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Tan YK, Siau CS, Ibrahim N, Kõlves K, Zhang J, Chan CMH, Ho MC, Gan CH, Amit N, Mohd Ridzwan Goh NS, Chan LF. Validation of the Malay version of the Patient Health Questionnaire-4 (PHQ-4) among Malaysian undergraduates. Asian J Psychiatr 2024; 99:104134. [PMID: 39018701 DOI: 10.1016/j.ajp.2024.104134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Revised: 05/05/2024] [Accepted: 05/18/2024] [Indexed: 07/19/2024]
Abstract
The study's objective is to validate the Malay version of the Patient Health Questionnaire-4 (PHQ-4) among Malaysian undergraduates. A cross-sectional survey was distributed at three universities in Malaysia (N = 500; mean age = 21.66 ± 1.57). The internal consistency of the Malay PHQ-4 was acceptable (α = .78, 95 % CI [.74, .81]), while the test-retest reliability was good (ICC = .77, 95 % CI [.34, .91], p < .001). The one-factor structure showed the best fit in confirmatory factor analysis and was similar across sexes. The Malay PHQ-4 has acceptable psychometric properties and can be used for pre-clinical screening purposes among Malaysian undergraduate students.
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Affiliation(s)
- Yee Kee Tan
- Centre for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.
| | - Ching Sin Siau
- Centre for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.
| | - Norhayati Ibrahim
- Centre for Healthy Aging and Wellness (H-Care), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia; Institute of Islam Hadhari, Universiti Kebangsaan Malaysia, Bangi, Malaysia.
| | - Kairi Kõlves
- Australian Institute for Suicide Research and Prevention, World Health Organization Collaborating Centre for Research and Training in Suicide Prevention, School of Applied Psychology, Griffith University, Mt. Gravatt, Queensland, Australia.
| | - Jie Zhang
- School of Public Health, Shandong University, Jinan, China; Department of Sociology, State University of New York, Buffalo State, Buffalo, NY, USA.
| | - Caryn Mei Hsien Chan
- Centre for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.
| | - Meng Chuan Ho
- Centre for Pre-U Studies, UCSI University (Springhill Campus), Port Dickson, Malaysia.
| | - Chun Hong Gan
- Centre for Rehabilitation and Special Needs Studies (iCaRehab), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.
| | - Noh Amit
- Centre for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.
| | | | - Lai Fong Chan
- Department of Psychiatry, Faculty of Medicine, National University of Malaysia (UKM), Kuala Lumpur, Malaysia.
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Ngamchaliew P, Kaewkuea N, Nonthasorn N, Vonnasrichan T, Rongsawat N, Rattanachai L, Chaipipattanakij W, Kamolnawin S, Vichitkunakorn P. Acceptance of COVID-19 vaccination and vaccine confidence levels in Thailand: A cross-sectional study. Vaccine 2023; 41:6589-6598. [PMID: 37743117 DOI: 10.1016/j.vaccine.2023.09.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 09/01/2023] [Accepted: 09/10/2023] [Indexed: 09/26/2023]
Abstract
BACKGROUND Vaccination is considered effective for minimising the impact of COVID-19. Pandemic control depends on high vaccination rates and confidence levels among the population. This study determined COVID-19 vaccine acceptance and confidence levels among vaccinated Thai participants. METHODS An online cross-sectional study was conducted between 13 September 2021 and 14 January 2022 among individuals ≥ 18 years. An online questionnaire was distributed via social media platforms and posters in public places in Thailand. It included four components (demographic characteristics, COVID-19 vaccine regimens, vaccine acceptance, and confidence). Statistical analyses included a chi-squared test, Wilcoxon signed-rank test, and multivariate logistic regressions. RESULTS Approximately 88.4% of the participants accepted the vaccine. Almost half had confidence in 'unconcerned about vaccine side effects' (48.2%), 'trust in vaccine effectiveness' (44.3%) and 'trust in government vaccine policy' (43.4%). Multiple logistic regression indicated that males and high education significantly correlated with vaccine acceptance. Higher age (45-59 years and ≥ 60 years) and low monthly income (≤5,000 THB) were significantly associated with trust in government vaccine policy. The 1stCoronaVac/2ndCoronaVac/3rdBNT162b2 regimen group was significantly associated with unconcern about vaccine side effects compared to the 1stAZD1222/2ndAZD1222 regimen group. CONCLUSIONS Over half of vaccinated participants indicated concern about COVID-19 vaccine side effects and distrust in vaccine effectiveness and government policy; nonetheless, almost all took the COVID-19 vaccine. Participants who received the 1stCoronaVac/2ndCoronaVac/3rdBNT162b2 regimen were unconcerned about vaccine side effects. Some socio-demographic factors were associated with vaccine acceptance and high confidence, which should be sought while designing interventions to improve COVID-19 vaccination rates.
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Affiliation(s)
- P Ngamchaliew
- Department of Family and Preventive Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand
| | - N Kaewkuea
- Medical Student, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand
| | - N Nonthasorn
- Medical Student, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand
| | - T Vonnasrichan
- Medical Student, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand
| | - N Rongsawat
- Medical Student, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand
| | - L Rattanachai
- Medical Student, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand
| | - W Chaipipattanakij
- Medical Student, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand
| | - S Kamolnawin
- Medical Student, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand
| | - P Vichitkunakorn
- Department of Family and Preventive Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand.
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Groenewald C, Isaacs D, Maluleka M. "It Doesn't Cure, but It Protects": COVID-19 Vaccines through the Eyes of Children and Their Parents. Vaccines (Basel) 2023; 11:1305. [PMID: 37631873 PMCID: PMC10459681 DOI: 10.3390/vaccines11081305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 07/18/2023] [Accepted: 07/27/2023] [Indexed: 08/27/2023] Open
Abstract
Recently, studies have examined COVID-19 vaccine acceptance and/or hesitancy amongst adult populations across the globe. However, there is a paucity of literature illustrating children's voices in vaccination debates. This article draws on qualitative data collected via a mixed-methods study that explored South Africans' experiences during the COVID-19 pandemic between 2020 and 2021. Interviews were conducted with a purposive sample (N = 29) of children (>18 years) and their parents regarding their initial perspectives on COVID-19 vaccines. Given the dyadic nature of our study, we explored the intergenerational influence that parents' perspectives had on children's vaccine acceptability and the role that vaccine literacy, or lack thereof, played in vaccine decision making. Findings showed a great level of vaccine acceptability among children and parents, where many placed hopes in the vaccines to promote societal health and wellbeing. Intergenerational transfer of perspectives was observed where children's willingness to receive a vaccine was intrinsically linked to their parents' vaccine acceptability. Some participants also expressed concerns about COVID-19 vaccines, related to misinformation, mistrust, and limited vaccine literacy. We discuss the findings as they relate to vaccine and health literacy, also considering the prospective implications of this work as we enter the "recovery" period of the pandemic.
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Affiliation(s)
- Candice Groenewald
- Human and Social Capabilities Division, Human Sciences Research Council, Durban 4001, South Africa;
- Department of Psychology, Rhodes University, Makhanda 6139, South Africa
- South African Research Ethics Training Initiative, University of KwaZulu-Natal, Pietermaritzburg 3209, South Africa
- DSI-NRF Centre of Excellence in Human Development, University of the Witwatersrand, Johannesburg 2000, South Africa
| | - Dane Isaacs
- Desmond Tutu Centre for Religion and Social Justice, University of the Western Cape, Cape Town 7535, South Africa;
| | - Mafanato Maluleka
- Human and Social Capabilities Division, Human Sciences Research Council, Durban 4001, South Africa;
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4
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Santi T, Hegar B, Munasir Z, Prayitno A, Werdhani RA, Bandar INS, Jo J, Uswa R, Widia R, Vandenplas Y. Factors associated with parental intention to vaccinate their preschool children against COVID-19: a cross-sectional survey in urban area of Jakarta, Indonesia. Clin Exp Vaccine Res 2023; 12:240-248. [PMID: 37599811 PMCID: PMC10435772 DOI: 10.7774/cevr.2023.12.3.240] [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: 03/10/2023] [Revised: 04/07/2023] [Accepted: 04/12/2023] [Indexed: 08/22/2023] Open
Abstract
Purpose We reported a survey-based study assessing the parental intention to vaccinate children of 5 to 7 years old against coronavirus disease 2019 (COVID-19). The aim of this study is to assess factors influencing the parental intention to vaccinate their children against COVID-19. Materials and Methods This study adopted a cross-sectional design, held at the public health center of Senen district, Jakarta, Indonesia from November 1-30, 2022. The off-line questionnaires were distributed via the school administrator to all eligible parents. Factors associated with intention to vaccinate were analyzed with the regression logistic models. Results Of the 435 parents in this study, 215 had already vaccinated their children against COVID-19 (49.4%), and the overall intention of the participants to vaccinate was 69.7%. Factors associated with intention to vaccinate the children against COVID-19 were parental employment status, parental COVID-19 vaccine status and concern of contracting COVID-19. Parents who are employed, had completed vaccines with COVID-19 booster vaccine, and had concern of their children contracting COVID-19 were more likely to vaccinate their children (odds ratio [OR], 2.10; 95% confidence interval [CI], 1.22-3.69; p=0.011; OR, 2.15; 95% CI, 1.21-3.83; p=0.013; OR, 2.40; 95% CI, 1.34-4.30; p=0.004, respectively). Concern on the vaccine's side effects was negatively associated with the willingness to vaccinate. Conclusion This study showed that childhood COVID-19 vaccine only covered half of the population, with parental intentions for childhood COVID-19 vaccination being high, reaching almost two-thirds of the study participants. Factors influencing parental intentions were employment status, parental COVID-19 vaccine status, concerns about COVID-19 and concerns about vaccine side effects.
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Affiliation(s)
- Theresia Santi
- Doctoral Program in Medical Science, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Badriul Hegar
- Department of Child Health, Cipto Mangunkusumo Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Zakiudin Munasir
- Department of Child Health, Cipto Mangunkusumo Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Ari Prayitno
- Department of Child Health, Cipto Mangunkusumo Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Retno Asti Werdhani
- Department of Community Medicine, Cipto Mangunkkusumo Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | | | - Juandy Jo
- Mochtar Riady Institute for Nanotechnology, Tangerang, Indonesia
- Department of Biology, Faculty of Science and Technology, Universitas Pelita Harapan, Tangerang, Indonesia
| | - Ruswati Uswa
- Public Health Study Program, Faculty of Public Health, Universitas Indonesia, Jakarta, Indonesia
| | - Ratna Widia
- Public Health Study Program, Faculty of Public Health, Universitas Indonesia, Jakarta, Indonesia
| | - Yvan Vandenplas
- Vrije Universiteit Brussel, Universitair Ziekenhuis Brussel, KidZ Health Castle, Brussel, Belgium
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Merid Y, Tekleselasie W, Tesfaye E, Gadisa A, Fentahun D, Abate A, Alemu A, Mihret A, Mulu A, Gelanew T. SARS-CoV-2 Infection-and mRNA Vaccine-induced Humoral Immunity among Schoolchildren in Hawassa, Ethiopia. Front Immunol 2023; 14:1163688. [PMID: 37398668 PMCID: PMC10308774 DOI: 10.3389/fimmu.2023.1163688] [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: 02/11/2023] [Accepted: 05/31/2023] [Indexed: 07/04/2023] Open
Abstract
Background With the persisting low vaccination intake, particularly in children of low-and middle-income countries (LMICs), seroepidemiological studies are urgently needed to guide and tailor COVID-19 pandemic response efforts in schools and to put mitigation strategies in place for a future post-pandemic resurgence. However, there is limited data on SARS-CoV-2 infection-induced and vaccine-induced humoral immunity in schoolchildren in LMICs, including Ethiopia. Methods As the spike receptor binding domain (RBD) is the major target for neutralization antibodies and useful to predict the correlates of protection, we used an in-house anti-RBD IgG ELISA to assess and compare infection-induced antibody response at two-time points and BNT162b2 (BNT) vaccine-induced antibody response at a one-time point in schoolchildren in Hawassa, Ethiopia. In addition, we measured and compared the levels of binding IgA antibodies to spike RBD of SARS-CoV-2 Wild type, Delta, and Omicron variants in a small subset of unvaccinated and BNT-vaccinated schoolchildren. Results When we compare SARS-CoV-2 infection-induced seroprevalences among unvaccinated school children (7-19 years) at the two blood sampling points with a 5-month interval, we observed an over 10% increase, from 51.8% (219/419) in the first week of December 2021 (post-Delta wave) to 67.4% (60/89) by the end of May 2022 (post-Omicron wave). Additionally, we found a significant correlation (p = 0.001) between anti-RBD IgG seropositivity and a history of having COVID-19-like symptoms. Compared to the levels of SARS-CoV-2 infection-induced anti-RBD IgG antibodies before vaccination, higher levels of BNT vaccine-induced anti-RBD IgG antibodies were observed even in SARS-CoV-2 infection-naïve schoolchildren of all age groups (p = 0.0001). Importantly, one dose of the BNT vaccine was shown to be adequate to elicit a strong antibody response in schoolchildren with pre-existing anti-RBD IgG antibodies comparable to that of SARS-CoV-2 infection-naive schoolchildren receiving two doses of BNT vaccine, suggesting a single dose administration of the BNT vaccine could be considered for schoolchildren who had prior SARS-CoV-2 infection when a shortage of vaccine supply is a limiting factor to administer two doses irrespective of their serostatus. Despite the small sample size of study participants, the BNT vaccine is shown to be immunogenic and safe for schoolchildren. Irrespective of schoolchildren's vaccination status, we observed a similar pattern of significantly higher levels of IgA antibodies to Delta-RBD than to Omicron-RBD (p < 0.001) in a randomly selected subset of schoolchildren, yet comparable to Wuhan-RBD, suggesting these schoolchildren were more likely to have had SARS-CoV-2 infection with Delta variant. Additionally, we noted a broader IgA antibody reactivity to SARS-CoV-2 variants in vaccinated schoolchildren with prior SARS-CoV-2 infection, supporting the superiority of hybrid immunity. Conclusion Our serological data indicate a significant increase in SARS-CoV-2 seroprevalence in children at a post-Omicron five-month follow-up compared to a post-Delta enrolment. Despite the small sample size of study participants, the BNT vaccine is shown to be immunogenic and safe for schoolchildren. Hybrid immunity would likely provide a broader humoral immunity against Wuhan strain, Delta, and Omicron variants than natural infection or vaccination alone does. However, future longitudinal cohort studies in SARS-CoV-2-naïve and COVID-19-recovered schoolchildren receiving the BNT vaccine are needed for a better understanding of the kinetics, breadth, and durability of BNT vaccine-induced multivariant-cross reactive immunity.
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Affiliation(s)
- Yared Merid
- College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
| | | | - Emnet Tesfaye
- College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
| | - Anteneh Gadisa
- College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
| | | | | | - Aynalem Alemu
- Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | - Adane Mihret
- Armauer Hansen Research Institute, Addis Ababa, Ethiopia
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Lee KY, Dabak SV, Kong VH, Park M, Kwok SLL, Silzle M, Rachatan C, Cook A, Passanante A, Pertwee E, Wu Z, Elkin JA, Larson HJ, Lau EHY, Leung K, Wu JT, Lin L. Effectiveness of chatbots on COVID vaccine confidence and acceptance in Thailand, Hong Kong, and Singapore. NPJ Digit Med 2023; 6:96. [PMID: 37231110 PMCID: PMC10208906 DOI: 10.1038/s41746-023-00843-6] [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: 10/03/2022] [Accepted: 05/12/2023] [Indexed: 05/27/2023] Open
Abstract
Chatbots have become an increasingly popular tool in the field of health services and communications. Despite chatbots' significance amid the COVID-19 pandemic, few studies have performed a rigorous evaluation of the effectiveness of chatbots in improving vaccine confidence and acceptance. In Thailand, Hong Kong, and Singapore, from February 11th to June 30th, 2022, we conducted multisite randomised controlled trials (RCT) on 2,045 adult guardians of children and seniors who were unvaccinated or had delayed vaccinations. After a week of using COVID-19 vaccine chatbots, the differences in vaccine confidence and acceptance were compared between the intervention and control groups. Compared to non-users, fewer chatbot users reported decreased confidence in vaccine effectiveness in the Thailand child group [Intervention: 4.3 % vs. Control: 17%, P = 0.023]. However, more chatbot users reported decreased vaccine acceptance [26% vs. 12%, P = 0.028] in Hong Kong child group and decreased vaccine confidence in safety [29% vs. 10%, P = 0.041] in Singapore child group. There was no statistically significant change in vaccine confidence or acceptance in the Hong Kong senior group. Employing the RE-AIM framework, process evaluation indicated strong acceptance and implementation support for vaccine chatbots from stakeholders, with high levels of sustainability and scalability. This multisite, parallel RCT study on vaccine chatbots found mixed success in improving vaccine confidence and acceptance among unvaccinated Asian subpopulations. Further studies that link chatbot usage and real-world vaccine uptake are needed to augment evidence for employing vaccine chatbots to advance vaccine confidence and acceptance.
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Affiliation(s)
- Kristi Yoonsup Lee
- Laboratory of Data Discovery for Health (D24H), Hong Kong Science Park, Hong Kong Special Administrative Region, Hong Kong, China
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | | | - Vivian Hanxiao Kong
- Laboratory of Data Discovery for Health (D24H), Hong Kong Science Park, Hong Kong Special Administrative Region, Hong Kong, China
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Minah Park
- Department of Health Convergence, Ewha Womans University, Seoul, Korea
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Shirley L L Kwok
- Laboratory of Data Discovery for Health (D24H), Hong Kong Science Park, Hong Kong Special Administrative Region, Hong Kong, China
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Madison Silzle
- Health Intervention and Technology Assessment Program, Ministry of Public Health, Nonthaburi, Thailand
| | - Chayapat Rachatan
- Health Intervention and Technology Assessment Program, Ministry of Public Health, Nonthaburi, Thailand
| | - Alex Cook
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Aly Passanante
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - Ed Pertwee
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - Zhengdong Wu
- Laboratory of Data Discovery for Health (D24H), Hong Kong Science Park, Hong Kong Special Administrative Region, Hong Kong, China
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Javier A Elkin
- Department of Digital Health and Innovation, World Health Organization, Genève, Switzerland
| | - Heidi J Larson
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Eric H Y Lau
- Laboratory of Data Discovery for Health (D24H), Hong Kong Science Park, Hong Kong Special Administrative Region, Hong Kong, China
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Kathy Leung
- Laboratory of Data Discovery for Health (D24H), Hong Kong Science Park, Hong Kong Special Administrative Region, Hong Kong, China.
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China.
- The University of Hong Kong-Shenzhen Hospital, Shenzhen, China.
| | - Joseph T Wu
- Laboratory of Data Discovery for Health (D24H), Hong Kong Science Park, Hong Kong Special Administrative Region, Hong Kong, China.
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China.
- The University of Hong Kong-Shenzhen Hospital, Shenzhen, China.
| | - Leesa Lin
- Laboratory of Data Discovery for Health (D24H), Hong Kong Science Park, Hong Kong Special Administrative Region, Hong Kong, China.
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China.
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK.
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Bektas İ, Bektas M. The effects of parents' vaccine hesitancy and COVID-19 vaccine literacy on attitudes toward vaccinating their children during the pandemic. J Pediatr Nurs 2023:S0882-5963(23)00105-7. [PMID: 37142496 PMCID: PMC10130325 DOI: 10.1016/j.pedn.2023.04.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 04/22/2023] [Accepted: 04/22/2023] [Indexed: 05/06/2023]
Abstract
PURPOSE The study was conducted to examine the effects of parents' vaccine hesitancy and COVID-19 vaccine literacy on their attitudes toward vaccinating their children during the COVID-19 pandemic. DESIGN AND METHODS The study was descriptive, cross-sectional, and comparative. The data were collected from 199 parents with children aged 0-18 using a Google Form on social media. In the study, the Parent Introductory Information Form, the Vaccine Hesitancy Scale in Pandemics, and the COVID-19 Vaccine Literacy Scale were used. In the analysis of the data, numbers, percentages, and means were calculated, and the significance test of the difference between the two means and the logistic regression analysis were used. RESULTS Parents' vaccination hesitancy scale sub-dimensions and COVID-19 vaccine literacy scale sub-dimensions together explain 25.4% of their attitudes toward having their children vaccinated against COVID-19. When the variables were examined individually, it was determined that the sub-dimensions of the Vaccine Hesitancy Scale in Pandemics alone significantly affected their attitudes during the pandemic period (p < 0.001). CONCLUSIONS Parents are hesitant about getting their children vaccinated against COVID-19. Improving vaccine literacy can increase vaccination rates in special groups to overcome vaccine hesitancy.
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Affiliation(s)
- İlknur Bektas
- İzmir Bakırçay University, Faculty of Health Science, Nursing Department, Izmir, Turkey.
| | - Murat Bektas
- Dokuz Eylul University Faculty of Nursing, Inciraltı, Izmir, Turkey
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Al Ghafri T, Badahdah A, Al Awaidy S, Khamis F, Anwar H, Al Barwani N, Al Tamimi S, Hanashi AA, Al Yaaquba AG, Qatan R, Al Mukhaini A, Al Harrasi A, Al Balushi A, Al Aamri S, Al Rabaani M, Al Musalhi A, Al Bulushi A. Mothers' Intention to Vaccinate Their Children Aged 5-11 Against COVID-19: A Cross-sectional Survey. Oman Med J 2023; 38:e462. [PMID: 36873794 PMCID: PMC9975923 DOI: 10.5001/omj.2023.47] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Accepted: 09/07/2022] [Indexed: 11/03/2022] Open
Abstract
Objectives COVID-19 vaccines lower the risk of infection hospitalization, and death. Despite the safety and effectiveness of COVID-19 vaccines, some caregivers are hesitant to vaccinate their children against COVID-19. In this study, we explored the factors that influence Omani mothers' intentions to vaccinate their 5-11 year-old children. Methods Of the 954 mothers approached, 700 (73.4%) participated in a cross-sectional face-to-face interviewer-administered questionnaire in Muscat, Oman, between 20 February and 13 March 2022. Data on age, income, level of education, trust in doctors, vaccine hesitancy, and intention to vaccinate their children were collected. Logistic regression was used to assess determinants of mothers' intention to vaccinate their children. Results Most mothers had 1-2 children (n = 525, 75.0%), had a college degree or higher education (73.0%), and were employed (70.8%). More than half (n = 392, 56.0%) reported that they were likely or very likely to get their children vaccinated. The intention to get children vaccinated was associated with older age (odds ratio (OR) = 1.05, 95% CI: 1.02-1.08; p =0.003), trust in their doctor (OR = 2.12, 95%, CI: 1.71-2.62; p < 0.001), and low vaccine hesitancy (OR = 25.91, 95% CI: 16.92-39.64; p < 0.001). Conclusions Understanding the factors that influence caregivers' intentions to vaccinate their children against COVID-19 is important for the development of evidence-based vaccine campaigns. To increase and sustain high vaccination rates for COVID-19 vaccination in children, it is critical to address the factors that cause caregiver hesitation about vaccines.
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Affiliation(s)
- Thamra Al Ghafri
- Directorate General of Health Services, Ministry of Health, Muscat, Oman
| | - Abdallah Badahdah
- School of Psychology, Sociology and Rural Studies, South Dakota State University, Brookings, USA
| | | | - Faryal Khamis
- Adult Infectious Diseases, Department of Medicine, Royal Hospital, Muscat, Oman
| | - Huda Anwar
- Directorate General of Health Services, Ministry of Health, Muscat, Oman
| | - Nada Al Barwani
- Directorate General of Health Services, Ministry of Health, Muscat, Oman
| | - Saif Al Tamimi
- Directorate General of Health Services, Ministry of Health, Muscat, Oman
| | - Ahmed Al Hanashi
- Directorate General of Health Services, Ministry of Health, Muscat, Oman
| | | | - Reem Qatan
- Directorate General of Health Services, Ministry of Health, Muscat, Oman
| | - Ameena Al Mukhaini
- Directorate General of Health Services, Ministry of Health, Muscat, Oman
| | - Abeer Al Harrasi
- Directorate General of Health Services, Ministry of Health, Muscat, Oman
| | - Anbren Al Balushi
- Directorate General of Health Services, Ministry of Health, Muscat, Oman
| | - Salma Al Aamri
- Directorate General of Health Services, Ministry of Health, Muscat, Oman
| | - Muna Al Rabaani
- Directorate General of Health Services, Ministry of Health, Muscat, Oman
| | - Asma Al Musalhi
- Directorate General of Health Services, Ministry of Health, Muscat, Oman
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Al-Qerem W, Al Bawab AQ, Hammad A, Jaber T, Khdair SI, Kalloush H, Ling J, Mosleh R. Parents' attitudes, knowledge and practice towards vaccinating their children against COVID-19: a cross-sectional study. Hum Vaccin Immunother 2022; 18:2044257. [PMID: 35240943 PMCID: PMC9225601 DOI: 10.1080/21645515.2022.2044257] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 02/04/2022] [Accepted: 02/16/2022] [Indexed: 12/31/2022] Open
Abstract
The question of whether children should be vaccinated against COVID-19 is currently being argued. The risk-benefit analysis of the vaccine in children has been more challenging because of the low prevalence of acute COVID-19 in children and the lack of confidence in the relative effects of the vaccine and the disease. One of the most convincing arguments for vaccinating healthy children is to protect them from long-term consequences. The aim of this study was to assess Jordanian parents' intention to vaccinate their children. This is an Internet-based cross-sectional survey. The researchers prepared a Google Forms survey and shared the link with a number of Jordanian Facebook generic groups. Data were gathered between September and November 2021. In this study, convenience sampling was used. Knowledge about COVID-19 and preventive practices against COVID-19 were calculated for each participant. A total of 819 participants completed the survey (female = 70.9%). Of these, 274 (30.2%) participants intended to vaccinate their children, whereas the rest were either unsure 176 (21.5%) or intended not to vaccinate their children 396 (48.4%). The variables that increased the odds of answering "No" vs "Yes" to "will you vaccinate your children against COVID-19" included not willing to take the vaccines themselves (OR 3.75; CI, 1.46-9.62) and low protective practice group (OR 1.73;CI, 1.12-2.68). Participants had significant levels of refusal/hesitancy. Several barriers to vaccination were identified; attempts to overcome these should be stepped up.
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Affiliation(s)
- Walid Al-Qerem
- Faculty of Pharmacy, Al-Zaytoonah University of Jordan, Amman, Jordan
| | | | - Alaa Hammad
- Faculty of Pharmacy, Al-Zaytoonah University of Jordan, Amman, Jordan
| | - Tasneem Jaber
- Faculty of Pharmacy, Al-Zaytoonah University of Jordan, Amman, Jordan
| | - Sawsan I Khdair
- Faculty of Pharmacy, Al-Zaytoonah University of Jordan, Amman, Jordan
| | - Haneen Kalloush
- Faculty of Pharmacy, Al-Zaytoonah University of Jordan, Amman, Jordan
| | - Jonathan Ling
- School of Health Sciences & Wellbeing, University of Sunderland, Sunderland, UK
| | - Rami Mosleh
- Department of Pharmacy, Faculty of Medicine & Health Sciences, An-Najah National University, Nablus, Palestine
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El-Ghitany EM, Ashour A, Omran EA, Farghaly AG, Hassaan MA, Azzam NFAEM. COVID-19 vaccine acceptance rates and predictors among the Egyptian general population and Healthcare workers, the intersectionality of age and other factors. Sci Rep 2022; 12:19832. [PMID: 36400940 PMCID: PMC9672568 DOI: 10.1038/s41598-022-23825-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Accepted: 11/07/2022] [Indexed: 11/19/2022] Open
Abstract
The promise of COVID-19 vaccines in ending the pandemic can only be achieved by overcoming the challenge of vaccine refusal. Healthcare workers (HCWs) are the trusted advisors of vaccination decisions. Recommendations for vaccinating children against COVID-19 are recently gaining more public health attention due to the role of children in disease transmission and associated morbidities. Vaccination is one of the first medical decisions parents or guardians make on behalf of their children. To investigate the determinants associated with vaccine acceptability among the general population through a direct interview questionnaire and assess guardians' views towards childhood COVID-19 vaccinations. This cross-sectional study included 2919 participants A pre-designed structured questionnaire about COVID-19 vaccination acceptability was completed by trained interviewers and interviewing the participants or their guardians (for those below 18 years old). Nearly two-thirds of participants (66.5%) accepted vaccination, 20.2% were refusing and 13.3% were hesitant. Most participants who were guardians of children below 12 years and from 13 to 17 years reported that they would accept vaccination of their children (72.5% and 70.5%, respectively). The acceptance rate among HCWs was 58.2%. The main reasons beyond vaccine refusal were mistrust of vaccine efficacy (39.5%) and having concerns regarding vaccine safety (38.8%). In a multivariable regression model, being male (OR 1.362, 95% CI 1.082-1.714, p = 0.008) resident in rural area (OR 1.796, 95% CI 1.435-2.247, p = 0.000), and lower education (OR 1.245, 95% CI 1.018-1.523, p = 0.033) were associated with an increased acceptance to be vaccinated. The acceptance rate for vaccinating children reported among their guardians was higher than adults for themselves. Extremes of age showed higher vaccine acceptance compared to young adults. Upper Egypt governorates (Faiyum and Giza) were outpacing Lower Egypt governorates in vaccination acceptance rates.
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Affiliation(s)
- Engy Mohamed El-Ghitany
- grid.7155.60000 0001 2260 6941Department of Tropical Health, High Institute of Public Health, Alexandria University, Alexandria, 21526 Egypt
| | - Ayat Ashour
- grid.7155.60000 0001 2260 6941Department of Family Health, High Institute of Public Health, Alexandria University, Alexandria, 21526 Egypt
| | - Eman A. Omran
- grid.7155.60000 0001 2260 6941Department of Microbiology, High Institute of Public Health, Alexandria University, Alexandria, 21526 Egypt
| | - Azza Galal Farghaly
- grid.7155.60000 0001 2260 6941Department of Tropical Health, High Institute of Public Health, Alexandria University, Alexandria, 21526 Egypt
| | - Mahmoud A. Hassaan
- grid.7155.60000 0001 2260 6941Institute of Graduate Studies and Research, Alexandria University, Alexandria, Egypt
| | - Nashwa Fawzy Abd El-Moez Azzam
- grid.7155.60000 0001 2260 6941Department of Microbiology, High Institute of Public Health, Alexandria University, Alexandria, 21526 Egypt
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11
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Mohamad E, Tham JS, Mohd Ajis SZ, Hamzah MR, Ayub SH, Tri Sakti AM, Azlan AA. Exposure to Misinformation, Risk Perception, and Confidence towards the Government as Factors Influencing Negative Attitudes towards COVID-19 Vaccination in Malaysia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14623. [PMID: 36429342 PMCID: PMC9690819 DOI: 10.3390/ijerph192214623] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 11/03/2022] [Accepted: 11/04/2022] [Indexed: 06/16/2023]
Abstract
INTRODUCTION This study explored exposure to misinformation, COVID-19 risk perception, and confidence towards the government as predictors of negative attitudes toward the COVID-19 vaccine. METHODS A cross-sectional survey was carried out from 30 June to 30 August 2021 involving 775 respondents. The survey instrument for the questionnaire was an adaptation from various different studies consisting of five main variables: (1) misinformation about vaccination; (2) risk perception toward COVID-19; (3) attitudes toward the vaccination programme; (4) intention to get vaccinated; and (5) public confidence in the government in executing the vaccination programme. RESULTS The results of this study indicate that higher exposure to misinformation led to higher levels of negative attitudes toward the COVID-19 vaccine. When the perceived risk of COVID-19 infection was high, mistrust of vaccine benefits was low but there were also higher worries about the future effects of the vaccine. Confidence in the government was associated with lower negative attitudes toward the COVID-19 vaccine. CONCLUSION The results of this study may help develop an understanding of negative attitudes toward vaccinations in Malaysia and its contributing factors.
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Affiliation(s)
- Emma Mohamad
- Centre for Research in Media and Communication, Faculty of Social Sciences and Humanities, Universiti Kebangsaan Malaysia, Bangi 43600, Selangor, Malaysia
- UKM × UNICEF Communication for Development Centre in Health, Faculty of Social Sciences and Humanities, Universiti Kebangsaan Malaysia, Bangi 43600, Selangor, Malaysia
| | - Jen Sern Tham
- Department of Communication, Faculty of Modern Languages and Communication, Universiti Putra Malaysia, Seri Kembangan 43400, Selangor, Malaysia
| | - Siti Zaiton Mohd Ajis
- Centre for Research in Media and Communication, Faculty of Social Sciences and Humanities, Universiti Kebangsaan Malaysia, Bangi 43600, Selangor, Malaysia
- UKM × UNICEF Communication for Development Centre in Health, Faculty of Social Sciences and Humanities, Universiti Kebangsaan Malaysia, Bangi 43600, Selangor, Malaysia
| | - Mohammad Rezal Hamzah
- Department of Communication, Faculty of Business and Communication, Universiti Malaysia Perlis, Kangar 01000, Perlis, Malaysia
| | - Suffian Hadi Ayub
- Faculty of Communication and Media Studies, Universiti Teknologi MARA, Shah Alam 40450, Selangor, Malaysia
| | - Andi Muhammad Tri Sakti
- Centre for Research in Media and Communication, Faculty of Social Sciences and Humanities, Universiti Kebangsaan Malaysia, Bangi 43600, Selangor, Malaysia
- UKM × UNICEF Communication for Development Centre in Health, Faculty of Social Sciences and Humanities, Universiti Kebangsaan Malaysia, Bangi 43600, Selangor, Malaysia
- Faculty of Communication Science, Mercu Buana University, Jakarta 11650, Indonesia
| | - Arina Anis Azlan
- Centre for Research in Media and Communication, Faculty of Social Sciences and Humanities, Universiti Kebangsaan Malaysia, Bangi 43600, Selangor, Malaysia
- UKM × UNICEF Communication for Development Centre in Health, Faculty of Social Sciences and Humanities, Universiti Kebangsaan Malaysia, Bangi 43600, Selangor, Malaysia
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12
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Validation and Cultural Adaptation of the Parent Attitudes about Childhood Vaccines (PACV) Questionnaire in Arabic Language Widely Spoken in a Region with a High Prevalence of COVID-19 Vaccine Hesitancy. Trop Med Infect Dis 2022; 7:tropicalmed7090234. [PMID: 36136645 PMCID: PMC9504773 DOI: 10.3390/tropicalmed7090234] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Revised: 09/01/2022] [Accepted: 09/06/2022] [Indexed: 11/16/2022] Open
Abstract
The parents’ attitude toward vaccinating children and adolescents against coronavirus disease 2019 (COVID-19) remains inconsistent and needs further elucidation. The high rates of COVID-19 vaccine hesitancy in the Middle East and North Africa (MENA) region require intensive research to understand the determinants of this phenomenon. This study aimed to validate a version of the Parent Attitudes about Childhood Vaccines (PACV) tool in Arabic, the most widely spoken language in the MENA. The study objectives included the investigation of Arab-speaking parents’ views regarding COVID-19 vaccination of their children. Parents living in Egypt with at least one child aged 5−18 years were eligible to participate in the study that was conducted through an online survey with 15 PACV items. The PACV tool was translated into Arabic using forward and backward translation. To assess the psychometric properties of the Arabic version of PACV, Pearson’s correlation coefficient and exploratory and confirmatory factor analysis (EFA and CFA) were performed. A total of 223 parents participated in the study: 59.82% aged 30−39 years, 69.20% were females, 46.19% were university-educated, and 40.63% had one child. The overall Cronbach’s alpha for the Arabic version of PACV was 0.799. The EFA of the 15 items showed that three domains were most conceptually equivalent. All items had a positive significant correlation with the mean score of each subscale except for item 4 (r = 0.016, p = 0.811). Regression analyses results indicated that education, previous COVID-19 infection, vaccine status of parents, and PACV score were significantly associated with the intention of the parents to vaccinate their children against COVID-19. The CFA results showed that most of the factor loadings were statistically significant (p < 0.010) except for items 4 and 7. However, the root mean square error of approximation (RMSEA = 0.080) and the standardized root mean squared residual (SRMR = 0.080) indicated that the model had a reasonable fit, and the three factors were good in reproducing each correlation. Our study results indicated the validity and reliability of the PACV instrument in Arabic language. Consequently, the PACV can be used to assess COVID-19 vaccine hesitancy in a majority of MENA countries for better delineation of this highly prevalent phenomenon in the region.
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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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AlJamaan F, Temsah MH, Alhasan K, Alenezi S, Alhaboob A, Alrabiaah A, Batais M, Alshahrani F, Assiri RA, Bafaqih H, Alaraj A, Al Qadrah B, Alhaidary A, Saad K, Saddik B, Halwani R, Rabaan AA, Al-Subaie S, Barry M, Al-Tawfiq JA. SARS-CoV-2 variants and the global pandemic challenged by vaccine uptake during the emergence of the Delta variant: A national survey seeking vaccine hesitancy causes. J Infect Public Health 2022; 15:773-780. [PMID: 35728424 PMCID: PMC9212873 DOI: 10.1016/j.jiph.2022.06.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 06/13/2022] [Accepted: 06/14/2022] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Herd immunity for COVID-19 is the ultimate goal to end the pandemic. Emergence of SARS-CoV-2 variants has been a subject of considerable debate regarding vaccines effectiveness. This ongoing discussion and other evolving variables contribute to the hesitancy toward vaccines and levels of vaccination acceptance among both the healthcare workers and the public. This study was conducted to assess COVID-19 vaccine uptake and hesitancy among the Saudi Arabian population during the emergence of SARS-CoV-2 Delta variant. METHODS A national cross-sectional survey conducted between June 28 and July 5, 2021. The survey collected sociodemographic information, personal and family history of previous COVID-19 infection, adherence to precautionary measures, COVID-19 vaccination status, parental willingness to vaccinate their teenage children, and address variable associated with hesitancy to receive vaccination. RESULTS Among the 4071 participants, 67 % were women, 86 % of the participants received COVID-19 vaccine, 70 % had very high or high commitment with COVID-19 precautionary measures. On multivariate analysis, vaccine hesitancy was less likely in men (OR 0.652, p-value < 0.001), those who had direct family members infected with COVID-19 (OR 0.455, p-value < 0.001), and those who reported using the Ministry of Health official channels as information sources (OR 0.522, p-value < 0.001), while those younger than 44 years had higher hesitancy to receive the vaccine (1.5-2.1 times). Of the participants, only 42 % showed willingness to vaccinate their teenage (12-18 years old) children. CONCLUSIONS The participants in this study had high COVID-19 vaccination rate; however, hesitancy was reported more commonly among women. Their willingness to vaccinate their teenage children was much lower. Participants relying on social media platforms were highly hesitant to receive vaccination. Public health officials should scale up their efforts targeting females, young population, and parents by vaccination awareness campaigns, and refute misinformation spread on social media, especially with the emergence of variants and the news burst that coincide with them.
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Affiliation(s)
- Fadi AlJamaan
- Critical Care Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
| | - Mohamad-Hani Temsah
- Pediatric Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia; Prince Abdullah Ben Khaled Celiac Disease Research Chair, Department of Pediatrics, Faculty of Medicine, King Saud University, Saudi Arabia.
| | - Khalid Alhasan
- Pediatric Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia; Pediatric Kidney Transplant, Organ Transplant Center of Excellence, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.
| | - Shuliweeh Alenezi
- Department of Psychiatry, King Saud University, Riyadh, Saudi Arabia.
| | - Ali Alhaboob
- Pediatric Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
| | - Abdulkarim Alrabiaah
- Pediatric Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
| | - Mohammed Batais
- Department of Family and Community Medicine, King Saud University Medical City, Riyadh, Saudi Arabia.
| | - Fatimah Alshahrani
- Division of Infectious Diseases, Department of Internal Medicine, College of Medicine, King Saud University and King Saud University Medical City, Riyadh, Saudi Arabia.
| | - Rasha Asaad Assiri
- Department of Basic Medical Sciences, College of Medicine, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia.
| | - Hind Bafaqih
- Pediatric Critical Care Department, Prince Sultan Military Medical City, Riyadh, Saudi Arabia.
| | - Ali Alaraj
- Department of Medicine, College of Medicine, Qassim University, Qassim, Saudi Arabia; Dr Sulaiman Al Habib Medical Group, Riyadh, Saudi Arabia.
| | - Bedoor Al Qadrah
- Pediatric Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
| | - Abdulilah Alhaidary
- Nursing Department, King Saud University Medical City, Riyadh, Saudi Arabia.
| | - Khaled Saad
- Department of Pediatrics, Assiut University, 71516, Egypt.
| | - Basema Saddik
- Department of Family and Community Medicine, College of Medicine, University of Sharjah, Sharjah 27272, the United Arab Emirates; Sharjah Institute of Medical Research, University of Sharjah, Sharjah 27272, the United Arab Emirates.
| | - Rabih Halwani
- Sharjah Institute of Medical Research, University of Sharjah, Sharjah 27272, the United Arab Emirates; Department of Clinical Sciences, College of Medicine, University of Sharjah, Sharjah 27272, the United Arab Emirates.
| | - Ali A Rabaan
- Molecular Diagnostic Laboratory, Johns Hopkins Aramco Healthcare, Dhahran 31311, Saudi Arabia; College of Medicine, Alfaisal University, Riyadh 11533, Saudi Arabia; Department of Public Health and Nutrition, The University of Haripur, Haripur 22610, Pakistan.
| | - Sarah Al-Subaie
- Critical Care Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
| | - Mazin Barry
- Division of Infectious Diseases, Department of Internal Medicine, College of Medicine, King Saud University and King Saud University Medical City, Riyadh, Saudi Arabia; Division of Infectious Diseases, Faculty of Medicine, University of Ottawa, K1H 8M5, Canada.
| | - Jaffar A Al-Tawfiq
- Specialty Internal Medicine and Quality Department, Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia; Infectious Disease Division, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA; Infectious Disease Division, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
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Iraqi Parents' Knowledge, Attitudes, and Practices towards Vaccinating Their Children: A Cross-Sectional Study. Vaccines (Basel) 2022; 10:vaccines10050820. [PMID: 35632576 PMCID: PMC9144119 DOI: 10.3390/vaccines10050820] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 05/16/2022] [Accepted: 05/17/2022] [Indexed: 12/12/2022] Open
Abstract
The focus of coronavirus disease 2019 (COVID-19) vaccination campaigns has been the adult population, particularly the elderly and those with chronic diseases. However, COVID-19 can also affect children and adolescents. Furthermore, targeting this population can accelerate the attainment of herd immunity. The aim of the current study was to evaluate parental intentions to vaccinate their children and the variables associated with them. An online questionnaire was circulated via generic Iraqi Facebook groups to explore parental intentions regarding the vaccination of their children. Multinomial regression analysis was conducted to evaluate variables associated with parental vaccination acceptance. A total of 491 participants completed the study questionnaire. Only 38.3% of the participants were willing to vaccinate their children against COVID-19, while the rest either refused to vaccinate their children (35.6%) or were unsure whether they would (26.1%). Participants’ perceptions about the effectiveness (OR = 0.726, 95% CI = 0.541−0.975, p = 0.033) and safety (OR = 0.435, 95% CI = 0.330−0.574, p < 0.0001) of COVID-19 vaccines were significantly associated with parental acceptance of having children vaccinated. Participants who had received or who were planning to receive the COVID-19 vaccine were significantly less likely to reject vaccinating their children (OR = 0.156, 95% CI = 0.063−0.387, p < 0.0001). There is high refusal/hesitancy among Iraqi parents to vaccinate their children, which is associated with concerns related to the safety and efficacy of COVID-19 vaccines. More efforts, including educational and awareness campaigns to promote the safety and efficacy of COVID-19 vaccines, should be made to increase parental acceptance of childhood COVID-19 vaccinations in Iraq.
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COVID-19 Parental Vaccine Hesitancy in Romania: Nationwide Cross-Sectional Study. Vaccines (Basel) 2022; 10:vaccines10040493. [PMID: 35455243 PMCID: PMC9024952 DOI: 10.3390/vaccines10040493] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Revised: 03/11/2022] [Accepted: 03/21/2022] [Indexed: 12/21/2022] Open
Abstract
Background: COVID-19 vaccination started in Romania in December 2020. Child vaccination started in 2021 with children aged 12–15 years in August. For children aged 5–11 years, vaccination started in January 2022. The aim of our study was to describe COVID-19 vaccination hesitancy in Romanian children and vaccine acceptability in the general population. As parental consent is required for child vaccination in Romania, these aspects have a significant association. Methods: An analytical cross-sectional survey was conducted in October and November 2021 during the peak of the 4th COVID-19 wave. Results: After validation, 1645 participants formed the main study group: median age 35 years, 72.83% women, and 35.44% from the medical domain. In total, 1311 (79.70%) participants were vaccinated against COVID-19 and 188 (11.42%) had vaccinated their 12–18-year-old children against COVID-19. Parents’ level of education, geographic area of residence, and COVID-19 vaccination status were significantly associated with COVID-19 vaccination. The hesitancy factors of child vaccination included the novelty of COVID-19 vaccines (62, 47.32%), fear of adverse reactions (32, 24.42%), and anti-vaccinism in general (29, 22.13%). In the studied group, only 188 (11.42%) participants recommended vaccination of 5–11-year-old children. Vaccine acceptability was higher in the general population (1311, 79.70%) than in the medical domain (326 out of 583, 55.91%). General vaccine hesitancy was based mainly on beliefs regarding inefficiency (131, 39.22%) and fears about the side effects of the vaccine (76, 22.75%). Conclusions: Overall, the acceptability of COVD-19 vaccines in the Romanian population was influenced by the level of education, area of residence, and being a COVID-19-vaccinated parent. Public health intervention programs are essential.
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Nonvignon J, Owusu R, Asare B, Adjagba A, Aund W, Karene Hoi Ting Y, Naa Korkoi Azeez J, Gyansa-Lutterodt M, Gulbi G, Amponsa-Achiano K, Dadzie F, Armah GE, Brenzel L, Hutubessy R, Resch SC. Estimating the cost of COVID-19 vaccine deployment and introduction in Ghana using the CVIC Tool. Vaccine 2022; 40:1879-1887. [PMID: 35190206 PMCID: PMC8813551 DOI: 10.1016/j.vaccine.2022.01.036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 01/18/2022] [Accepted: 01/19/2022] [Indexed: 12/11/2022]
Abstract
Current COVID-19 vaccine supply market means LMICs will have to rely on a combination of different sources/types of vaccines to meet their demand. Deployment of COVID-19 vaccine plans in Ghana will cost $348.7–$436.1 million for coverage of 17.5 million of eligible Ghanaians. Vaccine cost constitute 78–83% of total cost whereas the total vaccination cost is 0.48–0.60% of the country’s 2020 GDP. The WHO-UNICEF CVIC tool is useful for comprehensive COVID-19 vaccine deployment costing and resource planning.
Background This study estimated cost of COVID-19 vaccine introduction and deployment in Ghana. Methods Using the WHO-UNICEF COVID-19 Vaccine Introduction and deployment Costing (CVIC) tool Ghana’s Ministry of Health Technical Working Group for Health Technology Assessment (TWG-HTA) in collaboration with School of Public Health, University of Ghana, organized an initial two-day workshop that brought together partners to deliberate and agree on input parameters to populate the CVIC tool. A further 2–3 days validation with the Expanded Program of Immunization (EPI) and other partners to finalize the analysis was done. Three scenarios, with different combinations of vaccine products and delivery modalities, as well as time period were analyzed. The scenarios included AstraZeneca (40%), Johnson & Johnson (J&J) (30%), Moderna, Pfizer, and Sputnik V at 10% each; with primary schedule completed by second half of 2021 (Scenario 1); AstraZeneca (30%), J&J (40%), Moderna, Pfizer, and Sputnik V at 10% each with primary schedule completed by first half of 2022 (Scenario 2); and equal distribution (20%) among AstraZeneca, J&J, Moderna, Pfizer, and Sputnik V with primary schedule completed by second half of 2022 (Scenario 3). Results The estimated total cost of COVID-19 vaccination ranges between $348.7 and $436.1 million for the target population of 17.5 million. These translate into per person completed primary schedule cost of $20.9–$26.2 and per dose (including vaccine cost) of $10.5–$13.1. Again, per person completed primary schedule excluding vaccine cost was $4.5 and $4.6, thus per dose excluding vaccine also ranged from $2.2 – $2.3. The main cost driver was vaccine doses, including shipping, which accounts for between 78% and 83% of total cost. Further, an estimated 8,437–10,247 vaccinators (non-FTEs) would be required during 2021–2022 to vaccinate using a mix of delivery strategies, accounting for 8–10% of total cost. Conclusion These findings provide the estimates to inform resource mobilization efforts by government and other partners.
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Khan YH, Rasheed M, Mallhi TH, Salman M, Alzarea AI, Alanazi AS, Alotaibi NH, Khan SUD, Alatawi AD, Butt MH, Alzarea SI, Alharbi KS, Alharthi SS, Algarni MA, Alahmari AK, Almalki ZS, Iqbal MS. Barriers and facilitators of childhood COVID-19 vaccination among parents: A systematic review. Front Pediatr 2022; 10:950406. [PMID: 36507133 PMCID: PMC9731120 DOI: 10.3389/fped.2022.950406] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Accepted: 09/14/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND The acceptance of vaccination against COVID-19 among parents of young children plays a significant role in controlling the current pandemic. A wide range of factors that influence vaccine hesitancy in adults has been reported worldwide, but less attention has been given to COVID-19 vaccination among children. Vaccine hesitancy is considered a major challenge in achieving herd immunity, and it is more challenging among parents as they remain deeply concerned about their child's health. In this context, a systematic review of the current literature is inevitable to assess vaccine hesitancy among parents of young children to ensure a successful ongoing vaccination program. METHOD A systematic search of peer-reviewed English literature indexed in Google Scholar, PubMed, Embase, and Web of science was performed using developed keywords between 1 January 2020 and August 2022. This systematic review included only those studies that focused on parental concerns about COVID-19 vaccines in children up to 12 years without a diagnosis of COVID-19. Following PRISMA guidelines, a total of 108 studies were included. The quality appraisal of the study was performed by Newcastle-Ottawa Scale (NOS). RESULTS The results of 108 studies depict that vaccine hesitancy rates differed globally with a considerably large number of factors associated with it. The highest vaccine hesitancy rates among parents were reported in a study from the USA (86.1%) and two studies from Saudi Arabia (>85%) and Turkey (89.6%). Conversely, the lowest vaccine hesitancy rates ranging from 0.69 and 2% were found in two studies from South Africa and Switzerland, respectively. The largest study (n = 227,740) was conducted in Switzerland while the smallest sample size (n = 12) was represented by a study conducted in the USA. The most commonly reported barriers to childhood vaccination were mothers' lower education level (N = 46/108, 43%), followed by financial instability (N = 19/108, 18%), low confidence in new vaccines (N = 13/108, 12%), and unmonitored social media platforms (N = 5/108, 4.6%). These factors were significantly associated with vaccine refusal among parents. However, the potential facilitators for vaccine uptake among respondents who intended to have their children vaccinated include higher education level (N = 12/108, 11%), followed by information obtained through healthcare professionals (N = 9/108, 8.3%) and strong confidence in preventive measures taken by the government (N = 5/81, 4.6%). CONCLUSION This review underscores that parents around the globe are hesitant to vaccinate their kids against COVID-19. The spectrum of factors associated with vaccine hesitancy and uptake varies across the globe. There is a dire need to address vaccine hesitancy concerns regarding the efficacy and safety of approved vaccines. Local context is inevitable to take into account while developing programs to reduce vaccine hesitancy. There is a dire need to devise strategies to address vaccine hesitancy among parents through the identification of attributing factors.
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Affiliation(s)
- Yusra Habib Khan
- Department of Clinical Pharmacy, College of Pharmacy, Jouf University, Sakaka, Al-Jouf, Saudi Arabia
| | - Maria Rasheed
- Institute of Pharmacy, Lahore College for Women University, Lahore, Pakistan
| | - Tauqeer Hussain Mallhi
- Department of Clinical Pharmacy, College of Pharmacy, Jouf University, Sakaka, Al-Jouf, Saudi Arabia
| | - Muhammad Salman
- Institute of Pharmacy, Faculty of Pharmaceutical and Allied Health Sciences, Lahore College for Women University, Lahore, Pakistan
| | - Abdulaziz Ibrahim Alzarea
- Department of Clinical Pharmacy, College of Pharmacy, Jouf University, Sakaka, Al-Jouf, Saudi Arabia
| | - Abdullah Salah Alanazi
- Department of Clinical Pharmacy, College of Pharmacy, Jouf University, Sakaka, Al-Jouf, Saudi Arabia
| | - Nasser Hadal Alotaibi
- Department of Clinical Pharmacy, College of Pharmacy, Jouf University, Sakaka, Al-Jouf, Saudi Arabia
| | - Salah-Ud-Din Khan
- Department of Biochemistry, College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, Saudi Arabia
| | - Ahmed D Alatawi
- Department of Clinical Pharmacy, College of Pharmacy, Jouf University, Sakaka, Al-Jouf, Saudi Arabia
| | - Muhammad Hammad Butt
- Department of Medicinal Chemistry, Faculty of Pharmacy, Uppsala University, Uppsala, Sweden
| | - Sami I Alzarea
- Department of Pharmacology, College of Pharmacy, Jouf University, Sakaka, Al-Jouf, Saudi Arabia
| | - Khalid Saad Alharbi
- Department of Pharmacology, College of Pharmacy, Jouf University, Sakaka, Al-Jouf, Saudi Arabia
| | | | - Majed Ahmed Algarni
- Department of Clinical Pharmacy, College of Pharmacy, Taif University, Taif, Saudi Arabia
| | - Abdullah K Alahmari
- Department of Clinical Pharmacy, College of Pharmacy, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia
| | - Ziyad Saeed Almalki
- Department of Clinical Pharmacy, College of Pharmacy, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia
| | - Muhammad Shahid Iqbal
- Department of Clinical Pharmacy, College of Pharmacy, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia
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Zhu PH, Mhango SN, Vinnakota A, Mansour M, Coss-Bu JA. Effects of COVID-19 Pandemic on Nutritional Status, Feeding Practices, and Access to Food Among Infants and Children in Lower and Middle-Income Countries: a Narrative Review. CURRENT TROPICAL MEDICINE REPORTS 2022; 9:197-206. [PMID: 36249489 PMCID: PMC9549037 DOI: 10.1007/s40475-022-00271-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/22/2022] [Indexed: 01/11/2023]
Abstract
Purpose of Review The COVID-19 pandemic has affected children across the planet and the consequences on their health, nutritional status, and social structure have been more pronounced in low- and middle-income countries (LMICs). This review will focus on the effects of the COVID-19 pandemic on infant growth and feeding practices and access to food and obesity prevalence among children in LMICs. An electronic search was performed on MEDLINE and Embase to identify relevant articles in the English language. Recent Findings A higher prevalence of infections by the SARS-CoV-2 virus and a lower mortality rate were found in children in LMICs compared to western countries. In 2020, 22% and 52% of the wasting and deaths in children under 5 years of age in LMICS came from the sub-Saharan Africa region, respectively. Despite the decrease in stunting from 40% in 1990 to 24.2% in 2019, the prevalence remains above 30% in LMICs. Regarding breastfeeding practices in LMICs, many organizations recommend breastfeeding for infants and children born to infected mothers with SARS-CoV-2. This pandemic has resulted in higher food insecurity and disruption to access to health care and nutrition-related programs from schools; this situation has been more detrimental for younger children from LMICs. Summary Given the devastating effects of the COVID-19 pandemic on the nutritional status, higher food insecurity, and lack of access to health care for infants and children in LMICs, efforts from government, world organizations, and non-for-profit institutions should be implemented to ameliorate the effects of this pandemic.
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Affiliation(s)
- Paola Hong Zhu
- Division of Critical Care Medicine, Baylor College of Medicine, Texas Children’s Hospital, Houston, TX USA ,Department of Pediatrics, Baylor College of Medicine, Texas Children’s Hospital, Houston, TX USA
| | - Susan Nita Mhango
- Baylor College of Medicine Children’s Foundation Malawi, Lilongwe, Malawi
| | - Anirudh Vinnakota
- Department of Pediatrics, Baylor College of Medicine, Texas Children’s Hospital, Houston, TX USA
| | - Marwa Mansour
- Division of Critical Care Medicine, Baylor College of Medicine, Texas Children’s Hospital, Houston, TX USA ,Department of Pediatrics, Baylor College of Medicine, Texas Children’s Hospital, Houston, TX USA
| | - Jorge A. Coss-Bu
- Division of Critical Care Medicine, Baylor College of Medicine, Texas Children’s Hospital, Houston, TX USA ,Department of Pediatrics, Baylor College of Medicine, Texas Children’s Hospital, Houston, TX USA
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20
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COVID-19 Impact on Disparity in Childhood Immunization in Low- and Middle-Income Countries Through the Lens of Historical Pandemics. CURRENT TROPICAL MEDICINE REPORTS 2022; 9:225-233. [PMID: 36569790 PMCID: PMC9760533 DOI: 10.1007/s40475-022-00273-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/24/2022] [Indexed: 12/23/2022]
Abstract
Purpose of Review The COVID-19 pandemic, since 2020, has affected health care services and access globally. Although the entire impact of COVID-19 pandemic on existing global public health is yet to be fully seen, the impact of COVID-19 pandemic on global childhood immunization programs is of particular importance. Recent Findings Disruptions to service delivery due to lockdowns, challenges in vaccination programs, vaccine misinformation and hesitancy, and political and social economic inequalities all posed a threat to existing childhood immunization programs. These potential threats were especially critical in LMIC where childhood immunization programs tend to experience suboptimal implementation. Summary This review provides an overview of childhood immunizations and discusses past pandemics particularly in LMIC, factors contributing to disparities in childhood immunizations, and reviews potential lessons to be learned from past pandemics. Vaccine hesitancy, social determinants of health, and best practices to help lessen the pandemic's influence are also further elaborated. To address current challenges that hindered the progress made in prevention of childhood illnesses through vaccination campaigns and increased vaccine availability, lessons learned through best practices explored from past pandemics must be examined to mitigate impact of COVID-19 on childhood immunization and in turn conserve health and improve economic well-being of children especially in LMIC.
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