 59 Martin, Slovakia
| | - Henrieta Hudeckova
- Department of Public Health, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Mala Hora 11149/4B, 036 01 Martin, Slovakia
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Marziali E, Lontano A, Regazzi L, Paladini A, Villani L, Calabrò GE, Damiani G, Laurenti P, Ricciardi W, Cadeddu C. Factors Influencing the Choice to Advise for or against COVID-19 Vaccination in the Physicians and Dentists of an Italian Region. Vaccines (Basel) 2022; 10:1793. [PMID: 36366302 PMCID: PMC9696475 DOI: 10.3390/vaccines10111793] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Revised: 10/21/2022] [Accepted: 10/23/2022] [Indexed: 09/19/2023] Open
Abstract
Healthcare workers (HCWs), particularly physicians, are a relevant and trusted source of information for patients, especially when health-related choices such as vaccination are concerned. Between July and November 2022, we administered a web-based survey to physicians and dentists living in the Latio region of Italy to explore whether their background might affect their willingness to recommend the COVID-19 vaccination to their patients (RCVtoPat) and their relatives (RCVtoRel). We performed a multivariable logistic regression to study the association between the two outcomes (RCVtoPat and RCVtoRel) and their potential determinants in our sample (n = 1464). We found that being a dentist, an increasing fear of COVID-19, and having been previously vaccinated against flu are positively associated with both RCVtoPat and RCVtoRel, while a better self-rated knowledge of COVID-19 vaccines is associated only with RCVtoRel. No role was found for age, sex, civil status, education level, information sources, previous SARS-CoV-2 infection, and chronic diseases. A sub-group analysis of physicians alone (n = 1305) demonstrated a positive association with RCVtoRel of being specialized in diagnostic/therapeutic services and a negative effect on RCVtoPat of being trained in general practice. We provide useful insights about the factors that should be addressed to ensure HCWs exert a positive influence on their patients and communities.
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Affiliation(s)
- Eleonora Marziali
- Section of Hygiene, University Department of Life Sciences and Public Health—Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Alberto Lontano
- Section of Hygiene, University Department of Life Sciences and Public Health—Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Luca Regazzi
- Section of Hygiene, University Department of Life Sciences and Public Health—Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Andrea Paladini
- Section of Hygiene, University Department of Life Sciences and Public Health—Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Leonardo Villani
- Section of Hygiene, University Department of Life Sciences and Public Health—Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Giovanna Elisa Calabrò
- Section of Hygiene, University Department of Life Sciences and Public Health—Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Gianfranco Damiani
- Section of Hygiene, University Department of Life Sciences and Public Health—Università Cattolica del Sacro Cuore, 00168 Rome, Italy
- Department of Women, Children and Public Health—Fondazione Policlinico Universitario “A. Gemelli” IRCCS, 00168 Rome, Italy
| | - Patrizia Laurenti
- Section of Hygiene, University Department of Life Sciences and Public Health—Università Cattolica del Sacro Cuore, 00168 Rome, Italy
- Department of Women, Children and Public Health—Fondazione Policlinico Universitario “A. Gemelli” IRCCS, 00168 Rome, Italy
| | - Walter Ricciardi
- Section of Hygiene, University Department of Life Sciences and Public Health—Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Chiara Cadeddu
- Section of Hygiene, University Department of Life Sciences and Public Health—Università Cattolica del Sacro Cuore, 00168 Rome, Italy
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12
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Kimhi S, Eshel Y, Marciano H, Adini B. Impact of societal resilience on vaccine hesitancy and uptake: Lessons learned from the Israeli experience. INTERNATIONAL JOURNAL OF DISASTER RISK REDUCTION : IJDRR 2022; 79:103181. [PMID: 35873193 PMCID: PMC9293373 DOI: 10.1016/j.ijdrr.2022.103181] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 07/09/2022] [Accepted: 07/11/2022] [Indexed: 05/20/2023]
Abstract
BACKGROUND Vaccine hesitancy threatens COVID-19 pandemic management. Increasing vaccine uptake is important to containment of the virus, and achievement of herd immunity. OBJECTIVE To identify factors of resilience, distress, and well-being that impact vaccine hesitancy and uptake. METHOD A cross-sectional study was conducted during the pandemic's fourth wave. The data were collected by an internet panel company. A representative sample of Israeli residents (N = 2002) answered an online questionnaire. A stratified sampling method was employed regarding geographic distribution, gender, and age. As vaccine hesitancy poses a threat to the effective management of the pandemic, the outcome measures included vaccine hesitancy and uptake (dependent variables), and resilience, distress, and well-being (independent variables). RESULTS 24% of respondents reported a high level of vaccine hesitancy; 68% received 3 vaccines; 5% did not receive any vaccine. Six predictors together explained 22% of vaccine hesitancy and 15% of vaccine uptake.Path analysis indicated that: (a) Societal resilience was the best predictor of vaccine hesitancy and uptake: the higher the societal resilience, the lower vaccine hesitancy, and the higher vaccine uptake. (b) The higher sense of danger, the higher vaccine hesitancy, and the lower vaccine uptake. (c) The higher level of religiosity, the lower vaccine uptake. (d) The higher the family income, the lower level of vaccine hesitancy. CONCLUSIONS Findings suggest that public attitudes are primarily influenced by the degree of trust in the leadership and other components of societal resilience. Further research should investigate the impact of transparency concerning COVID-19 decision-making on vaccine hesitancy and uptake.
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Affiliation(s)
- Shaul Kimhi
- Multinational Resilience & Well-being Research Center, Tel Aviv University, Israel
| | - Yohanan Eshel
- Stress and Resilience Research Center, Tel Hai and University of Haifa, Israel
| | - Hadas Marciano
- Stress and Resilience Research Center, Tel-Hai College, The Institute of Information Processing and Decision Making (IIPDM), University of Haifa, Israel
| | - Bruria Adini
- Head of the Department of Emergency and Disaster Management, Multinational Resilience & Well-being Research Center, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Israel
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13
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Peterson CJ, Lee B, Nugent K. COVID-19 Vaccination Hesitancy among Healthcare Workers-A Review. Vaccines (Basel) 2022; 10:948. [PMID: 35746556 PMCID: PMC9227837 DOI: 10.3390/vaccines10060948] [Citation(s) in RCA: 84] [Impact Index Per Article: 42.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 05/25/2022] [Accepted: 06/06/2022] [Indexed: 02/04/2023] Open
Abstract
The COVID-19 pandemic and its associated vaccine have highlighted vaccine hesitancy among healthcare workers (HCWs). Vaccine hesitancy among this group existed prior to the pandemic and particularly centered around influenza vaccination. Being a physician, having more advanced education, and previous vaccination habits are frequently associated with vaccine acceptance. The relationship between age and caring for patients on COVID-19 vaccination is unclear, with studies providing opposing results. Reasons for hesitancy include concerns about safety and efficacy, mistrust of government and institutions, waiting for more data, and feeling that personal rights are being infringed upon. Many of these reasons reflect previous attitudes about influenza vaccination as well as political beliefs and views of personal autonomy. Finally, several interventions to encourage vaccination have been studied, including education programs and non-monetary incentives with the most effective studies using a combination of methods.
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Affiliation(s)
- Christopher J. Peterson
- School of Medicine, Texas Tech University Health Sciences Center, 3601 4th St., Lubbock, TX 79430, USA;
| | - Benjamin Lee
- School of Medicine, Texas Tech University Health Sciences Center, 3601 4th St., Lubbock, TX 79430, USA;
- College of Engineering, Texas Tech University, 2500 Broadway, Lubbock, TX 79409, USA
| | - Kenneth Nugent
- Department of Internal Medicine, Texas Tech University Health Sciences Center, 3601 4th St., Lubbock, TX 79430, USA;
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Gesser-Edelsburg A, Hijazi R, Cohen R. It Takes Two to Tango: How the COVID-19 Vaccination Campaign in Israel Was Framed by the Health Ministry vs. the Television News. Front Public Health 2022; 10:887579. [PMID: 35493372 PMCID: PMC9039239 DOI: 10.3389/fpubh.2022.887579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 03/17/2022] [Indexed: 11/30/2022] Open
Abstract
Background The internet has become a major resource in information transfer during COVID-19, and traditional means of communication are digitized and accessible online to the public at large. Objectives This study seeks to examine how Israel's two main television news channels (Channel 12 and Channel 13) covered the Covid-19 vaccination campaign, compared to how the Ministry of Health ran the campaign. Methods A qualitative study based on triangulation of online content analyses from three different sources: advertising campaigns, social media posts and reports on television news channels. The research sample included 252 reports from the newsrooms of Channel 13 (n = 151) and Channel N12 (n = 101), Israel's two leading news channels, all broadcast between December 1, 2020 and November 30, 2021. The sample also included posts from Israel Ministry of Health Facebook page and advertising campaigns from the Facebook page of the Israel Government Advertising Agency (LAPAM), which constructs advertising campaigns for the MOH (113 items). Results The research findings reveal congruence between the way the MOH framed its vaccination campaign and news coverage of the vaccination issue. The vaccination campaign used three primary framing strategies: (1) positive framing (emphasizing the vaccine's advantages and stressing that the vaccine is safe and effective based on cost-benefit calculations and public health perspectives); (2) fear appeal strategy (conveying persuasive messages that seek to arouse fear through threats of impending danger or harm); (3) attribution of responsibility strategy (blaming the unvaccinated and targeting all those who criticized Israel's generic vaccination policy). Conclusion As the watchdog of democracy, the news should function as a professional and objective source that criticizes government systems if necessary and strives to uncover the truth throughout the crisis. Public trust, which is so essential during such a crisis, can be achieved only if the news channels provide reports and meaningful journalistic investigations that challenge the system. By doing so, they can help fight conflicts of interest that divert management of the crisis from the professional health field to the political-economic arena.
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Affiliation(s)
- Anat Gesser-Edelsburg
- School of Public Health, University of Haifa, Haifa, Israel.,The Health and Risk Communication Lab, University of Haifa, Haifa, Israel
| | - Rana Hijazi
- School of Public Health, University of Haifa, Haifa, Israel.,The Health and Risk Communication Lab, University of Haifa, Haifa, Israel
| | - Ricky Cohen
- The Health and Risk Communication Lab, University of Haifa, Haifa, Israel.,The Cheryl Spencer Department of Nursing, University of Haifa, Haifa, Israel
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