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Moore CM, Wakim PG, Taylor HA. Factors Affecting COVID-19 Vaccine Decision-Making and Satisfaction: A Survey of U.S. High School Students. J Adolesc Health 2024; 74:1139-1145. [PMID: 38520433 PMCID: PMC11102307 DOI: 10.1016/j.jadohealth.2024.01.025] [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: 06/15/2023] [Revised: 01/23/2024] [Accepted: 01/24/2024] [Indexed: 03/25/2024]
Abstract
PURPOSE To investigate self-reported individual-, household-, and community-level factors impacting COVID-19 vaccination decision-making among a sample of high school-aged US adolescents. METHODS We surveyed adolescents ages 15-17 living in the United States during September and October 2022 (n = 454). Univariable and targeted bivariable and multivariable analyses were conducted to examine associations between adolescent characteristics and COVID-19 vaccination status, satisfaction with vaccination status, reasons weighed for and against vaccination, and experience of perceived access barriers. RESULTS More than three-quarters of high school-aged adolescents in our sample reported satisfaction with their current COVID-19 vaccination status, and respondents were more likely to report satisfaction with their COVID-19 vaccination status when they reported actively participating in the decision. DISCUSSION Adolescents remain an important age group for targeted public health and policy interventions given that their vaccination rates still lag behind averages for adults. Allowing for minor consent to vaccination, as well as parent-, school-, or peer-based interventions, may prove especially effective for addressing rates among high school-aged students.
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Affiliation(s)
- Claire M Moore
- Department of Bioethics, Clinical Center, National Institutes of Health, Bethesda, Maryland.
| | - Paul G Wakim
- Biostatistics and Clinical Epidemiology Service, Clinical Center, National Institutes of Health, Bethesda, Maryland
| | - Holly A Taylor
- Department of Bioethics, Clinical Center, National Institutes of Health, Bethesda, Maryland.
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2
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Wang H, van Prooijen JW, van Lange PA. How perceived coercion polarizes unvaccinated people: The mediating role of conspiracy beliefs. J Health Psychol 2024:13591053241238126. [PMID: 38494647 DOI: 10.1177/13591053241238126] [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: 03/19/2024] Open
Abstract
During the COVID-19 pandemic, different policies were implemented to increase vaccination uptake. Meanwhile, conspiracy theories spread widely, and vaccinated versus unvaccinated people increasingly polarized against each other. This study examined the associations between perceived vaccination coercion, conspiracy beliefs and polarization. We tested the relationship of vaccination status with perceived vaccination coercion, conspiracy beliefs, and polarization, with a total sample size of N = 1202 (n = 400 in China, n = 401 in the US, and n = 401 in the UK), among them n = 603 were vaccinated and n = 599 were unvaccinated. As pre-registered, unvaccinated people perceived more vaccination coercion and endorsed more conspiracy theories. Conspiracy mentality was positively related to perceived coercion. Contrary to our hypotheses, vaccinated people were more polarized toward unvaccinated people than vice versa. Finally, conspiracy beliefs mediated the link between perceived coercion and polarization among unvaccinated people.
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Affiliation(s)
- Haiyan Wang
- Vrije Universiteit Amsterdam, The Netherlands
- The Netherlands Institute for the Study of Crime and Law Enforcement (NSCR), The Netherlands
| | - Jan-Willem van Prooijen
- Vrije Universiteit Amsterdam, The Netherlands
- The Netherlands Institute for the Study of Crime and Law Enforcement (NSCR), The Netherlands
- Maastricht University, The Netherlands
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Knijff M, van Lier A, Boer M, de Vries M, Hament JM, de Melker HE. Parental intention, attitudes, beliefs, trust and deliberation towards childhood vaccination in the Netherlands in 2022: Indications of change compared to 2013. Vaccine 2024; 42:801-811. [PMID: 38216441 DOI: 10.1016/j.vaccine.2023.12.080] [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: 08/10/2023] [Revised: 12/21/2023] [Accepted: 12/27/2023] [Indexed: 01/14/2024]
Abstract
BACKGROUND Vaccine uptake within the Dutch National Immunisation Programme (NIP) has slightly declined since the COVID-19 pandemic. We studied psychosocial factors of vaccine uptake, namely parental intention, attitudes, beliefs, trust and deliberation (i.e., self-evidence), before (2013) and two years into the pandemic (2022). METHODS In 2022 and 2013, parents with a young child (aged < 3.5 years) participated in online surveys on vaccination (n = 1000 and 800, (estimated) response = 12.2 % and 37.2 %, respectively). Psychosocial factors were measured on 7-point Likert scales. Multivariate logistic regression analysis was used to study differences between parents in 2022 and 2013 in 'negative' scores (≤2) of psychosocial factors. RESULTS In both 2022 and 2013, most parents with a young child expressed positive intention (2022 = 83.1 %, 2013 = 87.0 %), attitudes (3 items: 2022 = 66.7 %-70.9 %, 2013 = 62.1 %-69.8 %) and trust (2022 = 51.8 %, 2013 = 52.0 %) towards the NIP and considered vaccinating their child as self-evident (2022 = 57.2 %, 2013 = 67.3 %). Compared to parents in 2013, parents in 2022 had significantly higher odds of reporting negative attitudes towards vaccination (3 items combined: OR = 2.84, 95 % CI = 1.09, 7.37), believing that vaccinations offer insufficient protection (OR = 4.89, 95 % CI = 3.19, 7.51), that the NIP is not beneficial for the protection of their child's health (OR = 2.23, 95 % CI = 1.15, 4.35), that vaccinating their child does not necessarily protect the health of other children (OR = 2.24, 95 % CI = 1.16, 4.33) or adults (OR = 2.22, 95 % CI = 1.32, 3.75) and that vaccinations could cause severe side effects (OR = 2.20, 95 % CI = 1.35, 3.58), preferring natural infection over vaccination (OR = 3.18, 95 % CI = 2.24, 4.51) and reporting low trust towards the NIP (OR = 1.73, 95 % CI = 1.08, 2.79). CONCLUSIONS Although most parents had positive intention, attitudes and trust towards vaccination and perceived vaccinating their child as self-evident, proportions of parents with negative scores were slightly larger in 2022 compared to 2013. Monitoring these determinants of vaccine uptake and developing appropriate interventions could contribute to sustaining high vaccine uptake.
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Affiliation(s)
- Marthe Knijff
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), P.O. Box 1, 3720 BA Bilthoven, the Netherlands.
| | - Alies van Lier
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), P.O. Box 1, 3720 BA Bilthoven, the Netherlands
| | - Maartje Boer
- Statistics, Data Science, and Modelling, National Institute for Public Health and the Environment (RIVM), P.O. Box 1, 3720 BA Bilthoven, the Netherlands
| | - Marion de Vries
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), P.O. Box 1, 3720 BA Bilthoven, the Netherlands
| | - Jeanne-Marie Hament
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), P.O. Box 1, 3720 BA Bilthoven, the Netherlands
| | - Hester E de Melker
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), P.O. Box 1, 3720 BA Bilthoven, the Netherlands
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Gramacho W, Turgeon M, Santos Mundim P, Pereira I. Why did Brazil fail to vaccinate children against COVID-19 during the pandemic? An assessment of attitudinal and behavioral determinants. Vaccine 2024; 42:315-321. [PMID: 38061957 DOI: 10.1016/j.vaccine.2023.11.064] [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: 05/20/2023] [Revised: 11/22/2023] [Accepted: 11/30/2023] [Indexed: 01/01/2024]
Abstract
The objective of this study is to identify the determining attitudinal, behavioral, and sociodemographic factors behind the vaccination decision of parents and guardians in Brazil regarding immunization of children against COVID-19. Our data is obtained from a national online survey of 1,872 parents or guardians of children between 5 and 11 years of age, conducted from May 16 to 25, 2022. Our results show that, in Brazil, the decision to vaccinate children against COVID-19 is better explained by attitudinal and behavioral factors than sociodemographic ones. More precisely, the choice to immunize children against COVID-19 is strongly associated with the parents or guardians' own COVID-19 vaccination status, their ambivalence regarding this decision, their political preferences, and media use. In particular, parents and guardians who did not vaccinate against SARSCov2 and who supported former president Jair Bolsonaro (the main anti-vaccine political leader in the country during the COVID-19 pandemic) were substantially less likely to vaccinate their children. Parents and guardians with greater exposure to the country's major TV news program (Jornal Nacional/TV Globo), however, were more likely to do so. Other findings show that evangelicals - whose religious leaders strongly supported the former president -, young parents and guardians, and those from lower economic status were also less likely to vaccinate their children.
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Nguyen KH, Zhao R, Chen S, Bednarczyk RA. Exclusive and dual influenza and COVID-19 vaccination among U.S. adults and adolescents in 2021. Ann Med 2023; 55:2196436. [PMID: 37052255 PMCID: PMC10116913 DOI: 10.1080/07853890.2023.2196436] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/14/2023] Open
Abstract
INTRODUCTION Despite recommendations for influenza and COVID-19 vaccines, studies have documented gaps and disparities in vaccination coverage for adults and adolescents. Understanding the proportion and demographics of those unvaccinated against influenza and/or COVID-19 is important for tailoring appropriate messaging and strategies to increase confidence and uptake. METHODS Using the 2021 National Health Interview Survey (NHIS), we assessed the prevalence of four vaccination patterns (exclusive influenza vaccination, exclusive COVID-19 vaccination, dual influenza and COVID-19 vaccination, and neither vaccination) by sociodemographic and other characteristics among adults and adolescents 12-17 years. Adjusted multivariable regression analyses were conducted to examine factors associated with each of the four vaccination categories among adults and adolescents. RESULTS In 2021, 42.5% of adults and 28.3% of adolescents received both influenza and COVID-19 vaccines, while approximately a quarter (22.4%) of adults and a third (34.0%) of adolescents did not receive either vaccine. Among adults and adolescents, 6.0% and 11.4% were exclusively vaccinated against influenza and 29.1% and 26.4% were exclusively vaccinated against COVID-19, respectively. Among adults, exclusive COVID-19 or dual vaccination was more likely to be associated with older age, non-Hispanic multi/other race, and having a college degree compared to their respective counterparts. Exclusive influenza or neither vaccination was more likely to be associated with younger age, having a high school diploma or less, living below the poverty level, and having a previous COVID-19 diagnosis. CONCLUSION During the COVID-19 pandemic, approximately two-thirds of adolescents and three-fourths of adults received exclusive influenza or COVID-19 vaccines or both vaccines in 2021. Vaccination patterns differed by sociodemographic and other characteristics. Promoting confidence in vaccines and reducing barriers to access is needed to protect individuals and families from severe health consequences of vaccine-preventable diseases. Being up-to-date with all recommended vaccinations can prevent a future resurgence of hospitalizations and cases.Key messages42.5% of adults and 28.3% of adolescents received both influenza and COVID-19 vaccines in 2021, while approximately a quarter (22.4%) of adults and a third (34.0%) of adolescents did not receive either vaccine; 6.0% of adults and 11.4% of adolescents were exclusively vaccinated against influenza and 29.1% of adults and 26.4% of adolescents were exclusively vaccinated against COVID-19.Among adults, exclusive COVID-19 vaccination or dual vaccination was more likely to be associated with older age, non-Hispanic multi/other race, and having a college degree or higher compared to their respective counterparts; exclusive influenza vaccination or neither vaccination was more likely to be associated with younger age, having a high school diploma or less, living below poverty level, and having a previous COVID-19 diagnosis compared to their respective counterparts.Promoting confidence in vaccines and reducing barriers to access is needed to protect individuals and families from severe health consequences of vaccine-preventable diseases. Being up-to-date with all recommended vaccinations can prevent a future resurgence of hospitalizations and cases, especially as new variants emerge.
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Affiliation(s)
- Kimberly H Nguyen
- Department of Public Health & Community Medicine, Tufts University School of Medicine, Boston, MA, USA
| | - Ruitong Zhao
- Department of Public Health & Community Medicine, Tufts University School of Medicine, Boston, MA, USA
| | - Siyu Chen
- Department of Public Health & Community Medicine, Tufts University School of Medicine, Boston, MA, USA
| | - Robert A Bednarczyk
- Hubert Department of Global Health, Emory University Rollins School of Public Health, Atlanta, GA, USA
- Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, GA, USA
- Emory Vaccine Center, Emory University, Atlanta, GA, USA
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6
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Higgins DM, Moss A, Blackwell S, O'Leary ST. The COVID-19 Pandemic and Parental Attitudes Toward Routine Childhood Vaccines. Pediatrics 2023; 152:e2023062927. [PMID: 37867454 DOI: 10.1542/peds.2023-062927] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/23/2023] [Indexed: 10/24/2023] Open
Abstract
BACKGROUND AND OBJECTIVES The coronavirus disease 2019 (COVID-19) pandemic may have impacted parental attitudes toward childhood vaccines. However, few data sources followed attitudes before and after onset of the pandemic. We used data from a parental survey to describe the effect of the pandemic on parental attitudes toward childhood vaccines. METHODS Data were analyzed from the Health eMoms survey which randomly sampled birthing parents in Colorado from 2018 to 2021 on several health topics including vaccine hesitancy. Population weighted multivariable regression was used to measure the association between overall vaccine hesitancy and 5 individual hesitancy questions and different COVID-19 pandemic periods: prepandemic (April 2018-February 2020); pandemic prevaccine (April 2020-December 2020); and pandemic postvaccine (January 2021-August 2021), adjusting for demographic factors. RESULTS Overall, 20.4% (726/3553) of respondents were vaccine hesitant. Vaccine hesitancy during pandemic time periods was not different from the prepandemic period (prevaccine adjusted odds ratio [aOR] = 0.82, 95% confidence interval [CI] = 0.65-1.04; postvaccine aOR = 1.07, 95% CI = 0.85-1.34). In analyses of individual hesitancy questions, parents were more likely to be unsure about trusting vaccine information in the pandemic postvaccine time period compared with the prepandemic period (aOR = 2.14; 95% CI = 1.55-2.96), and less likely to be unsure about their hesitancy toward childhood vaccines (aOR = 0.48; 95% CI = 0.27-0.84). CONCLUSIONS The COVID-19 pandemic was not associated with changes in parental vaccine hesitancy overall, although there were changes in trust about vaccine information and a polarization of vaccination attitudes.
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Affiliation(s)
- David M Higgins
- Adult and Child Center for Outcomes Research and Delivery Science (ACCORDS), University of Colorado/Children's Hospital Colorado, Aurora, Colorado
| | - Angela Moss
- Adult and Child Center for Outcomes Research and Delivery Science (ACCORDS), University of Colorado/Children's Hospital Colorado, Aurora, Colorado
| | - Sarah Blackwell
- Colorado Department of Public Health and Environment, Denver, Colorado
| | - Sean T O'Leary
- Adult and Child Center for Outcomes Research and Delivery Science (ACCORDS), University of Colorado/Children's Hospital Colorado, Aurora, Colorado
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7
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Ryan GW, Askelson NM, Woodworth KR, Lindley MC, Gedlinske A, Parker AM, Gidengil CA, Petersen CA, Scherer AM. Unvaccinated Adolescents' COVID-19 Vaccine Intentions: Implications for Public Health Messaging. J Adolesc Health 2023; 73:679-685. [PMID: 37395695 PMCID: PMC10529916 DOI: 10.1016/j.jadohealth.2023.05.023] [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: 11/14/2022] [Revised: 04/20/2023] [Accepted: 05/22/2023] [Indexed: 07/04/2023]
Abstract
PURPOSE COVID-19 vaccine uptake remains low for US adolescents and contributes to excess morbidity and mortality. Most research has assessed parental intention to vaccinate their children. We explored differences between vaccine-acceptant and vaccine-hesitant unvaccinated US adolescents using national survey data. METHODS A nonprobability, quota-based sample of adolescents, aged 13-17 years, was recruited through an online survey panel in April 2021. One thousand nine hundred twenty seven adolescents were screened for participation and the final sample included 985 responses. We assessed responses from unvaccinated adolescents (n = 831). Our primary measure was COVID-19 vaccination intent ("vaccine-acceptant" defined as "definitely will" get a COVID-19 vaccine and any other response classified as "vaccine-hesitant") and secondary measures included reasons for intending or not intending to get vaccinated and trusted sources of COVID-19 vaccine information. We calculated descriptive statistics and chi-square tests to explore differences between vaccine-acceptant and vaccine-hesitant adolescents. RESULTS Most (n = 831; 70.9%) adolescents were hesitant, with more hesitancy observed among adolescents with low levels of concern about COVID-19 and high levels of concern about side effects of COVID-19 vaccination. Among vaccine-hesitant adolescents, reasons for not intending to get vaccinated included waiting for safety data and having parents who would make the vaccination decision. Vaccine-hesitant adolescents had a lower number of trusted information sources than vaccine-acceptant adolescents. DISCUSSION Differences identified between vaccine-acceptant and vaccine-hesitant adolescents can inform message content and dissemination. Messages should include accurate, age-appropriate information about side effects and risks of COVID-19 infection. Prioritizing dissemination of these messages through family members, state and local government officials, and healthcare providers may be most effective.
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Affiliation(s)
- Grace W Ryan
- Division of Preventive and Behavioral Medicine, Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, Massachusetts.
| | - Natoshia M Askelson
- Department of Community and Behavioral Health, University of Iowa, Iowa City, Iowa
| | | | | | - Amber Gedlinske
- Department of Internal Medicine, University of Iowa, Iowa City, Iowa
| | | | - Courtney A Gidengil
- RAND Corporation, Boston, Massachusetts; Division of Infectious Diseases, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Christine A Petersen
- Department of Internal Medicine, University of Iowa, Iowa City, Iowa; Department of Epidemiology, University of Iowa, Iowa City, Iowa
| | - Aaron M Scherer
- Department of Internal Medicine, University of Iowa, Iowa City, Iowa
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8
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Fok CL, Fifita M, Tanjasiri SP. Decision-Making Regarding Elective Child and Adolescent Vaccinations Among Native Hawaiian and Pacific Islander Parents in Orange County. Health Promot Pract 2023:15248399231193707. [PMID: 37772336 DOI: 10.1177/15248399231193707] [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: 09/30/2023]
Abstract
Native Hawaiians and Pacific Islanders (NHPIs) in aggregate experience greater health burdens than non-Hispanic Whites, such as a higher incidence of cervical cancer and COVID-19. Given the importance of vaccinations in preventing and reducing the severity of diseases, such as the flu, cervical cancer, and COVID-19, the receipt of vaccines during childhood and adolescence is crucial. Therefore, this qualitative study aimed to explore the factors associated with NHPI parents' decisions regarding vaccinating their children with these elective vaccinations-that is, vaccinations not required for child care, preschool, or K-12 admissions in California but highly recommended. A total of 15 NHPI parents were recruited through a community-based organization. Semi-structured interviews explored parents' reasons for accepting or denying each vaccine for their child(ren). Results demonstrated variable acceptance of each vaccine, though consistent themes included protection and concerns over side effects. This study also found two general types of parents-those who treat vaccines the same and those with varying opinions about each vaccine. Results from this study demonstrate the family- and community-oriented nature of NHPI communities, suggesting that future interventions target not only parents but also their families and communities to cultivate vaccine acceptance through social networks. Furthermore, addressing all three vaccines during well-child visits may benefit parents who view each vaccine as separate entities with individual pros and cons. Such interventions could contribute toward reducing the burdens of particularly chronic health disparities.
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Affiliation(s)
| | - Melenaite Fifita
- University of California, Irvine, CA, USA
- Pacific Islander Health Partnership, Santa Ana, CA, USA
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9
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Kirui JC, Newberry DM, Harsh K. Strategies for Working With Parents With Vaccination Hesitancy. Neonatal Netw 2023; 42:254-263. [PMID: 37657807 DOI: 10.1891/nn-2022-0055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/19/2023] [Indexed: 09/03/2023]
Abstract
The purpose of this article is to provide an overview of effective strategies for working with parents' vaccination hesitancy or refusal. An overview of historical and current trends in vaccination hesitancy and factors that contribute to and strategies for addressing vaccine hesitancy are discussed. This includes an emphasis on the critical role played by health care providers, as trusted advisors and a primary source of health care information, in encouraging vaccine acceptance. Legal and ethical implications are also considered. Vaccination hesitancy strategies are most effective if they are timely, multifaceted, and collaborative.
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10
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Mansfield LN, Choi K, Delgado JR, Macias M, Munoz-Plaza C, Lewin B, Bronstein D, Chang J, Bruxvoort K. Decision-Making about COVID-19 Vaccines among Health Care Workers and Their Adolescent Children. West J Nurs Res 2023; 45:665-673. [PMID: 37096318 PMCID: PMC10280115 DOI: 10.1177/01939459231170981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2023]
Abstract
Health care workers promote COVID-19 vaccination for adolescent patients, and as parents, may influence their own children to get vaccinated. We conducted virtual, semi-structured qualitative interviews with vaccinated health care workers and their adolescent children to explore their decision-making process for COVID-19 vaccination. In total, 21 health care workers (physicians, nurses, and medical staff) and their adolescent children (N = 17) participated in interviews. The following three themes described parent-adolescent decision-making for COVID-19 vaccination: (1) family anticipation and hesitation about COVID-19 vaccine approval; (2) parents' or adolescents' choice: the decision maker for adolescent COVID-19 vaccination; and (3) leveraging one's vaccination status to encourage others to get vaccinated. Nurses encouraged adolescent autonomy in decisions for COVID-19 vaccination while physicians viewed vaccination as the parent's decision. Health care workers and their adolescent children used role-modeling to motivate unvaccinated peers and may model their decision-making process for adolescent COVID-19 vaccination with their own children to support their patients' and parents' vaccine decisions.
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Affiliation(s)
- Lisa N. Mansfield
- National Clinician Scholars Program,
Division of General Medicine & Health Services Research, Department of Medicine,
David Geffen School of Medicine at UCLA, University of California, Los Angeles, CA,
USA
- School of Nursing, University of North
Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Kristen Choi
- Department of Research &
Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA
- School of Nursing, University of
California, Los Angeles, CA, USA
- Department of Health Policy and
Management, Fielding School of Public Health, University of California, Los Angeles,
CA, USA
| | - Jeanne R. Delgado
- National Clinician Scholars Program,
Division of General Medicine & Health Services Research, Department of Medicine,
David Geffen School of Medicine at UCLA, University of California, Los Angeles, CA,
USA
- Division of General Pediatrics,
Department of Pediatrics, Children’s Hospital Los Angeles, University of Southern
California Keck School of Medicine, Los Angeles, CA, USA
| | - Mayra Macias
- Department of Research &
Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA
| | - Corrine Munoz-Plaza
- Department of Research &
Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA
| | - Bruno Lewin
- Southern California Permanente Medical
Group, Kaiser Permanente Southern California, Pasadena, CA, USA
| | - David Bronstein
- Southern California Permanente Medical
Group, Kaiser Permanente Southern California, Pasadena, CA, USA
| | - John Chang
- Department of Research &
Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA
| | - Katia Bruxvoort
- Department of Research &
Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA
- Department of Epidemiology, School of
Public Health, University of Alabama at Birmingham, Birmingham, AL, USA
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11
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Muscillo A, Lombardi G, Sestini E, Garbin F, Tambone V, Campanozzi LL, Pin P. Adolescents' Opinions on COVID-19 Vaccine Hesitancy: Hints toward Enhancing Pandemic Preparedness in the Future. Vaccines (Basel) 2023; 11:967. [PMID: 37243071 PMCID: PMC10222448 DOI: 10.3390/vaccines11050967] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 05/03/2023] [Accepted: 05/08/2023] [Indexed: 05/28/2023] Open
Abstract
To understand and assess vaccine reluctance, it is necessary to evaluate people's perceptions and grasp potential reasons for generic apprehension. In our analysis, we focus on adolescents' impressions towards anti-vaxxer behavior. The aim of the study is to figure out students' opinions about vaccine reluctance, connecting possible explanations that motivate anti-vaxxer decisions with common specific personality traits. We further investigate people's forecasts concerning the evolution of the pandemic. Between 2021 and 2022, we conducted a randomized survey experiment on a sample of high school individuals (N=395) living in different Italian regions. At that time, the vaccination campaign had already been promoted for nearly one year. From the analysis, it emerges that vaccinated people (92%), especially males, tend to be more pessimistic and attribute a higher level of generic distrust in science to anti-vaxxers. The results show that family background (mother's education) represents the most influential regressor: individuals coming from less educated families are less prone to attribute generic distrust and distrust of vaccines as principal reasons for vaccine reluctance. Similarly, those who rarely use social media develop a minor tendency to believe in a generic pessimism of anti-vaxxers. However, concerning the future of the pandemic, they are less likely to be optimistic toward vaccines. Overall, our findings shed light on adolescents' perceptions regarding the factors that influence vaccine hesitancy and highlight the need for targeted communication strategies to improve vaccination rates.
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Affiliation(s)
- Alessio Muscillo
- Department of Economics and Statistics, University of Siena, 53100 Siena, Italy
| | - Gabriele Lombardi
- Department of Statistics, Computer Science, Applications "Giuseppe Parenti", University of Florence, 50134 Florence, Italy
| | - Elena Sestini
- Department of Economics and Statistics, University of Siena, 53100 Siena, Italy
| | | | - Vittoradolfo Tambone
- Research Unit of Bioethics and Humanities, Campus Bio-Medico University of Rome, 00128 Rome, Italy
| | | | - Paolo Pin
- Department of Economics and Statistics, University of Siena, 53100 Siena, Italy
- Bocconi Institute for Data Science and Analytics (BIDSA), Bocconi Univerity, 20146 Milan, Italy
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Wu J, Quinn J, Middleman AB. Covering the Distance: A Study of Parent and Teen Attitudes on COVID-19 Mitigation Measures During the COVID-19 Pandemic. Cureus 2023; 15:e38615. [PMID: 37284384 PMCID: PMC10239983 DOI: 10.7759/cureus.38615] [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: 05/04/2023] [Indexed: 06/08/2023] Open
Abstract
Background The Unity® Consortium surveyed teens and parents and guardians of teens across the country at three distinct time points or waves during the COVID-19 pandemic to assess participant attitudes and beliefs regarding COVID-19 mitigation guidelines, such as mask-wearing and physical distancing. Methodology A third-party market research company conducted 15-minute, online surveys from nationally representative panels. Surveys were conducted at three distinct time points or waves (August 2020, February 2021, and June 2021) with 300 teens aged 13-18 years in each wave and 593/531/500 parents and guardians of teens aged 13-18 years in each wave, respectively. Participants responded using a five-point Likert scale (strongly agree to strongly disagree) on their COVID-19 experiences, including the perceived importance of strictly following mask-wearing and/or social distancing guidelines and the perceived effectiveness of mask-wearing and social distancing in preventing the spread of COVID-19. Data were analyzed for differences across waves and demographic variables. Statistical analyses included frequencies, analysis of variance (ANOVA), and t-tests/z-tests. Results While significantly more parents and teens in Waves 2 and 3 knew someone who was hospitalized or died due to COVID-19 compared to Wave 1, significantly fewer in Wave 3 reported experiencing a lot or some stress and worry regarding the pandemic. By Wave 3, 58% of teens and 56% of parents had received at least one dose of a COVID-19 vaccine. Despite changes in experiences over time, a significant majority of parents and teens consistently agreed on the importance and effectiveness of social distancing and masking guidelines against the spread of COVID-19. In Wave 3, the demographic variables significantly associated with agreement on importance included race (Black (92%) > White (80%)), community type (urban (91%) > suburban (79%) and rural (73%)), and positive vaccination status of parents and teens (92%/89%) > not vaccinated (73%/73%), respectively). The demographic variables significantly associated with agreement on effectiveness included race (Black (91%) > White (81%)), community type (urban (89%) > suburban (83%) and rural (71%)), and positive vaccination status of parents and teens (94%/90% > not vaccinated (72%/70%), respectively). Conclusions This study into the perceived importance and perceived effectiveness of mitigation strategies during the COVID-19 pandemic revealed differences in attitudes among sociodemographic groups. Understanding these differences can help shape how adherence to public health guidelines in a pandemic is promoted.
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Affiliation(s)
- Jillian Wu
- Pediatrics, Unity Consortium, Philadelphia, USA
| | - Jane Quinn
- Pediatrics, Unity Consortium, Philadelphia, USA
| | - Amy B Middleman
- Adolescent Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, USA
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13
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Jin SW, Lee Y, Brandt HM. Human Papillomavirus (HPV) Vaccination Knowledge, Beliefs, and Hesitancy Associated with Stages of Parental Readiness for Adolescent HPV Vaccination: Implications for HPV Vaccination Promotion. Trop Med Infect Dis 2023; 8:tropicalmed8050251. [PMID: 37235299 DOI: 10.3390/tropicalmed8050251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 04/18/2023] [Accepted: 04/20/2023] [Indexed: 05/28/2023] Open
Abstract
The vaccination against human papillomavirus (HPV) has shown effectiveness in preventing six different types of cancer. Despite a safe, effective HPV vaccine, vaccination coverage for adolescents remains suboptimal, especially in the Memphis, Tennessee metropolitan area. Parents/Guardians have a substantial influence on adolescent vaccination, but little is known about parental cognitive factors contributing to intent on adolescent HPV vaccination in this region. Thus, this study examined factors associated with stages of parental readiness for adolescent HPV vaccination by applying the transtheoretical model. A cross-sectional, online survey was conducted to collect quantitative data on sociodemographic characteristics; health-related information; HPV vaccination knowledge, beliefs, and hesitancy; and stages of readiness for adolescent HPV vaccination among parents. Convenience sampling was performed to recruit a total of 497 parents of adolescents aged 11-17 years in Shelby and Tipton Counties in Tennessee and DeSoto County in Mississippi. Binary logistic regression analyses showed that greater knowledge of HPV vaccination, greater perceived susceptibility to HPV, and lower levels of HPV vaccination hesitancy, respectively, distinguished higher from lower stages of parental readiness for adolescent HPV vaccination after controlling for other variables. The findings provide implications for developing readiness for stage-specific interventions targeted to effectively influence the parental decision-making process regarding HPV vaccination for adolescents.
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Affiliation(s)
- Seok Won Jin
- School of Social Work, The University of Memphis, 119 McCord Hall, Memphis, TN 38152, USA
- Department of Medical Humanities and Social Science, College of Medicine, Yonsei University, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea
| | - Yeonggeul Lee
- Social Science Research, University of Seoul, 163 Seoulsiripdaero, Dongdaemun-gu, Seoul 02504, Republic of Korea
| | - Heather M Brandt
- HPV Cancer Prevention Program, St. Jude Children's Research Hospital, 262 Danny Thomas Place, Memphis, TN 38105, USA
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14
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Harris JN, Mauro CM, Morgan TL, de Roche A, Zimet GD, Rosenthal SL. Factors impacting parental uptake of COVID-19 vaccination for U.S. Children ages 5-17. Vaccine 2023; 41:3151-3155. [PMID: 37045680 PMCID: PMC10080272 DOI: 10.1016/j.vaccine.2023.04.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 01/27/2023] [Accepted: 04/02/2023] [Indexed: 04/14/2023]
Abstract
COVID-19 vaccination of U.S. children lags behind adult vaccination, but remains critical in mitigating the pandemic. Using a subset of a nationally representative survey, this study examined factors contributing to parental uptake of COVID-19 vaccine for children ages 12-17 and 5-11, stratified by parental COVID-19 vaccination status. Among vaccinated parents, uptake was higher for 12-17-year-olds (78.6%) than 5-11-year-olds (50.7%); only two unvaccinated parents vaccinated their children. Child influenza vaccination was predictive of uptake for both age groups, while side effect concerns remained significant only for younger children. Although parents were more likely to involve adolescents in vaccine decision-making than younger children, this was not predictive of vaccine uptake. These results highlight the importance of addressing the unique and shared concerns parents have regarding COVID-19 vaccination for children of varying ages. Future work should further explore adolescent/child perspectives of involvement in COVID-19 vaccination decision-making to support developmentally appropriate involvement.
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Affiliation(s)
- Julen N Harris
- Department of Pediatrics, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, NY, USA; NewYork-Presbyterian Hospital, New York, NY, USA
| | - Christine M Mauro
- Department of Biostatistics at the Mailman School of Public Health at Columbia University Irving Medical Center, New York, NY, USA
| | - Tucker L Morgan
- Department of Biostatistics at the Mailman School of Public Health at Columbia University Irving Medical Center, New York, NY, USA
| | - Ariel de Roche
- Department of Pediatrics, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, NY, USA
| | - Gregory D Zimet
- Division of Adolescent Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Susan L Rosenthal
- Department of Pediatrics, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, NY, USA; Department of Psychiatry at Vagelos College of Physicians and Surgeons at Columbia University Irving Medical Center, New York, NY, USA.
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15
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English A, Middleman AB. Adolescents, Young Adults, and Vaccine Hesitancy: Who and What Drives the Decision to Vaccinate? Pediatr Clin North Am 2023; 70:283-295. [PMID: 36841596 DOI: 10.1016/j.pcl.2022.11.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/27/2023]
Abstract
Although vaccines are important for all age groups, issues of vaccine uptake and vaccine hesitancy have particular salience for the adolescent and young adult age group. This article reviews the importance of vaccination for adolescents and young adults, the variability in uptake of different vaccines, the reasons for vaccine hesitancy for this age group, and the legal framework for consent for vaccination. One important difference between vaccine hesitancy for adolescents and hesitancy for younger children or adults is the unique developmental, clinical, ethical, and legal context in which the decision to vaccinate is made.
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Affiliation(s)
- Abigail English
- Center for Adolescent Health & the Law, PO Box 3795, Chapel Hill, NC 27515, USA; Gillings School of Global Publlic Health, University of North Carolina, Chapel Hill.
| | - Amy B Middleman
- Department of Pediatrics, University of Oklahoma Health Sciences Center, 1200 Children's Avenue, Suite 12200, Oklahoma City, OK 73104, USA
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16
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Brandt S, Demmer RT, Walsh S, Mulcahy JF, Zepeda E, Yendell S, Hedberg C, Ulrich AK, Beebe T. COVID-19 Vaccine Hesitancy in a Population-Based Study of Minnesota Residents. Vaccines (Basel) 2023; 11:vaccines11040766. [PMID: 37112678 PMCID: PMC10143128 DOI: 10.3390/vaccines11040766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 03/24/2023] [Accepted: 03/29/2023] [Indexed: 04/03/2023] Open
Abstract
COVID-19 continues to be a public health concern in the United States. Although safe and effective vaccines have been developed, a significant proportion of the US population has not received a COVID-19 vaccine. This cross-sectional study aimed to describe the demographics and behaviors of Minnesota adults who have not received the primary series of the COVID-19 vaccine, or the booster shot using data from the Minnesota COVID-19 Antibody Study (MCAS) collected through a population-based sample between September and December 2021. Data were collected using a web-based survey sent to individuals that responded to a similar survey in 2020 and their adult household members. The sample was 51% female and 86% White/Non-Hispanic. A total of 9% of vaccine-eligible participants had not received the primary series and 23% of those eligible to receive a booster had not received it. Older age, higher education, better self-reported health, $75,000 to $100,000 annual household income, mask-wearing, and social distancing were associated with lower odds of hesitancy. Gender, race, and previous COVID-19 infection were not associated with hesitancy. The most frequently reported reason for not receiving a COVID-19 vaccination was safety concerns. Mask-wearing and being age 65 or older were the only strong predictors of lower odds of vaccine hesitancy for both the primary series and booster analyses.
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17
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Deng JS, Chen JY, Lin XQ, Huang CL, Tung TH, Zhu JS. Parental hesitancy against COVID-19 vaccination for children and associated factors in Taiwan. BMC Public Health 2023; 23:571. [PMID: 36973714 PMCID: PMC10041488 DOI: 10.1186/s12889-023-15158-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 01/30/2023] [Indexed: 03/29/2023] Open
Abstract
Background Since July 2021, some countries and regions have initiated the vaccination of minors against coronavirus disease (COVID-19), and parental COVID-19 vaccine hesitancy will affect the vaccination of minors. We aimed to identify the level of parental hesitancy to vaccinate their children against COVID-19 in Taiwan and the factors associated with vaccine hesitancy. Methods We conducted a population-based, self-administered online questionnaire in Taiwan to assess parental hesitancy and the factors influencing their children’s vaccination against COVID-19. Results Among 384 respondents, 64.1% were hesitant to have their children vaccinated against COVID-19. Mothers were more likely to hesitate to vaccinate their teens than their fathers (67.5% vs. 50%, P < 0.005). Multiple regression results showed that parents who were hesitant to vaccinate themselves (OR = 3.81, 95% CI:2.07–7.02) and those who scored lower on their perception of their children’s vaccination (OR = 9.73, 95% CI:5.62–16.84) were more hesitant to vaccinate their children with COVID-19 vaccine. Conclusions According to the study findings, 64.1% of Taiwanese parents were hesitant to vaccinate their children against COVID-19. Parents who were hesitant to receive the COVID-19 vaccine for themselves and had negative views of the vaccine for their children were more likely to be hesitant to vaccinate their children. An in-depth discussion of the factors affecting vaccine hesitancy and targeted health education is conducive to promoting vaccination in children with COVID-19.
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Affiliation(s)
- Jing-Shan Deng
- grid.469636.8Department of Infectious Diseases, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, 150 Ximen Street, Linhai, 317000 Zhejiang Province China
| | - Jau-Yuan Chen
- grid.454211.70000 0004 1756 999XDepartment of Family Medicine, Chang Gung Memorial Hospital Linkou Branch, Taoyuan City, Taiwan
| | - Xiao-Qing Lin
- grid.469636.8Department of Infectious Diseases, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, 150 Ximen Street, Linhai, 317000 Zhejiang Province China
| | - Chun-Lian Huang
- grid.469636.8Department of Infectious Diseases, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, 150 Ximen Street, Linhai, 317000 Zhejiang Province China
| | - Tao-Hsin Tung
- grid.469636.8Evidence-based Medicine Center, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, 150 Ximen Street, Linhai, 317000 Zhejiang Province China
| | - Jian-Sheng Zhu
- grid.469636.8Department of Infectious Diseases, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, 150 Ximen Street, Linhai, 317000 Zhejiang Province China
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18
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Kim S, Zhou K, Parker S, Kline KN, Montealegre JR, McGee LU. Perceived Barriers and Use of Evidence-Based Practices for Adolescent HPV Vaccination among East Texas Providers. Vaccines (Basel) 2023; 11:vaccines11040728. [PMID: 37112640 PMCID: PMC10146224 DOI: 10.3390/vaccines11040728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 03/17/2023] [Accepted: 03/21/2023] [Indexed: 03/29/2023] Open
Abstract
Adolescents living in rural areas are less likely to be up to date on the human papillomavirus (HPV) vaccine, which can prevent cervical cancer. We administered a telephone survey to 27 clinics in rural East Texas to assess perceived barriers to HPV vaccination and current use of evidence-based interventions to promote HPV vaccination. Perceived barriers were assessed using a 5-point Likert scale and clinical implementation of evidence-based practices was determined. Findings are reported using descriptive statistics. The most commonly reported barriers were missed vaccination opportunities due to the pandemic (66.7%), followed by vaccine hesitancy due to the pandemic (44.4%) and due to the HPV vaccine specifically (33.3%). Fewer than a third of clinics reported using the evidence-based strategies of use of a “refusal to vaccinate” form (29.6%), having an identified HPV vaccine champion (29.6%), and recommending the HPV vaccine at age 9 (22.2%). While many clinics surveyed currently implement evidence-based practices to promote HPV vaccination, there is a need and desire for additional HPV vaccination interventions in East Texas clinics.
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Affiliation(s)
- Sarah Kim
- Department of Medical Education, Baylor College of Medicine, Houston, TX 77030, USA
| | - Kelvin Zhou
- Department of Medical Education, Baylor College of Medicine, Houston, TX 77030, USA
| | - Susan Parker
- Dan L. Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, TX 77030, USA
| | - Kimberly N. Kline
- Department of Communication, The University of Texas at San Antonio, San Antonio, TX 78249, USA
| | - Jane R. Montealegre
- Dan L. Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, TX 77030, USA
- Department of Pediatrics, Baylor College of Medicine, Houston, TX 77030, USA
| | - Lindy U. McGee
- Dan L. Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, TX 77030, USA
- Department of Pediatrics, Baylor College of Medicine, Houston, TX 77030, USA
- Correspondence: ; Tel.: +1-713-873-6356
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19
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Factors Affecting Vaccine Attitudes Influenced by the COVID-19 Pandemic. Vaccines (Basel) 2023; 11:vaccines11030516. [PMID: 36992100 DOI: 10.3390/vaccines11030516] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 02/20/2023] [Accepted: 02/21/2023] [Indexed: 02/25/2023] Open
Abstract
The development of vaccines has significantly contributed to the success of disease prevention. However, there has been a sharp decline in immunization rates since COVID-19 spread globally. Seemingly overnight, the world shut down and most non-essential medical procedures were postponed. Since the COVID-19 vaccine became available, and the world started going back to normal these vaccine rates have not recovered. In this paper, we review the published literature to explore how convenience factors, perceived risk of vaccination, media or anti-vaccination ideals/movements, and healthcare professionals affect an individual’s compliance to be vaccinated to better understand the factors that contribute to the change in overall vaccination rates.
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20
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Coronado GD, Petrik AF, Slaughter M, Kepka D, Naleway AL. Adolescents Who Have Undergone Human Papillomavirus Vaccination Are More Likely to Get a COVID-19 Vaccine. J Adolesc Health 2023; 72:985-988. [PMID: 36781325 PMCID: PMC9918864 DOI: 10.1016/j.jadohealth.2022.12.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 11/22/2022] [Accepted: 12/22/2022] [Indexed: 02/13/2023]
Abstract
PURPOSE Human papillomavirus (HPV) and COVID-19 vaccination are both recommended for adolescents of ages 12-17. In May 2021, the Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices allowed the two vaccines to be administered concurrently. METHODS We identified adolescents of ages 12-17 using electronic health records from a large integrated delivery system. We assessed associations between socio-demographic characteristics and uptake of HPV vaccination and COVID-19 vaccination, as well as the cumulative proportion of adolescents who obtained a COVID-19 vaccine over time by HPV vaccination status. RESULTS We identified 40,819 adolescents; 65% had received any COVID-19 vaccination, and 79% had received any HPV vaccination. Adolescents who had initiated HPV vaccination had about 4-fold greater odds of having obtained a COVID-19 vaccine than those who had not (odds ratio = 4.02, 95% confidence interval = 3.81, 4.24). DISCUSSION Patterns of vaccination uptake suggest possible advantages to co-promotion of adolescent vaccines.
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Affiliation(s)
- Gloria D. Coronado
- Kaiser Permanente Center for Health Research, Portland, Oregon,Address correspondence to: Gloria D. Coronado, Ph.D., Kaiser Permanente Center for Health Research, 3800 N. Interstate Ave., Portland, OR 97227
| | | | | | - Deanna Kepka
- University of Utah School of Nursing, Salt Lake City, Utah
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21
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Owens C, Brandenburg D, Grant MJ, Carter K, Hoffman M, Hubach RD. Parental Concerns of Their Sexual and Gender Minority Adolescents Using HIV Pre-Exposure Prophylaxis. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2023; 35:85-99. [PMID: 36735230 DOI: 10.1521/aeap.2023.35.1.85] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Although parents of sexual and gender minority (SGM) adolescents are key stakeholders in SGM adolescents using HIV pre-exposure prophylaxis (PrEP), there is limited understanding of parental concerns and attitudes about their SGM adolescents taking PrEP. Fifty-four parents in the West South Central region of the U.S. completed an online, mixed-method, cross-sectional questionnaire to explore their concerns and questions about PrEP. Quantitative and qualitative results show that participants were more concerned about side effects, drug interactions, (non)adherence, and eligibility and duration of PrEP. Parents are less worried about picking PrEP from a pharmacy or returning to follow-up lab testing every three months. Most parents reported receiving medication information their adolescent takes from a medical provider and the media. Findings from this study can inform the development of parent-based PrEP interventions. Without further parent-based research and programming, SGM adolescents may continue to be disproportionately affected by HIV.
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Affiliation(s)
- Christopher Owens
- Department of Health Behavior, School of Public Health, Texas A&M University, College Station, Texas
- Center for Health Equity and Evaluation Research, School of Public Health, Texas A&M University
| | - Dakota Brandenburg
- Department of Public Health, College of Health and Human Sciences, Purdue University, West Lafayette, Indiana
| | - Morgan J Grant
- Department of Health Behavior, School of Public Health, Texas A&M University, College Station, Texas
- Center for Health Equity and Evaluation Research, School of Public Health, Texas A&M University
| | - Kaileigh Carter
- Department of Health Behavior, School of Public Health, Texas A&M University, College Station, Texas
| | | | - Randolph D Hubach
- Department of Public Health, College of Health and Human Sciences, Purdue University, West Lafayette, Indiana
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22
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Knowledge, Attitude, and Behavior toward COVID-19 Vaccination in Young Italians. Vaccines (Basel) 2023; 11:vaccines11010183. [PMID: 36680027 PMCID: PMC9865392 DOI: 10.3390/vaccines11010183] [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: 12/23/2022] [Revised: 01/09/2023] [Accepted: 01/13/2023] [Indexed: 01/18/2023] Open
Abstract
Purpose: The knowledge, attitudes, and behavior of young Italians towards the COVID-19 vaccination were analyzed in order to provide information useful to elaborate the strategies that can be implemented to obtain the best possible vaccination coverage in this population. Methods: A cross-sectional study was conducted on 5313 young people aged between 11 and 30 years. Data were collected through an online survey during the period from 1 to 10 March 2021. The answers to the questionnaire were analyzed using SPSS statistical software. Intention to vaccinate was studied by univariate analysis using Pearson’s chi-square test to assess differences between groups for categorical variables, and by multivariate analysis applying the binary logistic regression model, and the Hosmer−Lemeshow test was performed to assess goodness of fit. Results: Television (32.1%), internet/search engine (25.9%), and social networks (10.4%) were the main sources of information for young Italians. The survey analysis showed that 74.5% (3956) of the respondents were willing to be vaccinated against COVID-19 versus 25.5% (1357) who were against it. Demographic data, in particular, age, gender, experience with influenza vaccine, and level of knowledge about the disease, were significant determinants (p < 0.001) for the choice to vaccinate against COVID-19. Discussion: These results suggest that in order to implement the vaccination campaign, correct information is needed to improve awareness of the vaccine and COVID-19, while also taking into account the target group, which differs not only in age but also in the sources of information used compared to the adult population.
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23
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Venkatesh S, Gill A, Kim L, Doan SN. Mothers' intentions to vaccinate their children for COVID-19. AIMS Public Health 2023; 10:209-218. [PMID: 37063353 PMCID: PMC10091125 DOI: 10.3934/publichealth.2023016] [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: 10/22/2022] [Revised: 01/30/2023] [Accepted: 03/05/2023] [Indexed: 04/18/2023] Open
Abstract
Parents' intentions to vaccinate their children is an important area of investigation in light of the COVID-19 pandemic. There is a growing body of research examining factors that influence parents' vaccine intentions. The current study investigated factors that would influence maternal intent to vaccinate their children for COVID-19, shortly before the CDC approved vaccines for children 11 and younger. We had a sample of n = 176 mothers (Mchildage = 71.63 months, 52% White) from California fill out an online survey during February-April 2021. Our results suggest that perceived COVID-19 threat predicts mothers' intention to vaccinate their children (b = 0.370, p < 0.001), controlling for mothers' age, socioeconomic status, race, and child age. Child age (b = 0.027, p = 0.008), SES (b = 0.396, p = 0.018), and child previous flu shot (b = 0.725, p < 0.001) also positively predicted mothers' intention to vaccinate their children. Results are discussed in light of prior research on maternal vaccine intentions and hesitancy.
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Affiliation(s)
- Shruthi Venkatesh
- Department of Psychology, University of North Carolina, Greensboro
- * Correspondence:
| | - Alexandra Gill
- Department of Psychological Science, Pomona College, Claremont, CA
| | - Lauren Kim
- Department of Psychological Science, Pomona College, Claremont, CA
| | - Stacey N Doan
- Department of Psychological Science, Claremont Mckenna College and Department of Population Sciences, City of Hope National Medical Center
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Abstract
Purpose of Review In 2019, vaccine hesitancy (VH) was named as one of the top 10 threats to global health by the World Health Organization (WHO). We highlight the factors affecting VH, the role of VH in limiting vaccine uptake and inability to achieve collective immunity, and possible solutions. Recent Findings There are still uncertainties and concerns about the safety and efficacy of vaccines, which promote VH and undermine public confidence in immunization. WHO has designed the behavioral and social drivers (BeSD) tools and survey instruments that can be used by countries to assess reasons for poor vaccine uptake in childhood for COVID-19 and plan national vaccination programs to counter these misconceptions. Summary Vaccines are one of the best preventative measures that public health care has to offer. Evidence from across the world both in high-income countries (HICs) and low/middle-income countries (LMICs) show that VH is a significant phenomenon which is translating into geographical clustering of epidemics. A reasonably high acceptance and coverage rates are necessary for an immunization program to be successful. A context-specific and multifactorial intervention with more high-quality research is needed globally.
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25
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The Role of Knowledge, Attitude, Confidence, and Sociodemographic Factors in COVID-19 Vaccination Adherence among Adolescents in Indonesia: A Nationwide Survey. Vaccines (Basel) 2022; 10:vaccines10091489. [PMID: 36146569 PMCID: PMC9505584 DOI: 10.3390/vaccines10091489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 08/29/2022] [Accepted: 09/01/2022] [Indexed: 11/16/2022] Open
Abstract
COVID-19 vaccination in adolescents is important because the adolescent population has the highest incidence of COVID-19. This study aimed to explore the factors associated with COVID-19 vaccination adherence among Indonesian adolescents. This cross-sectional study involved 7986 adolescents, polled through online and offline surveys conducted in six major islands of Indonesia. The online questionnaire was distributed through popular social messaging and social media platforms. Our team also contacted schools and public places to recruit participants from remote areas. In total, 7299 respondents completed the questionnaire. Binary logistic analysis revealed that higher levels of knowledge, positive attitudes, and confidence in the COVID-19 vaccine were significantly associated with higher COVID-19 vaccination adherence in adolescents. Sociodemographic factors were also significantly associated with higher adherence to vaccination programs. Meanwhile, younger age and habitation in private housing were related to lower adherence to the vaccination program. Parental factors related to adolescent compliance were education level, household income, history of infection of family or friends with COVID-19, and working status. The national authorities and stakeholders should take extensive measures to increase attitude, knowledge, confidence, and family support among adolescence through multiple channels.
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26
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Shah MD, Szilagyi PG, Shetgiri R, Delgado JR, Vangala S, Thomas K, Dudovitz RN, Vizueta N, Darling J, Kapteyn A. Trends in Parents' Confidence in Childhood Vaccines During the COVID-19 Pandemic. Pediatrics 2022; 150:188519. [PMID: 35831931 PMCID: PMC10038210 DOI: 10.1542/peds.2022-057855] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/30/2022] [Indexed: 11/24/2022] Open
Affiliation(s)
- Megha D. Shah
- Los Angeles County Department of Public Health, Office of Health Assessment and Epidemiology, Los Angeles, CA
| | - Peter G. Szilagyi
- Department of Pediatrics, UCLA Mattel Children’s Hospital, University of California at Los Angeles, Los Angeles, CA
| | - Rashmi Shetgiri
- Los Angeles County Department of Public Health, Office of Health Assessment and Epidemiology, Los Angeles, CA
| | - Jeanne R. Delgado
- National Clinician Scholars Program, Division of General Internal Medicine and Health Services Research, University of California at Los Angeles, Los Angeles, CA
| | - Sitaram Vangala
- Department of Medicine Statistics Core, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, CA
| | - Kyla Thomas
- Dornsife College of Letters Arts and Sciences, Center for Economic and Social Research, University of Southern California, Los Angeles, CA
| | - Rebecca N. Dudovitz
- Department of Pediatrics, UCLA Mattel Children’s Hospital, University of California at Los Angeles, Los Angeles, CA
| | - Nathalie Vizueta
- Department of Pediatrics, UCLA Mattel Children’s Hospital, University of California at Los Angeles, Los Angeles, CA
| | - Jill Darling
- Dornsife College of Letters Arts and Sciences, Center for Economic and Social Research, University of Southern California, Los Angeles, CA
| | - Arie Kapteyn
- Dornsife College of Letters Arts and Sciences, Center for Economic and Social Research, University of Southern California, Los Angeles, CA
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Lee H, Choe YJ, Kim S, Cho HK, Choi EH, Lee J, Bae H, Choi SR, You M. Attitude and Acceptance of COVID-19 Vaccine in Parents and Adolescents: A Nationwide Survey. J Adolesc Health 2022; 71:164-171. [PMID: 35718652 PMCID: PMC9212673 DOI: 10.1016/j.jadohealth.2022.05.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 04/28/2022] [Accepted: 05/16/2022] [Indexed: 12/20/2022]
Abstract
PURPOSE Coronavirus disease 2019 (COVID-19) vaccines are currently authorized for emergency use in adolescents aged 12-17 years; however, there is concern and uncertainty regarding the safety and necessity of COVID-19 vaccination. A survey was carried out to assess the attitudes and acceptance towards vaccination in adolescents. METHODS A nationwide web-based survey was conducted among adolescents aged 12-17 years and their parents between June 29 and July 8, 2021 on a platform provided by the Ministry of Education. RESULTS A total of 341,326 parents and 272,914 adolescents participated in this study. Intention for vaccination was 69.1% for adolescents, and 72.2% of parents reported they would recommend vaccination for their child. Among adolescents, perception of safety (odds ratio [OR] 4.09, 95% confidence interval [CI] 3.95-4.22), effectiveness (OR 2.24, 95% CI 2.17-2.32), and risk-benefit (OR 1.75, 95% CI 1.72-1.78) had the highest impact on intention for vaccination. Also, perceived risk (OR 1.14, 95% CI 1.12-1.17), severity (OR 1.12, 95% CI 1.10-1.13) for COVID-19 infection, self-health perception (OR 1.12, 95%, CI 1.10-1.14) and recent vaccination of childhood vaccines (OR 1.25, 95% CI 1.19-1.32) were related to intention for COVID-19 vaccination. On the other hand, self-perceived knowledge (OR 0.96, 95% 0.95-0.98) was related to vaccine hesitancy. Gender or school district did not influence intention for COVID-19 vaccination in adolescents. DISCUSSION Decisions on COVID-19 vaccination for adolescents should be a shared process between adolescents, parents, and physicians based on updated information on safety and effectiveness.
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Affiliation(s)
- Hyunju Lee
- Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Korea,Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
| | - Young June Choe
- Department of Pediatrics, Korea University Anam Hospital, Seoul, Korea
| | - Shinkyeong Kim
- Department of Public Health Sciences, Graduate School of Public Health, Seoul National University, Seoul, Korea
| | - Hye-Kyung Cho
- Department of Pediatrics, Gachon University College of Medicine, Gil Medical Center, Incheon, Korea
| | - Eun Hwa Choi
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea,Department of Pediatrics, Seoul National University Children's Hospital, Seoul, Korea
| | - Jia Lee
- Division of Immunization, Korea Disease Control and Prevention Agency, Cheongju, Korea
| | - Hyuna Bae
- Division of Immunization, Korea Disease Control and Prevention Agency, Cheongju, Korea
| | - Sae-Rom Choi
- Division of Immunization, Korea Disease Control and Prevention Agency, Cheongju, Korea
| | - Myoungsoon You
- Department of Public Health Sciences, Graduate School of Public Health, Seoul National University, Seoul, Korea.
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28
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Khatatbeh M, Albalas S, Khatatbeh H, Momani W, Melhem O, Al Omari O, Tarhini Z, A'aqoulah A, Al-Jubouri M, Nashwan AJ, Adwan G, Altaany Z, Nashwan A, Al-Waqfi K, Abuirsheid L, Ayasreh R, Al Mutairi M, Al-Tammemi AB. Children's rates of COVID-19 vaccination as reported by parents, vaccine hesitancy, and determinants of COVID-19 vaccine uptake among children: a multi-country study from the Eastern Mediterranean Region. BMC Public Health 2022; 22:1375. [PMID: 35850675 PMCID: PMC9294741 DOI: 10.1186/s12889-022-13798-2] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 07/11/2022] [Indexed: 01/22/2023] Open
Abstract
Background Huge efforts are being made to control the spread and impacts of the coronavirus pandemic using vaccines. However, willingness to be vaccinated depends on factors beyond the availability of vaccines. The aim of this study was three-folded: to assess children’s rates of COVID-19 Vaccination as reported by parents, to explore parents’ attitudes towards children’s COVID-19 vaccination, and to examine the factors associated with parents’ hesitancy towards children’s vaccination in several countries in the Eastern Mediterranean Region (EMR). Methods This study utilized a cross-sectional descriptive design. A sample of 3744 parents from eight countries, namely, Iraq, Jordan, Kuwait, Lebanon, Palestine, Qatar, Saudi Arabia (KSA), and the United Arab Emirates (UAE), was conveniently approached and surveyed using Google forms from November to December 2021. The participants have responded to a 42-item questionnaire pertaining to socio-demographics, children vaccination status, knowledge about COVID-19 vaccines, and attitudes towards vaccinating children and the vaccine itself. The Statistical Package for Social Sciences (SPSS- IBM, Chicago, IL, USA) was used to analyze the data. A cross-tabulation analysis using the chi-square test was employed to assess significant differences between categorical variables and a backward Wald stepwise binary logistic regression analysis was performed to assess the independent effect of each factor after controlling for potential confounders. Results The prevalence of vaccinated children against COVID-19 was 32% as reported by the parents. Concerning parents’ attitudes towards vaccines safety, about one third of participants (32.5%) believe that all vaccines are not safe. In the regression analysis, children’s vaccination was significantly correlated with parents’ age, education, occupation, parents’ previous COVID-19 infection, and their vaccination status. Participants aged ≥50 years and those aged 40-50 years had an odds ratio of 17.9 (OR = 17.9, CI: 11.16-28.97) and 13.2 (OR = 13.2, CI: 8.42-20.88); respectively, for vaccinating their children compared to those aged 18-29 years. Parents who had COVID-19 vaccine were about five folds more likely to vaccinate their children compared with parents who did not receive the vaccine (OR = 4.9, CI: 3.12-7.70). The prevalence of children’s vaccination in the participating Arab countries is still not promising. Conclusion To encourage parents, vaccinate their children against COVID-19, Arab governments should strategize accordingly. Reassurance of the efficacy and effectiveness of the vaccine should target the general population using educational campaigns, social media, and official TV and radio channels. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13798-2.
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Affiliation(s)
- Moawiah Khatatbeh
- Department of Basic Medical Sciences, Faculty of Medicine, Yarmouk University, Irbid, Jordan.
| | - Samir Albalas
- Department of Health Services Administration, Yarmouk University, Irbid, Jordan
| | - Haitham Khatatbeh
- Doctoral School of Health Sciences, Faculty of Health Sciences, University of Pécs, Pécs, Hungary
| | - Waleed Momani
- Department of Basic Medical Sciences, Faculty of Medicine, Yarmouk University, Irbid, Jordan
| | - Omar Melhem
- Department of Nursing, Fatima College of Health Sciences, Abu Dhabi, United Arab Emirates
| | - Omar Al Omari
- College of Nursing, Sultan Qaboos University, Muscat, Oman
| | - Zeinab Tarhini
- CAPTuR Laboratory, Control of Cell Activation in Tumor Progression and Therapeutic Resistance, Limoges, France.,Institute of Epidemiology and Tropical Neurology, GEIST, Limoges, France
| | - Ashraf A'aqoulah
- Department of Health Systems Management, College of Public Health and Health Informatics, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.,King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | | | - Abdulqadir J Nashwan
- Nursing Department, Hazm Mebaireek General Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Ghaleb Adwan
- Department of Biology and Biotechnology, An-Najah National University, Nablus, Palestine
| | - Zaid Altaany
- Department of Basic Medical Sciences, Faculty of Medicine, Yarmouk University, Irbid, Jordan
| | - Ayat Nashwan
- Department of Sociology and Social Work, Yarmouk University, Irbid, Jordan
| | - Khaled Al-Waqfi
- Department of Basic Medical Sciences, Faculty of Medicine, Yarmouk University, Irbid, Jordan
| | - Lujain Abuirsheid
- Department of Basic Medical Sciences, Faculty of Medicine, Yarmouk University, Irbid, Jordan
| | - Raghad Ayasreh
- Department of Basic Medical Sciences, Faculty of Medicine, Yarmouk University, Irbid, Jordan
| | | | - Ala'a B Al-Tammemi
- Migration Health Division, International Organization for Migration (IOM), Amman, Jordan
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COVID-19 Vaccine Hesitancy among Adolescents: Cross-Sectional School Survey in Four Chinese Cities Prior to Vaccine Availability. Vaccines (Basel) 2022; 10:vaccines10030452. [PMID: 35335083 PMCID: PMC8952375 DOI: 10.3390/vaccines10030452] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 03/09/2022] [Accepted: 03/14/2022] [Indexed: 02/01/2023] Open
Abstract
To address the novel coronavirus disease (COVID-19) pandemic, development and regulatory evaluations have been accelerated for vaccines, authorizing emergency use. To anticipate vaccine preparedness in adolescents, we studied COVID-19 vaccination awareness and willingness to vaccinate before the vaccine became available. We conducted a cross-sectional survey among 9153 (4575 boys, 50%) students with a mean age of 14.2 years old in four cities in China to collect information on demographic characteristics and their COVID-19 vaccination concerns. Multinomial logistic regression was used to analyze the influencing factors of vaccine hesitancy (“not sure”) and resistance (“do not want it”). The results showed that 2891 (31.6%) were hesitant and 765 (8.4%) were resistant to being vaccinated. Additionally, multivariable analyses showed that vaccine hesitancy and vaccine resistance were associated with living in the Beijing area (OR = 1.62; 95% CI: 1.40–1.88; OR = 1.81; 95% CI: 1.44–2.28), lack of influenza vaccination experience (OR = 1.33; 95% CI: 1.14–1.55; OR = 1.57; 95% CI: 1.25–1.98), no perceived susceptibility (OR = 1.72; 95% CI: 1.50–1.97; OR = 3.57; 95% CI: 2.86–4.46), and perceiving no cues to action (OR = 3.24; 95% CI: 2.56–4.11; OR = 27.68; 95% CI: 21.81–35.13). Postulating a highly effective vaccine (OR = 0.84; 95% CI: 0.72–0.98; OR = 0.66; 95% CI: 0.52–0.83) decreased both vaccine hesitancy and resistance. Vaccine hesitancy alone was associated with girls (OR = 1.21; 95% CI: 1.09–1.36) and was less common among students boarding at school (OR = 0.79; 95% CI: 0.68–0.92), postulating convenient vaccine access (OR = 0.84; 95% CI: 0.73–0.96), and having doctors’ recommendation (OR = 0.86; 95% CI: 0.76–0.98). In conclusion, the results of the study showed that vaccine hesitancy among students in China was associated with limited health literacy and lower risk awareness. Our findings in China suggest that educating youth regarding COVID-19 and the safety and effectiveness of immunization help reduce concerns and increase vaccine confidence and acceptance.
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