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Biasio LR, Zanobini P, Lorini C, Monaci P, Fanfani A, Gallinoro V, Cerini G, Albora G, Del Riccio M, Pecorelli S, Bonaccorsi G. COVID-19 vaccine literacy: A scoping review. Hum Vaccin Immunother 2023; 19:2176083. [PMID: 36794338 PMCID: PMC10026896 DOI: 10.1080/21645515.2023.2176083] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023] Open
Abstract
To address vaccine hesitancy, specific self-rated tools have been developed to assess vaccine literacy (VL) related to COVID-19, including additional variables, such as beliefs, behavior, and willingness to be vaccinated. To explore the recent literature a search was performed selecting articles published between January 2020 and October 2022: 26 papers were identified using these tools in the context of COVID-19. Descriptive analysis showed that the levels of VL observed in the studies were generally in agreement, with functional VL score often lower than the interactive-critical dimension, as if the latter was stimulated by the COVID-19-related infodemic. Factors associated with VL included vaccination status, age, educational level, and, possibly, gender. Effective communication based on VL when promoting vaccination is critical to sustaining immunization against COVID-19 and other communicable diseases. The VL scales developed to date have shown good consistency. However, further research is needed to improve these tools and develop new ones.
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Affiliation(s)
| | - Patrizio Zanobini
- Department of Health Sciences, University of Florence, Florence, Italy
| | - Chiara Lorini
- Department of Health Sciences, University of Florence, Florence, Italy
| | - Pietro Monaci
- Medical Specialization School of Hygiene and Preventive Medicine, University of Florence, Florence, Italy
| | - Alice Fanfani
- Medical Specialization School of Hygiene and Preventive Medicine, University of Florence, Florence, Italy
| | - Veronica Gallinoro
- Medical Specialization School of Hygiene and Preventive Medicine, University of Florence, Florence, Italy
| | - Gabriele Cerini
- Medical Specialization School of Hygiene and Preventive Medicine, University of Florence, Florence, Italy
| | - Giuseppe Albora
- Medical Specialization School of Hygiene and Preventive Medicine, University of Florence, Florence, Italy
| | - Marco Del Riccio
- Department of Health Sciences, University of Florence, Florence, Italy
| | - Sergio Pecorelli
- Scientific Advisory Committee, Giovanni Lorenzini Foundation, Milan, Italy
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Bellomo RK, Cerabona V, Massimi A, Migliara G, Sparano M, Novello F, Schilirò T, Siliquini R, Villari P, De Vito C. Who chooses alternative sources of information about childhood vaccinations? A cross-sectional study. Front Public Health 2023; 11:1225761. [PMID: 37771825 PMCID: PMC10525346 DOI: 10.3389/fpubh.2023.1225761] [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: 05/22/2023] [Accepted: 08/28/2023] [Indexed: 09/30/2023] Open
Abstract
Introduction Vaccine hesitancy can lead to problematic outcomes in terms of public health. A factor playing a fundamental role in this dynamic is the source of information considered by parents in the decision-making progress that leads to the acceptance or refusal of childhood vaccinations. This study aims to investigate the sources of information considered by the parents of children attending primary and secondary schools in two large Italian cities and to identify predictors that led to choosing alternative sources of information. Methods An online questionnaire was administered to the parents of students attending elementary, middle, and high schools in Rome and Turin. Two validated tools were used: the Parent Attitudes about Childhood Vaccines Survey and the Vaccine Health Literacy of adults in Italian. Sources of information about vaccinations, trust toward the healthcare system, hesitancy and attitudes about COVID-19 vaccinations, were also investigated. A multivariable logistic regression model was built to identify predictors of the preferred sources of information on the topic. Results Totally, 2,301 answers to the survey were collected from June to October 2021. Of these, 1,127 came from parents in Rome (49%) and 1,174 from parents based in Turin (51%) with a mean age of 47.7 years (±6.4). The majority of the respondents were mothers (81%), married (73%), with two or more children (70.5%). The multivariable logistic regression model results showed that fathers were more inclined than mothers to use alternative sources of information (OR 1.48, 95% CI 1.29-2.00). Moreover, a higher level of vaccine hesitancy was a strong predictor for choosing alternative sources of information (OR 2.45, 95% CI 1.73-3.46). The HLVa-it scores show that parents with a lower Vaccine Literacy (VL) were more inclined to use alternative sources of information. Discussion Addressing health literacy issues and changing the official forms of communication could help improving vaccine acceptance. This study shows the importance of rebuilding a trusting relationship between patients and health care providers, which is fundamental in the fight against vaccine hesitancy.
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Affiliation(s)
- Rosa Katia Bellomo
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Vito Cerabona
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Azzurra Massimi
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Giuseppe Migliara
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Michele Sparano
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | | | - Tiziana Schilirò
- Department of Public Health and Pediatrics, University of Turin, Turin, Italy
| | - Roberta Siliquini
- Department of Public Health and Pediatrics, University of Turin, Turin, Italy
- A.O.U. City of Health and Science of Turin, Turin, Italy
| | - Paolo Villari
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Corrado De Vito
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
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3
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Collini F, Bonaccorsi G, Del Riccio M, Bruschi M, Forni S, Galletti G, Gemmi F, Ierardi F, Lorini C. Does Vaccine Confidence Mediate the Relationship between Vaccine Literacy and Influenza Vaccination? Exploring Determinants of Vaccination among Staff Members of Nursing Homes in Tuscany, Italy, during the COVID-19 Pandemic. Vaccines (Basel) 2023; 11:1375. [PMID: 37631943 PMCID: PMC10458978 DOI: 10.3390/vaccines11081375] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 08/11/2023] [Accepted: 08/16/2023] [Indexed: 08/29/2023] Open
Abstract
BACKGROUND Low coverage of influenza vaccination in nursing home (NH) staff may be attributed to factors such as vaccine confidence (VC) and vaccine literacy (VL). Our study aimed to evaluate the role of VL and VC in predicting the intention to get the influenza vaccine in a sample of employees of NHs in Tuscany, Italy. METHODS Data from staff members in Tuscany were collected using an online questionnaire that examined influenza vaccination history, intentions, demographic information, health status, and VL. Statistical analyses explored the relationships between VC, VL, and vaccination intentions. RESULTS The study included 1794 respondents, (86.3%) and assistants/aides (58.1%), with a median age of 46 years. The intention to get vaccinated was significantly higher among those with health risk conditions, and there was a positive association between VC and VL, specifically its interactive/critical component. The mediation analysis showed that VC completely mediated the relationship between VL and the intention to get vaccinated, with significant effects observed in different subgroups. CONCLUSIONS VC is a key factor that mediates the effect of VL on vaccine intention. These results suggest that interventions aimed at improving VL alone may not be sufficient to increase vaccine uptake unless VC is also addressed.
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Affiliation(s)
- Francesca Collini
- Quality and Equity Unit, Regional Health Agency of Tuscany, 50141 Florence, Italy
| | | | - Marco Del Riccio
- Department of Health Sciences, University of Florence, 50134 Florence, Italy
| | - Mario Bruschi
- Department of Health Sciences, University of Florence, 50134 Florence, Italy
| | - Silvia Forni
- Quality and Equity Unit, Regional Health Agency of Tuscany, 50141 Florence, Italy
| | - Giacomo Galletti
- Quality and Equity Unit, Regional Health Agency of Tuscany, 50141 Florence, Italy
| | - Fabrizio Gemmi
- Quality and Equity Unit, Regional Health Agency of Tuscany, 50141 Florence, Italy
| | - Francesca Ierardi
- Quality and Equity Unit, Regional Health Agency of Tuscany, 50141 Florence, Italy
| | - Chiara Lorini
- Department of Health Sciences, University of Florence, 50134 Florence, Italy
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4
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Lorini C, Del Riccio M, Zanobini P, Biasio RL, Bonanni P, Giorgetti D, Ferro VA, Guazzini A, Maghrebi O, Lastrucci V, Rigon L, Okan O, Sørensen K, Bonaccorsi G. Vaccination as a social practice: towards a definition of personal, community, population, and organizational vaccine literacy. BMC Public Health 2023; 23:1501. [PMID: 37553624 PMCID: PMC10408168 DOI: 10.1186/s12889-023-16437-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 08/02/2023] [Indexed: 08/10/2023] Open
Abstract
BACKGROUND A comprehensive and agreed-upon definition of vaccine literacy (VL) could support the understanding of vaccination and help policy-makers and individuals make informed decisions about vaccines. METHODS To shed some light on this debate and provide clarity, a scoping review was conducted to collect, summarize, and analyse available definitions of VL. Based on the findings of the scoping review, a new and comprehensive definition was proposed by a panel of experts. RESULTS Fifty-three articles were included, and two of them appeared to be the milestones around which the other definitions were grouped. The new definition proposed by the panel of experts included not only the personal perspective, but also the community, population, and organizational perspectives. Moreover, due to the increasing complexity of the social context with respect to the ability to navigate, understand, and use information and services, the definition of organizational vaccine literacy and the attributes of a vaccine literate healthcare organization have been proposed. CONCLUSION The new definition can contribute to the overall paradigm of health literacy and its distinct component of vaccine literacy, possibly improving the implementation of public health strategies to allow vaccination to be understood as a social practice by the entire community. This study describes the conceptual foundations, the competencies, and the civic orientation to be considered when developing measurement tools devoted to assessing VL at the different levels and in different contexts.
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Affiliation(s)
- Chiara Lorini
- Department of Health Sciences, University of Florence, Viale Giovanni Battista Morgagni 48, 50134, Florence, Italy.
- Health Literacy Laboratory (HeLiLab), University of Florence, Viale Giovanni Battista Morgagni 48, 50134, Florence, Italy.
| | - Marco Del Riccio
- Department of Health Sciences, University of Florence, Viale Giovanni Battista Morgagni 48, 50134, Florence, Italy
| | - Patrizio Zanobini
- Department of Health Sciences, University of Florence, Viale Giovanni Battista Morgagni 48, 50134, Florence, Italy
- Health Literacy Laboratory (HeLiLab), University of Florence, Viale Giovanni Battista Morgagni 48, 50134, Florence, Italy
| | | | - Paolo Bonanni
- Department of Health Sciences, University of Florence, Viale Giovanni Battista Morgagni 48, 50134, Florence, Italy
| | - Duccio Giorgetti
- Medical School of Specialization in Hygiene and Preventive Medicine, University of Florence, Largo Giovanni Alessandro Brambilla 3, 50134, Florence, Italy
| | - Valerio Allodola Ferro
- Department of Law, Economics and Human Sciences, Mediterranea University of Reggio Calabria, Via Dell'Università 25, 89124, Reggio Calabria, Italy
| | - Andrea Guazzini
- Department of Education, Literatures, Intercultural Studies, Languages and Psychology, University of Florence, Via Di San Salvi 12, 50135, Florence, Italy
| | - Olfa Maghrebi
- Department of Education, Literatures, Intercultural Studies, Languages and Psychology, University of Florence, Via Di San Salvi 12, 50135, Florence, Italy
| | - Vieri Lastrucci
- Epidemiology Unit, Meyer's Children University Hospital, Viale Gaetano Pieraccini, 24, 50139, Florence, Italy
| | - Lisa Rigon
- Medical School of Specialization in Hygiene and Preventive Medicine, University of Florence, Largo Giovanni Alessandro Brambilla 3, 50134, Florence, Italy
| | - Orkan Okan
- Department of Sport and Health Sciences, Technical University of Munich, 80992, Munich, Germany
| | - Kristine Sørensen
- Global Health Literacy Academy, Viengevej 100, 8240, Risskov, Denmark
| | - Guglielmo Bonaccorsi
- Department of Health Sciences, University of Florence, Viale Giovanni Battista Morgagni 48, 50134, Florence, Italy
- Health Literacy Laboratory (HeLiLab), University of Florence, Viale Giovanni Battista Morgagni 48, 50134, Florence, Italy
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Stefanizzi P, Provenzano S, Santangelo OE, Dallagiacoma G, Gianfredi V. Past and Future Influenza Vaccine Uptake Motivation: A Cross-Sectional Analysis among Italian Health Sciences Students. Vaccines (Basel) 2023; 11:vaccines11040717. [PMID: 37112629 PMCID: PMC10143571 DOI: 10.3390/vaccines11040717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 03/21/2023] [Accepted: 03/22/2023] [Indexed: 04/29/2023] Open
Abstract
Despite its effectiveness in the prevention of seasonal flu, influenza vaccination uptake remains low, even among healthcare workers (HCWs), despite their occupational risk. The aim of this study was to explore the association between main reasons for accepting or refusing influenza vaccination and the decision to receive the vaccination during both previous and following year among health sciences students. A multi-center, cross-sectional study was performed using a validated online questionnaire. Data were analyzed by performing univariable and multivariable logistic analysis. Data from over 3000 participants showed that avoiding the spread of infection to family members and the general population (aOR: 43.55), as well as to patients (aOR: 16.56) were the main reasons associated with the highest probability of taking the influenza vaccination the following year. On the contrary, not considering influenza as a severe disease was the reason associated with the lowest probability for past (aOR: 0.17) and future vaccination (aOR: 0.01). Therefore, the importance of vaccination to protect others should always be the core of vaccination campaigns for health sciences students, together with tools to increase their awareness of the severity of this disease.
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Affiliation(s)
- Pasquale Stefanizzi
- Interdisciplinary Department of Medicine, University of Bari Aldo Moro, Piazza G. Cesare 11, 70121 Bari, Italy
| | | | - Omar Enzo Santangelo
- Regional Health Care and Social Agency of Lodi, ASST Lodi, Piazza Ospitale 10, 26900 Lodi, Italy
| | - Giulia Dallagiacoma
- Department of Public Health, Experimental and Forensic Medicine, School of Public Health, University of Pavia, 27100 Pavia, Italy
- Department of Global Public Health, Karolinska Institute, 171 77 Stockholm, Sweden
| | - Vincenza Gianfredi
- Department of Biomedical Sciences for Health, University of Milan, Via Pascal 36, 20133 Milan, Italy
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6
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Yorulmaz DS, Kocoglu-Tanyer D. A vaccine literacy scale for childhood vaccines: Turkish validity and reliability vaccine literacy scale. J Public Health (Oxf) 2023. [DOI: 10.1007/s10389-023-01878-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/13/2023] Open
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7
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Zhang E, Dai Z, Wang S, Wang X, Zhang X, Fang Q. Vaccine Literacy and Vaccination: A Systematic Review. Int J Public Health 2023; 68:1605606. [PMID: 36866001 PMCID: PMC9970990 DOI: 10.3389/ijph.2023.1605606] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Accepted: 02/06/2023] [Indexed: 02/16/2023] Open
Abstract
Objectives: Vaccine literacy (VL) is an essential component of health literacy and is regarded as the promising technique for eliminating vaccine hesitancy. This review summarizes the relationship between VL and vaccination, including vaccine hesitancy, vaccination attitude, vaccination intention, and vaccination uptake. Methods: A systematic search was conducted in the PubMed, Embase, Web of Science, CINAHL, PsycINFO, and Cochrane Library databases. Studies that explored the relationship between VL and vaccination were included, and the PRISMA recommendations were followed. Results: 1523 studies were found, and 21 articles were selected. The earliest article was published in 2015 and focused on the HPV vaccination and VL of female college students. Three studies surveyed parents' VL about childhood vaccinations, and the remaining 17 focused on COVID-19 VL in different groups. Conclusion: Although VL plays a role in determining the level of vaccine hesitancy across various populations, the association remains unclear. In the future, additional assessment methods could be developed and used to conduct prospective cohort and longitudinal studies to determine the causal relationship between VL and vaccination.
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Affiliation(s)
- Enming Zhang
- School of Nursing, Shanghai Jiao Tong University, Shanghai, China
| | - Zhengyue Dai
- School of Nursing, Shanghai Jiao Tong University, Shanghai, China
| | - Suxing Wang
- School of Nursing, Shanghai Jiao Tong University, Shanghai, China
| | - Xiaolong Wang
- School of Nursing, Shanghai Jiao Tong University, Shanghai, China
| | - Xian Zhang
- Nursing Department, Caohejing Community Health Service Center, Shanghai, China,*Correspondence: Xian Zhang, ; Qiong Fang,
| | - Qiong Fang
- School of Nursing, Shanghai Jiao Tong University, Shanghai, China,*Correspondence: Xian Zhang, ; Qiong Fang,
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Lastrucci V, Lorini C, Stacchini L, Stancanelli E, Guida A, Radi A, Morittu C, Zimmitti S, Alderotti G, Del Riccio M, Bechini A, Boccalini S, Bonaccorsi G. Determinants of Actual COVID-19 Vaccine Uptake in a Cohort of Essential Workers: An Area-Based Longitudinal Study in the Province of Prato, Italy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13216. [PMID: 36293802 PMCID: PMC9603237 DOI: 10.3390/ijerph192013216] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 10/12/2022] [Accepted: 10/13/2022] [Indexed: 06/16/2023]
Abstract
Identifying determinants of COVID-19 vaccine uptake is essential for developing effective strategies for promoting vaccination. This longitudinal study aimed to explore predictors of actual COVID-19 vaccine uptake in workers involved in essential services during the first lockdown period in the Prato Province (Italy). All essential workers were invited and surveyed before COVID-19 vaccine approval (96.5% participation rate). Participants were followed up to evaluate their actual COVID-19 vaccination uptake using the vaccination register. Multinomial models were performed to assess predictors of delayed vaccination or non-vaccination. A total of 691 participants were included, of whom 21.7% had delayed the vaccination and 4.4% were unvaccinated. Participants with a sufficient level of health literacy were 50.2% in the vaccinated-on-time group and 32.3% in the unvaccinated group. The multinomial model predictors of delayed vaccination were work type (OR = 0.51), age between 50 and 59 years (OR = 1.82), and influenza vaccination uptake in the last season (OR = 2.51). Predictors of being unvaccinated were work type (OR = 0.33) and attitudes related to attributing less importance to COVID-19 preventive measures (OR = 0.47). Findings showed distinct predictors for COVID-19 vaccination delay and for being unvaccinated. Being unvaccinated seems to be associated with a general skepticism toward prevention measures.
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Affiliation(s)
- Vieri Lastrucci
- Epidemiology Unit, Meyer Children’s Hospital, 50139 Florence, Italy
- Department of Health Sciences, University of Florence, Viale GB Morgagni 48, 50134 Florence, Italy
| | - Chiara Lorini
- Department of Health Sciences, University of Florence, Viale GB Morgagni 48, 50134 Florence, Italy
| | - Lorenzo Stacchini
- Medical Specialization School of Hygiene and Preventive Medicine, University of Florence, 50134 Florence, Italy
| | - Enrica Stancanelli
- Medical Specialization School of Hygiene and Preventive Medicine, University of Florence, 50134 Florence, Italy
| | - Andrea Guida
- Medical Specialization School of Hygiene and Preventive Medicine, University of Florence, 50134 Florence, Italy
| | - Alessio Radi
- Medical Specialization School of Hygiene and Preventive Medicine, University of Florence, 50134 Florence, Italy
| | - Chiara Morittu
- Medical Specialization School of Hygiene and Preventive Medicine, University of Florence, 50134 Florence, Italy
| | - Salvatore Zimmitti
- Medical Specialization School of Hygiene and Preventive Medicine, University of Florence, 50134 Florence, Italy
| | | | - Marco Del Riccio
- Medical Specialization School of Hygiene and Preventive Medicine, University of Florence, 50134 Florence, Italy
| | - Angela Bechini
- Department of Health Sciences, University of Florence, Viale GB Morgagni 48, 50134 Florence, Italy
| | - Sara Boccalini
- Department of Health Sciences, University of Florence, Viale GB Morgagni 48, 50134 Florence, Italy
| | | | - Guglielmo Bonaccorsi
- Department of Health Sciences, University of Florence, Viale GB Morgagni 48, 50134 Florence, Italy
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